Talk:Dilation and evacuation

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Contents 1 Amerocentrism? 2 NPOV links 3 Pictures 4 A bit of a problem 5 1st trimester

[edit] Amerocentrism?

"Approximately 11% of abortions are performed in the second trimester. In 2002, there were an estimated 142,000 second-trimester abortions[1]." The title of the cited work strongly suggests that this sentence should be qualified with "in the United States". The figure also seems very low if it's the whole world. Does anyone know for sure?--Dub8lad1 16:52, 30 May 2006 (UTC)

Yes, that should be qualified. I will fix that presently. If anyone has figures for other countries, they would certainly improve the article. Lyrl

[edit] NPOV links

Re: edits made by Abort73 - please ensure that links are informative and unbiased; if you link to an external page with bias, be sure to note it in the link description. Wikipedia is not a platform for self-promotion.--TurabianNights 15:37, 21 June 2006 (UTC)

[edit] Pictures

What would be the thought on adding a picture to show what the process looks like? I'm thinking if the masturbation page includes pictures to what mastubation looks like, then why shouldn't the same go for abortion? Samuraidragon 18:10, 15 February 2007 (UTC)

There is no comparison, because the masturbation article does not include any photos of people masturbating. There are ancient paintings and other pieces of artwork depicting masturbation, but there are no graphic photos. In regards to this article, I don't think that photographic imagery is necessary to understand a surgical procedure. Such a precedent is evident; photos are almost universally absent from articles about surgical procedures. If you want my guess, it's probably because any informative value that a photo of a bloody surgical procedure could provide would be greatly outweighed by the shocking and sickening impact of the image. Descriptions can provide that information, without causing distress to readers. I think that anyone who tries to include the kind of imagery that you are suggesting will be met with resistance. Joie de Vivre 19:18, 15 February 2007 (UTC)

I think it would be a good idea to show the surgical procedue.As an ex-nurse I can only see that it will enlighten people to the truth about abortion,surely that is what an encyclopedia is for?To give a truthful meaning about the subject in question.Rosenthalenglish 19:36, 15 February 2007 (UTC)

This topic has already been driven into the ground at Talk:Abortion (see Archive box > Notable precedents... > Graphic pictures). The consensus is that the photos are disgusting, that they violate NPOV, and that they are not acceptable. I suggest that you refrain from igniting that discussion here. It will cause a commotion and any such photos will almost certainly be removed. Joie de Vivre 19:54, 15 February 2007 (UTC)

Its a great pity you could not be polite in your reply.Your agressivness makes me wander if you are really putting a neutral view on this subject.Rudeness is not needed.Pleasentness and a smile go a long way.I was not igniting anything,only commenting on what had already been written on this page.An apology for your attitude would be nice .Its people like you who try to bully people like me not to partake in this project.I have always tried to follow the rules but at 54 years old I do not have to tolerate rudeness.I repeat I only made a comment.Is that not why we have these talk areas?Or are bullies like you able top do and say what you like and accuse people of starting trouble when they havent done anything.Rosenthalenglish 14:11, 16 February 2007 (UTC)

I'm saying this as someone who's been visiting Talk:Abortion for almost two years now: yes, the subject has been gone over multiple times in that period, and, yes, we have gotten to the point where we've felt we've had our fill of it for this lifetime.

We should be clear about what is meant by "pictures," whether it's medical diagrams, or graphic photos of aborted fetuses. Those have pretty much been decided against for all the reasons Joie has already gone over (not informative, not NPOV, off-putting to the point of negatively impacting article readability for readers who are more sensitive to such imagery). As for medical diagrams, someone has yet to bring something workable to the table, because any such image would need to meet Wikipedia's copyright policy before it could be used in an article.

Rosenthalenglish, I think the policy you need to apply to Joie de Vivre is AGF (Assume Good Faith), and, Joie, I think you need to keep in mind DBN (Don't Bite Newcomers). I don't see Joie's comment as bullying to any degree, just a bit terse and short, because I've seen rudeness in action on Wikipedia and it usually involves personal attacks/insults. I think Joie's response needs to be interpreted in light of the fact that we have tread this subject before, which is why we've gotten to the point of simply saying, "Please see the archives." However, checking Rosenthal's edit history, it's clear to me that he hasn't posted to Talk:Abortion before, and thus probably isn't likely to be familiar with its history. I don't think his post here was meant to push the issue just for the sake of it like some of the posts at Talk:Abortion have seemed. -Severa (!!!) 15:59, 16 February 2007 (UTC)

I think Severa's assessment is correct. Thank you very much for stepping in to mediate, Severa. Yes, my comments, while not violating policy, were a bit defensive in their tone. I will certainly keep in mind that if someone renews an old (and tiring) discussion, that does not necessarily mean that they were aware of the precedent, nor does it necessarily mean that any malice was intended by bringing it up. If Rosenthalenglish is willing to accept my understanding of this situation, I will ignore their "bully" comments so we can move on. Joie de Vivre 16:24, 16 February 2007 (UTC)

[edit] A bit of a problem

It seems that this article focuses souly on abortion and not the medical aspects of the procedure which is also used for removal of miscarried tissue which has not been expelled. If anyone would care to throw in additional details on this it would be helpful to anyone who is about to go through this procedure because of miscarriage, as my wife just did.--71.207.30.125 01:50, 4 March 2007 (UTC)

There seems to be some confusing conflict of procedure names when looking at miscarriage vs. induced abortion procedures. Dilation and cutterage (D&C) is technically where the uterus is actually scraped with a sharp instrument. But D&C as a term is commonly used to refer to suction removal of a miscarriage - I think that procedure is actually covered in suction-aspiration abortion. It appears that some sources talking about miscarriage recognize that D&C is the wrong name, and so are calling it suction D&C, suction D&E, or just D&E [1] [2]. But abortion sources (those currently used in this article) define D&E as more than just suction, as an instrumental procedure involving dismemberment.

Maybe we could have something at the top redirecting people to the vacuum aspiration article for information on the miscarriage procedure? And then the name of that article might need to be changed to remove the word 'abortion', if it's going to cover the miscarriage procedure also. Hmm. I'll see what responses are here for a few days and then maybe post over at Talk:suction-aspiration abortion. Lyrl ^Talk _C 16:56, 4 March 2007 (UTC)

You might want to check menstrual extraction too. Joie de Vivre 17:31, 4 March 2007 (UTC)

First off, 71.207.30.125, let me say that I'm really sorry to hear about your loss, and I wish the best for you and your wife. The medical term for a miscarriage is a "spontaneous abortion," and, if I remember correctly, the corresponding terms for miscarriages which are not complete are "missed abortion" and "incomplete abortion" (see Miscarriage#Forms and types). A miscarriage, technically, is still considered an abortion, so the parts of Dilation and curettage that focus on the D&C procedure in relation to miscarriage are still discussing an abortion, in the strictest sense. But the crucial difference between a miscarriage and a surgical abortion is that the former occurs naturally while the latter must be induced artificially. I'm not sure about the use of the D&E or suction-aspiration procedures in relation to abortion, but, a suggestion would be to disambiguate articles along those lines. Something like having two articles, one titled Dilation and evacuation (induced abortion) and the other Dilation and evacuation (miscarriage) could be useful in resolving any confusion, and would certainly help to seperate coverage of induced abortion from coverage of miscarriage. Hope this helps. -Severa (!!!) 13:21, 5 March 2007 (UTC)

Typical UK method for surgical terminations (prior to about 13/40) is for dilatation and then suction. D&C was most commonly used in cases of excessively heavy period investigation (i.e. nothing to do with abortions/miscarriages) and the aim was to obtain endometrial lining tissue sample for histology (looking for hyperplasia or cancer) and with the hope that small polyps might be removed at the same time (so therapeutic as well as investigative). Since this gynaecological proceedure has largely been replaced by hysteroscopy (direct visual inspection). "Dilation and curettage (D&C) is no longer performed for cases of simple menorrhagia, having a reserved role if a spontaneous abortion is incomplete" (see Menorrhagia#Treatment Options for UK guidelines).

Returning to matters in hand, UK terminology should now use miscarriage for spontaneous loss (vs deliberate termination) - see excellent The Management of Early Pregnancy Loss (PDF) Royal College of Obstetricians and Gynaecologists, "4. Appropriate terminology" on page 2. The proceedure for removing retained products of conception in incomplete miscarriage is termed (in the UK) "Surgical uterine evacuation (ERPC) has been the standard treatment offered to women who miscarry." (page6) (ERPC=Evacuation of Retained Products of Conception) and on the next page is stated "Surgical uterine evacuation for miscarriage should be performed using suction curettage." - and that "vacuum aspiration is preferable to sharp curettage in cases of incomplete miscarriage". So neither D&C nor D&E as terms should apply in cases of incomplete miscarriage.

As for terminations and which proceedures are used, the RCOG's Medical terms explained defines "Surgical abortion - A type of abortion using suction instruments or D&E to remove a pregnancy." and "D&C (dilatation and curettage) - A small operation which opens the entrance of the womb (the cervix ) in order to remove tissue from the lining of the womb (the endometrium )." whilst "D&E (dilatation and evacuation) - A type of surgical abortion using surgical instruments to end the pregnancy.".

So D&C should be re gynaecological proceedure (nothing to do with miscariage/abortion see the article D&C that notes that use for abortions is historical), ERPC for incomplete miscarriages and D&E for surgical abortion (deliberate termination). Suction-aspiration abortion is not, I think, a term we would use in the the UK but rather use the overall term of D&E (i.e. under a general anaesthetic dilate and then use of Electric vacuum aspiration). Hope this helps with sorting out which articles should cover what. David Ruben ^Talk 01:45, 6 March 2007 (UTC)

I think maybe the line I had the biggest problem with was "Dilation and evacuation is the most common form of second trimester abortion." The fact that the procedure itself is refereed to as an abortion instead of a procedure to remove a miscarried fetus or preform an abortion. The line is worded as such that it would lead a reader to believe that the procedure has one purpose only, and thats to preform an abortion, not just removed a miscarried fetus. Also 71.207.30.125 is me, forgot to log in.--Azslande 06:12, 9 March 2007 (UTC)

Is this an American vs. British English issue? On a women's message board I frequent, most women who miscarry say they have a D&C (though they are not having the procedure described in Wikipedia's D&C article, which seems to be written from a U.K. perspective). From DavidRuben's description, it sounds like the same procedure in the U.K. is called a D&E (though it is not the procedure described in this article, which is written from a U.S. perspective). Azslande, are you from the U.K.? If you're in the U.S., that would disprove my American vs. British English theory. Lyrl ^Talk _C 04:20, 10 March 2007 (UTC)

I am from the United States, but I didn't even think that it might be a UK vs US issue. Perhaps the article should be split into several articles to clarify the differences or perhaps the article be reworked to have a section for each procedure.--Azslande 03:10, 11 March 2007 (UTC)

[edit] 1st trimester

The last edit gave a section for 1st trimester D&E and described SVA. However, the sources say otherwise. [3] [4] [5] [6], etc. Even the miscarriage site doesn't specify that D&E is used before 12 weeks. I do not believe that 1st trimester D&E is something supported by the sources, so I have removed that section.-Andrew c 22:12, 7 April 2007 (UTC)

The sources support the definition as an SVA synonym: [7] [8] [9]

This was initially brought up in #A bit of a problem. In that section, Azslande and David Ruben described their real-life experiences as D&E being an SVA synonym. Both definitions appear to be common. Lyrl ^Talk _C 23:12, 7 April 2007 (UTC)