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Abortion Start‑class

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Conception vs. fertilization

To me, these two words are synonyms, and when editing relevent articles (such as this one) I try to use both words to avoid repeating the same word over and over again. But all of my edits have been changed to use 'fertilization' exclusively, never mentioning 'conception' in the article. Any ideas why? Lyrl 15:32, 10 June 2006 (UTC)

First of all, the article is Fertilisation. Conception redirects there. But second of all, there has been an effort by the ACOG to define "conception" at implantation. TO avoid confusion, I personally use Fertilisation if I am talking about the union of a sperm and egg. However, I am not the one who changed your edits so I cannot speak for them.--Andrew c 23:22, 10 June 2006 (UTC)

I am, but Andrew speaks for me on this matter. Al 23:28, 10 June 2006 (UTC)

Thanks for the clarification re:ACOG. On spelling, the 'z' spelling gets 18 million hits on Google. The 's' spelling gets only 3 million hits. The Misplaced Pages article indicates that both spellings are acceptable, but that the 'z' spelling is more widely used. Lyrl 01:13, 11 June 2006 (UTC)

In regards to spelling, its a matter of British English vs. American English. The normal convention is to pick one and use it consistently throughout the article. I personally think it is a hassle to have to add excessive code in order to avoid a redirect and get the spelling correct, by typing ], so I just stick with the Brittish spelling for ease. I bet there is a big discussion about the spelling over at that talk page.--Andrew c 23:19, 11 June 2006 (UTC)

Yes and I should add that Google results are frequently criticised for establishing prominence of a term. They only reflect internet usage and are therefore biased to Americans and especially not reflective of Indians and others who use English in less developed countries Nil Einne 12:02, 17 June 2006 (UTC)

Established pregnancy?

The edit refers to "established pregnancy" as a medical term, but it's not one I'm familiar with. In one location, it seems to be used synonomously with implanted pregnancy (replaced the phrase 'detectable pregnancy'), while in the other location it seems to mean a pregnancy further along (discounting early pregnancy losses). Does anyone have a link to a definition? Lyrl 01:20, 13 June 2006 (UTC)

The phrase apparently comes from a political document, not a medical dictionary. A few years ago the AMA House of Delegates passed, by majority vote, a resolution from the "Medical Student Section" opposing the FDA Director's decision not to approve over-the-counter access to "Plan B" (the so-called morning-after pill). The resolution included this paragraph:

Whereas, The Plan B pill is a post-coital contraception method which transiently provides a high dose of (1) combined estrogen and progestin or (2) progestin-only to inhibit or delay ovulation--or induce minor changes to the endometrium to inhibit ovum implantation; therefore, it cannot terminate an established pregnancy;

The undue weight given that resolution in this article is presumably motivated by the support it gives to the POV which pervades this article.NCdave (talk) 23:04, 4 February 2008 (UTC)

BTW, does anyone know what the vote was by which Resolution 443 passed? I know it was not unanimous, because I know that it was opposed by the American Academy of Family Physicians. If the fact that it passed is noteworthy, then surely the margin is, too.

It also seems to me that if we are to include a political resolution in favor of that position, we should also include resolutions taking the opposite view. NCdave (talk) 23:14, 4 February 2008 (UTC)

Breastfeeding as abortion

Some anti-abortion groups acknowledge the postfertilization effect of breastfeeding, but defend it based on the bioethical principle of double effect. Use of hormonal contraceptives, including EC, is usually motivated by an intention to avoid pregnancy - when one of the proposed mechanisms operates after fertilization, they consider these methods immoral. Breastfeeding is motivated by - and has the primary effect of - nourishing a child. Because the intention is presumably not related to avoiding pregnancy, they do not consider immoral any secondary, or double, effect of harm done to unimplanted embryos.

The way I see it, these groups must therefore agree that breastfeeding can cause abortions (under their view) but it's acceptable because it's a secondary effect and not part of the primary purpose. And I guess this means that any woman who continues breastfeeding to avoid pregnancy is as bad as someone who uses EC etc... I'm not suggesting we include the later but I do think we need to mention that they accept that breastfeeding can cause abortions assuming it's the case which it must be Nil Einne 12:18, 17 June 2006 (UTC)

I question that any woman would breastfeed primarily as a method of birth control. Breastfeeding is painful for the first several weeks as the nipples toughen up. Infants generally feed for 20-45 minutes at a time, with 1.5-2 hours between the starts of feedings, including at night. That means mothers of newborns can have an infant latched on for up to 12 hours out of every day. And if extended breastfeeding is practiced (in the U.S., anything over a year, although the WHO defines it as anything over two years), the challenges of breastfeeding a toddler also make breastfeeding probably the most inconvenient form of birth control ever. I just cannot see any woman going through that unless their primary motivation was to provide the best nourishment possible for their child. Lyrl 13:46, 17 June 2006 (UTC)

As OR, I know of at least one such case. As it happens, it was unsuccessful; she got pregnant within the year. Al 15:13, 17 June 2006 (UTC)

I'm confused, are people arguing that the Lactational Amenorrhea Method doesn't exist? Or that it doesn't work? Or that no one practices it? or what.... (perhaps we could find a way to wikilink to LAM)--Andrew c 15:19, 17 June 2006 (UTC)

The argument: Is a woman's only or primary reason for breastfeeding ever birth control?

I'm arguing that a woman would not breastfeed unless her primary reason was to feed the child. Most women only use LAM as birth control if they were going to breastfeed anyway. While I can see help in avoiding pregnancy as being one of several factors that makes a woman choose to breastfeed, I just can't see it being the factor. Lyrl 19:11, 17 June 2006 (UTC)

Recent edit warring: I personally think the previous version was better than the recent edits that changed the title. This article is about the beginning of pregnancy controversy, and the only reason breastfeeding infertility is mentioned is because one of the definitions of pregnancy would thereby define LAM as abortion. Also, a fact tag was recently placed on something that seems like common sense. Could that tag be further explained please? Is this citation (last paragraph) ok to add to the article if it really is needed? NYT Magazine--Andrew c 00:06, 21 June 2006 (UTC)

Changes to breastfeeding section

The topic of the section is not breastfeeding infertility. The topic is the controversy over whether breastfeeding can cause abortions. A more accurate description than "breastfeeding infertility" is needed.

What definition is being tagged as unsourced? That pregnancy is sometimes defined as beginning at fertilization? That's the main topic of this article and is well-sourced in the "Definitions" section. That abortion is often defined as ending a pregnancy? A define:abortion search on Google shows that six of the seven top hits have "termination of pregnancy" or "loss of pregnancy" as part of the definition.

Or is it the connection between the definition of pregnancy, the definition of abortion, and the conclusion that breastfeeding is abortifacient? The cite later in the breastfeeding section says so: On page 63 of the 5th edition of "Does the Birth Control Pill Cause Abortions," you mention a physician as stating that breastfeeding can cause abortions. This site also draws the connection: if the emergency contraception pill causes abortions by blocking implantation, then by the same definition breast feeding may as well. As does this one: So, if emergency contraception is an abortifacient, so is breast feeding.

I would be happy to add one or more of these sources to the article if it is clarified for me what is being questioned. Lyrl 00:12, 21 June 2006 (UTC)

I think the entire section needs work, currently reading as if breastfeeding is a common cause of abortion. It needs to downplay this, as breastfeeding stops ovulation and it is not often that fertilisation occurs. It is also confusingly worded, saying that, if pregnancy is defined by implantation, then not implanting is abortion - surely this should be if pregnancy is defined by fertilisation. The section after (Affected birth control methods) deals with this better, and I would question the need for a seperate section on breastfeeding.

I don't think the article correctly establishes the arguments about the classification of methods as contraceptives or abortifacients. It should be explicitly stated that if this definition of the start is used then these types of birth control methods are seen as abortive. I'm going to try a slight reorganisation which I hope will fix this. violet/riga (t) 19:41, 21 June 2006 (UTC)

Concerns about "Ethics of Preventing Pregnancy"

I read the article up until the "Ethics of preventing Pregnancy" point, and found most of it really good, however in this section there are a couple of phrases which I don't like and one which I don't even underestand.

I'll start with the one I don't understand, "The intention of a woman to prevent pregnancy is an important factor in whether or not the act of contraception is seen as abortive by some pro-life groups." What exactly does this mean, I read it a few times and it still confuses me. Please can someone rephrase it or explain it here?

Now to the bits that bother me. "Some pro-choice groups have expressed concern that the movement to recognize hormonal contraceptives as abortifacient will also cause breastfeeding to be considered an abortion method." Have expressed concern? They are trying to trip people up saying "well if this is abortive so is THIS! What do you think about that". Of course that might not be the best thing to say, but "express concern" come on...

Chooserr 16:25, 23 July 2006 (UTC)

Breastfeeding prevents embryos from implanting. However, women who breastfeed do not intentionally prevent those embryos from implanting - it is a side effect of feeding their child. The intention of the woman (feeding her child) makes the embryo death associated with breastfeeding moral. But the exact same effect (preventing embryos from implanting) is, according to these groups, immoral if caused by the Pill - because the woman is intending to prevent pregnancy.

Does that help? Lyrl _Contribs 18:01, 23 July 2006 (UTC)

history of the controversy of beginning of pregnancy

...how come there's no mention of it? are there any objections to adding a few sentences about "quickening" and how human chorionic gonadotropin testing changed the definition of the beginning in human understanding? (it would be sort of a mini history of the pregnancy test, i guess...i think it's interesting in particular that it was not possible to medically confirm pregnancy before 7wks gestation until mid 1970s...) Cindery 16:51, 6 September 2006 (UTC)

I think that is a very good idea. This article was created because the debate was taking up too much space on the abortaficent and EC articles. I still feel this article needs work, and giving background and historical information is one step towards improving it. --Andrew c 22:16, 6 September 2006 (UTC)

References

I am reverting the last edit by Andrew c to the last version by me though I have no intention of violating the 3R rule.

Reasons: 1. Some of the references are not really references at all and haven't contributed in any way to the content of the article. As such shouldn't they be in a separate external links section? Andrew c's seems to have missed the point behind my change. As he says, " websites can be used as references". And I agree with him. My issue is that they are being used as references even though they aren't.

2. Also, even if they can indeed be shown to be acceptable references, reverting is a blunt tool and wiped out other changes I made to the article. Poweroid 16:54, 8 September 2006 (UTC)

1. If you remove references, you need to put a fact tag after the claims because now the claims are not cited. The first footnote is helpful, while not exactly a reference, it is an example the debate in the format of a medical journal. Instead of removing the note, I'd suggestion prefacing it with the words "For example..." The second and third links are references for a hospital and a medical company supporting the LMP gestational age counting. If we can keep the reference for doctors supporting the statement, I don't see why the hospital and medical company needs to go (if anything, combine the 3 different sources into one footnote). Finally, the 4th footnote that was removed is a clear citation of a pro-life organization considering EC to be an abortion. If we remove that note, we no longer have a verifiable source on this view. I still support including these footnotes as they were. However, I'd be interested in hearing counter arguments, and views from other editors.

2. I understand that reverting can remove helpful and neutral changes, and I apologize if I removed helpful content. However, your wikilink the terms contraceptives and menstruation isn't helpful because the first is a redirect to birth control, which is already linked to in the same sentence (menstruation is a redirect to Menstrual cycle, so adding brackets around the term is less prefered than to creating a soft redirect by typing ]). However, I will try to be mindful of removing helpful content in the future when doing reverts. I apologize if my revert came off as too aggressive. I hope we can work these matters out! (and I too have no intention of edit warring or coming close to the 3RR rule). --Andrew c 17:15, 8 September 2006 (UTC)

Hmm. Helpful points Andrew. OK, let me edit again to take account of your comments above and see if you approve. Poweroid 17:54, 8 September 2006 (UTC)

Instead of keeping the reference for doctors and adding the references to hospital and medical company I'd have preferred to remove all three references. However I have, in fact, restored the two I deleted.

With respect the pro-life group I don't have any pro-life or pro-choice agenda but just didn't think that it merited being quoted as a reference rather than just where I've got it now, in external links. I'm open to other editors' views.

I've taken your advice on the wikified links and have reversed my original edit + modified the menstuation one. Poweroid 18:20, 8 September 2006 (UTC)

Statements in Misplaced Pages articles, especially if they are possibly controversial, need cites - proof that Wikpedia editors are not just making this stuff up.

The statement "professionals have debated the issue in medical journals" needs to be supported by proof. A citation to such a debate provides support for the statement.

The statement "Use of these drugs... is seen by some pro-life groups as immoral... because of the possibility of causing what they believe to be an abortion." also needs support. A citation to a pro-life group stating that oral contraceptive pills cause abortions provides support for the statement.

Renaming the citation section to "footnotes" or something may be more accurate, but the main issue is that Misplaced Pages articles need to be verifiable. The citations that have been removed have hurt the verifiability of this article by disconnecting statements in the article with the specific sources that support them. Lyrl _Contribs 22:30, 8 September 2006 (UTC)

I noticed there is a site about pregnancy symptoms in the external links section. How is that relevant to the article topic? Lyrl _Contribs 22:34, 8 September 2006 (UTC)

I've just noticed you've changed the references all back to pretty much how they were before I edited the article at all. And it's probably how Andrew would prefer it too. To me it looks all screwed up and, unlike other articles, has references all over the place even when they are more appropriate in External Links. I'm not into edit wars but when I get a chance to read up some more on what constitutes valid references - and do some more research into how references are used in other articles - I'll be back with a more persuasive argument. Poweroid 12:56, 11 September 2006 (UTC)

External links are for general information on a topic. If the validity of a specific sentence or paragraph is being supported, that's when references/footnotes are used. My concern on removing the current footnote system is that it destroys the connection between the specific sentences/paragraphs and the evidence used to support them. This makes the article more difficult for a reader to independently verify. At least, that's my understanding of it. Lyrl _Contribs 22:36, 11 September 2006 (UTC)

Origin of controversy

I believe the source used "American College of Obstetricians and Gynecologists Terminology Bulletin. Terms Used in Reference to the Fetus. No. 1. Philadelphia: Davis, September, 1965." is questionable. Searching google for "American College of Obstetricians and Gynecologists Terminology Bulletin" gets one hit, a pro-life page. Searching google for "Terms Used in Reference to the Fetus" gets 48 hits, also pro-life sites. Does Ferrylodge have a copy of this source, or is the actually source a secondary source which is claiming to use this ACOG Bulletin? I think the best thing would be to find a good, reliable source (not a pro-choice/life site) that explains the history of the controversy, and site them instead. I'm not sure if such a source exists though.-Andrew c 01:31, 23 January 2007 (UTC)

The citation I used is from a congressional hearing record. See here. Is more needed?Ferrylodge 01:35, 23 January 2007 (UTC)

Well you should accurately cite where your information comes from. I'll look into this further, but if you get a chance, it'd be nice if you could replace the citation with the hearing citation.-Andrew c 02:04, 23 January 2007 (UTC)

I've expanded the footnote.Ferrylodge 02:18, 23 January 2007 (UTC)

Just in case you were curious Misplaced Pages:Citing_sources#Say_where_you_got_it. And I can't figure out how to view the text in the Senate Hearing that is referencing this Bulletin. Any suggestions? Thanks again.-Andrew c 02:24, 23 January 2007 (UTC)

Thanks for the info. I'm not sure you can view the Senate hearing online. One approach would be to go to the link I provided, and click on "Find Libraries", then input your zip code.Ferrylodge 02:40, 23 January 2007 (UTC)

According to aTime article, the "Human Life Bill" was a bill proposed by Jesse Helms in 1981, which was designed to "statutorily establish the beginning of human life at conception." The article Congressional hearing states:

" hearings provide a forum where facts and opinions can be presented from witnesses with varied backgrounds, including Members of Congress and other government officials, interest groups, and academics, as well as citizens likely to be directly or indirectly affected by the proposal."

We really cannot ascertain from the tiny snippet of the document offered by the Google Books search who provided the testimony regarding ACOG or in what context they did so. But, even so, their citation of the ACOG Bulletin is an example of a secondary source, which really is not sufficient to support the claims in the "How the Controversy Began" section. We would need to refer to the original ACOG Bulletin. -Severa (!!!) 14:20, 24 January 2007 (UTC)

I quoted directly from the original ACOG bulletin. I only mentioned the Senate hearing to help confirm for Andrew c. the authenticity of the original ACOG bulletin. If you would like to obtain a copy of the Bulletin, feel free to call ACOG at 202-863-2518.Ferrylodge 14:46, 24 January 2007 (UTC)

You quote one line from the Bulletin "Conception is the implantation of a fertilized ovum." Everything else seems to be personal commentary/OR. I could do the same thing.

Traditionally, pregnancy was defined as beginning with fertilization. However, with advances is medical knowledge things began to change. In 1959, Min Chueh Chang's successfully performed IVF in rabbits. The scientific consensus was beginning to recognize how imprecise the traditional definition was. Test tubes did not become pregnant, even though they contained fertilized eggs. With a greater understanding of the female reproductive system, coupled with technological advances in IVF and birth control, it was becoming gradually clear to the scientific community that pregnancy began when a fertilized egg was implanted on the uterus wall. This is exemplified when the ACOG announced in 1965 that "Conception is the implantation of a fertilized ovum." This change however is sometimes criticized in the abortion debate arena by those who personally believe human life begins at fertilization.

Of course this is over the top, and I would never suggest it be part of the article. I do think we should cut down on the editorializing in the current version, and perhaps find a neutral, reliable source that summarized the change, because right now all we have sourced is a single sentence from the Bulletin.-Andrew c 17:50, 24 January 2007 (UTC)

The Bulletin is available to the public. Do I have to get you a copy?Ferrylodge 17:53, 24 January 2007 (UTC)

I'm in agreement with Andrew c that quoting a single line from the ACOG document is not a "direct quotation." "Conception is the implantation of a fertilized ovum" seems to be the only bit of the Terminology Bulletin anyone feels like quoting. The current version is especially problematic given the fact that it makes the unsourced, speculatory assertation that the issuing of the bulletin by ACOG was motivated by political ends. It might have just as well been that the bulletin was an attempt to refine to the definition of pregnancy to bring it into alignment with the new scientific evidence from the IVF experiments. The simple fact is that we don't have a reliable source to back up an assertation that there was an underlying motive either way, and, thus, including the suggestion in the article is counter to WP:V, WP:NOR, and WP:NPOV. It should thus be removed.

As an aside, there wasn't a single return for in a PubMed search for an "ACOG Terminology Bulletin," although there were some for "ACOG Practice Bulletins" and "ACOG Technical Bulletins" . -Severa (!!!) 19:09, 24 January 2007 (UTC)

Ferrylodge, I'm not sure if you got a chance to read Misplaced Pages:Citing_sources#Say_where_you_got_it yet. You need to cite The Human Life Bill. Just because they are citing other sources does not mean you can bypass the middle man.-Andrew c 02:31, 25 January 2007 (UTC)

Hi andrew c., I did look at that link. Footnote 8 mentions the Human Life Bill. Did you take a look at footnote 8? Is that not adequate?Ferrylodge 02:38, 25 January 2007 (UTC)

Are we consulting the original sources (i.e. hardbound medical textbooks c. 1972) on Boving, etc. in writing this? Because "borrowing" the information and citations from secondary sources really wouldn't be sufficient. Successive dependence on secondary sourcing tends to work like a telephone game. -Severa (!!!) 03:44, 25 January 2007 (UTC)

Yes, I am consulting original sources. Also, I am trying to find online links as best I can so people can verify the authenticity themselves, without having to go to the library like I had to do today. Please note the biographic information I inserted into the footnote about Dr. Biggers. This guy was extremely reputable, and he OPPOSED the bill that Severa has so diligently attributed to Senator Helms.Ferrylodge 03:59, 25 January 2007 (UTC)

Alright. Thanks for clearing that up. I appreciate that you actually went out of your way to go to the library. -Severa (!!!) 04:10, 25 January 2007 (UTC)

Yeah, and I had to mess with microfiche. It was painful.Ferrylodge 04:17, 25 January 2007 (UTC)

Langman's Medical Embryology

I believe the way that this is referenced is misleading (I tried to change the wording to be more accurate, but I feel it shouldn't be there). Langman's doesn't go out and give a straight forward definition of pregnancy. The citation mentions how gestational age is counted. It mentions Last Normal Menstrual Period (LNMP) (roughly a 40 week pregnancy) and it mentions counting from fertilization (roughly a 38 week pregnancy). It chooses to count from fertilization. This doesn't mean that they are defining pregnancy as starting at fertilization. This is a book on Embryology, and of course part of embryo development occurs during fertilization. No one is arguing that an embryo magically starts to develop at implantation. The focus of Langman's is the embryo, so it isn't strange at all that they start counting at fertilization. The focus is NOT on the woman, or pregnancy in general. On top of that, on page 41 they discuss contraception. They mention IUDs, oral hormonal contraception, and mifepristone (among others). They say that the pill works be preventing ovulation, they say it isn't clear that IUDs prevent fertilization or implantation, but they clearly consider IUDs contraception, and they say the mifepristone is an abortifacients . Judging by this, it is clear that Langman's does not support the arguments put forth in this article that certain forms of controversial BC are abortifacients. So a) they never say that pregnancy starts at fertilization (they say embryo development starts then) and b) they clearly say that IUDs, while possibly preventing implantation are not abortifacients. I'd propose removing that sentence, and possibly finding another medical text to replace it (if one exists).-Andrew c 00:11, 26 January 2007 (UTC)

Beginning of the Controversy

The first sentence under the Beginning of the Controversy section, states that the word "conception" has been used in reference to the beginning of pregnancy long before the discovery of fertilization, however, when clicking on the fertilization article, it says that it is also known as conception (which is a bit confusing). Also the reference to what most dictionaries said by the 1960s is misleading, because I think it implies, at least indirectly, that that has always been the definition of pregnancy. Just my thoughts on the matter, Chooserr 02:22, 26 January 2007 (UTC)

I suppose it would be good for Misplaced Pages to somewhere state when fertilization was discovered, by whom, and what the definition of "conception" was prior to that. I'll look into it.Ferrylodge 02:39, 26 January 2007 (UTC)

4-March-2007 edits

• I broke up the one long sentence in the introduction into two sentences for easier readability.
• I changed "are considered" to "might be" abortifacient, since most of the proposed post-fertilization mechanisms have not been proven.
• I added a wikilink to the fertilisation article (which uses the British spelling)
• I re-added the modern dictionary definition "from conception until birth" that had been moved from the "Definition" section to the history section.
• I removed the commentary on how implantation "makes more sense" out of the "Definition" section and back into the "detectable pregnancy" section where it is more obviously commentary and not a definition.
• In the history section ("beginning of the controversy") I changed "more generally" to "originally" and removed the tangent about contemporary definitions.
• I renamed "Claims of abortion" to "Birth control - mechanism of action" which I believe is more descriptive - the section is mainly describing how birth control works. I also did a copyedit on the first paragraph in this section.
• I changed "Birth control methods that are alleged to be abortions" back to "Possibly affected birth control methods" for two reasons:
  • "Possibly affected..." is shorter
  • Whether or not one defines pregnancy at implanation, these methods are still "possibly affected" by having postfertilization mechanisms. I believe focusing attention on the question of the existence of postfertilization mechanisms (with the "possibly affected..." title) is better than focusing attention on the morality of preventing implantation (with the "...alleged to be abortions" title).
• I re-added the deleted section on the ethics of preventing implantation. I don't understand why it was deleted.
• I deleted "acting as an early sign that a pregnancy may occur" from the paragraph on EPF - it implicitly defines pregnancy as beginning at implantation. NPOV dictates that this article only describe the different definitions, not offer statements (either explicit or implicit) about which definition is correct.
• I removed the qualifier "fertilized" from "zygote". One, it is the ovum that is fertilized, not the zygote. Two, I don't think zygotes resulting from processes other than fertilization (cloning?) are at all relevant to this article.
• I removed the commentary on chemical pregnancies (those that can be detected with hCG blood or urine tests - "chemical" tests - but never grow large enough to be seen on an ultrasound - a "clinical" test). One, it did not add anything to the article. Two, a woman's personal feelings about the significance of an early miscarriage will vary widely from woman to woman, and implying that all chemical pregnancies are not worthy of "notice" is possibly offensive.

Lyrl _C 17:50, 4 March 2007 (UTC)

Why even care?

Why does this "controversy" even matter. We should be focusing on when LIFE begins, not when PREGNANCY does.

Beginning of Pregnancy ≠ Beginning of Life Junulo 00:57, 3 December 2007 (UTC)

That is covered in the article on Abiogenesis. Zodon (talk) 06:14, 4 April 2008 (UTC)

"scientists generally avoid describing facts using terminology with emotional or political overtones"

AFAIK, there is no scientific basis for the claim that "scientists generally avoid describing facts using terminology with emotional or political overtones." In my experience, scientists very commonly use terminology with emotional or political overtones. If someone can find a scientific study to support the claim, please feel free to reinsert it into the article, with an appropriate reference. NCdave (talk) 21:49, 4 February 2008 (UTC)

Likewise, "The latter question also has no scientific definition since, from a biological standpoint, life is a continuum without a discrete starting point" has the same problem: AFAIK, there is no scientific basis for the claim that life is a continuum with no distinct starting point. Rather, that sentence is an editorial comment, arguing the POV that those wacky pro-lifers who talk about life beginning at fertilization are unscientific. NCdave (talk) 21:54, 4 February 2008 (UTC)

I have removed the editorial comment. NCdave (talk) 23:47, 4 February 2008 (UTC)

Reverted the edit, then redid most of it, in order to refine the one bit that got removed, but still seemed worthwhile. i.e. The distinction between the analog view of life as a continuum, vs. the discrete (the individual starts here - e.g. Legal problem). Removed the no starting point part (clearly irrelevant), however life comes from life is quite common view in biology and elsewhere. Tried to neutralize some of the language around the bit that put back to address concerns here. Zodon (talk) 06:54, 4 April 2008 (UTC)

Life as a continuum

This phrase in the introductory paragraph is pure unsourced commentary: "biologically, life is usually regarded as a continuum." It seems to be advancing the position that no one's life has a beginning. Is there any cited source that discusses this unusual philosophy, in connection with the controversy about the beginning of pregnancy? In any event, this material is tangential to the subject at hand, and I support deletion of this sentence. I did delete it, and have now been falsely accused of "vandalism" for having done so. This material seems to be merely an argumentative response to those who believe that there is such a thing as a beginning of a human life.

It is common knowledge that biological life is a continuum. The issue about the beginning of pregnancy is controversial because some people liken the "beginning of pregnancy" to the beginning of a unique, individual human life, rather than likening it to a change from inanimate to animate matter.

I am open to be persuaded here. However, right now there is no consensus for inclusion of this material.Ferrylodge (talk) 20:45, 9 April 2008 (UTC)

The vandalism mentioned in the revert was the insertion of duplicate copies of several segments of the article by 222.221.6.144, not the removal of the discreet vs. continuum sentence. You were clearly trying to clean up the vandalism; wasn't sure if your removal of said sentence was intentional or accidental. Sorry if that wasn't clear in edit summary.

As to discreet vs. continuous - part of it is that something that happens gradually may be difficult to assign a specific beginning point to. People gradually acquire characteristics that we think of as making them individuals. If you look at psychology, many of those aspects don't develop until months or years after birth. (Language, differentiation of self, recognition of rights of other people, ...) That there is a sequence of developments, with gradually changing abilities, etc. seems widely accepted. (The seven ages of man, many places you can't vote until a certain age, etc.) So that the individual develops though a whole lot of stages and phases hardly seems an unusual observation. Likewise in biology, there are lots of stages and steps and developments in reproduction.

So the idea that there is A beginning, a single, specific hard edge may or may not be applicable. Or it may have a beginning, but a gradual beginning, something that fades in.

As to inclusion here - it seems to be relevant, since it notes that by trying to define an event, a moment where we say this is pregnant, this is not (or this is an individual, this is not), one is imposing a discreet (yes/no) view on a complex series of processes. So you may get differences of opinion (e.g. controversy) about what point to pick. Removing such an observation makes it sound like the debate is just about where to draw the line, keeping it in acknowledges that whether a line can be drawn may be part of the controversy. Perhaps it could use clarification? Zodon (talk) 02:07, 10 April 2008 (UTC)

The lead paragraph should summarize what's in the rest of the article, and the stuff in the rest of the article should be notable and relevant information that is supported by reliable sources. The sentence that I deleted does not seem to summarize what's in the rest of the article, and is not supported by reliable sources. I'm not aware that anything in Sagan's book mentions the controversy about whether pregnancy begins at fertilization as opposed to implantation, or mentions that a human life might not have a beginning.

As far as I understand, the controversy about when pregnancy begins is primarily about whether it is defined as starting at fertilization or instead is defined as starting at implantation.

If this article is going to expansively address whether or not a human life has a discrete beginning, then this article is really going to have to be expanded enormously. Right now, I think it would be best to just narrowly address the controversy that this article initially addressed: whether pregnancy is defined to begin at fertilization or at implantation.

Even if a human life has a value or a magnitude that increases gradually instead of suddenly, still in either case it must have a beginning at some point. And there is no reason to get into such issues here in this article, unless we cite a reliable source that seeks to synthesize all of these various arguments and philosophies. See WP:SYN.Ferrylodge (talk) 02:26, 10 April 2008 (UTC)

Zodon, do you still want to try a clarification? If not, I'll try again to make the lead paragraph shorter.Ferrylodge (talk) 03:43, 11 April 2008 (UTC)

I still think clarification would be better than deletion. "..., still in either case it must have a beginning at some point." That represents one set of points of view, but not all major points of view. Something can have many beginnings - consider the multiple types of causation, as for instance set out by Aristotle, or the stories of inventions laid out by James Burke in Connections. A state can exist with no beginning point - consider mathematical models of limits - something can approach a limit but never reach it (so whatever point you chose that has a characteristic, one can find something before it that also had the characteristic, but the first point for which this is not true does not have the characteristic, e.g. some of Zeno's paradoxes). There are lots of states or things that have no beginning point or multiple beginnings.

Since the article doesn't currently give any clear rigorous definitions that involve pregnancy starting at fertilization, it is a bit hard to discuss what such a definition might look like. In light of in vitro fertilization, etc. it might wind up being something where a beginning could only be determined retroactively, or might involve intention and various modes of causation. Or perhaps it might involve a fuzzy state - with women varying from not pregnant (e.g. right after a menses) to some level of possibility of pregnancy for most of their reproductive lives, and occasionally getting into higher probabilities of pregnancy (e.g. approaching or after implantation). Definitions that start pregnancy before the association of blastocyst with implantee may wind up having to deal with not only a complex series of biological processes but with causation, intention, ... Or they might remain vague in order to brush such details under the rug. To me the sentence in question tries to briefly encapsulate those sorts of difficulties.

Agree that moving into discussing the beginnings of the individual debate is not a profitable way to go for this article. (There probably are other articles about that.) So rephrasing to link more tightly to definition of pregnancy would probably be beneficial.

If you think the citation is weak, perhaps adding an annotation to the article to that effect would help (additional citation needed, or whatever - I don't know the right code for it). Somebody came up with this citation quite soon after the citation needed tag was there, so a request for further citation might well be productive. I don't think the idea is so radically off topic or unfounded that it needing quick action in terms of deletion. Zodon (talk) 17:28, 14 April 2008 (UTC)

OK, as you suggested, I'll try "rephrasing to link more tightly to definition of pregnancy."Ferrylodge (talk) 02:59, 30 May 2008 (UTC)

Definition of contraception controversy?

Some of the issues this article covers aren't neatly described by when pregnancy begins. Would it be better to title the article as a controversy over what is contraception (vs. abortion)? Lyrl _C 01:37, 6 August 2008 (UTC)

What issues do you mean? In rereading nothing struck me as obviously unrelated to that. (Not saying there isn't anything, just not sure what bits gave rise to the question.) This issue also would apply to other procedures (like in vitro fertilization/fertility treatments, etc.), so don't think it is just about definition of contraception. (If want to retitle it, new title should encompass that as well.) Zodon (talk) 05:23, 6 August 2008 (UTC)

Partly that the HHS draft regulation avoids the issue of pregnancy altogether in defining abortion. Misplaced Pages's abortion article also does not mention pregnancy in its definition of abortion. When some people involved in the argument aren't arguing about pregnancy, defining the controversy as over the definition of pregnancy doesn't really cover it. I'm not sure what a better title would be, though. Lyrl _C 21:38, 7 August 2008 (UTC)

IUD

On page 5 of this PDF James Trussell states, "Its very high effectiveness implies that emergency insertion of a copper IUD must be able to prevent pregnancy after fertilization." Trussell seems to be very respected in the field of birth control; given his opinion on IUDs I am hesitant to remove them from the "possibly affected methods" list. Lyrl _C 21:37, 7 August 2008 (UTC)

Well, I think this may be a case of you both being right. We are discussing two different uses of IUDs. The typical use of IUD shouldn't be listed as "possibly affected", however the use IUDs as EC is "possibly affected". If we can make that distinction clear, we could list the two uses of IUDs in each section. -Andrew c  21:53, 7 August 2008 (UTC)

If I understand correctly, the different uses don't cause different mechanisms: it's just which mechanism is primary and which is secondary that are affected. Used as emergency contraception, the IUD is likely to be exposed to zygotes, and it seems plausible the IUD as EC prevents pregnancy primarily by affecting these zygotes. Used as ongoing contraception, the IUD is unlikely to be exposed to zygotes, because it's very good at being spermicidal and ovicidal: in this situation, being spermicidal and ovicidal is a primary mechanism.

But even when used as ongoing contraception, an IUD may rarely be exposed to zygotes. So post-fertilization action would be a plausible secondary mechanism. I don't understand a conclusion that post-fertilization action never happens with normal IUD use: why would the IUD affect those zygotes any differently than the ones it is exposed to when used as EC? Lyrl _C 22:52, 7 August 2008 (UTC)

Sorry, I wasn't thinking about EC. As Andrew c inferred, I was looking in the IUD section of Contraceptive Tech, and it seems quite clear in stating that in regular use as a contraceptive method, it operates by preventing fertilization. (e.g., page 130) "IUDs prevent fertilization and thus are true contraceptives." However, as Lyrl notes, when used as emergency contraception, part of its efficacy may be by preventing pregnancy after fertilization. (The only reason given for that inference is their very high effectiveness as EC.)

It may be a case of the primary mechanism being sufficiently effective that the secondary mechanism never happens, in which case it might be pointless/harmful/confusing to say that it is a mechanism.

The evidence they seem to give the most weight to is tubal flushing studies when doing Pomeroy's sterilization. They indicate that in women not using contraception, eggs were recovered in about half of the women. In women using IUD no fertilized normally dividing eggs were recovered.

I edited the text to help clarify. What do you think would be clearest way to handle the two uses? To put separate item for IUD as emergency contraceptive in the possibly affected methods, noting the inferred secondary after fertilization mechanism in that application, or to merge the lists, but noting that in regular use it prevents fertilization and only in EC does there appear to be a question? Zodon (talk) 06:21, 8 August 2008 (UTC)

For the first few decades of IUD use, it was thought that IUDs worked only by preventing the implantation of embryos. The 1980s studies showing that the devices were spermicidal and ovicidal were almost revolutionary. It has taken quite a while for the results of those studies to get around, and much literature is focused on correcting the outdated belief that the "normal" mechanism for IUDs is to prevent implantation.

I believe the tubal flushing studies involved about a dozen women each in the IUD and control groups. While certainly sufficient for determining a primary mechanism, that seems like a rather small study size from which to conclude that IUDs never, ever harm zygotes.

Chemical pregnancies (rises in levels of hCG) can only be detected after implantation. Studies of chemical pregnancies in IUD group vs. non-contracepting group are relevant in showing IUDs do not work by harming implanted embryos. The studies showing no increased risk of first-trimester miscarriage due to IUDs are also reassuring in this regard. But these studies are not relevant to proposed mechanisms that might act before implantation, so I'm not sure they need to be discussed in this article.

If I understand correctly: if the primary mechanism were sufficiently effective to prevent the secondary mechanism from happening, the pregnancy rate of IUD users would be zero. A non-zero pregnancy rate means that any secondary mechanisms (if they exist) have a chance to come into play. Does that make sense? Lyrl _C 21:20, 8 August 2008 (UTC)

"If the primary mechanism were sufficiently effective to prevent the secondary mechanism from happening, the pregnancy rate of IUD users would be zero. A non-zero pregnancy rate means that any secondary mechanisms (if they exist) have a chance to come into play." That would only be the case if one assumes that the mechanisms are independent. If, for instance, the mechanisms act in concert, so they fail in synchrony, then that need not be the case (e.g., if they both work or fail simultaneously, then the only way for the secondary method to act is if other factors (such as ovulation already having occurred before IUD insertion) prevent the primary mechanism from working.)

There is no a-priori reason to assume that the mechanism of action must be the same for EC use as for normal contraceptive use. It could be, but it might not be. For instance, the act of introducing a foreign body into the uterus could cause transient changes that might affect implantation then, but might not be a factor at other times. (I am not saying that this is so, but one can't just dismiss the possibility either.) So in terms of understanding the logic of the situation, it need not be a case of primary vs. secondary action at all, it could just as well be totally different mechanisms when the device is first introduced vs. ongoing.

From a logical standpoint, there are various ways that the EC and ongoing uses could exercise different mechanisms. Of course all of this, just as your conjectures above, are just for sake of understanding what could be.

As to the tubal flushing studies, I haven't read them. I will have to look up the references. Of course our interpretation/evaluation of them would be WP:OR. The authors of Contraceptive Tech seemed to find them compelling.

Contraceptive technology is quite clear in several places indicating that prevention of fertilization is the mechanism of action for IUD when used as a regular contraceptive. It also differentiates IUDs from the hormonal methods which might have post-fertilization effects.

I may have been a little hasty in reverting your edit (sorry), but I find the total removal of the contraceptive technology conclusions and reference quite shocking. My understanding of wikipedia policy and the reputation of Contraceptive tech suggest that it is an especially authoritative source. (Since it is a second or third-party source, reviewed by experts in the field, and highly regarded in the field.) It was on the basis of that reputation that I made the changes to begin with. Is Contraceptive tech not a good source by Misplaced Pages standards? (Why are these other sources better?) Do you feel that I misinterpreted what CT said? Unless there is something wrong with the use of contraceptive tech's conclusions, I would like to try to integrate their conclusions, rather than just throwing them out. I will try to come up with a suggestion that integrates Lyrl's changes as well. Zodon (talk) 23:05, 21 August 2008 (UTC)

I apologize for the slight on CT. I was copying and pasting from history and another article; it would have been better if I had taken the time to integrate the CT reference. I have also never seen CT in person, only read about it. I was unaware that it explicitly differentiated IUDs from hormonal methods; knowing that casts a different light on things for me. I agree about CT's stellar reputation, and it certainly overshawdows the Stanford and Mikolajczyk reference. It's the Trussell reference (one of CT's authors) that makes me hesitant to include a bald statement that there is no possibility IUDs act after fertilization.

You have a good point about the possibility of transient effects after insertion. Our speculation about such things can't go into the article, but I think they are useful for discussion: it gives us something to look for to see if someone else had this idea and published it, and it helps inform our editorial judgment.

I think this is what I'm remembering reading about the flushing studies (from here):

A Chilean research team found few eggs in the tubes and uteruses of IUD-using women. They searched for ova by flushing the uterus on the second through the fifth day after ovulation. Eggs were found in one-third of 36 women using no contraceptives, while only one egg was recovered among 22 users of inert IUDs that contain no copper and none in 43 users of copper IUDs. (This is a reference to PMID 3311625.)

PMID 3360166 also appears to be relevant. Lyrl _C 02:02, 23 August 2008 (UTC)

Proposed changes

I would like to make these changes to the article:

• Remove the statement about chemical pregnancies: as I explained above, while these studies were important in understanding how IUDs work, I do not believe they have particular relevance to this article.
• Re-integrate the IUD into the "possibly affected" list. I am open to stronger wording on spermicide/ovicide being the only known mechanism, lack of medical community support for the idea of secondary mechanisms, etc. But I do not believe the current sources support a "no possibility this method is affected" categorization.

Any comments? Lyrl _C 00:43, 26 August 2008 (UTC)

History - Location of IVF and Wording

Any chance of getting an explanation for this revert? There is no way that something that happed in 1978 motivated events in previous decades.Ferrylodge (talk) 03:13, 1 February 2009 (UTC)

1) "Centuries ago" is a bit too poetic, along the lines of "A long time ago in a galaxy far, far away" or "once upon a time".

2) If you read carefully, I think you'll find that it's mentioned as a reason why this continues to make sense, not a chronological cause. Spotfixer (talk) 03:19, 1 February 2009 (UTC)

(undent)Spotfixer, the section as you seem to like it starts with the word "previously." Previous to what??? This is exceedingly bad syntax. The same paragraph discusses the 1828 and 1913 editions of Webster's Dictionary, and also discusses discoveries in 1875. So the term "centuries ago" is most appropriate. I'll try to change it to something else that you'll like better, but really you should see that starting with the word "previously" makes no sense. I'll address your other point after we get this straightened out.Ferrylodge (talk) 03:26, 1 February 2009 (UTC)

I've changed it to the following, which hopefully will be satisfactory to you:

In the past, pregnancy has been defined in terms of conception. For example, Webster's Dictionary defined "pregnant" (or "pregnancy") as "having conceived" (or "the state of a female who has conceived"), in its 1828 and 1913 editions. However, in the absence of an accurate understanding of human development, early notions about the timing and process of conception were often vague.

Ferrylodge (talk) 03:31, 1 February 2009 (UTC)

On your other point, this section on "History" is entirely chronological, except for one uncited sentence about something that happened in 1978. All I've suggested doing is to merely move the uncited sentence to chronological order. Where it is now, the sentence is confusing, and seems to imply that in vitro fertilization was one of the reasons why Boving and ACOG did what they did. It very obviously was not. Again, I'll try to rewrite in a manner that you might find more satisfactory.Ferrylodge (talk) 03:34, 1 February 2009 (UTC)

Okay, I rewrote like this. Hopefully that will be okay with you. If not please explain. Thanks.Ferrylodge (talk) 03:41, 1 February 2009 (UTC)

I have no complaints. Thanks for helping improve the article. Spotfixer (talk) 04:01, 1 February 2009 (UTC)

I shortened the item a bit and moved it back up to where it was. It does not make sense to put the relation between IVF and definition of pregnancy in 1978 because we have no evidence that the influenence occurred or started then. IVF did not begin with the first successful use in humans, it had been researched for decades (performed in animals, etc.) For instance "A large number of experiments beginning in 1878 contributed to the first successful reports of IVF over 75 years later. The discovery of sperm capacitation in 1951 was central to the development of IVF technology, and it was rapidly followed by the first convincing reports of IVF in several species."

So by 1959, and certainly by 1965, people working in the field would be likely to be aware of IVF and the potential for its use in humans. So it is not an anachronism to mention such research and considerations in the late 50's and early 60's, where the item resides.

Also, I edited the heading of this discussion so that it was not listed as a subsection of the previous (unrelated) topic, and gave a more descriptive heading. (Hope that's okay.) Zodon (talk) 12:10, 1 February 2009 (UTC)

Thanks for doing the research and making this right. Spotfixer (talk) 12:50, 1 February 2009 (UTC)

(undent)I agree with Spotfixer that Zodon should be thanked for doing this research. However, there is still a big problem here. The article currently says that one of the motivations that led to a revised definition of pregnancy (by ACOG and Boving) was IVF. While that's certainly hypothetically possible, there's not a scintilla of evidence that ACOG or Boving gave any consideration to IVF in 1959 or 1965. And this discussion between myself, Spotfixer, and Zodon has not turned up any such evidence. Spotfixer inserted IVF into this article. Spotfixer, please tell us whether you have any evidence (i.e. any reliable source) indicating that IVF has ever been considered relevant to the definition of pregnancy by the people who formulated those definitions. Is there any reliable source that has ever discussed IVF in connection with the definition of pregnancy?

If IVF was not part of the history of the "Beginning of Pregnancy Controversy", then we ought to remove it from the history section. It either belongs in a different section, or (if no reliable source can be found) should be removed.

Additionally, according to the footnoted Webster's Dictionary from 1828 and 1913, "pregnant" and "pregnancy" were defined as "The state of a female who has conceived, or is with child." In turn, the word "conceive" was defined as "To receive into the womb and begin to breed" or "To have an embryo or fetus formed in the womb." Under any of those definitions, a petri dish obviously could not be considered pregnant.Ferrylodge (talk) 18:34, 1 February 2009 (UTC)

The issue here is that, if pregnancy is defined from fertilization, as some would like to insist, then petri dishes would indeed be pregnant. If IVF were a deep, dark secret until the first human trials, then you'd have some argument. However, like all such technologies, it was tested on animals long before they dared risk a human. Previously, the term was somewhat ambiguous, sow when they clarified it, they took these factors into account. Not that "receive into the womb" almost specifies implantation. Spotfixer (talk) 20:09, 1 February 2009 (UTC)

You may have a point, and I encourage you to follow up with reliable sources. But I hope we can do follow up in the section about IVF, instead of the history section, unless there is some source indicating that IVF was actually a consideration of Boving and ACOG.Ferrylodge (talk) 20:29, 1 February 2009 (UTC)

I see that Zodon has reverted. There is no valid reasons why this stuff should be in the chronological history section, rather than the separate section on IVF.

The current article is grossly misleading, in suggesting that Boving or ACOG were motivate by any considerations regarding IVF. The person who inserted this info into this article stated above: "it's mentioned as a reason why this continues to make sense, not a chronological cause." This does not belong in the history section, and moreover iot seems to me like original research. I'd be glad to leave this misinformation for a week or so, and then will move it to the IVF section.Ferrylodge (talk) 21:50, 1 February 2009 (UTC)

1. Doesn't breastfeeding do the same thing as the Pill? Eternal Perspective Ministries, 2006. Accessed May 2006.

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