Talk:Dilation and evacuation/Archive 1

Archive 1

Amerocentrism?

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

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

NPOV links

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

A bit of a problem

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

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

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

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

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

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

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

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

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

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

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

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

1st trimester

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

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

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

Well this isn't a matter of ME being right and YOU being wrong, or vice versa. This is a POV conflict. Some sources say A and some sources say B. Therefore, we need to express that in the article. I would propose that we mention in the lead that the term D&E can sometimes be used synonymously with suction/vacuum aspiration, especially in UK, Aus. However, I believe that we should, like WebMD and Planned Parenthood, use this article to describe the 2nd tri abortion procedure. The other option I see, is to turn this page into a disambig page and then have an article like Dilation and evacuation (second trimester) or Dilation and evacuation (US). The option I do not feel works is obscuring the fact that in many contexts, D&E refers directly to a specific 2nd tri procedure. How do you think we should present the conflicting definitions of D&E?-Andrew c 17:50, 9 April 2007 (UTC)

Azslande reports that he lives in the U.S., so apparently the minority usage of D&E as a non-instrumental procedure is not restricted to the U.K. and Australia. (Unless he is referring to the second trimester procedure - he didn't say, and I just assumed first trimester because that's more common. Hm.) It is definitely a minority usage, though - would it work to just state that explicitly in the introduction? "...usually refers specifically to a second-trimester procedure, however a few sources use the term dilation and extraction to refer to a simpler first-trimester procedure." And then list the first trimester section last in the article?

To complicate matters further, whatever we do here, I'd like to also do at Dilation and curettage, since that term is also commonly used to refer to suction removal of uterine contents ("suction curettage" in contrast to "sharp curettage" that involves an actual curette). Lyrl ^Talk _C 22:11, 9 April 2007 (UTC)

I believe that the term, when used to include first trimester procedures, is used as a sort of umbrella term to include any procedure that involves dilating the cervix and then removing the contents of the uterus (often with vacuum aspiration). But the thing is, this use of D&E is inclusive of MVA and EVA, so the first trimester procedure of D&E isn't any different from MVA and EVA. Therefore, the wording "a few sources use the term D&E to refer to a simpler first-trimester procedure" may work better as "Some sources use the term D&E to refer more generally to any procedure that involves the processes of dilation and evacuation, which includes the first trimester procedures of MVA and EVA (or Suction-aspiration abortion)." However, I think including a section on the first trimester procedure may be confusing. I'd prefer to just have a link to an article on that more specific procedure, and note that some uses of EVA include the 2nd tri procedure discussed in this article, and the 1st tri procedures discussed in other articles.-Andrew c 22:23, 9 April 2007 (UTC)

Description of procedure

Severa just deleted a detailed description of the procedure in favor of a more general description on the grounds that one is from a legal document and the other is from Web MD. If a procedure is more accurately described in one source than another, the more complete description is preferable. The appeal to source is specious.

In light of Severa's revert, I am not sure why there is a separate "description" section at all. It does not state much that is not already stated in the lead.L.C. Porrello 00:43, 27 April 2007 (UTC)

See WP:RS, WP:V, and WP:CITE for more information on how sources are a very important consideration in adding information to an article. The WebMD source, "Dilation and evacuation (D&E) for abortion," provides a detailed description of the procedure, so why not expand the one in this article from there? We should rely mainly on primary medical sources, rather than sources that cite medical information secondhand, such as legal cases. Taking the description of D&E from Gonzales v. Carhart would be the equivalent of taking the description at Liposuction from a malpractice lawsuit. Also the "detailed description" added was copied verbatim from Gonzales v. Carhart so WP:COPY would apply. -Severa (!!!) 01:18, 27 April 2007 (UTC)

Good analogy. If the legal text from a case on liposuction were superior, it should be used in favor of an inferior text from a medical source.

Regarding copyright and the Gonzales v. Carhart opinion, I believe the text is public domain. Please correct me if I am mistaken.

I think your suggestion to expand the article from Web MD is excellent. I am not familiar with the copyright rules in that case. Can you please advise? L.C. Porrello 01:31, 27 April 2007 (UTC)

Whether a description is "inferior" or "superior" is, of course, a subjective judgment. However, it it is preferable to stick with medical sources, simply because the medical source is providing the information firsthand (i.e. it is a "primary source"), whereas any legal case would be citing the information secondhand (i.e. it is a "secondary source"). The rule of thumb to follow when summarising what is said in a source is to paraphrase, and not to rely too heavily on direct quotations, as this can often make an article more difficult to understand. -Severa (!!!) 03:55, 27 April 2007 (UTC)

I'm conflicted on how I feel about this matter. Expanding the section seems reasonable. I also believe citing medical sources is superior to quoting the court decision for a number of reasons. The court case dealt entirely with US doctors, where wikipedia is written to a world audience. I also do not believe that quoting so much text extensively is helpful. Kennedy wasn't writing an encyclopedia article, he was commenting on court testimony concerning federal law in a highly politicized Supreme Court case. There are some tone issues, and the differences between the procedures are gone into depth (we should probably establish in a more direct way the main elements common throughout the procedure, and perhaps discuss variations after that). In summary, while I think citing medical sources is superior, I do not object to citing the court decision on principle. I do think that we should cite more than one source, and we shouldn't simply delete the sourced material we already have and replace it entirely with long quotes from a highly politicized court case. If we use the court case as a source, we should use it to supplement what we already have, and then we should paraphrase and summarize instead of quoting. -Andrew c 13:57, 27 April 2007 (UTC)

Regarding the subjectivity of "superior" or "inferior," I think perhaps Severa was unintentionally too general. Firstly, the problem in assessing what is best for this article isn’t subjectivity. The problem is a lack of a clear idea of audience, voice, and intent. This is a problem throughout Wikipedia, especially in the pages on abortion related issues. Nevertheless, granted what we already see implied on these pages about audience, voice, and intent, it might be difficult to asses whether the SCOTUS’s Gonzales v. Carhart text is better or worse than the full Web MD text--but it is clear that the full text from SCOTUS or Web MD is far superior to what is currently presented. So while I agree with Andrew’s assessment on theoretical grounds, I disagree with Severa’s decision to replace a superior text with one that is clearly inferior, at the expense of the article, based solely on general and theoretical considerations. Since the SCOTUS text is public domain and superior to what is currently presented, I move that it be restored until a more comprehensive text, including the best from Web MD and, if needed, SCOTUS, can be included. Such a revision would include a high level of detail presented in a way that can be understood by the average layman.L.C. Porrello 16:43, 30 April 2007 (UTC)

Regarding the SCOTUS text: I think the paragraph on dilation could be mostly moved over to the cervical dilation article. Ferrylodge has been adding wikilinks to cervical dilation in a number of these abortion articles. While it currently has a hatnote that it's not about the surgical procedure, it would be a nice centralized place to have that information (as opposed to repeating it in each one of the articles IDX, D&E, D&C, and vacuum aspiration). I believe it would also tie in well with the article's current topic of childbirth - artificial prostaglandins like misoprostol are used in surgical dilation, as well as to induce labor, and natural prostaglandins are in semen - thus pelvic rest for women at risk for premature labor.

The second paragraph - I'm not convinced a play-by-play description of dismembering a fetus is more informative than "the fetus is separated into pieces, which are removed one at a time." The level of detail in this paragraph is in my opinion too high and is not consistent with other Wikipedia articles on surgical procedures, such as liposuction and coronary bypass surgery.

The last paragraph from the SCOTUS text, on feticide as part of the procedure, I think does need to be in this article. Lyrl ^Talk _C 02:06, 1 May 2007 (UTC)

I second your proposal to include the feticide text. Perhaps you can include it here first for everyone to take a look at.

Although I introduced the SCOTUS text, I am now not sure if a play by play of just medical facts is better either. I do, however, think the current description is inadequate, the SCOTUS text is superior, and a more descriptive text needs to be written and considered.L.C. Porrello 22:30, 1 May 2007 (UTC)

I have not had time to work on this, and tomorrow's not looking good either. By Saturday evening, at least, I plan on coming up with some suggestions. I don't mean to hold anyone else up from working on the article, if others have ideas. Lyrl ^Talk _C 02:23, 4 May 2007 (UTC)

Deleted controversy section

I deleted the "controversy" section because the "sources" it linked too did not seem relevant. It linked to a page describing the procedure, and the author of the section claimed that this page contradicted claims that the procedure involves tearing a fetus into pieces while it is still alive before removing it, when in fact I do not believe the page contradicted such a thing. "Removing large pieces of tissue" from the uterus is in my mind likely a euphemism for doing just such a thing. —Preceding unsigned comment added by Udqbpn (talk • contribs) 04:01, 13 July 2010 (UTC)

Pictures

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

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

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

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

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

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

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

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

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

The practice of including photos and illustrations in articles about medical procedures is a general practice across all of Wikipedia. It is universal. In other words, it is warranted by all of Wikipedia, not just a single article. If anything warrants debate it is why articles pertaining to abortion do not have pictures. The omission of pictures or illustrations demonstrates that this topic (and other abortion related topics?) are being dealt with differently from all other medically related topics in Wikipedia. And this suggests a grave violation of the NPOV rule.L.C. Porrello 22:35, 1 May 2007 (UTC)

Again, there are no high quality, neutral, encyclopedic images of this topic that have a free image license. Occasionally, we get people saying they can contact a pro-life group to see if they can release their images under the GFDL, but this brings up POV concerns. I'm again going to point out the image use policy "Do not upload shocking or explicit pictures, unless they have been approved by a consensus of editors for the relevant article" and that the existence of something else on wikipedia isn't necessarily the best argument to use. If you look at Talk:Clitoris, Talk:Vulva, Talk:Abu Ghraib torture and prisoner abuse, Talk:Fetus, Talk:Decapitation, Talk:Pregnancy etc you will see a history of debate concerning graphic and explicit images. Illustrations and images with labels seem more accepted than the more graphic images. Sometimes censored or partially censored images have been accepted. It really is a case by case thing, and given the consensus concerning images on Talk:Abortion and given our image use policy, any image is going to need community support before inclusion (not to mention again that free images of abortion are non-existent).-Andrew c 23:06, 1 May 2007 (UTC)

I’d have to disagree with your comment. A theoretical discussion is exactly what is needed. It is fine to speak of “assuming good faith,” and I think that people here do a pretty decent job considering how hot this topic is. Nevertheless, ignoring that there is a debate implicitly raging in these pages has become counterproductive.

I am not interested in uploading “shocking or explicit pictures.” I am interested in illustrations or photos that, granted a NPOV, will illuminate a procedure. And clinical accuracy and illustrative value is the only measure that should be used to decide whether to include a photo or illustration. If an illustration is clinically accurate, it deserves inclusion--regardless of whether some find it shocking. On the other hand, there is a lot of confusion on this subject in Wikipedia pages having to do with abortion. Just because pictures come from a pro-choice or pro-life source does not mean that they are not NPOV. Technical accuracy is the measure of NPOV, not source and not shock value.

Again, I believe that the general rejection of pictures itself reflects a POV bias. In this, it is the lack of pictures that is a violation of the NPOV rule. I would wager that 99 times out of 100 those who include images are pro-life and those who cry “non-NPOV” against those pictures are pro-choice. In some cases, they may be right. However, they cannot be right in all cases, and so what has happened is that the voices of those who are pro-choice are currently prevailing. This is contrary to the NPOV rule and spirit of Wikipedia.

To overcome the POV bias in the articles on abortion and prove good faith--which can not longer be assumed since all of the abortion articles are tainted by a pro-choice POV-- those who cry POV against the pictures or illustrations of abortion procedures presented here should need to detail why the pictures in question are tainted by POV or provide suitable pictures themselves. I can guarantee you that no pro-lifer will protest against clinically accurate illustrations of abortion procedures that come from a pro-choice source.

Both those who are pro-choice and those who are pro-life need to prove good faith. Pro-lifers mustn’t include picture only to shock and those who are pro-choice need to evaluate pictures or illustrations solely on their clinical accuracy and illustrative value.L.C. Porrello 00:28, 2 May 2007 (UTC)

I agree with a lot of your sentiment. Therefore, it is confusing when you say you disagree with me. Are you claiming that wikipedia no longer works by consensus, or were you disagreeing with something else I said that wasn't any image is going to need community support before inclusion ?-Andrew c 01:29, 2 May 2007 (UTC)

Sorry for the confusion, Andrew! The only part that I disagreed with was the comment that accompanied your post, that a theoretical discussion wouldn't be helpful. I am new to this topic, and I do respect your investment in it and the work you've done.L.C. Porrello 15:32, 2 May 2007 (UTC)

I have said more than once on the IDX page that I feel the line drawings by Jenny Westberg, published in Life Advocate in 1993 (that started the whole anti-PBA social movement) would be both aesthetically acceptable and of historical interest to the topic. No one has expressed an objection. But the drawings are, to my knowledge, under copyright by Ms. Westberg.

Cries of censorship with regard to pictures are not exclusive to the abortion articles: see Talk:Pre-ejaculate for an additional example to those Andrew c gave. So, is it the pro-life or the pro-choice side that objects to having an inline picture of a penis with pre-ejaculate fluid on it?

In the current political climate, most graphic abortion-related images are shown by the pro-life side. But in the days of campaigns to legalize abortion, graphic images of women who had died from illegal abortions - naked, lying in pools of their own blood - were shown by the pro-choice side. Even within the abortion debate, I'm not convinced editor's positions on images can be so easily drawn along pro-life/pro-choice lines.

I would support adding a non-graphic, clinically accurate, GFDL-compatible licensed image that adds to the educational content of this article. Lyrl ^Talk _C 01:51, 2 May 2007 (UTC)

I would guess that those who are pro-life might also generally object to graphic images of male genitalia and seminal fluid, but that clearly is not a pro-life v. pro-choice issue, and it would be misleading to suggest that it is. Nevertheless, if a reasonable case could be made that such an image would add to the educational content of an article and is not merely prurient, it should be included. Personally, I think such an image could be helpful. Seminal fluid is not too easy to describe.

It is exactly a “non-graphic, clinically accurate, GFDL-compatible licensed image that adds to the educational content of this article” that I would like to see. If we are all in agreement that where an illustration comes from is not important so long as it is clinically accurate and serves to provide clarity along the same lines as illustrations in other medical articles, I will try to find images.

In the “Controversy” section, I would not be opposed to juxtaposing graphic images of women who have died from illegal abortions against graphic images of aborted fetuses. Both speak very powerfully about how terribly difficult this issues is. My fear would be that readers would have trouble getting past the overwhelming emotive content to see the issues driving the deaths.L.C. Porrello 15:32, 2 May 2007 (UTC)

I think adding a cartoon picture of the procedure would be very appropriate for this section. If it looks disgusting or not, is irrelevant. — Preceding unsigned comment added by DrOliJ (talk • contribs) 12:29, 18 May 2013 (UTC)

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External links modified

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Contradiction

The article says "Under no circumstances is the fetus being dismembered alive," and then proceeds to describe a circumstance where the fetus IS dismembered alive: "In some countries where ultrasound guidance is not used, the prior step of removal of internal organs is not performed and the dismemberment occurs while the fetus is alive." The first statement should be qualified - perhaps "under no circumstances *in the US*". Unless of course the second statement is erroneous... it is after all unsourced. Since I don't know the answers I will leave the editing to someone else :) 114.198.116.58 (talk) 03:19, 29 April 2018 (UTC)

Updating reasons for D&E- epidemiology

The current article cites US abortion statistics from 2002. There is more updated epidemiology statistics from a 2015 CDC report. Specifically, of the roughly 630,000 abortions performed per year, 8.9% are performed in the second trimester (>13 weeks gestation) and with 7.6% between 14-20 weeks and 1.3% at >21 weeks gestation. I think this section should be updatedInquiryirl (talk) 01:32, 16 July 2019 (UTC)

Citation needed

Hi Inquiryirl you added this sentence The reason for D&E rather than the simpler DVC, Dilation and Vacuum Curettage, is that the fetal skeleton begins to calcify at 14 weeks and the fetus can not be removed by suction alone without adding the necessary citation. I have thus added a "citation needed" tag. When you add the citation, you can remove the tag. Thanks, Elysia (Wiki Ed) (talk) 21:34, 23 July 2019 (UTC)

Updates

Hello fellow Wikipedians, Regarding the cervical dilation section, I would like to add another citation from WHO, Clinical practice handbook for safe abortion, 2014, that supports using cervical preparation with osmotic dilators or medications in order to reduce risk and facilitate dilation. This will involve a minor edit to the first sentence of this section. I am new at adding citations and welcome feedback on this process. See my sandbox for more information.Purplemountain1 (talk) 00:52, 22 August 2019 (UTC)

As an update to the note above regarding adding the WHO citation--I am doing so today and see the first sentence of the cervical preparation section may be improved by changing it to "Prior to the procedure, cervical preparation with osmotic dilators or medications is recommended in order to reduce risk of complications and to facilitate cervical dilation during the procedure." I will add two references with this (WHO 2014 and Fox 2014). I believe this is an improvement as sometimes clinicians other than surgeons are involved in this part of D&E, and also cervical preparation reduces risk of injury (that risk is not eliminated, as the current text implies). Purplemountain1 (talk) 18:30, 28 August 2019 (UTC)

Risks

Hello Fellow Wikepedians, I would like to add the following under the Risk section:

Complication rates after D&E are similar to or lower than those associated with medical abortion after 13 weeks, though few studies exist comparing the two approaches. In certain clinical scenarios--severe anemia, for example-- D&E may be preferred over medical abortion.

I'm aware that Sonalkar 2017 reference is a primary source and I'm looking for other more updated reviews/secondary sources. Purplemountain1 (talk) 18:34, 22 August 2019 (UTC)

On further reflection, I think this information regarding comparing D&E to medical abortion is better situated under the "alternatives" section and I'll put it in there.Purplemountain1 (talk) 21:06, 28 August 2019 (UTC)

References

Surgical procedure

Hello fellow Wikipedians, I would like to add the following content to the procedure section: Generally, the procedure takes less than half an hour.(Hammond 2009). This is a review article. --Purplemountain1 (talk) 14:20, 10 October 2019 (UTC)

Recovery

Dear Fellow Wikipedians, I plan to add a reference and a bit of additional content as follows: Generally, the woman may return to work the following day.(Hammond 2009)--Purplemountain1 (talk) 14:29, 10 October 2019 (UTC)