Talk:Abortion and mental health/Archive 3

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Two Kinds of Evidence Define WEIGHT

Is there general agreement with the observation that there are two broad components of WP:weight: (1) the weight of facts (data points) as reported in peer reviewed literature, and (2) the weight of conclusions and inferences offered by experts as expressed either as part of the individual studies or through review articles or by committees.

Agree or disagree here:

In medical science, the trend is toward evidence based medicine which ranks the value or weight of studies based on objective criteria. Wikipedia's evidence based medicine article is pretty good, and in it you will see that the opinions of experts are the lowest ranked of all evidence regarding the benefits or risks of a medical treatment (in this case, abortion).

This low ranking for expert opinion reflects the experience of the medical profession that new research will often displace previously held beliefs, even widely held beliefs, about even non-controversial treatments, much less controversial ones. Moreover, it reflects what Michael Crichton, M.D., has rightly noted: "[T]he work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world."

I by no means oppose including expert opinions or consensus statements from Wikipedia articles. I do object to using these, especially selected statements which support a POV-push, as an argument for deleting verifiable information from peer reviewed studies which run counter to the POV of certain editors. It is especially inappropriate to exclude mention of recent research from an article simply because it has not yet been included in pre-existing literature reviews.

Let us compile a list of the sources which MastCell and others have proposed as proving that there is a CONSENSUS opinion among medical experts that PAS does not exist and that other negative mental health effects associated with abortion are nil, or at least extremely rare.

  • (The APA group) Adler, Russo, Major, David et al. "Psychological responses after abortion." Science, April 1990, 248: 41-44.
  • Stotland NL. The myth of the abortion trauma syndrome. Commentary. JAMA. 1992 Oct 21;268(15):2078-9.

Please add to the list above if I am missing anything. Bazelon and Mooney don't qualify, as they are not themselves experts and are just citing the 1989 APA group. The Grime's paper doesn't count either, since he merely cites Stotland. Citations like these are simply circular citing the two already above. Also, don't include Koop since his letter actually contradicts the APA group's conclusions. Koop said the evidence in 1989 was too poor to draw conclusions while the APA group said the evidence then was adequate to conclude that there was no significant mental health threat. So Koop really tells us nothing. He is significant as a flashpoint in the controversy, but would hardly pretend to inform us what the consensus view is.

What I'd like to see is for you to build this list up with experts in the field, and most especially to identify polls of experts who have concurred with the view that there are no significant mental health effects. A single researcher, abortion counselor, or abortion provider (such as Planned Parenthood) asserting that there is general agreement the view that there are no mental health risks is not the same as EVIDENCE that there is general agreement with that view among health professionals. List these single endorsers of the idea, if you like, but be honest and identify if they are simply asserting a consensus or if they have polling data that demonstrates a consensus.

Let's build a list of evidence supporting this view which is favored by some editors of this article. Then, when you are done, I am prepared to give you a list of many more experts, the majority of whom are pro-choice, who will disagree with Adler, Stotland, Russo, etc., and thereby will prove that there is no consensus of expert opinion which justifies using the WEIGHT argument to exclude facts from peer reviewed journals which undermine the views of one group of experts or the other. I believe this exercise will help demonstrate the need to build this article on facts, not "improper synthesis" or the misrepresentation of isolated expert opinions as "consensus opinions."

Are you up to this challenge?--Strider12 (talk) 20:43, 5 January 2008 (UTC)

Strider12, this issue has been discussed several times already. миражinred (speak, my child...) 20:47, 5 January 2008 (UTC)
I have more background with legal matters than with medical, so this is how I view it: it's all about burden of proof. Is the burden of proof on the greater medical community to prove that some theory is false, that some disease does not exist? Or is the burden of proof on those who proposed the diagnosis/new discovery/theory/what have ye to prove that it does, in fact, exist, separate and apart from any combination of other, proven diseases? If it's the former, then my limited knowledge of science is entirely wrong. The burden of proof should be on you to come up with studies that prove that a) PAS is a real phenomenon and b) it's not the same as PTSD - abortion could be a trauma to some and not to others, crossing picket lines of pro-lifers could be a trauma, unwanted pregnancy itself could be a trauma. Doctors are, in some sense, still scientists, and scientists have to control for variables like that when proving things, which seems to be the number one fault with the studies I've looked at. Kuronue | Talk 01:11, 6 January 2008 (UTC)
Agreed. You can't tell everyone to prove a disease's non-existence. However: we're not here to prove anything. We're here to present the facts, and only the facts. If reports are inconclusive, we say that in the article. No decision needs to be made on whether or not post-abortion syndrome is real. All we do is read the reports and summarize them, without regard for how they make the topic "sound". That's it. Once everyone realizes this, then maybe some progress can be made. Equazcion •✗/C • 01:38, 6 Jan 2008 (UTC)
True. миражinred (speak, my child...) 03:07, 6 January 2008 (UTC)
Yes. The point of Wikipedia is not for us to re-argue a scientific debate, build a case, and try to "prove" or "disprove" anything ourselves. Our job is to summarize the state of knowledge on the topic. User:Kuronue's comments on burden of proof are spot-on. In any case, the claim of consensus is quite well-sourced. We have statements from the two relevant professional medical organizations, the American Psychiatric Association and the American Psychological Association. We have articles in Science, JAMA, etc. We have a very recent review in Annals of Internal Medicine, one of the top medical journals in the world, stating explicitly that "the so-called 'post-abortion syndrome' does not exist". We also have mainstream-media articles from the New York Times Magazine, PBS, and Washington Monthly. This is ironclad sourcing for the claim of consensus; they can't be blithely dismissed and replaced with citations to David Reardon. At the same time, most commentators recognize that abortion can be a life stress, as can carrying an unwanted pregnancy to term, or crossing a picket line to be treated by a doctor wearing a bulletproof vest, or being vilified, etc. Some women develop psychological problems following an abortion, but the consensus of experts in the field is that the choice to have an abortion does not place a woman at higher risk. These things are all evident in the sources already cited, and I'm still not certain why there's such resistance to accurately reflecting them in the article. MastCell Talk 03:21, 6 January 2008 (UTC)
Yours and Equazcion's comments are dead on. Wikipedia is not the place to stage debates on whether or not PAS indeed exists. This is a controversial topic, but the edit war was never so heated to the point that it led to full protection. This is indeed troubling. миражinred (speak, my child...) 03:27, 6 January 2008 (UTC)
True, but at this point I could get behind merging this into or making it officially a split-off of "Post-Truamatic Stress Disorder" and being done with it. "Some pro-life advocates and scientists believe in a form of PTSD that they have dubbed "Post-Abortion Syndrome" or something. OF course it would never fly as being NPOV enough; but then, I'm not actively editing this article anymore because I'm rather tired and jaded with a lot of arguments in various reproductive-based articles in the last year or so. Sometimes I get so wound up in the argument I forget about the article at hand, and I apologize for digressing. Kuronue | Talk 04:46, 6 January 2008 (UTC)

These answers are very humorous. Note: no one rises to the challenge to offer any more evidence of the claim of consensus. Just the 1990 and 1992 sources and MastCell continues to claim that the prominent abortionist David Grime's article for new interns in Internal Medicine, which merely cites Stotland's commentary in 1992, proves that this is still the consensus! How desperately people run from the challenge to provide evidence!

Fortunately, Kuronue at least makes a valid point regarding that there is obligation on the part of those proposing PAS to prove that post-traumatic stress disorder is associated with abortion. I agree. But I also note, it is not MY job to prove it since that would be original research. It is my job--and that of all the editors on this article--to ALLOW the evidence that PTSD is associated with abortion to be presented--along with any EVIDENCE that there is not an association. Fair enough. But in the real world where Wikipedia editors conspire to purging any evidence that undermines their denials of PAS, every bit of evidence I ad gets immediately blanked (a form of vandalism). (See for example MastCells argument for purging the South Africa studies finding regarding PTSD.)

A true collaboration and NPOV article would allow everyone to put forward ALL STATISTICALLY VALIDATED FINDINGS IN PEER REVIEWED JOURNALS, without regard to whether the authors are perceived to be pro-choice and anti-abortion. But no, in this article, even if authors are pro-choice, if their findings don't support the views of Stotland, and Russo's APA gang, it should be blanked. All I ask is the right to put in peer reviewed material. And I should also be able to put in opinions of experts like DePuy and Fogel--who are pro-choice but disagree with Stotland and Russo. And wouldn't it be fair to put in what Rue actually described PAS to be, since that is the subject of the article. (No, that too get's blanked because it's easier to tear down strawmen.) Oh, and even though Stotland is one of the star witnesses for the denial team, my excerpts from Stotland's later (peer-reviewed) admission that some women do have severed dealyed reactions must also be cut because it shows that even Stotland is not as adament now as she was in 1992.

Finally, Kuronue's point also cuts the other way. The proponents of a medical treatment, in this case abortion, have a duty to prove that the procedure is safe and beneficial. The question of whether it is safe is of course part of this controversy. We know that it is linked with six fold increase risk of suicide (Gissler's population study in Finland, also cut from this article) and immediatly elevated rates of psychiatric illness treated in and out of hospitals (Coleman and Reardon-- also purged from the article). But what is amazing is the total lack of studies showing that abortion actually produces any benefits in regard to women's physical or mental health. Well, there is one known benefit. High schoolers who abort are more likely to finish high school than are their classmates who carry to term and stay home to raise their baby and get a GED.

The challenge remains. Show me evidence of a consensus beyond the 1990 Adler Russo article and Stotland? Bazelon and others who merely quote Russo or Stotland are just regurgitations of the views of same few "experts." This is like "proving" that there is no global warming by insistently citing the same one or two global warming deniers. The fact is that neither the weight of expert opinion nor the weight of evidence (statistically validated facts) support MastCell's argument that WEIGHT is an excuse for censoring the evidence I keep trying to put into this article.

Show me the evidence of any poll of physciains, therapists, APA members, or others who verify Stotland or Russo's (or even Grimes') claims. --Strider12 (talk) 04:09, 8 January 2008 (UTC)

Vandalism is, by Wikipedia definition, a bad-faith act that intentionally damages an article. Since everyone here is only trying to make the article as good as possible, albeit in their own image, I would ask you to not accuse others of vandalism. They're editing the article based on what they think is best, just as you are. They may not agree with you but what they are doing is far from intentional disruption. You would also do well to stop accusing the other side of "purging any evidence that undermines their denials of PAS", for the same reason, and besides which it is getting rather annoying to keep hearing in every single response and edit summary you offer. I'd also like to remind you that the page is currently protected, and if you want to work towards unprotecting it then you will want to make some effort at diplomacy. Your constant accusations are not productive and will only prolong this.
As for where to go from here, see my suggestion in the section below. But nothing can happen until the accusations stop. We can't even get a good discussion going until you agree to this. If you feel the other side is acting that inappropriately, you need to file a complaint at WP:AN/I or WP:Dispute resolution. But don't waste time here with accusations. They won't go anywhere and they only hinder this discussion. Equazcion •✗/C • 04:28, 8 Jan 2008 (UTC)
I only continue to mention purging because I have repeatedly asked the editors to join me in condemning the past 'purging' which was openly discussed by anon 131 (who probably has another name now) and endorsed by margerinered. I'll stop mentioning it when I finally see at least a few editors agree that it was a mistake and should have been better handled back then. If we are going to start working toward a consensus, it should begin with an agreement that purging facts from peer reviewed studies is a violation of policy. (Again, I have no problem with people inserting additional facts from studies if they feel someone has cherry-picked only the most favorable facts. But adding material is far different than deleting material.)
But so far no one has risen to the challenge to admit that past edits, by at least one editor, went against good policy and good editing. Does anyone want to sign on to this challenge of agreeing that the previous purging of all the peer reviewed studies and sources (whether bg Reardon or any other researcher published in peer reviewed journals) as inappropriate?
Are we agreed that material from these studies should be replaced? Are we agreed that we will no longer set ourselves up as being better able to judge what studies are reliable than the peer reviewers and to allow the studies to simply be presented, as long as the results are presented in NPOV manner? These are simple requests. If we can agree to them, I'd be quite happy to stop pointing out that a policy of purging material dominated this article for several months before I started making contributions.--Strider12 (talk) 16:19, 8 January 2008 (UTC)
I'm not sure how many outside opinions you need before you realize that your accusations of "purging" and "vandalism" are both ridiculous and counterproductive. As to evidence of a consensus, it is based on numerous reliable secondary sources (position statements from the 2 major medical bodies (APA's), review article in a major medical journal, mainstream-media articles from the New York Times Magazine and PBS), supported by a handful of primary sources. That's the standard for sourcing on Wikipedia, believe it or not. Your other claims further undermine any residual credibility you have: Grimes is not an "abortionist", but a widely published obstetrician/gynecologist and researcher. His review article is not for "new interns", as you claim, but for internists (which describes all who practice internal medicine at any level). This is a common confusion for laypeople, but I'm sure that as you claim to be a peer-reviewer for medical journals, you are aware of this distinction. MastCell Talk 19:37, 8 January 2008 (UTC)
What two "major medical bodies" have issued official position statement on abortion and mental health? The APA, is not an medical association, it's an association for psychologists (PhD's not MD's or even RN's). And the APA's only official position on abortion is from 1969 stating that abortion should be legalized as a civil right. The APA task force from 19870-1990 published a review article which was never adopted as an official position.
If you're trying to portray Stotland's COMMENTARY in JAMA as the official position of JAMA or the AMA, again you are simply wrong. It is her personal commentary on the issue, one she has subsquently modified. And a single review article by Grimes (which isn't even a review article on psychological effects, unlike the 1990 APA task force which actually reviewed studies) is not determinative. In fact, Grime's conclusions are totally rejected by an equally authorative review article for OB's, Thorp JM, Hartmann KE, Shadigian E. Long-Term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence. Obstetrical and Gynecological Survey 2003, 58(1):67-79. Also, while Grimes certainly is a widely published OB/GYN, epidemiologist, and professor of medicine, he also performs and teaches abortions on a regular basis. All of this is well documented. I'll grant he is an expert, like Reardon, but he is hardly anymore nuetral on abortion. In depositions on cases against abortion reglations, he has testified that he became active in abortion and family planning because he sees population control as a top priority.
Why can't we just agree to treat the opinions of pro-choice advocates with the same level of both reservation and respect with which we treat anti-abortion advocates. I'm in favor of treating all experts equally. Both sides have expertise. Both sides help us to intepret the facts. Readers have a right to learn (1) the facts, and (2) what both sides expert's say.
As stated above, WEIGHT has two elements: objective facts and expert opinions. The former includes statistically verified findings in peer reviewed journals. The latter includes the authors of those journal articles. Why is is so hard to agree that both of these should be incorporated into this article? Why do you insist that Bazelon and others are the final arbiters of where the WEIGHT belongs no matter how many studies and experts I produce to show that the WEIGHT does not belong where Bazelon, Stotland, Russo, and Grimes say it does?
I'm still waiting to see you write that the past purging was wrong. I'm still waiting to see you agree that there is a difference beween facts and opinions and that facts are more important to judging WEIGHT than just the opinions of a selected few experts. And I'm still waiting for a link to Wikipeida policy that shows that secondary sources are preferable to primary sources.--Strider12 (talk) 22:37, 8 January 2008 (UTC)
Why can't we just agree to treat both views on post-abortion syndrome equally? Because of WP:WEIGHT. We treat them in proportion to their acceptance by experts in the field. They are not equal in that respect, so we don't treat them equivalently. Your fundamental inability to grasp this is unfortunate. As to secondary sources, I provided a link in one of the above threads. Please read Wikipedia:No original research. Please. Among other useful instructions which you continually ignore, it states that: "Wikipedia articles should rely on reliable, published secondary sources." Again, please read this policy. MastCell Talk 03:04, 9 January 2008 (UTC)

End this

I'm not sure if anyone's seen this yet: http://www.nytimes.com/2007/01/21/magazine/21abortion.t.html

"...the idea that abortion is at the root of women’s psychological ills is not supported by the bulk of the research. Instead, the scientific evidence strongly shows that abortion does not increase the risk of depression, drug abuse or any other psychological problem any more than having an unwanted pregnancy or giving birth."

I think that rather than looking at studies and other scientific data yourselves, it would be better to use a third-party summary, such as this one. This is from a recent article in the New York Times. Paraphrase it and use it in the article's lead, and work towards explaining it in the rest of the article.

Strider: I know you will have problems with this. If you can produce a third-party take on this from a source that's just as reliable, please present it. But I think we need to forget about reading scientific studies ourselves, for now, because they're too open to interpretation. Let's use third-party analyses of those studies instead. Equazcion •✗/C • 01:59, 6 Jan 2008 (UTC)

Strider12 have said that Emily Bazelon, the writer of the article is pro-choice and thus biased. As for me, I read this article last year. миражinred (speak, my child...) 02:58, 6 January 2008 (UTC)
I agree with Equizacion 100%, but a quick review of the last 100kb or so of discussion here and at Talk:David Reardon reveals a remarkably strenuous effort to argue that we should rely more on individual editors' cherry-picking of the primary literature rather than, say, the New York Times Magazine or PBS. In fact, that's the root of the problem here. It's always good to have a sanity check; I hope that the ongoing accumulation of outside opinions will convince Strider12, but I'm not especially optimistic. MastCell Talk 03:09, 6 January 2008 (UTC)
The problem with an issue like this is that _everyone_ has an opinion. Middle-schoolers who get squeamish about the concept of childbirth and (heaven forbid) any of the steps leading up to that spout off bumper sticker slogans. If you're looking for an entirely neutral source you won't find one; everyone has a bias. Instead you have to evaluate the statement. We can put that in and attribute it to the Times, and the Times is considered a good source. Furthermore, if we include things from specific studies we ought to include a synopsis of the entire study or not use it at all. It's not our job to synthesize a cohesive worldview for people, merely to collect the facts as they have been reported by others and leave people to make their own choices. Kuronue | Talk 04:52, 6 January 2008 (UTC)

I'm going to have to pull a policy card on this one. The author is of no consequence. The NY Time Magazine is a reliable source, and that can really be the end of it. Strider can claim the author is pro-choice and that this somehow invalidates the reliability of the article, but a reliable source is a reliable source, and that can't be undermined by complaining about who wrote it. As far as I know, this publication's articles are a source of more-or-less unbiased reporting - although I'm not entirely sure of that, only because it's the "magazine" section and not the newspaper itself. It the magazine is supposed to be an unbiased source, though, then we can trust this analysis for the article's sake. Equazcion •✗/C • 09:36, 6 Jan 2008 (UTC)

This article is cited many times in the article already. It is certainly a reliable source in the sense that it can and should be cited as an example of the opinions out there. But certainly your not arguing that any conclusions drawn by the New York Times are gospel? And therefore no other sources that conflict with the NYT gospel should be allowed into a Wikipeida article?--Strider12 (talk) 04:13, 8 January 2008 (UTC)
Unless that's what I said, I think you should refrain from putting words into my mouth. I think you really need to learn how to discuss productively so I'm not even going to answer you until you rephrase this question. If you need guidance, see WP:CIVILITY. Let me know when you're ready to move forward. Equazcion •✗/C • 04:35, 8 Jan 2008 (UTC)
Did you not notice that I asked questions? I didn't put words into your mouth. It seriously appeared to me that you were suggesting that Bazelon's article was a definitive one which should guide and determine the scope, tenor, and slant of this article on post-abortion syndrome. I found that hard to believe as it is just a single source out of several hundred reliable sources available. I apologize if my "gospel" refernence was offensive. But I was only seeking to prompt you to agree that Bazelon's article is just one reliable rouce and that other sources, especially from peer reviewed journals, and a syndicated columnists's interviews with for psychiatrist and obstetrician Julius Fogel, should also be accepted as reliable sources.--Strider12 (talk) 04:54, 8 January 2008 (UTC)
Of course I noticed that you asked questions. If I hadn't noticed that, then I couldn't request that you rephrase those questions. Now, reliable sources are not determined by their author but rather their publication. So if you want to present an article, then please post a link for consideration. Again though, I ask that you avoid studies and focus instead on third-party reports. We have gotten nowhere trying to determine what should be included from studies -- we need another source to make that decision for us. Equazcion •✗/C • 05:00, 8 Jan 2008 (UTC)
I thought Wikipedia policy gave peer reviewed sources highest ranking for reliability. The problems on this article arise not because MastCell or others believe that the peer reviewed studies I have cited are not accurately cited, but rather because the findings of all these studies published since 1992 do not support the conclusions drawn by a couple sources in 1990 and 1992 which continue to be cited by people like Bazelon as authorativie representations of what most experts think.
Here is a list of just a few review articles and books dealing with the literature. But I anticipate that MastCell and others will argue that these too should be excluded because they do not support the views of Stotland, Russo, Bazelon and Grimes.
  • Thorp JM, Hartmann KE, Shadigian E. Long-Term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence. Obstetrical and Gynecological Survey 2003, 58(1):67-79. —Preceding unsigned comment added by Strider12 (talk • contribs) 16:04, 8 January 2008 (UTC)
  • Elizabeth Ring-Cassidy, Ian Gentles. Womens's Health After Abortion. 2002
  • Coleman, P. K., Reardon, D. C., Strahan, T., & Cougle, J. (2005). The psychology of abortion: A review and suggestions for future research. Psychology and Health, 20, 237-271. (Coleman is the most published researcher in the field of abortion and mental health)
  • Coleman PK. Induced Abortion and Increased Risk of Substance Abuse: A Review of the

Evidence, Current Women’s Health Reviews, 2005, 1, 21-34.

I could add dozens of more sources. I literally have a file draw full only five feet away. And in addition to primary sources I have used several reliable secondary sources in the past only to have the information aggressively deleted. These deletions are explained away with only the that they conflict with DENIAL GROUP's viewpoint as championed by Russo, Major, and Stotland...and supported by Bazelon and Mooney, pro-choice writers who have selectively decided to hold Russo and Stotland as "the experts" who speak for the consensus of all experts. In other words, the views of the handful of "experts" who reprseent the DENIAL GROUPl are being touted as the official view of this article which must govern the WEIGHT of all material in it.

Because the DENIAL camp is the "official view" (for several editors) and because the DENIAL camp's position cannot withstand any direct comparison to evidence or the opinions of those who don't share their veiws, including pro-choice experts such as Wilmoth, Fogel, DePuy, Fergusson and others, evidence and opinions, precisely 100% of my contributions are deleted and challenged with frivolous arguments. Because virtually every peer reviewed study published in the last fifteen years does not support the DENIAL CAMP's position, the "viligent" "purging"--to quote the openly discussed policy of some editors-- continues.

The dispute over this article is not about any shortage of reliable sources, the core dispute is over the claim that the WEIGHT of expert opinion justifies the deletion of facts, sources, and conflicting opinions. As noted in the section above, even this WEIGHT argument is flimsy and stands on the committee report of six APA members in 1990 adn a commentary by psychiatrist Nada Stotland in 1992 (plus insistence on hiding Stotland's subsequent admission that there may be more to post-abortion reactions than she thought in 1992).

True collaboration simply requires finding a place for all the evidence people bring forward and editing for completeness and clarity.

For example, I've been accused of "cherry picking" the PTSD results of the South Africa study. MastCell says that the decline in anxiety and depression from immediately before the abortion to a couple months after is important to note. Fine. The solution to "cherry picking" is not to delete my material but to add other information from the study, such as that regarding anxiety and depression, if an editor thinks it important. I fully support that. I honestly believe I am not cherry picking but am bringing forward relevent information. If others want to bring forward relevent information that they think I should have included to put the source into better balance, bravo. That is what multi-author collaboration is supposed to do. The problem here is not that I am unwilling to respect the contributions of others, but that those advocating for the views of the DENIAL GROUP are insisting that all evidence which undermines the views of their few experts should be stricken, debated, hassled with any excuse at hand.

Why can't we just include the evidence, state it in an NPOV fashion, and let readers draw their own conclusions? If I leave evidence out that someone else wants in, put it in. But don't expect me to limp away quietly when there is a "vigilient" campaign as 131 described it to "purge" information that runs counter to the DENIAL GROUP's "politically correct" effort to prevent Wikipedia readers from seeing all the evidence.Strider12 (talk) 15:52, 8 January 2008 (UTC)

If you are able to phrase your comment in a civil and constructive manner, ideally with PubMed links to the sources you mention, I'll be happy to respond. Otherwise I continue to think that shunning is the best approach here. MastCell Talk 19:41, 8 January 2008 (UTC)

WP:RS states that "Wikipedia articles should point to all major scholarly interpretations of a topic." That would seem to include (1) pro-choice experts who disagre with Stotland, Russo, MAjor, Grimes, (2) anti-abortion experts who disagree with them and are published in peer reviewed journals, and (3) a substantial number of researchers (like Gissler) who have no known position on abortion.--Strider12 (talk) 23:10, 8 January 2008 (UTC)

Wikipedia does point to all major interpretations of a topic. Hence this article, which covers "post-abortion syndrome" despite the fact that it is not a medical condition and is widely rejected by experts in the field as a proposed diagnosis. The idea that abortion is harmful to women's mental health is covered far out of proportion to the support the idea has among experts in the field, which is demonstrably negligble. What is the point of your citation of WP:RS here? MastCell Talk 02:28, 9 January 2008 (UTC)
My point is that the views of those, including both pro-choice and pro-life experts who agree there are significant effects of aboriton on mental health should be included alongside the views of deniers like Stotland and Russo.
Once again, you keep aserting that this idea has little support among experts in the field is supported by only two substantive articles, the Adler, Russo, Major 1990 article in Science and Stotland's commentary. These two sources, which Bazelon and Mooney regurgitate, are given undue weight and are being used to suppress both studies and the expert opinion of Fogel, Wilmouth, DuPuy, Zimmerman, Rue, Coleman, Cougle, REardon, Shuping, Ney, Burke, and hosts of others.
Again, I challenge you to give actual evidence that the views of Stotland and Russo are shared by the vast majority of physicians, psychologists, psychiatrists, or any group outside the pro-choice advocacy subgroup of the APA (Section 34, if I recall). Where are the polls of physicians showing that onlyu 3% believe that PAS is real, for example?--Strider12 (talk) 03:42, 9 January 2008 (UTC)
You know, I'm actually quite tired of your ceaseless tendentiousness and POV-pushing. Stop using the words "purging", "denial", etc. That would be a first step toward regaining some credibility as a potentially collaborative editor. Secondly, I'm not going to endlessly repeat myself. The claim of consensus is adequately sourced, to the American Psychological and Psychiatric Associations, the absence of any medical recognition of "post-abortion syndrome" (e.g. DSM-IV), the recent high-impact review article in Annals, and mainstream media pieces by the New York Times Magazine and PBS. If you can't accept that, take your advocacy elsewhere. MastCell Talk 05:58, 9 January 2008 (UTC)

Bazelon's Errors, Biases, and Distortions

For analyses by media experts, researchers, and commentary by persons interviewed by Bazelon, see Symposium: Is There a Post-Abortion Syndrome The contribution "Heartless Bastards" is particularly interesting. As several note, it is especially revealing that while briefed by many on Fergusson's study, by far the best controlled study looking at the matter, Bazelon omitted all mention of Fergusson's study, much less his pro-choice position, because she clearly wanted to make it appear that only anti-abortion radicals believed that abortion could cause negative mental health effects.--Strider12 (talk) 04:54, 8 January 2008 (UTC)

Please re-read WP:V and WP:RS before proposing that this source be included in the article in any way, shape, or form. MastCell Talk 19:43, 8 January 2008 (UTC)
"The Afterparty of Death," "Poetry of Life?" The site is also a partner of townhall.com. No way this passes WP:V or WP:RS. миражinred (speak, my child...) 20:18, 8 January 2008 (UTC)

I'm not proposing any of the articles about Bazelon's articles should included in this article. That would be original research. It might be appropriate to include in Bazelon's own Wikipeida entry as criticism of her reporting/advocacy. But not here. I'm including it in the discussion page, however, so that interested editors can see that her magazine article was not objective and therefore should not be treated as a major source determining the WEIGHT of expert opinion. It is a POV pushing magazine article, but a significant one in that it is in NYT Magazine, and so deserving a place in this article. But it should NOT be given undue weight.--Strider12 (talk) 22:08, 8 January 2008 (UTC)

It's not given "undue weight". It's actually given far less prominence than it ought to receive. MastCell Talk 02:30, 9 January 2008 (UTC)


Grimes' Biased Review

Hoeldtke N. Late sequelae of induced abortion. Ann Intern Med. 2004 Apr 20;140(8):620-6. (Reprinted with authors' permission)

TO THE EDITOR: I was surprised to read the review of induced abortion by Grimes and Creinin (1). Several years ago, Dr. Grimes stated, “Traditional review articles are not just obsolete; they also are nonreproducible and of low scientific quality . . . [O]ne analysis . . . found a significant inverse relationship between adherence to scientific standards for a literature review and the self-professed expertise of an author” (2). Indeed, Grimes and Creinin’s current review seems to bear this out, being crippled by selective literature citation and hyperbole.
Grimes and Creinin stated that abortion has no effect on future reproductive function and cited a 14-year-old review article. They ignored a more recent review that reached some different conclusions(3). While citing a 12-year-old commentary as proof that there is no “postabortion trauma syndrome,” they failed to mention the limited follow-up periods that hamper most research regarding psychological implications of induced abortion. They also neglected to discuss 2 recent large studies demonstrating increased deaths from suicide in women who have had abortions compared with women who carried their pregnancies to term, in both Finland (4) and the United States(5). Regardless of whether this association is one of causation or of common underlying risk factors, it cannot be ignored. A patient seeking an abortion appears to be at higher risk for suicide. Surely this is information relevant to internists.
Grimes and Creinin cavalierly characterized 3000 pregnancy care centers as “biased counseling centers.” At the same time, they recommended the National Abortion Federation and the Planned Parenthood Federation of America, both organizations with a vested interest in the provision of abortion. To insinuate that these organizations aren’t biased while stating that pregnancy care centers are is disingenuous at best.
Finally, given the target audience of internists, it is a glaring oversight that Grimes and Creinin’s review does not specifically mention abortion and patients with medical conditions. Internists care for patients with significant medical problems who become pregnant. Many of these patients, and some physicians, may presume that induced abortion is the management of choice, a presumption often based on misinformation or outdated thinking. In these cases, referral to an obstetrician or a maternal–fetal medicine physician for evaluation and counseling should be considered. This provides the patient an opportunity to exercise her autonomy in a thoroughly informed context.
Nathan Hoeldtke, MD Honolulu, HI 96859
References
1. Grimes DA, Creinin MD. Induced abortion: an overview for internists. Ann Intern Med. 2004;140:620-6. [PMID: 15096333]
2. Grimes DA. Evidence-based medicine: keeping your practice from getting stale. Contemporary OB/GYN. 1999;Jan:41-54.
3. Thorp JM Jr, Hartmann KE, Shadigian E. Long-term physical and psychological health consequences of induced abortion: review of the evidence. Obstet Gynecol Surv. 2003;58:67-79. [PMID: 12544786]
4. Gissler M, Hemminki E, Lonnqvist J. Suicides after pregnancy in Finland, 1987-94: register linkage study. BMJ. 1996;313:1431-4. [PMID: 8973229]
5. Reardon DC, Ney PG, Scheuren F, Cougle J, Coleman PK, Strahan TW. Deaths associated with pregnancy outcome: a record linkage study of low income women. South Med J. 2002;95:834-41. [PMID: 12190217]

In his response Grimes and Creinin state: "We agree with Dr. Hoeldtke that systematic reviews of the literature are superior to narrative reviews. However, our article was invited as a primer for internists, not as a systematic or narrative review. Hence, our citation of the literature was by nature incomplete."

Ergo: Grimes himself admits that this source is not a review of medical literature on the psychological effects of abortion, as anyone reading the article should have been able to see. Case closed.--Strider12 (talk) 03:33, 9 January 2008 (UTC)

You seem to keep forgetting that I have actual full-text access to these journals, and can therefore rather easily and repeatedly detect your obvious attempts at cherry-picking and selective quotation. You quote Grimes as if he's "admitting" that his review is worthless. Grimes goes on to state, in response to Hoeldtke's letter:

Dr. Hoeldtke makes a common error in logic regarding potential late sequelae of abortion: post hoc ergo propter hoc reasoning (after the fact, therefore on account of the fact). That one event (for example, suicide) follows another event does not imply a causal link between the two. In a notable example of this erroneous reasoning, Dr. Reardon, the lead author of the fifth reference in Dr. Hoeldtke’s letter, has argued in print that penile amputation with a kitchen knife is a late consequence of abortion...
Congressional hearings identified hundreds of counseling centers that deceptively portray themselves as abortion clinics. These centers have been documented to “detain, harass, and coerce women”. Regardless of one’s views on abortion, such behavior is unethical...
Thorough (and recent) reviews of the literature refute the notion of long-term adverse emotional consequences of induced abortion. This was the conclusion of both the Koop report and a special panel of the American Psychological Association.

So this is a source you yourself are citing. In it, not only is the consensus on post-abortion syndrome yet again decisively affirmed, but David Reardon comes in for special criticism for his faulty reasoning. Yet you cite this as if Grimes "admitted" his review is worthless, "biased", etc. You officially have zero credibility at this point; you have cherry-picked and misused the medical literature to the extent that nothing you say is believable and everything requires hands-on verification. For what is hopefully one of the last times, Wikipedia is not a venue for you to advocate for your agenda. Take it elsewhere; I'm pretty much done responding to you, other than to correct your more obvious deceptions which might not be evident to those without access to the full text you selectively mine. MastCell Talk 06:11, 9 January 2008 (UTC)
Well said. миражinred (speak, my child...) 21:09, 9 January 2008 (UTC)
Agreed. If this won't stop, let's do a straw poll (or other options). This is taking up immense amounts of space and time. Phyesalis (talk) 04:59, 10 January 2008 (UTC)
Good job, MastCell. To request unprotection see WP:RPP. I don't think a straw poll is necessary. This page already shows consensus. A single, vocal editor violating multiple policies doesn't change anything. If Strider continues editing the way she has been, an AN/I request can be made for warning/action on her account. Equazcion •✗/C • 07:43, 10 Jan 2008 (UTC)

More on Grimes

Hold it a minute, Equazcion. Before declaring a "winner," how about the opportunity for a response!

The accusation that I'm hiding things is simply false. In fact, I'm glad that MastCell looked it up and gave us more.

For my part, I didn't have Grime's permission to print his letter in toto, and so limited myself ot Hoeldtke and the relevent excerpt from Grimes.

Furthermore, nothing in the portion of Grime's letter reprinted by MastCell changes the fact that he did NOT do a literature review and is just citing Stotland. In other words, MastCell only puts forward that Grimes had other arguments to make (all of which are irrelevent to the point at hand, which was MastCell previous misrpresentation of Grime's article as a NEW review article that gave an updated view of abortion and mental health literature.)

In short, MastCell has not refuted at all my point that Grimes is not an extra source of new evidence showing a consensus of expert opinion that there are not mental health effects of abortion, he is just a source citing the same handful of old claims of consensus.

Indeed, even in this additional portion of his letter just once again repeats "This was the conclusion of both the Koop report and a special panel of the American Psychological Association" citing the 1990 Adler (Science) article, confirming Hoeldtke's point that he is ignoring recent studies, including a real review of the literature on psych studies (Thorp, et all 2003). And of course, he didn't have access to Fergusson's study. Thus, the count of all the sources used by Grimes, Stotlan, APA 1990, and Koop still doesn't add to the list of sources supporting the deniers view, which I've requested above.

Second, as this entry is part of a discussion, not the article itself, I am merely citing Hoeldtke as an example of the FACT that Grime's view is not widely supported by other doctors.

Third, the sections you add from Grime's letter do not claim or offer any new evidence that most doctors don't believe there are any long term mental health effects. Instead, he charges pregnancy help cernters with deception, not relevent to this article, admits that suicide is linked to abortion but dismisses it arguing there is no evidence of a causal link (ignoring the fact that there are many suicide letters lined to abortion...but that's another matter, and mocks Reardon for having documented from the court records that Lorena Bobbitt testified that she had flashbacks to her coerced abortion at the very time she was picking up the knife to mutilate her husband, almost exactly at the three years anniversary date of her abortion. Whether or not there was a CAUSAL connection between Bobbit's attack and her abortion is certainly unknown, but that Reardon points out that there may have been is hardly a basis for dismissing dozens of peer reviewed, statistically validated studies he has done. The fact that Grimes' feels he must resort to an ad hominem attack is evidence that he has little else in the way of evidence to support his arguments other than he old cites to 1990 and 1992.

Grimes also falsely accuses Hoeldtke of making a post hoc ergo propter hoc reasoning. In fact, Hoeldtke is very careful to avoid making such an error, writing: "Regardless of whether this association is one of causation or of common underlying risk factors, it cannot be ignored. A patient seeking an abortion appears to be at higher risk for suicide. Surely this is information relevant to internists." The error is not Hoeldtkes' it is Grimes' error to withhold relevent information from a review article.

Aside from the fact that Grimes offers more arguments, none of which bring new insights to the question at hand, why do the Deniers cheer MastCell for adding this quote? It doesn't prove anything other than the fact that Grimes didn't roll over and cry uncle when rebuked by Hoeldtke. Instead, he mocked Reardon, attacked pregnancy centers' ethics, cited Koop and the 1990 APA panel, and argued that he was justified in omitting any mention of the suicide studies (and other post 1995 studies on abortion and mental health) because the causal link had not yet been established to his satisfaction. The latter is just moving the goal posts, of course. Grimes well knows that epidemiological studies never prove causation, they provide statistical evidence of associations which support theories, in this case, they support the theory that abortion is a contributing factor in suicide and higher rates of mental helath problems.

All these arguments and counterarguments do not change the fact that Grimes admits that he did not do an independent, updated review of the literature on abortion and mental health. Therefore his article should not be given any WEIGHT as "a review article of abortion and mental health." Case closed. By "Case closed" I don't mean this PROVES a link between abortion and mental health problems; I mean it proves THIS citation to Grimes is not an independent review of abortion/mental health literature. It is not an article that contributes any information beyond the APA 1990 and Stotland 1992 articles on which it relies.

I repeat my request from "TWO KINDS OF WEIGHT" above for evidence and sources that rely on more than the following two items to support the claim that there is a consensus of medical opinion that there are no lasting mental health effects of abortion.

  • (The APA group) Adler, Russo, Major, David et al. "Psychological responses after abortion." Science, April 1990, 248: 41-44.
  • Stotland NL. The myth of the abortion trauma syndrome. Commentary. JAMA. 1992 Oct 21;268(15):2078-9.

Above, I also gave a half dozen more recent sources pointing in a direction opposite to the two sources above, including sources by pro-choice proponents.

MastCell says she is tired of the "tendatious" manner in which I keep insisitng on evidence are arguing that my sources deserve equal weight. She is tired that I inist there are experts other than the few people Bazelon, Moody, and Grimes have enshrined as the only "experts" (Stotland, Russo, Adler, Major) whose opinion count in determining WEIGHT.

I am equally tired of the "tendatious" refusal of those in the denial camp to address the clear questions I have raised regarding the two kinds of evidence involved in weight, or to offer more evidence than regurgitations of these two 1990 and 1992 sources.--Strider12 (talk) 13:30, 10 January 2008 (UTC)

"For my part, I didn't have Grime's permission to print his letter in toto, and so limited myself ot Hoeldtke and the relevent excerpt from Grimes."
Copyright is not an excuse for misrepresenting a source by only reporting part of it. You don't need to copy the entire source in order to accurately represent what it says. You can paraphrase or use excerpts -- which is what you did, but you only selected the parts that, if taken alone, skew the source's finding. You say you chose to only quote "relevant excerpts", but if your source in the end states that "Thorough...reviews of the literature refute the notion of long-term adverse emotional consequences of induced abortion," don't you think that's also pretty relevant?
"MastCell previous misrpresentation"
You don't get to accuse people of misrepresentation. I hope you can appreciate the perceived hypocrisy in your statement, given the above.
"Third, the sections you add from Grime's letter do not claim or offer any new evidence that most doctors don't believe there are any long term mental health effects. Instead, he charges pregnancy help cernters with deception, not relevent to this article, admits that suicide is linked to abortion but dismisses it arguing there is no evidence of a causal link....."
You really need to take a look at WP:OR and WP:SYN. When you write Wikipedia articles, you don't get to think past the point put forth by the source, at least not further than "how can this be summarized in simpler language for the article". You criticize the source as if your opinion on it has some bearing on what goes into this article. I assure you it does not.
Consensus has been established, so I'm requesting unprotection for this page. Strider will have to be dealt with at AN/I if she continues to make edits that go against consensus. Equazcion •✗/C • 14:08, 10 Jan 2008 (UTC)
You accuse me of misrepresentation, then charge that I should not accuse MastCell of misrpresentation....? The only reason I dug into the Grimes article is because MastCell represented as a new, updated, indepedent review article of abortion and mental health. I found a third party criticism pointing out that it was not an actual review but offers merely a cite back to Stotland PLUS Grimes admitting that it wasn't a reveiw article, even though he insists that he still stands by his conclusions. The fact that Grimes stands by his opinion is not the issue and it was not a misrepresentation on my part not to include his charges regarding Reardon and pregnancy centers. The ISSUE being addressed is "Did Grimes do an independent review of the literature and reach the conclusion from the independent review that there are not mental health risks to abortion." Grimes' own answer is essentially, "No, I didn't review the literature. But Stotland and Adler's APA group (from 1990 and 1992) support my position and Koop in 1989 said there wasn't enough evidence to draw any conclusions, so that doesn't contradict my conclusion, and all the studies and review articles published since, while finding statistical associations, don't prove causation." THAT is not evidence that Grimes' opinion reflects the WEIGHT of where the opinion of ALL experts in the field. THAT does not refute the dozens of experts, pro-choice and anti-abortion, who disagree with Stotland, Adler, Russo, and Grimes. THAT does not prove that editors like MastCell have a legitimate reason to keep deleting material citing other experts and peer reviewed studies which demonstrate the weakness of Grimes' position.--Strider12 (talk) 14:59, 10 January 2008 (UTC)
"The ISSUE being addressed is 'Did Grimes do an independent review...'"
No, that's not the issue. Grimes was still providing a primer to internists, which is important to the topic, and we can cite it as such in the article. Whether or not it can be defined technically as a "review" is of little consequence, except to nitpick MastCell's choice of words. Equazcion •✗/C • 15:19, 10 Jan 2008 (UTC)
I don't dispute that Grime's article can be cited as a primer for internists. But the issue I have raised is the request that MastCell and others provide some evidence that the WEIGHT of opinion really lies with excluding dozens of experts, secondary sources and primary sources which I and others have tried to add to this article. And all they do is cite a handful of secondary sources (like Grimes, Moody, and Bazelon) which ALL ignore the last fifteen years of research and new opinions offered by experts and continue to cite the old two standards Adler 1990 and Stotland 1992. That is the point: Grimes does not contribute new information beyond Adler and Stotland.
To me THE ISSUE is that this combination of a few sources citing only two primary sources is an excessively narrow selection of available primary and secondary sources. The sources preferred by MastCel simply give too much weight to these two primary (and dated) sources. More importantly, these interrelated, self-referencing sources do not sufficiently "prove" where the weight of evidence and opinion lies to justify the continued deletion of findings and opinions, by both pro-choice and anti-abortion researchers, subseqent to 1992 which tend to undermine the views espoused by Adler and Stotland.
The ISSUE is about WEIGHT. And MastCell's tendatious insistence that her sources alone should determine the WEIGHT of this article is simply not justified by the evidence. So far those in the denial camp continue to refuse to bring forward any fresh evidence, even secondary sources, that do not rest exclusively on Adler, Stotland, Russo and Major. Further, no one has given reasons why all the primary and secondary sources I have listed above, and used in the past, should be deleted...other than that their inclusion undermines the tone of Adler and Stotland's pronunciations on this issue. I am not the one arguing for cutting of material, even material that I disagree with. I am simply arguing for an inclusive policy allowing addition of material.--Strider12 (talk) 16:34, 10 January 2008 (UTC)
If you weren't arguing about inclusion of that source then we're talking in abstractions. Let's get down to it: Give a fresh example of a statement you'd like to insert into the article, and its source, that the others wouldn't allow. Please try to be concise. We'll go from there. Equazcion •✗/C • 18:56, 10 Jan 2008 (UTC)
For my part, I'm not interested in responding to any further statements that include language like "denial camp". For the record, reliable secondary sources include a position statement of the APA, review article from Annals of Internal Medicine, and mainstream media pieces from the New York Times Magazine and PBS (supported by a mountain of primary sources, it goes without saying). These secondary sources cover overlapping ground from different angles and reach similar conclusions (which Strider12 dismissively calls "self-referencing"). Strider12 contends that these published, reliable secondary sources are undermined by her interpretation of more recent primary data. So on the one hand we have multiple consistent, reliable published secondary sources. On the other hand we have... Strider12's reading of recent literature. It's clear which of the two should form the basis of the article. Let's move on. MastCell Talk 19:47, 10 January 2008 (UTC)

← I wasn't too happy with "denial camp" either but was offering the benefit of the doubt -- "denial" doesn't need to mean "in denial" as in denying the truth. But I agree the more offensive meaning seems to have been in use here. Equazcion •✗/C • 19:57, 10 Jan 2008 (UTC)

I use "denial camp" as short for Stotland, Russo, Major, Bazelon and the handful of others who promote a broad denial of the idea that there are any post-abortion mental health problems.
MastCell says "For the record, reliable secondary sources include a position statement of the APA, review article from Annals of Internal Medicine, and mainstream media pieces from the New York Times Magazine and PBS (supported by a mountain of primary sources, it goes without saying)." But when I ask for any primary sources, this mountain crumbles down to two sources the "position statement of the APA" (which is not an APA position statement but a report from six APA members who formed a team review, but was never officially adopted as the APA position by the governing body), and Stotdland's commentary, both of which are cited ad nauseum by Grime in Annal of Internal MEdicne, Bazelon in NYT, and the PBS story which was just a video version of Bazelons' article. Again, I plead with you, show me the "mountain of primary sources." I'm very familiar with the primary sources and everyone you can point to will show that some women have significant mental health problems...in some cases as few as 10 percent, but some times as high as 40%. In any even, even one case of abortion related PTSD per 100,000 cases is actually proof that PAS exists, even if is rare.
Specific suggestions in response to Equazcion are in a new section below.--Strider12 (talk) 03:44, 11 January 2008 (UTC)
Just stop spinning. You clearly used "denial camp" in reference to editors of this article, not in reference to Stotland et al. You've gone completely off the deep end. One case in 10,000 of PTSD after abortion equals "post-abortion syndrome"?!? The background prevalence of PTSD in this age group is around 10%. You may as well say that 10% of women suffer PTSD after graduating from high school and call it "post-graduation syndrome". In any case, the fact that all reliable, independent secondary sources reinforce each other indicates the strength of those conclusions and the WP:WEIGHT which attaches to them; your attempts to spin this consensus into some sort of failing are bizarre. MastCell Talk 05:14, 11 January 2008 (UTC)

Causal Connections & Post-Partum Syndrome and Post-Abortion Syndrome

In MastCell's discussion at Post-Abortion Trauma -- An expanded purging of inconvenient evidence she states: "In fact, there are no conclusive data on the cause of post-partum depression..."

She here is correctly pointing out that the CAUSAL connections between depression after childbirth and depression after abortion are very difficult, if not impossible, to prove. Should we therefore deny that they exist? No. Higher rates of depression have been reliably observed after both deliveries and abortion, and record based studies have shown that both hospitalization and outpatient treatment for depression is actually more common in 180 days after abortion than after childbirth.

In any event, if MastCell advocates that lack of conclusive proof of a causal connection is a basis for generally denying the existence of mental health effects associated with abortion, why is she not also editing the article on post-partum depression to deny that depression post-partum is associated with pregnancy outcome? Why do different standards apply to abortion? Why do experts and research findings that disagree with the deniers like Stotland and Russo need to be blanked from this article in order to promote the view of a minority? --Strider12 (talk) 16:05, 10 January 2008 (UTC)

If a person has been editing one article based on principles that could apply to other articles, that does not require them to actually go and edit those articles or else admit fault in their argument. People edit the articles they choose to edit and are not required to edit similar articles just because others feel it would prove their loyalty to their reasoning. I've heard this argument before and it makes no sense so let's not even start. Equazcion •✗/C • 19:02, 10 Jan 2008 (UTC)
Of course, there are major differences between post-partum depression and "post-abortion syndrome". To start with, one is a real diagnosis, found in the DSM-IV and recognized by the psychiatric community, while the other is not. That's a starting point for anyone concerned with WP:WEIGHT rather than asserting their own opinion. Another difference is that research on post-partum depression has proceeded organically from the medical community in a relatively non-judgemental and depoliticized environment (Tom Cruise notwithstanding). In contrast, "post-abortion syndrome" is essentially a political creation of a subset of the pro-life movement, with the expressed intent of generating fear, uncertainty and doubt and opening another "front" in the abortion wars. And that's David Reardon's own description of it (e.g. "In some cases, it is unnecessary to convince people of abortion's dangers. It is sufficient simply to raise enough doubts about abortion that they will refuse actively to oppose the proposed anti-abortion initiative.") But I digress. MastCell Talk 19:15, 10 January 2008 (UTC)

I find this quite worrying

I am quite new to editing wikipedia and I'm concerned by a lot of what I'm reading in this debate. I just tend to follow pages I think I know something about and know a think or two about abortion as I teach about US politics and learned a fair bit about the issue from that. I linked to the Post abortion syndrome page as I had never actually heard about it before, and immediately thought the article was written to try to disprove the alleged condition's existence. When I noticed this on-going debate, I decided to read some of the references in the article to see if they were being fairly reported. I came across an article about a study in Finland that in the article seemed to suggest that more woman who gave birth committed suicide than woman who had abortions (it suggested this by quoting raw statistics.) I suspected that this was misleading on the basis I realised that more pregnancies lead to birth than lead to abortion, so I decided to check the reference carefully. True enough, it appeared that a misleading inference had been given by quoting raw statistics than if the rate per 100,000 figures had been used, so I tried to improve the article by changing the statistics used, and then changing the quoted part of the conclusion to the actual summary of the conclusion. I thought that was fair, and yet my changes were quickly reverted - not in themselves changes but just outright reverted!

Is there really concensus on nall the contents of the article or have other with alternative points to add just been driven away?

I'll continue to watch this debate with interest. Cheers Fishiehelper2 (talk) 17:57, 10 January 2008 (UTC)

No, I don't think there's consensus on the article as a whole, and it could certainly use dramatic improvement. I hope you stick around and contribute; unfortunately, getting one's introduction to editing on a highly contentious article can be an off-putting experience. MastCell Talk 18:15, 10 January 2008 (UTC)
I haven't seen the particular reference you're referring to but if it has been used as you describe it would constitute original research and needs to be removed. Equazcion •✗/C • 18:41, 10 Jan 2008 (UTC)
Both sides have misquoted things out of context; however, changing statistics without mentioning it on the talk page looks like vandalism or POV pushing, which is probably why it was reverted. Try fixing it again now that we have a heads-up. Kuronue | Talk 02:24, 11 January 2008 (UTC)

"Feelings experienced after miscarriage or abortion"

What is the purpose of this section? If it's meant to list the proposed symptoms of post-abortion syndrome, then it needs to be retitled and reworded. If it's just a list of things that may happen to women psychologically following an abortion, then it needs to be removed. Equazcion •✗/C • 21:10, 10 Jan 2008 (UTC)

Ongoing misrepresentation

Regarding Nada Stotland's 1998 case discussion (PMID 9659865), which has been presented by User:Strider12 as Stotland "describing her surprise" at "discovering first-hand" the emotional harm of abortion ([1]), I've removed this as more of the same endemic misrepresentation of the literature by this editor, as described above. The case describes a woman who entered psychoanalysis after leaving a bad relationship and moving to a new and unfamiliar city; she did not require psychiatric care as a result of the abortion. In the context of two miscarriages, she developed a normal grief reaction during which she recalled an abortion which she'd had 10 years earlier. Subsequently she had 2 normal children and earned tenure in her faculty position; Stotland describes her last contact with the patient as "a combination of pep talk and revisited insight. Julia had a second baby. According to her Christmas cards, she is about to earn tenure and she is happy with her children, her husband, her work, and herself." This is hardly a pro-choice advocate being confronted first-hand with the psychological devastation of abortion and rethinking her deeply held beliefs - though Strider12 presents it as such. But let me close out by quoting the article itself a bit further (emphasis is mine):

It is not clear whether the abortion 10 years before would have become an issue had the patient not suffered the loss of two pregnancies during the analysis. It was not presented as a problem at the outset, nor would the analyst necessarily have identified it as a potential problem. It was not a focus of the analysis, nor was it found to be an etiologic factor in the patient's presenting symptoms. The unintended pregnancy and abortion themselves were more likely symptomatic of the patient's sense of abandonment.

This is hardly "surprise", or a "first-hand discovery" of the harms of abortion, or even testament to any sort of "post-abortion syndrome." I've therefore removed the reference as misleadingly presented and not topical to "post-abortion syndrome". MastCell Talk 22:45, 10 January 2008 (UTC)

Now you are clearly not only cherry picking but blanking what Stotland said and misleading those who have not read the article. It is certainly true that Stotland is not making a 180 degree turn to being against abortion. But she is certainly retreating from her prior statement that there is nothing at all to post-abortion reactions and admitting that reactions are more complex than she had originally thought. That the woman began to fare better AFTER intensive grief counseling in which the abortion issue was a major factor and cause of her emotional turmoil (triggered by the abortion) does not change the fact that Stotland herself observed and recognized that the subseqeunt miscarriage triggered latent, suppressed emotional problems stemming FROM THE ABORTION.
Tendatious deletions of material with false accusations that it is misleading are not constructive. The better course of action is to retain my contribution and add your own notes from the same source, noting for example that the woman fared better after counseling.
If the views of Stotland in this article are not noteworthy, neither is her JAMA commentary. If you want to include one, you should include both.--Strider12 (talk) 03:55, 11 January 2008 (UTC)
No. She did not "retreat" from any prior conclusions, as evident by the fact that her review article, published years later in 2003, reinforces the views you claim she "backed away from" (PMID 15985924). "Triggered by the abortion" is simply your false, whole-cloth spin of the article - as the quotes I provided above demonstrate, the abortion was "not found to be an etiologic factor in the patient's symptoms". You've gone from simply engaging in original synthesis to a pattern of actively misrepresenting the express statements found in the medical literature, and it's a disturbing development. MastCell Talk 05:19, 11 January 2008 (UTC)
See the excerpt below regarding what Stotland now preaches:
Stotland recommended that when doing an initial evaluation of a woman patient, psychiatrists should take a sexual history and include a question about previous pregnancies and outcomes.
"If a woman has had an abortion, ask about the circumstances surrounding her decision-whether she thought it through beforehand and talked about her experience with friends and/or relatives," Stotland advised.
The patient should also be asked whether she is comfortable with her decision and experience. "If not, ask whether she wants to work on unresolved issues. This can be accomplished by various means including a religious consultation and psychotherapy," she advised.
If she still believed there were NO mental health problems associated with abortion, why would she recommend screening for some key risk factors for negative reactions and even encourage ALL therapists to start inquiring about abortion history as an opening to "work on unresolved issues." If you've been reading studies by Reardon, Coleman, and Rue you will see that THEY are the ones who first started recommending this kind of intake and query to open discussion of "unresolved issues."
Instead of accusing me of misrepresentations just because I have more access to the literature than you do, you should do your homework and stop trying to portray me as a lier. Not everyone has as much access to these sources as you or I, so while many may believe your accusations who do not have access to the full sources, it is clearly true that while Stotland is still adamantly pro-choice and still believes abortion can be beneficial to women, she is no longer promoting the blanket denials that there are NO mental health risks associated with abortion. THAT is my point.--Strider12 (talk) 21:48, 11 January 2008 (UTC)
The point, however, is that a previous abortion could complicate future miscarriages and other problems, not that abortion itself causes problems. And this article isn't titled "potential mental health risks of abortion", it's entitled "post-abortion syndrome"; the above says nothing about the mysterious "illness" caused by abortion. Kuronue | Talk 22:24, 11 January 2008 (UTC)

Material that should be included

A few things to start:

1. PAS as proposed by Rue and the start of the political controversy over this term

In 1981 psychologist and trauma specialist Vincent Rue testified before Congress that he had treated women who had experienced traumatic reactions to abortion resulting in the same type of post-traumatic stress disorder he had treated in VietnNam Vets, with the exception that the stressor in this case was abortion rather than battlefield violence. He proposed the name "Post-Abortion Syndrome" (PAS)[1] and the term was soon picked up and used by abortion opponents to refer to any negative emotional reactions associated with abortion, not just PTSD as Rue had intended it.
Soon after giving this testimony, Rue was threatened with legal action by the general counsel the American Psychiatric Association if any notes he published making reference to the PTSD diagnosis for abortion did not include a specific disclaimer stating that the APA denies that there is "any clinical evidence for the basis of the diagnosis of ‘post-abortion syndrome."[2]

2. The expert opinion of Julius Fogel, certainly at least equal to Stotland's views as both are pro-choice psychiatrists.

In 1989 Dr. Julius Fogel, who is both a psychiatrist and an obstetrician who had performed over 20,000 abortions, affirmed that in his expert opinion abortion is psychologically traumatic:
Every woman--whatever her age, background or sexuality--has a trauma at destroying a pregnancy. A level of humanness is touched. This is a part of her own life. When she destroys a pregnancy, she is destroying herself. There is no way it can be innocuous. One is dealing with the life force. It is totally beside the point whether or not you think a life is there. You cannot deny that something is being created and that this creation is physically happening.... Often the trauma may sink into the unconscious and never surface in the woman's lifetime. But it is not as harmless and casual an event as many in the proabortion crowd insist. A psychological price is paid. It may be alienation; it may be a pushing away from human warmth, perhaps a hardening of the maternal instinct. Something happens on the deeper levels of a woman's consciousness when she destroys a pregnancy. I know that as a psychiatrist.[3]

3. Summary of the key issues by Gregory Wilmouth, editor of a special review of the literature and issues. (And also a pro-choice advocate.)

In 1992, the Journal of Social Issues dedicated an entire issue to research relating to the psychological effects of elective abortion. In an overview of the contributors papers the editor, Dr. Gregory Wilmoth, concluded: "There is now virtually no disagreement among researchers that some women experience negative psychological reactions postabortion. Instead the disagreement concerns the following: (1) The prevalence of women who have these experiences . . . , (2) The severity of these negative reactions . . . , (3) The definition of what severity of negative reactions constitutes a public health or mental health problem . . . , [and] (4) The classification of severe reactions . . . "[4]

4. The following section should be replaced as it is all well documented.

Reactions Associated With Abortion (removed section pasted from history)

Strider12, this is what the "history" section is for. There are archives of older versions of the article. There is no reason to put this into the talk page. The studies were deleted because of the interminable edit war anyways. миражinred (speak, my child...) 04:10, 11 January 2008 (UTC)
Two issues jump out. Number one is WP:BLP: this passage accuses the general counsel of the American Psychiatric Association of threatening legal action against Vincent Rue. The source for this conententious rumor/allegation is an appendix of an obscure book by a pro-life author put out by an even more obscure publisher. This simply does not meet the sourcing requirements given in WP:BLP, and it's highly questionable as a source even outside of BLP. Secondly, Strider12 has forfeited the right to be taken at her word with regard to sources, as a result of past gross misrepresentations and a habit of contextomy. Therefore, before accepting any source from her, we need to be able to see and verify the actual source, not just accept Strider12's summary of it. MastCell Talk 17:59, 11 January 2008 (UTC)
Absurd arguments. What objective third party source do you have that the author and publisher are unreliable? I could make the same complaint against any published book. And I have not never misrepresented anything. Your lack of civility in accusing me of such is, I believe, a violation of policy.
But that aside, I don't care if you take out the paragraph about the APA's response, but the fact tha Rue proposed the definition of PAS is appropriate, even necessary. The general belief that PAS means any type of abortion reaction is simply off base. And Rue at least deserves credit for stirring up this debate over the term.--Strider12 (talk) 21:32, 11 January 2008 (UTC)

Stubbing the article

I think this is a really good idea - in fact, I was considering doing it when User:Equazcion beat me to it. The article had turned into an unstructured and not-particularly-readable mess of quotes taken from various primary sources to stress one point or another. I think starting over from the intro (which is actually pretty good) is a good idea. The first step might be to compile a list of reliable secondary sources on the topic, beyond what we have so far, as these should form the basis of the article. Using secondary sources to guide coverage, rather than relying on individual editors' selected excerpts from the primary literature, might help us avoid some of the problems we've been encountering. MastCell Talk 17:52, 11 January 2008 (UTC)

This was actually not my intent in cutting down the article. I don't see any reason it needs to be expanded. All we need is a summary of the proposed syndrome and the stances of the various official medical/psychiatric organizations. I don't see the need for anything else. Equazcion •✗/C • 18:03, 11 Jan 2008 (UTC)
Ah, I misunderstood. Well, perhaps you're right. In any case, it looks better now than it did before. MastCell Talk 18:06, 11 January 2008 (UTC)


Is NOW really non-aligned?

I have made a few small changes that I though improved the article, and was off to chance the NOW link from the 'non-aligned' category to the 'pro-choice' category' when I realised that that may be a controversial move - so I'll raise the point here. NOW is clearly a pro-choice organisation that is actively involved in fighting against restictions on the right to an abortion. Can anyone think of an argument that would support it remaining as non-aligned? —Preceding unsigned comment added by Fishiehelper2 (talk • contribs) 19:44, 11 January 2008 (UTC)

Sorry I forgot to sign for myself! getting a link to NOW that illustrates my point: [http:/www.now.org/issues/abortion] —Preceding unsigned comment added by Fishiehelper2 (talk • contribs) 19:50, 11 January 2008 (UTC)

NOW Is definitely, unabashedly a pro-choice organization. No controversy there. But you are confusing the National Organization for Women with "Now," a PBS television news program with David Brancaccio . It's the latter that's used as a reference under "non-aligned" groups.--IronAngelAlice (talk) 19:55, 11 January 2008 (UTC)
Thanks for that! My mistake! Fishiehelper2 (talk) 20:02, 11 January 2008 (UTC)
Actually, when I first looked at the website I was thinking the same thing. I couldn't believe that NOW was listed as a non-aligned website. миражinred (speak, my child...) 20:19, 11 January 2008 (UTC)


Whether the NOW PBS program's report was biased is another question, as it clearly takes the same position on PAS as advocated by Planned Parenthood and NOW--namely that it is all a political contrivance.--Strider12 (talk) 21:22, 11 January 2008 (UTC)
Coincidentally, that happens to be the position "advocated" by the vast majority of the scientific, medical, and psychological communities as well. Presumably, PBS also takes the same position as Planned Parenthood on the question of whether the world is round or flat, but that's not evidence of pro-choice bias. MastCell Talk 22:51, 11 January 2008 (UTC)

Is shorter better?

I must say that while this current version is short on offering readers much substantative information, if for example they are looking for sources to get started on a research paper, it is at least far less biased than the previous long form.--21:19, 11 January 2008 (UTC)Strider12 (talk)

This is an encyclopedia article on a medical condition. Those don't normally include a list and details of each study that was conducted to determine the condition's existence or lack thereof. The purpose that list served, and the only reason the article became that way, was because the two sides kept feeling the need to present evidence to support their argument. We're not here to help students with research papers, although there are plenty of references and external sources here to get them going. Equazcion •✗/C • 21:48, 11 Jan 2008 (UTC)

I'm not disagreeing. Short avoids controversial edits and the need to balance, rebalance, or dispute the balance of the article. I would think, however, that one of the goals of Wikipedia is to give people more substantive articles. --Strider12 (talk) 22:00, 11 January 2008 (UTC)

That is one of the goals, but another of the goals is to decide which material is actually of substance, and "encyclopedic". A thorough article needs only to contain a description of the proposed condition and the official conclusions on its existence, not the series of studies by which those conclusions were arrived at. Equazcion •✗/C • 22:54, 11 Jan 2008 (UTC)
On the one hand, this isn't so much an article on a medical condition as an article on a purported diagnosis unrecognized by the medical/psychiatric community and propagated via predominantly political advocacy. In that context, it is perhaps relevant to talk in a bit more detail about the evidence for existence of this "syndrome" than it would be for, say, lupus. On the other hand, it may make more sense to broaden the article scope to abortion and mental health - while this opens Pandora's box for those inclined to disregard WP:WEIGHT and WP:SYN, it at least would align the article title with the research that has been done. MastCell Talk 22:57, 11 January 2008 (UTC)
Good point. This topic is different form other medical conditions in that regard. However I suggest everyone that's been involved up until now refrain from taking it upon themselves to expand the article. If it warrants expanding, let's leave it up to others. For obvious reasons. Equazcion •✗/C • 23:03, 11 Jan 2008 (UTC)

I like the shorter version a lot better also. миражinred (speak, my child...) 23:10, 11 January 2008 (UTC)

I'm happy to let it be for awhile in terms of expansion. When the APA's new position statement comes out, it will probably need to be updated, but I have no idea what it will say or exactly when it will be published. MastCell Talk 23:17, 11 January 2008 (UTC)
Agreed that subject is a bit different than other medical topics, however, this doesn't mean that expansion need go over the science of it (again, leading to the same problems) but should perhaps focus on new developments (per MastCell). I think the shorter version seems to have been a crowd-pleasing compromise - good work. Phyesalis (talk) 15:20, 12 January 2008 (UTC)

Sources don't supported statement

The article states: "Primarily a term used by pro-life advocates,[2][3][4]" but none of the sources report, much less provide evidence, that this term is mostly used by pro=life advocates. It appears that this is just a point in the intro where one or more editors have chosen to put three pro-choice articles as citations. In other words, I can find no quotes in the articles supporting the statement that PAS is "primarily a term used by pro-life advocates." They do all echo the charge that pro-life advocates have been particularly involved in raising public awareness of this proposed diagnosis in order to advance their political objective. But not that they are the ones who "primarily use the term." Should be rephrased, or just cut.--Strider12 (talk) 00:41, 15 January 2008 (UTC)--Strider12 --Strider12 (talk) 02:00, 15 January 2008 (UTC)

I agree - I can see no reason for this bit in the article. Fishiehelper2 (talk) 01:37, 15 January 2008 (UTC)
I'm not sure if any source explicitly states this, but do they need to? This doesn't seem like a controversial point. The term is primarily used by pro-life advocates -- none of the pro-choice or neutral media use the term except to describe the claims of pro-life sources. I don't see anyone else using the term. Is this point really debatable? Equazcion •✗/C • 14:00, 15 Jan 2008 (UTC)
If the point is not really debatable, why does the point require three references? Cheers Fishiehelper2 (talk) 22:56, 15 January 2008 (UTC)
There are three sources because it prevents the debatable point from becoming deleted. миражinred (speak, my child...) 23:44, 15 January 2008 (UTC)
If the point is self evidently true, which I assume it is, then there is no need for references to be cited. I think it is the use of the references that is causing the debate rather than the substance of the point. Maybe everyone would be happy to have the point made without supporting references? Fishiehelper2 (talk) 23:59, 15 January 2008 (UTC)
Well, first off, the lead section usually doesn't need to be cited. And "But it's true!" argument won't prevent anything in any articles from being deleted. It's not about what is true, but about verifiability. To back a controversial point, they must be backed by reliable sources, which they are. For more information, read WP:V. миражinred (speak, my child...) 00:05, 16 January 2008 (UTC)
True but there's a bit of SYN in that argument. If we're drawing a new conclusion based on the sum total of what we see in the cited references, but the conclusion itself is never actually stated in one of those references, that's certainly SYN. The counterpoint to that, though... is that the lead of any article is going to be a summary of source content, so SYN-y statements are often present. For instance if an article about planes has lots of different sections for different types of planes, and each section says "this type of plane is expensive", it's fine to sum that up in the lead as "planes are generally expensive". I think the statement can stay the way it is, its only saving graces being that it's in the lead and that it's not a debated point. If this point were specifically controversial then I would say it should go. Equazcion •✗/C • 02:54, 16 Jan 2008 (UTC)
I mostly object to the smuggling in of biased references. Also, it is certainly sufficient to simply state that the proposed diagnosis is controversial and is not in the DSM -- which implictly means it is not recognized by the APA, but I don't even mind underscoring that it is not recognized by the APA with the expanded sentence. To preface that it is not an accepted diagnosis with it is "Primarily used by pro-lifers" is padding that is intended to be dismissive. Do we bother to say that "only creationists believe in creationism" or "Evolution is a term mostly used by proponents of evolution," etc. Clearly, the proponents of PAS (which are not all prolifers, actually it is pro-choice advocates who have proposed the label PASS...see the pro-choice support group www.afterabortion.com) are the ones who use the term and opponents of the proposed diagnosis only use it to discuss their disagreemnt. That will be true of any disputed theory or label. Including this dismissive "mostly used by pro-lifers" plus the latter sections regarding the charge that it is used by pro-lifers political purposes is redundant loading. I see no problem with "Some physicians and pro-choice advocates have argued that attempts to popularize the term "post-abortion syndrome" are a tactic used by pro-life advocates for political purposes." Combined with, "it's not recognized in the DSM", that is sufficient to explain the controversy. --Strider12 (talk) 17:03, 17 January 2008 (UTC)
It is partially intended to be dismissive, but for good reason. If we leave it out, the lead would send the message that although PAS isn't officially recognized, it's still a commonly used term among everyone and generally is UNofficially recognized -- neither of which are so. The fact is (whether there is a source or not, but we do agree nevertheless) that PAS is a term used primarily by pro-lifers. Equazcion •✗/C • 17:10, 17 Jan 2008 (UTC)

Proposed edit to lead section, by Strider

Post-abortion syndrome (PAS), post-traumatic abortion syndrome and abortion trauma syndrome are terms proposed to describe cases of post-traumatic stress disorder which may be attributable to abortion.[5] [6][7] [8] Primarily a term used by pro-life advocates,[9][10][11] PAS is not a medically recognized syndrome;[12][13] PAS is not listed in the Diagnostic and Statistical Manual of Mental Disorders, and neither the American Psychological Association nor American Psychiatric Association recognize it. Some physicians and pro-choice advocates have argued that attempts to popularize the term "post-abortion syndrome" are a tactic used by pro-life advocates for political purposes.[13][14][15][16]

While some studies have shown a correlation between abortion and clinical depression, anxiety, suicidal behaviors, or adverse effects on women's sexual functions for a small number of women, these correlations may be explained by pre-existing social circumstances and emotional health.[17] According to the American Psychological Association, various factors, such as emotional attachment to the pregnancy, lack of support, and conservative views on abortion, may increase the likelihood of experiencing negative reactions. Studies have either failed to establish a causal relationship between abortion and negative psychological symptoms experienced by women, or been inconclusive.[18] On the other hand, a number of researchers have concluded that abortion has positive or neutral effects on women's psychological well-being.

This was an edit made by Strider which I reverted. The first couple of sentences alone seemed to be controversial; whether or not the cases involved post-traumatic stress is debatable, I think. Anyway, please discuss this here first. Equazcion •✗/C • 02:30, 17 Jan 2008 (UTC)

Looking again I really disagree with this version. "[PAS etc] are terms proposed to describe cases of post-traumatic stress disorder which may be attributable to abortion" seems to me as much more "ify" wording than what's there now. It's better to leave it more general -- PAS describes a set of psychological characteristics that are proposed to occur as a result of abortion. In other words: The term PAS isn't all that's being proposed, as this new version would imply -- but the connection between the symptoms and the abortion also, which is something this version seems to eliminate. Equazcion •✗/C • 02:49, 17 Jan 2008 (UTC)
I've read both versions several times and my gut feeling is that I could see merit in expanding the current version by adding in the point Strider is making - perhaps adding 'It is characterised by some as being a form of post-traumatic stress disorder that may be attributable to abortion' and references. Cheers Fishiehelper2 (talk) 10:23, 17 January 2008 (UTC)
The possible link to PTSD is worth mentioning so I gave this a shot, see the revised first sentence of the article. Equazcion •✗/C • 15:36, 17 Jan 2008 (UTC)


Here is what I proposed a month or two of course, but it got deleted.

Post-abortion syndrome (PAS), is a highly controversial term first proposed by psychologist Vincent Rue to describe a variant of post-traumatic stress disorder (PAS) where the stressor was a traumatic abortion.[19] The term "post-abortion syndrome", however, has been popularized by opponents of abortion in such a way that it is more generally understood to refer to any negative emotional or psychological reactions to abortion, not just traumatic symptoms.

As PAS, PASS, and "abortion trauma syndrome" are commonly understood to refer to any negative emotional reactions to abortion, it may be appropriate to EXPAND this article to addresses the issue of abortion and mental health in all respects, but it should be clear that this goes beyond the definition of PAS as proposed by Rue, investigated by researches, and defended by therapists who believe PAS deserves its own classification.

But such a broadening would move us back into the contentious arguments about what studies should be included and perhaps the need to examine both history and controversy surrounding questions related to abortion and mental health and the peer reviewed studies related to abortion and mental health.

If this article is really about PAS, it should be about PAS as a subset of PTSD--which is how it is actually proposed and defined. See Speckhard, A. & Rue, V. Postabortion Syndrome: An Emerging Public Health Concern Journal of Social Issues, Vol.48, No. 3, 1992, pp.95-119. Otherwise this article is nothing more than the setup of a strawman.--Strider12 (talk) 16:48, 17 January 2008 (UTC)

Do you have any evidence of the fact that this is how it's "commonly understood"? If all the research is based on its definition as a separate entity, then how can we say it's commonly understood as something different? Besides which, the word "syndrome" has its own definition, which doesn't fit with the common understanding you claim. Equazcion •✗/C • 16:53, 17 Jan 2008 (UTC)
I am extremely opposed to the inclusion of the phrase "post-traumatic abortion syndrome". PTSD is very specific, involving a perceived ontological threat (as in you think you're in danger in dying). What are the R and V sources we're using for this? Not one of the four cited sources mentions "Post-traumatic abortion syndrome", as far as I can tell. I'm going to remove this label from the lead.
Because it is not a recognized diagnosis, I would say that it is commonly understood as BS. And since PAS is BS, we should focus on the fact that it's not a legitimate phenomenon per the DSM and both APAs (not to mention the numerous studies outside of Pro-life political agendas that continue to find no reliable relationship.) Phyesalis (talk) 17:07, 17 January 2008 (UTC)
VERY BAD IDEA to bring up studies on this talk page :) But I do think a focus on the positions of official organizations is perfectly valid. If there's no source for the term you object to then remove it. I myself have never seen that term either, and anyone with a reliable source can re-insert it later. Equazcion •✗/C • 17:14, 17 Jan 2008 (UTC)
If you read Speckhard above, even just the abstract, you will see that it is ACTUALLY defined as abortion related PTSD. Period. That it is commonly understood to mean any negative emotional reactions to abortion is evident by the fact that in the long history of this article editors have tried to add sources and arguments regarding other emotional reactions, like depression, guilt, anxiety, etc....which are not part of the PTSD constellation of symptoms (not that PSTD patients may not also have these symptoms). Indeed, as I recall the NYT Magazine article by Bazelon, for example, doesn't even bother to give the definition of PAS proposed by Speckhard and Rue but goes on to discuss abortion and mental health in general terms.
Actually, I think it would be simpler if this article simply stuck to PAS as defined by Speckhard and Rue. But I think it impossible to keep it so narrowed. Nonetheless, it should give the proper definition and then, if necessary, move on to discuss broader abortion and mental health issues which popularly get bundled into the labels PAS, PASS, abortion trauma syndrome, etc.
I interpret Phyesalis's complaint to mean that he or she would rather tilt at a stawman labeled "BS" than actually have to discuss the real proposed diagnosis which has been carefully defined and researched. In fact, Brenda Major, a pro-choice researcher who opposes any public policy changes related to abortion and mental health, has herself reported that 1.4 percent of women in a sample she studies had PTSD related to their abortions. Read her abstract here: Psychological responses of women after first-trimester abortion. It is this sort of argument for excluding inconvenient, but verifiable facts, which makes this article so contentious. --Strider12 (talk) 17:21, 17 January 2008 (UTC)
If the definition were as you claim, "period", then the official organizations couldn't possibly denounce its existence, so regardless of how the term may have been originally defined, its meaning today is significantly different, period. Besides which, even the studies you've sourced in support of the counter-argument proceed from the basis of PAS being a separate entity. Equazcion •✗/C • 17:27, 17 Jan 2008 (UTC)
That the official organizations don't accept either (a) the need for a new term and/or (b) that abortion should be recognized as a cause of PTSD doesn't mean that they deny the right of Rue and Stotland to define a term that they (Rue and Stotland) invented. That research has been done to see if there is any validity to (b) demonstrates that the proposed theory that abortion and PTSD may be connected is a viable one, still being tested, still controversial, and still dismissed by many, but it is a proposal that continues to be studied and deserves, in my opinion, to at least be properly defined in a Wikipedia article.
Also, for what it is worth, to my knowledge only Stotland has ever used the term "abortion trauma syndrome" -- and she is an opponent of the PAS label (and therefore may refuse to use it). So "abortion trauma syndrome" is not used by pro-lifers at all. PAS is the term proponents use, or they talk about other abortion and mental health issues under accepted terms like depression, anxiety, substance abuse, etc. PAS is meant, as originally and currently defined by Rue, Speckhard, Burke and other psychologists who are proponents of the term, to refers to traumatic symptoms. Note, even Stotland use the word "trauma" in her label for this controversial issue. To therapists, "trauma" has more precise meaning than to many lay persons.--Strider12 (talk) 17:34, 17 January 2008 (UTC)

(undent)I think you might have misunderstood my post - I am opposed to the phrase "post-traumatic abortion syndrome" which I didn't see in the 4 sources cited. And of course it would be simpler if we just kept with Speckhard and Rue but this would be giving them WP:Undue weight. And Major's conclusion was 1% of women reported PTSD symptoms - this does not mean they have PTSD. But let's focus on the fact that she says:

" Prepregnancy history of depression was a risk factor for depression, lower self-esteem, and more negative abortion-specific outcomes 2 years postabortion. Younger age and having more children preabortion also predicted more negative abortion evaluations. CONCLUSIONS: Most women do not experience psychological problems or regret their abortion 2 years postabortion, but some do. Those who do tend to be women with a prior history of depression."

So it's not abortion, but pre-existing mental health issues. That's what the article should focus on - a) PAS is not a legitimate diagnosis and b) the confounding factor is pre-existing mental health issues, ergo, abortion is not causing anything but exacerbating conditions already present. Phyesalis (talk) 17:36, 17 January 2008 (UTC)

PS. Since "abortion trauma syndrome" is only used by one person, it doesn't deserve to be mentioned as an alternative term in this article, so I removed it. Equazcion •✗/C • 17:39, 17 Jan 2008 (UTC)

Major looked at very strict criteria for abortion related PTSD. That is why she reported a much lower incidence level than did the South Africa study, for example. Regardless, if only 1 percent or .01 percent of women have abortion related PTSD, this supports the observation and argument of Speckhard and Rue that some women may experience abortion as a traumatic experience, which they label (perhaps unwisely) PAS. This article is not about what the MAJORITY of women experience after an abortion, if anything, it is about PAS -- even if it occurs very rarely. The real contoversy is about how common negative abortion reactions are, not that they occur sometimes. But that point get lost in the hyperbole of both sides.--Strider12 (talk) 17:49, 17 January 2008 (UTC)

If that's the controversy, it belongs in other abortion articles. This article is about a separate syndrome which may or may not exist. "Does abortion carry significant potential for negative after-effects?" -- If this is the question you seek to address, this is not the place to do it. The possible negative effects of abortion, apart from a separate syndrome, belong in the abortion article. Equazcion •✗/C • 18:18, 17 Jan 2008 (UTC)

(edit conflict) A rate of PTSD of 1% after abortions is not evidence of a "post-abortion syndrome". As has been repeatedly pointed out, the background prevalence of PTSD in this age group is as high as 10%. Everyone agrees that a small number of women experience negative reactions to abortion. However, the consensus view is that these reactions generally occur in the context of other socioeconomic and psychological risk factors, and that abortion is not different from any other life stress (for instance, an unplanned pregnancy) as a potential trigger. The PAS people argue that women who would otherwise have been psychologically healthy do not just experience normal feelings of confusion or regret, but are pathologically scarred by abortion in particular; there is simply no real mainstream medical or psychiatric support for this claim.

More generally, PTSD is a somewhat generic term for a pathological reaction to any event perceived as traumatic. PTSD is well-documented after violent personal assault, kidnapping, military combat, natural and man-made disasters, severe motor vehicle accidents, diagnosis of a life-threatening illness, rape, incest, and childhood sexual abuse, among other triggers. Yet for some odd reason, no one has proposed a subdiagnosis of "post-car-accident syndrome", "post-incest syndrome", "post-rape syndrome", or "post-violent-assault syndrome". Why should abortion warrant a specific sub-diagnosis of PTSD? It's obviously not unique as a stressor, and the rate of PTSD after abortion is clearly far lower than after many of the traumatic experiences I've listed above. The answer is simple, obvious, and undeniable: abortion is singled out for its own "syndrome" because of the accompanying political battle. David Reardon says as much himself, and any thinking person realizes this. "Post-abortion syndrome" is a political tool. No one can reasonably argue that abortion is physicially harmful to women - the risk of death after abortion is about 14 times lower than the risk of dying in childbirth. So the argument is that abortion psychologically harms women. This is usually tightly coupled to political efforts to restrict access to abortion to protect women from these alleged psychological harms. See, for example, the Missouri ballot initiative that David Reardon is currently gathering signatures for.

The question of how to accurately and neutrally cover this issue is much simpler, though. Rather than wading through dozens of not-particularly-notable primary-source definitions and redefinitions of the term, we simply need to base the article on what reliable, independent secondary sources have to say. That's what is getting lost in the hyperbole. MastCell Talk 18:31, 17 January 2008 (UTC)

Now you're engaging in a lot of original research and argumentation. Major's study carefully avoided any background PTSD by assessing whether each and every symptom was attributable to the abortion rather than some other cause. The South Africa study looked at background rates of PTSD (prior to abortion) and found, if I recall correctly, about a 65% increase in number of women qualifying for all factors for a PTSD diagnosis within a few months after the abortion...and that too asked if women attributed their reactions to abortion.
Arguing about whether or not YOU feel it is credible is irrelevent. The point is that this article should describe what PAS was defined to be by its proponents and should include references to studies that have investigated it. Simply making this a place for highlighting secondary sources which deny it exists, and often don't even know that it is defined as PTSD, is POV pushing. I have no problem with all the references denying that it exists, but once again the verifiable sources which I provide are being "blanked" including both primary and secondary sources, even if I don't add any text! The efforts of some to deny readers any references to sources that actually define and describe PAS is is getting silly. --Strider12 (talk) 18:59, 17 January 2008 (UTC)
P.S. I agree with MastCell that there is not and never was a need for the term PAS, just as there is not a need for the term post-rape trauma synddrome. In my opinion, Rue should have just stuck with PTSD. But the term is out there now and this article is about that term, and therefore about PTSD and abortion. I don't see the point of the rant about Reardon. As far as I've seen, he doesn't use the term and hardly even discusses traumatic reactions. Probably because he isn't a trauma expert like Rue. Instead, most of his research deals with specific symptoms such as depression or anxiety.--Strider12 (talk) 19:07, 17 January 2008 (UTC)
Please supply the specific primary source you'd like us to use for the definition of PAS. Wikipedia is indeed a place for highlighting what independent, reliable secondary sources have to say about a topic. If you feel they've been "selectively" highlighted, simply supply an equally independent, reliable secondary source drawing a different conclusion and we can incorporate it. You selectively (mis)quote Major, again, whose study's conclusions were clearly evidence against the existence of anything resembling PAS. The 1% incidence of PTSD she reports was not attributable to solely abortion; she writes in the paper: "The design of this study does not permit determination of whether psychological distress reported by our participants after abortion was caused by the abortion or by other events (eg, divorce or job loss) that intervened between the abortion and subsequent assessments of distress." MastCell Talk 20:06, 17 January 2008 (UTC)
The Speckard Rue citation is one of the earliest to define PAS.
You continue to misrepresent the literature. In the quote you cite Major is discussing measures of "distress: in her study, not measures of abortion related PTSD. Those specific symptoms ARE closely measured in relation to abortion, and abortion alone. See p 779 of her paper in which the abortion specific PTSD instrument is described:
The presence of postabortion syndrome was assessed (T4) with a published measure of PTSD created for use with Vietnam War veterans29 that was adapted to make it specific to responses to the abortion. This measure assessed PTSD using diagnostic criteria set forth in the diagnostic manual of the DSM-III-R.30 Women were asked whether the abortion was persistently reexperienced (in dreams or flashbacks, for example); whether there was persistent avoidance of stimuli associated with the abortion (such as efforts to avoid feelings or thoughts associated with abortion); whether there was a numbing of general responsiveness that had not been present before the abortion; and whether there were persistent symptoms of increased arousal (such as difficulty falling asleep). If these symptoms occurred, women were asked whether they lasted more than 1 month. If so, women were classified as meeting the criteria for PTSD; otherwise, they were classified as not showing evidence of this syndrome.
In other words, her measures attempted to exclude all cases of PTSD that may be associated with other trauma. As PTSD is often related to multiple traumas, this does not mean that other traumas did not contribute to these cases, but it is clear that the measure was intended to identify only cases where abortion was also a contributing factor of the trauma. This narrow abortion specific questionnaire is why she reports PTSD levels below that of other researchers. Ironically, since avoidance behavior is a factor of PTSD, it is likely that many women experiencing PTSD are not aware or cannot articulate that abortion is the reason they are avoiding, for example, vacuum cleaners.--Strider12 (talk) 23:28, 17 January 2008 (UTC)

What's in a name?

I just reverted an attempt to change the term 'pro-life' to 'anti-abortion' - I really believe it is better if we can agree to use the terms 'pro-choice' and 'pro-life' than end up with the terms 'pro-abortion' and 'anti-abortion'. As I see it, almost all of us are pro-abortion in some circumstances anti-abortion in others - though people disagree greatly about where the balance should be. However, the terms 'pro-choice' and 'pro-life' do make clearer the key distinction between the two groups - whether the woman's choice should trump the interests of the fetus or whether the life of the fetus trumps the woman's right to choose. Also, the terms pro-choice and pro-life are the terms used by the two camps to describe themselves. Do others agree? Cheers Fishiehelper2 (talk) 19:21, 17 January 2008 (UTC)

Yes - this is one issue where there is actually something approaching a guideline, though I can't find the link right now. We generally use self-applied descriptors for these two camps, in the interest of balance - they should be "pro-choice" and "pro-life", rather than "anti"-anything. MastCell Talk 19:57, 17 January 2008 (UTC)
Agreed, this is the accepted terminology and there's no reason to deviate from that. Equazcion •✗/C • 19:58, 17 Jan 2008 (UTC)

Well, I was trying to apply a more global word. I don't know if "pro-life" translates across cultural lines. "Anti-abortion" is far more clear. Also, the opposite of "anti-abortion" is "abortion rights advocates." I do believe that "anti-abortion advocates" and "abortion rights advocates" are far more global and easily understandable than "pro-life" and "pro-choice" which are not terms used in Asia, for example.--IronAngelAlice (talk) 00:49, 18 January 2008 (UTC)

The Asians are reading the Asian language wikis, I think. For the English one, we should probably stick with the terminology most commonly used in the English-speaking world, which are pro-life/pro-choice, unless I'm mistaken there too. Regardless, if there is a question of which terms to use, that's not something to try and change here, 'cause there's a whole abortion debate with lots of other articles that are much more central to the issue, and they, to my knowledge, use life/choice. Perhaps bring this up centrally at the abortion article or wikiproject, if it's a real issue. Equazcion •✗/C • 06:40, 18 Jan 2008 (UTC)
I agree with Equazcion, this is not the place for that debate. I'd be interested in it over at Abortion, though. Phyesalis (talk) 09:58, 18 January 2008 (UTC)

Asia was only an example. The broader issue is not using the rhetoric of the "pro-life/pro-choice" debate.--IronAngelAlice (talk) 23:08, 18 January 2008 (UTC)

More Stubbing Needed?

I added three references that defined PAS and have measured PTSD after abortion, and have once again had them blanked. Instead, only a single article by Gomez is being allowed to stand in for what PAS is proposed to be, plus the assertion, which is not found in Gomez, that it is proposed "to occur in a small percentage of women" is added to even this one pro-PAS citation. Then no less than EIGHT citations are thrown in to hammer home the POV that this is all nonsense, essentially telling readers that they can ignore the Gomez cite. (By blanking the many other sources that discuss the proposed PAS and investigate PTSD symtpoms associated with abortion, the bias of those editors who keep blanking these sources is reinforced.)

It has been proposed that this article should be about PAS alone, as properly defined to be a form of PTSD associated with abortion as the trauma. That is probably a good idea. I suggest we cut the entire second paragraph, which is not about PAS or PTSD but a general ramble about abortion and mental health.

Secondly, we should put the EIGHT citations, and any others that people want to add, all under External Links, sorted under the appropriate categories.

I propose the article should then read as follows:

Post-abortion syndrome (PAS) is a controversial term proposed to describe cases of post-traumatic stress disorder arising from a traumatic abortion experience.(1 cite Speckhard, Rue) PAS is not recognized as a syndrome by either the American Psychological Association or the American Psychiatric Association, nor is it listed in [Diagnostic and Statistical Manual of Mental Disorders].(no cite needed) Some have argued that pro-life advocates are attempting to popularize the term "post-abortion syndrome" for political purposes.[one cite]

Based on comments by Equazcion, I think that is enough said. In my opinion, external links to all the articles for or against can then just be added below in a list without comment. Then, instead of arguing about the text, all we need to do is try to stop people from blanking references to outside sources, including the blanking of peer reviewed sources (which is especially troubling.

The first cite should be: Speckhard, A. & Rue, V. Postabortion Syndrome: An Emerging Public Health Concern Journal of Social Issues, Vol.48, No. 3, 1992, pp.95-119. I'd suggest for the second cite: Stotland NL (2003). "Abortion and psychiatric practice". J Psychiatr Pract 9 (2): 139–49.--Strider12 (talk) 23:37, 18 January 2008 (UTC)

I don't have a problem with including the Speckhard/Rue citation in the opening, where you had placed it. I can't figure out though - why doesn't it show up on PubMed? I'm able to find and read the article by going to the J Soc Issues website, but I can't pull it up by Rue or Speckhard's name on PubMed. I'd prefer a PubMed- or journal-based citation to one to speckhard.com. MastCell Talk 23:49, 18 January 2008 (UTC)
I think it's important to note that the "symptoms" only occur in a small percentage of women (like less than 1% per Gomez (?)). Also it isn't the term which is controversial, but the whole idea - the proposal conflates the two. And "traumatic abortion experience" - huh? It's not like those women who had pre-existing mental health issues and showed some "symptoms" had some unusually different abortion experience - what happened? Abortion clinic get bombed? Power outage in the middle of the procedure? This phrasing is POV implying that abortion is a "traumatic experience". Can't get on board with that. Phyesalis (talk) 00:32, 19 January 2008 (UTC)
Many psych and social science journals simply aren't indexed in PubMed.
Regarding "This phrasing is POV implying that abortion is a "traumatic experience"." My phrasing just reflects what Speckhard and Rue have defined their proposed diagnosis to be. I, and we, as editors are not saying "abortion IS a traumatic experience" we're saying that proponents of PAS have PROPOSED that abortion may be a traumatic experience which results in PTSD. That is the proposal. As you see, I stated what is proposed in one sentence and left in two sentences that (a) demonstrate that this proposal is not accepted by either APA, and (b) is considered to be a political tactic by some critics. How can that not be a fair, NPOV report?--Strider12 (talk) 00:37, 19 January 2008 (UTC)
J Soc Issues is PubMed-indexed - at least, some articles are (e.g. PMID 17073030). I'm not clear on why this particular article is not. Still, not a big deal, but let's use the journal-based website rather than speckhard.com. MastCell Talk 00:51, 19 January 2008 (UTC)