As per a suggestion by Jimmy Wales jwales@bomis.com I wish to bring this matter to your attention.
I did try a correction earlier in the 'edit this entry' function but I believe the edit I am suggesting is a little more than it can handle.
TIA Eileen
RE: http:/en.wikipedia.org/w/wiki.phtml?title=Intact_dilation_and_extraction
I am unsure of the procedure for making the type of changes that this page requires in order to make it accurate. This is obviously a subject which has been subjected to a great deal of controversy and dare I say propaganda and this has led to a great deal of erroneous information disseminated as fact.
There are a number of major errors in the Wikipedia entry describing the D&X abortion procedure. The most glaring error is the statement that this sis a late term abortion. While it might be described as a late abortion, performed around the middle of the pregnancy, it is certainly almost never performed "Late Term" which is the last third of the pregnancy or to be technically correctly after 26.6 weeks. This procedure would usually be impossible to perform that late in the pregnancy.
I also note the use of "birth canal" to describe the vagina as if a woman had an exit chute on her baby factory; and the use of "womb" in place of 'uterus'. Both these terms, and the misstatement of the time the procedure is performed, lead me to believe the article was mainly written by somebody opposed to abortion who was more interested in getting a subtle message out then actually providing honest information. Since we are describing a medical procedure appropriate medical/biological terminology which is well understood by the general population is the appropriate vocabulary.
May I suggest reading this article before using the term "PBA" as loosely as it is used in your current entry. http://womensenews.org/article.cfm/dyn/aid/499/
I have linked Dr. Haskell's paper on my web site. To the best of my knowledge since this was presented at a public forum and also was presented into evidence at a Senate hearing it would be considered "public domain' so there really is no reason you may not add it to your papers if you so desire.
I have redone your page and would be happy to discuss any corrections you see needed. You have my full permission to use the page as I have amended it since much of the work on its creation had already been done by you.
Thank you for your consideration in this matter and I look forward to hearing from you. I would prefer to retain my anonymity, since I have been subjected to threats in the past, but would suggest that if you are interested in confirming the facts as I presented them Dr. Haskell would probably be your best source,
Eileen E EileenE@GMX.Net
Cada niño un niño querido. Chaque enfant un enfant voulu. Jedes Kind ein gewünschtes Kind. Cada criança uma criança querida Ogni bambino un bambino desiderato. Every child a wanted child.
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<div id='article'><h1 class='pagetitle'>Intact dilation and extraction</h1><p class='subtitle'>From Wikipedia, the free encyclopedia. <br><small>Find out how you can help <a href='http://wikimediafoundation.org/fundraising' class='internal'>support</a> Wikipedia's phenomenal growth.</small>
<p><a name="top"></a><p><table border="0" id="toc"><tr><td align="center"> <b>Table of contents</b> <script type='text/javascript'>showTocToggle("show","hide")</script></td></tr><tr id='tocinside'><td align="left"> <div style="margin-bottom:0px;"> <A CLASS="internal" HREF="#Definition">1 Definition</A><BR> </div> <div style="margin-bottom:0px;"> <A CLASS="internal" HREF="#Circumstances_in_which_the_procedure_is_performed">2 Circumstances in which the procedure is performed</A><BR> </div> <div style="margin-bottom:0px;"> <A CLASS="internal" HREF="#Legal_and_political_situation_in_the_United_States">3 Legal and political situation in the United States</A><BR> </div> <div style="margin-left:2em;"> <A CLASS="internal" HREF="#About_the_terminology">3.1 About the terminology</A><BR> <A CLASS="internal" HREF="#Efforts_to_ban_the_procedure">3.2 Efforts to ban the procedure</A><BR> </div> <div style="margin-bottom:0px;"> <A CLASS="internal" HREF="#Legal_and_political_situation_in_the_United_Kingdom">4 Legal and political situation in the United Kingdom</A><BR> </div> </td></tr></table><P> <H2><a name="Definition">Definition</a></H2> <p> <strong>Intact dilation and extraction</strong> is a mid-term or second trimester <a href="/wiki/Abortion" title="Abortion">abortion</a> technique in which the patient's <a href="/wiki/Cervix" title="Womb">cervix</a> which is the muscle ring that controls entry to the <a href="/wiki/Uterus"><b> uterus </b></a> is dilated and the <a href="/wiki/Fetus" title="Fetus">fetus</a> extracted in substantially one piece. The term <em>"dilation and extraction"</em> or <em>"D&X"</em> was coined in 1992 by Dr. Martin Haskell to describe a variation on the more common Dilation and Evacuation (D&E - see below). At the same time roughly Dr. James McMahon, since deceased, developed a similar but substantially different procedure procedure which could be used later in the pregnancy and he used the term <em>"intact dilation and evacuation"</em> to identify it. Dr Haskell's procedure eventually became known by the term <em>"intact D&X"</em> which was the name he used to describe it when he<a href=http://eileen.undonet.com/Main/7_R_Eile/Haskell_Desc.html><b> presented a paper </b></a> on the procedure to his peers in 1992. <p> <H2><a name="Circumstances_in_which_the_procedure_is_performed">Circumstances in which the procedure is performed</a></H2> <p> Intact D&X procedures are performed by only a small number of abortion providers currently and for this reason they are much less common than the D&E procedure which is the preferred second trimester method in the USA. They are most frequently used in the second trimester between weeks 18 and 21 of pregnancy. Only about 0.01% of abortions are performed after this point so this makes the D&X even more rare after week 21. They may be performed during the third trimester of <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> if they are possible and one of the requirements would be that the fetus be small for gestational age (SGA). This is because the head, the largest part of the fetus, must be made small enough to permit it to be extracted through the minimally dilated cervix. After the second trimester the head is normally too large for such a procedure and further dilation of the cervix might damage the cervix and compromise future pregnancies for the woman.
This procedure is chosen when the physician performing the abortion has the skills needed and may be the procedure of choice when: <ul><li>The fetus is <a href="/wiki/Dead" title="Dead">dead</a>. </li><li>The fetus is alive, but continued pregnancy would place the woman's life in severe danger. </li><li>The fetus is alive, but continued pregnancy would grievously damage the woman's health and/or disable her. </li><li>The fetus is so malformed that it can never gain consciousness and will die shortly after birth. </li><li>The fetus is alive, but the woman wishes to end her pregnancy for non-medical/psychological reasons. </li><li>The woman has for reasons of her own requested that her pregnancy be terminated before the fetus is viable in states where this is legal. Most states do not legally permit abortions past the point of viability, usually considered to be 23/24 weeks today. </li></ul><p> One of the fetal defects which fall into this category is <a href="/wiki/Hydrocephalus" title="Hydrocephalus">hydrocephalus</a> which physicians refer to as a neuralk tube defect. Approximately 1 in 2,000 fetuses develop hydrocephalus while in the uterus; this is about 5,000 a year in the <a href="/wiki/United_States" title="United States">United States</a>. The defect is not usually discovered until late in the second <a href="/wiki/Trimester" title="Trimester">trimester</a> of pregnancy. <p> If a fetus develops hydrocephalus, the <a href="/wiki/Head" title="Head">head</a> may expand to a size of up to 250% of the radius of a newborn <a href="/wiki/Skull" title="Skull">skull</a>, making it impossible for it to perform a removal through the <a href="/wiki/Vagina" title="Vagina">vagina</a>. In such a case, the <a href="/wiki/Physician" title="Physician">physician</a> may elect to perform an intact D&X procedure by draining off the fluid from the <a href="/wiki/Brain" title="Brain">brain</a> area, which permits the fetal skull to collapse and the bones in the skull to slide over each other, then withdrawing the dead fetus through the partly dilated cervix. You might think of this as rtrying to remove an inflated baloon through a small hole in a paper bag without tearing the bag. Once the baloon is deflated the removal is easy. A type of caesarian section delivery, called a hysterotomy, may allow the delivery of a hydrocephalic fetus although such major surgery, with its inherent dangers, is not always in the best interest of the woman. Furthermore the hysterotomy may leave a scar that is easily ruptured in future pregnancies. <p> In the 2 to 3 day procedure, the <a href="/wiki/Cervix" title="Cervix">cervix</a> is dilated. The fetus is delivered feet-first, facing toward the woman's spine. The <a href="/wiki/Surgeon" title="Surgeon">surgeon</a> inserts a sharp object into the soft opening at the bottom of the fetal head just above the neck, and then inserts a vacuum tube through which the brains and its fluids are extracted. The head of the fetus contracts at this point and allows the fetus to be more easily removed from the <a href="/wiki/Uterus" title="Uterus">womb</a>. The fetus can then be removed with less damage to the woman. The technique was pioneered by Dr. <a href="/w/wiki.phtml?title=Martin_Haskell&action=edit" class='new' title="Martin Haskell">Martin Haskell</a> in <a href="/wiki/1992" title="1992">1992</a>. <p> Intact D&X procedures are not performed during the first trimester, because there are better ways to perform abortions. There is no need to follow such a procedure because the fetus' head is quite small at this stage of gestation and can be quite easily removed from the woman's uterus. <p> <H2><a name="Legal_and_political_situation_in_the_United_States">Legal and political situation in the United States</a></H2> <p> <H3><a name="About_the_terminology">About the terminology</a></H3> This procedure is often referred to as "<a href="/wiki/Partial-birth_abortion" title="Partial-birth abortion">partial-birth abortion</a>" among the media and among pro-life groups although there has never been a medical description of this "partial birth abortion" procedure and such descriptions as have been written into legislation have been continually found unconstitutional because they can describe a number of different abortion procedures. In the medical field intact dilation and extraction is sometimes referred to as a <em>D&X procedure</em> (not to be confused with the much more common variation <em>D&E procedure</em> (<a href="/w/wiki.phtml?title=Dilation_and_evacuation&action=edit" class='new' title="Dilation and evacuation">dilation and evacuation</a>.) <p> <H3><a name="Efforts_to_ban_the_procedure">Efforts to ban the procedure</a></H3> Since <a href="/wiki/1995" title="1995">1995</a>, led by Congressional <a href="/wiki/United_States_Republican_Party" title="United States Republican Party">Republicans</a>, the <a href="/wiki/United_States_House_of_Representatives" title="United States House of Representatives">U.S. House of Representatives</a> and <a href="/wiki/United_States_Senate" title="United States Senate">U.S. Senate</a> have moved several times to pass measures banning the procedure. After several long and emotional debates on the issue, such measures passed twice by wide margins, but <a href="/wiki/United_States_President" title="United States President">President</a> <a href="/wiki/Bill_Clinton" title="Bill Clinton">Bill Clinton</a> <a href="/wiki/Veto" title="Veto">vetoed</a> those bills in April 1996 and October 1997 on the grounds that they did not include health exceptions. Subsequent Congressional attempts at overriding the veto were unsuccessful. <p> On <a href="/wiki/October_2" title="October 2">October 2</a>, <a href="/wiki/2003" title="2003">2003</a>, with a vote of 281-142, the <a href="/wiki/United_States_House_of_Representatives" title="United States House of Representatives">House</a> again approved a measure banning the procedure. Through this legislation, a doctor could face up to two years in prison and face civil lawsuits for performing such an abortion. A woman who undergoes the procedure cannot be prosecuted under the measure. On <a href="/wiki/October_21" title="October 21">October 21</a>, <a href="/wiki/2003" title="2003">2003</a>, the <a href="/wiki/United_States_Senate" title="United States Senate">United States Senate</a> passed the same bill by a vote of 64-34. The measure does not contain health exemptions, just the same as previous ones considered by the US Supreme Court. It remains to be seen whether the Supreme Court will also find the language in the bill (Called S3 in the Senate) too broad to actually describe an identifiable medical procedure so that physicians who perform abortions will know exactly what is being banned and what they may and may not do when performing such surgery. Either or both grounds, health exception and vague terminology, would permit an appeal to the Supreme Court eventually and if found valid would render the legislation unconstitutional. <p> The <a href="/wiki/American_Civil_Liberties_Union" title="American Civil Liberties Union">American Civil Liberties Union</a> and the <a href="/w/wiki.phtml?title=National_Abortion_Federation&action=edit" class='new' title="National Abortion Federation">National Abortion Federation</a> planned to file a lawsuit challenging the constitutionality of the October 2, S3, bill. Courts have struck down several similar state statutes. <p> <H2><a name="Legal_and_political_situation_in_the_United_Kingdom">Legal and political situation in the United Kingdom</a></H2> <p> Questioned about UK government policy on the issue in <a href="/wiki/Parliament_of_the_United_Kingdom" title="Parliament of the United Kingdom">Parliament</a>, ministers of the <a href="/wiki/British_government#Government" title="British government">British government</a> have stated (for example, on <a href="/wiki/May_12" title="May 12">May 12</a>, <a href="/wiki/2003" title="2003">2003</a>) that although this method of abortion would be legal if judged appropriate, "We are not aware of the procedure referred to as 'partial-birth abortion' being used in Great Britain." <p> </div><br clear=all>
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Eileen wrote:
I also note the use of "birth canal" to describe the vagina as if a woman had an exit chute on her baby factory; and the use of "womb" in place of 'uterus'. Both these terms, and the misstatement of the time the procedure is performed, lead me to believe the article was mainly written by somebody opposed to abortion who was more interested in getting a subtle message out then actually providing honest information. Since we are describing a medical procedure appropriate medical/biological terminology which is well understood by the general population is the appropriate vocabulary.
May I suggest reading this article before using the term "PBA" as loosely as it is used in your current entry. http://womensenews.org/article.cfm/dyn/aid/499/
In both these cases, the problem is that there is no entirely neutral terminology. Using strictly medical terms is considered biased by the anti-abortion community, as they see it as an attempt to cast a moral issue as a strictly sanitized medical issue; using non-medical terms is seen as similarly biased by the pro-abortion community. My preferred solution would be to use both sets of terms interchangeably--both "womb" and "uterus" and both "birth canal" and "vagina/cervix/vulva"). In particular I don't really see anything wrong with "birth canal", and have seen it used in pro-abortion literature as well as anti-abortion literature.
As for the term "Partial Birth Abortion" itself, there's no good solution to that either that I can see. Certainly there some be some discussion about the controversy over terminology, but simply adopting an alternate term would be biased as well. The only other term in reasonably widespread use is "late term abortion", but as you pointed out some of these procedures do not actually occur in the last trimester, so can't really fall under that heading. So I'd say keeping the term PBA with the qualification that some abortion supporters object to the term is the best solution.
I have linked Dr. Haskell's paper on my web site. To the best of my knowledge since this was presented at a public forum and also was presented into evidence at a Senate hearing it would be considered "public domain' so there really is no reason you may not add it to your papers if you so desire.
I don't think this particular claim is true. Plenty of copyright papers are presented at public fora and remain copyrighted (Martin Luther King's "I Have A Dream" speech is probably the most well-known). I don't think things entered into evidence at Senate hearings are automatically stripped of copyright either, but someone more familiar with copyright law would have to comment on that.
As a general comment, while I think it is a good thing to make medical articles more precise, Wikipedia is also not a medical encyclopedia, so articles should be written in a general context and for a general audience. Taking a strictly clinical view of some of these controversial issues would itself be adopting a point of view, and we don't wish to endorse any particular point of view. I'll also note that there's a ton of propaganda on both sides of the issue here: anti-abortionists try to make their descriptions of "PBA" as gruesome as possible, while abortion supporters try to make their descriptions of "PBA" sound as much like a "normal" surgical procedure as possible, to emphasize the "move along, nothing to see here" POV (or, alternately, so jargon-filled and obtuse as to be incomprehensible to a general audience). I don't think either is a good solution, which is why I object somewhat to your suggestion that we should adopt more clinical terminology in the article (I'd similarly object to suggestions from the other side that we adopt particularly gruesome terminology). You do seem aware that there is propaganda surrounding this issue, but you seem much more aware of propaganda on one side of the issue than on the other side.
-Mark
At 11:24 AM 10/28/03 -0800, Delirium wrote:
Eileen wrote:
I also note the use of "birth canal" to describe the vagina as if a woman had an exit chute on her baby factory; and the use of "womb" in place of 'uterus'. Both these terms, and the misstatement of the time the procedure is performed, lead me to believe the article was mainly written by somebody opposed to abortion who was more interested in getting a subtle message out then actually providing honest information. Since we are describing a medical procedure appropriate medical/biological terminology which is well understood by the general population is the appropriate vocabulary.
May I suggest reading this article before using the term "PBA" as loosely as it is used in your current entry. http://womensenews.org/article.cfm/dyn/aid/499/
In both these cases, the problem is that there is no entirely neutral terminology. Using strictly medical terms is considered biased by the anti-abortion community, as they see it as an attempt to cast a moral issue as a strictly sanitized medical issue; using non-medical terms is seen as similarly biased by the pro-abortion community. My preferred solution would be to use both sets of terms interchangeably--both "womb" and "uterus" and both "birth canal" and "vagina/cervix/vulva"). In particular I don't really see anything wrong with "birth canal", and have seen it used in pro-abortion literature as well as anti-abortion literature.
Womb is a fine old English word, uterus is medical Latin. Both are perfectly acceptable.
There is little or no "pro-abortion literature": those of us who support abortion rights also support the rights of women to have children if they wish--and, in fact, part of the fight for reproductive freedom is an ongoing battle against forced sterilization. If you're trying for neutrality, don't use one side's terminology for the other.
As for the term "Partial Birth Abortion" itself, there's no good solution to that either that I can see. Certainly there some be some discussion about the controversy over terminology, but simply adopting an alternate term would be biased as well. The only other term in reasonably widespread use is "late term abortion", but as you pointed out some of these procedures do not actually occur in the last trimester, so can't really fall under that heading. So I'd say keeping the term PBA with the qualification that some abortion supporters object to the term is the best solution.
There is a legitimate medical term for this procedure, which goes back to before the anti-choice movement politicized it: intact dilation and extraction. That some people haven't heard the term doesn't mean we can't use it.
What I think we should do is use the medical term, and note that some abortion opponents prefer to call it by a recently-invented term that makes better anti-abortion propaganda.