Talk:Dilation and evacuation

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Wiki Education assignment: 2023-24 WikiMed Directed Studies

This article was the subject of a Wiki Education Foundation-supported course assignment, between 23 October 2023 and 18 November 2023. Further details are available on the course page. Student editor(s): SDlren (article contribs). Peer reviewers: Tacobellbeanburrito.

— Assignment last updated by Ewingdo 15:21, 8 November 2023 (UTC)[reply]

Peer Review

Is everything in the article relevant to the article topic? Is there anything that distracted you?

The article is overall adequately complete. It includes relevant information surrounding D&E, its indications, descriptions, risks, alternatives and even the recent laws judicial changes surrounding abortion in the United States. There were no sections of the article that I found distracting or irrelevant to the topic.

Is the article neutral? Are there any claims, or frames, that appear heavily biased toward a particular

The article appears to be neutral. It does a good job of pointing out the standard management of D&E with relevant sources. It also indicates instances where there is a no consensus or insufficient evidence.

Are there viewpoints that are overrepresented, or underrepresented?

The article doesn’t advocate for any certain viewpoints. It does mention the impact of abortion laws on the D&E procedure. However, discussing the varying viewpoints around abortion laws would not be appropriate for this article.

Check the citations. Do the links work? Does the source support the claims in the article?

All of the citations are functional. I was able to connect the information included in the article to the citations listed.

Is each fact supported by an appropriate, reliable reference? Where does the information come from? Are these neutral sources? If biased, is that bias noted?

Each new piece of information is supported by a relevant and appropriate reference. A lot of the information is sourced from American Congress of Obstetricians and Gynecologists, a very credible organization. Other information is sourced from reputable journals like Obstetrics and Gynecology. Those journal articles seem to be neutral in viewpoints.

Is any information out of date? Is anything missing that should be added?

A lot of the information originally included in the article was outdated. SDlren did a great a job of adding statistics from 2022-2023. Relevant information surrounding the new abortion laws was also included. A lot of the sources cited were recently published as well.

Tacobellbeanburrito (talk) 15:14, 15 November 2023 (UTC)[reply]

The description of the procedure is significantly lacking detail and information. My edit was reverted for "POV-pushing" after my attempt to fix that.

My recent edit to the article was reverted by @Avatar317 for what he describes as "repeated POV pushing by trying to hide POV language." The edit included additions of detail and statistics, including the prevalence of the procedure and the events that occur during a dilation & evacuation abortion. The reverter implies that the use of the terms "dismemberment" and "decapitation" in relation to the fetus are an attempt to "push a POV," yet that is precisely how the procedure is described in textbooks and training manuals relating to this procedure. As it stands, all the article states about the use of surgical tools in removing the fetus is, "uterine contents are removed using a cannula to apply aspiration, followed by forceps to remove fetal parts." This is a very vague, unspecific, and undetailed explanation of what occurs. My proposed adjustments to the Surgical procedure section would have adjusted the section to read:

A speculum is placed in the vagina to allow visualization of the cervix. If osmotic dilators were placed prior to the procedure, these are removed.^[1]

The cervix may be further dilated with rigid dilator instruments such as Hegar and Pratt dilators (as opposed to osmotic dilators).^[2] Sufficient cervical dilation decreases the risk of morbidity, including cervical injury and uterine perforation.^[3]^[2] Uterine contents (such as amniotic fluid) are removed using a suction cannula, followed by forceps to dismember and extract the body parts of the fetus.^[4]^[5] Crushing or decapitation of the fetal skull with forceps may be necessary to extract the head, especially later on in the second trimester.^[6]

Tissue inspection after the procedure ensures removal of the fetus in its entirety. The procedure may be performed under ultrasound guidance to aid in visualizing uterine anatomy and to assess if all tissue has been removed at the completion of the procedure.^[7] Operative ultrasonography is beneficial because it can reduce the risk of uterine perforation.^[8] The procedure usually takes less than half an hour.^[9]

This isn't "POV pushing." This is precisely how the procedure is performed, and it is described as such in a book written by Warren Hern, a widely referenced and notable provider in the abortion industry. DocZach (talk) 02:23, 3 December 2024 (UTC)[reply]

^ Management of unintended and abnormal pregnancy : comprehensive abortion care. Paul, Maureen. Chichester, UK: Wiley-Blackwell. 2009. ISBN 978-1444312935. OCLC 424554827.{{cite book}}: CS1 maint: others (link)
^ ^a ^b "Second-Trimester Abortion – ACOG". www.acog.org. Retrieved 2019-07-09.
^ Newmann, Sara J.; Dalve-Endres, Andrea; Diedrich, Justin T.; Steinauer, Jody E.; Meckstroth, Karen; Drey, Eleanor A. (2010-08-04). "Cervical preparation for second trimester dilation and evacuation". The Cochrane Database of Systematic Reviews (8): CD007310. doi:10.1002/14651858.CD007310.pub2. ISSN 1469-493X. PMID 20687085.
^ Organization, World Health (2014). Clinical practice handbook for safe abortion. World Health Organization. Reproductive Health and Research. Geneva. p. 52. ISBN 9789241548717. OCLC 879416856.{{cite book}}: CS1 maint: location missing publisher (link)
^ Hern, Warren M. (1984). Abortion Practice. Lippincott. p. 145. Fetal tissues are significantly softened, permitting easy dismemberment.
^ Hern, Warren M. (1984). Abortion Practice. Lippincott. p. 154. A long curved Mayo scissors may be necessary to decapitate and dismember the fetus, since it may be impossible to apply forceps or to do so while avoiding the thinned-out cervix.
^ Paul, Maureen, Hrsg. Lichtenberg, Steve, Hrsg. Borgatta, Lynn, Hrsg. Grimes, David A., Hrsg. Stubblefield, Phillip G., Hrsg. Creinin, Mitchell D., Hrsg. (2011). Management of Unintended and Abnormal Pregnancy Comprehensive Abortion Care. John Wiley & Sons. ISBN 9781444358476. OCLC 899157428.{{cite book}}: CS1 maint: multiple names: authors list (link)
^ Stubblefield, Phillip G.; Carr-Ellis, Sacheen; Borgatta, Lynn (July 2004). "Methods for Induced Abortion". Obstetrics & Gynecology. 104 (1): 174–185. doi:10.1097/01.AOG.0000130842.21897.53. ISSN 0029-7844. PMID 15229018.
^ Hammond, C. (2009). "Recent advances in second-trimester abortion: an evidence-based review". Am J Obstet Gynecol. 200 (4): 347–356. doi:10.1016/j.ajog.2008.11.016. PMID 19318143.

[:052-1] Management of unintended and abnormal pregnancy : comprehensive abortion care. Paul, Maureen. Chichester, UK: Wiley-Blackwell. 2009. ISBN 978-1444312935. OCLC 424554827.{{cite book}}: CS1 maint: others (link)

[:0324-2] "Second-Trimester Abortion – ACOG". www.acog.org. Retrieved 2019-07-09.

[:13-3] Newmann, Sara J.; Dalve-Endres, Andrea; Diedrich, Justin T.; Steinauer, Jody E.; Meckstroth, Karen; Drey, Eleanor A. (2010-08-04). "Cervical preparation for second trimester dilation and evacuation". The Cochrane Database of Systematic Reviews (8): CD007310. doi:10.1002/14651858.CD007310.pub2. ISSN 1469-493X. PMID 20687085.

[:042-4] Organization, World Health (2014). Clinical practice handbook for safe abortion. World Health Organization. Reproductive Health and Research. Geneva. p. 52. ISBN 9789241548717. OCLC 879416856.{{cite book}}: CS1 maint: location missing publisher (link)

[5] Hern, Warren M. (1984). Abortion Practice. Lippincott. p. 145. Fetal tissues are significantly softened, permitting easy dismemberment.

[6] Hern, Warren M. (1984). Abortion Practice. Lippincott. p. 154. A long curved Mayo scissors may be necessary to decapitate and dismember the fetus, since it may be impossible to apply forceps or to do so while avoiding the thinned-out cervix.

[:422-7] Paul, Maureen, Hrsg. Lichtenberg, Steve, Hrsg. Borgatta, Lynn, Hrsg. Grimes, David A., Hrsg. Stubblefield, Phillip G., Hrsg. Creinin, Mitchell D., Hrsg. (2011). Management of Unintended and Abnormal Pregnancy Comprehensive Abortion Care. John Wiley & Sons. ISBN 9781444358476. OCLC 899157428.{{cite book}}: CS1 maint: multiple names: authors list (link)

[8] Stubblefield, Phillip G.; Carr-Ellis, Sacheen; Borgatta, Lynn (July 2004). "Methods for Induced Abortion". Obstetrics & Gynecology. 104 (1): 174–185. doi:10.1097/01.AOG.0000130842.21897.53. ISSN 0029-7844. PMID 15229018.

[:32-9] Hammond, C. (2009). "Recent advances in second-trimester abortion: an evidence-based review". Am J Obstet Gynecol. 200 (4): 347–356. doi:10.1016/j.ajog.2008.11.016. PMID 19318143.

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