Talk:Pregnancy

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Removed details

This:

More specific, the cannabinoid receptor CB1 are at high levels on the blastocyst (fertilized egg), ready to the attachment with the endocannabinoid anandamide, an N-Acylethanolamine, if present at low level (temporary reduction), at the uterine lining (endometrium), which are necessary for the fertilized embryo can attach itself to the uterine wall, i.e. implantation, and without this connection, there will be no pregnancy.[1][2][3]

was put into the middle of the lead, and I can't imagine why that level of detail was put in that place. Nobody except a researcher is likely to need to know this level of technical detail. I could imagine it being included in an article somewhere (though perhaps not a general article like this one), but I can't imagine it being needed at the top of the article. WhatamIdoing (talk) 22:00, 30 July 2023 (UTC)[reply]

References

  1. ^ Wang, Haibin; Huirong, Xie; Dey, Sudhansu K. (2006-06-16). "Endocannabinoid signaling directs periimplantation events". AAPS J. 8 (2): E425–E432. doi:10.1007/BF02854916. PMC 3231559. PMID 16808046.
  2. ^ Wang, Haibin; Matsumoto, Hiromichi; Guo, Yong; Paria, Bibhash C.; Roberts, Richard L.; Dey, Sudhansu K. (2003-11-26). "Differential G protein-coupled cannabinoid receptor signaling by anandamide directs blastocyst activation for implantation". Proc Natl Acad Sci USA. 100 (25): 14914–14919. doi:10.1073/pnas.2436379100. PMC 299852. PMID 14645706.
  3. ^ Trabucco, E.; Acone, G.; Marenna, A.; Pierantoni, R.; Cacciola, G.; Chioccarelli, T.; Mackie, K.; Fasano, S.; Colacurci, N.; Meccariello, R.; Cobellis, G.; Cobellis, L. (2009-06-01). "Endocannabinoid System in First Trimester Placenta: Low FAAH and High CB1 Expression Characterize Spontaneous Miscarriage". Placenta. 30 (6): 516–522. doi:10.1016/j.placenta.2009.03.015. ISSN 0143-4004. PMID 19419760.

MOS:GNL in the lead

On 5 September Klisz removed the word woman's from the lead, though without reason. About twenty minutes ago, Crossroads restored it with an edit summary, I then removed it again citing MOS:GNL and MOS:SEAOFBLUE. Crossroads has restored it a second time.

With respect to Crossroads' second edit summary, the third bullet point of Wikipedia:Gender-neutral language#Precision and clarity does not apply. We aren't making a direct statement that men can have a uterus. Though that certainly is true for cisgender men (see Persistent Müllerian duct syndrome), trans men, and non-binary people. The fourth bullet point doesn't apply in this circumstance, as when modern WP:MEDRS sources discuss uteri they typically do so without gendered adverbs like woman, though some still use sexed adverbs like female. And the sixth bullet point does not apply, as we are already linking to uterus and the sex and gender distinction is not overly helpful in this regard.

Gender-neutral language issues aside, there is also a MOS:SEAOFBLUE issue here. That one is pretty clear that When possible, do not place links next to each other, to avoid appearing like a single link. Because the current text reads "woman's uterus", while being two separate links, it appears to be a single one when rendered. If we are going to keep woman here, which as I've said seems not necessary, at the very least it should not be wikilinked there per SEAOFBLUE. Sideswipe9th (talk) 00:20, 12 September 2023 (UTC)[reply]

Refreshing myself of the two past discussions linked in the edit summary, neither of those actually addressed the substance behind the edits to this sentence over the last few days. Both of those prior discussions were specifically relating to including content relating to trans pregnancies in the lead. This issue is not that, as it is about using gendered language for terminology that does not need to be gendered, and is not gendered in recent MEDRS. Sideswipe9th (talk) 00:32, 12 September 2023 (UTC)[reply]
We aren't making a direct statement that men can have a uterus. A stated purpose of the edit is to avoid saying that women have uteri, on the basis that men (and nonbinary people) can too. For the same reason, the sixth bullet point does apply as well.
The fourth bullet point doesn't apply in this circumstance, as when modern WP:MEDRS sources discuss uteri they typically do so without gendered adverbs like woman - this is not correct and easily disproven. 2021 2021 2021 2020 2020 2020 2020 2022 2020 etc. etc. Almost all such sources refer to the people affected by pregnancy as women, straightforwardly.
MOS:SEAOFBLUE states when possible, it isn't a hard and fast rule. But if that is the issue, then removing the wikilink would suffice. Neither it nor GNL justify removing a word that both experts and everyday readers use commonly, typically, and freely.
This discussion which I linked in my edit summary opened with the user proposing to remov[e] words such as "woman". This did not succeed after discussion and never has. Crossroads -talk- 00:42, 12 September 2023 (UTC)[reply]
Correct, but there could be some middle ground here; e.g., there is probably no reason to write "woman's uterus" when just "uterus" will do. But I'm opposed to peppering this article with language like "pregnant people" and "people with uteruses" and so on, because it's still not the conventional way across all RS to write about this subject (even among MEDRS sources, where usage remains sharply divided), so it is jarring to many readers (and highly socio-politicized to many of them as well). As with singular-they becoming the new normal, such language might become the new normal over time, but it has not yet. WP's articles are not the place to engage in a "culture war"; we should steer as far away from that as is practical with bounds of policy.  — SMcCandlish ☏ ¢ 😼  00:48, 12 September 2023 (UTC)[reply]
Another way to address the SEAOFBLUE issue is just to not link to Woman. We're not expecting readers to need that link to be able to understand this article, after all. WhatamIdoing (talk) 00:29, 15 September 2023 (UTC)[reply]
this is not correct and easily disproven Actually, a PubMed search for uterus AND woman, filtered to show only reviews, meta-analysis, and systematic reviews shows 126 papers published in the last five years. However a PubMed search for uterus NOT woman, with the same filters, returns 1,446 results. There is an order of magnitude more papers publish that do not use gendered terminology here than use it. Even if you count all papers published since 1975, uterus AND woman has 562 results, to uterus NOT woman's 5,881. I am very certain that MEDRS do not overwhelmingly use gendered adverbs when discussing uteri. Sideswipe9th (talk) 00:53, 12 September 2023 (UTC)[reply]
It should also be noted that everywhere else in the article where we mention uteri, we either say "the uterus" or just "uterus", without gender modifier. If we don't need that modifier in the article's body, why do we need it in the lead? Sideswipe9th (talk) 01:10, 12 September 2023 (UTC)[reply]
Something is apparently problematic with the search feature used in that way; I tried to verify the results and they don't work out. For example this article shows up in your "NOT" search but very clearly uses "woman" and "women" heavily throughout, both in the abstract and in the rest. Same here. This one uses it heavily in the body of the article. This one uses the term. And here. I could go on but clearly the NOT function in PubMed is not able to identify articles that use "uterus" and not "woman" or "women", hence invalidating the analysis. The fact that the same pattern in the results goes back to 1975, when the idea of avoiding "woman" because of pregnant non-women was nonexistent, is also telling.
The present lead sentence is (a) the status quo and there was not a consensus to change that in the past, and (b) acts as a very broad overview, which later sentences do not. Crossroads -talk- 01:16, 12 September 2023 (UTC)[reply]
It's the pluralization of woman to women. Unlike a Google search, PubMed does not always automatically search for plurals or synonyms.
Modifying the search to uterus AND (woman OR women) returns 565 results for the last five years, with the same filters. Whereas uterus NOT (woman OR women) returns 1,154 results. Expanding that to all papers ever indexed by PubMed gives uterus AND (woman OR women) 2,170 results and uterus NOT (woman OR women) 4,374 results. There's still an order of magnitude difference for the last five years, though overall the pattern is roughly 2:1 in favour genderless terminology when describing the uterus. Sideswipe9th (talk) 01:25, 12 September 2023 (UTC)[reply]
Your results only search titles and abstracts; a look at the fully viewable ones reveals that they generally use those terms in the source even if they happen not to do so in the abstract; e.g. [1][2][3] It remains the case that almost all sources on the topic refer to the group affected by pregnancy as women, straightforwardly. Crossroads -talk- 01:36, 12 September 2023 (UTC)[reply]
Perhaps they use gendered adverbs for discussing pregnancy, I haven't checked too deeply as it's tangential to this discussion, but not for the uterus. Each of those three papers, as well as the five this comment do not use a gendered adverb when discussing the uterus. And most instances of the term also do not use a sexed adverb either. Overwhelmingly when sources discuss uteri they do so using gender-neutral and sex-neutral terminology.
As an amusing aside, as you highlighted a French language paper above, the French word for uterus; utérus, is a masculine noun. Sideswipe9th (talk) 01:49, 12 September 2023 (UTC)[reply]
For what little it is worth, I support removing "woman" from "uterus" for the simple fact that pregnancies in girls 10-14 are hardly unknown, and it rings culturally hollow to me to refer to such people as "women." But happy to go wherever consensus leads. Cheers. Dumuzid (talk) 03:37, 12 September 2023 (UTC)[reply]
You do know PubMed contains articles about non-human organisms with uteri...?[4][5][6][7] There are 837 results in the last 5 years for "mouse" AND "uterus", 517 for rat, etc.
EDIT: Now I see that you limited it to reviews/metas/SRs; but that still yields hundreds of articles in other animals, including 26 in pigs, 47 in cows, etc. JoelleJay (talk) 04:26, 12 September 2023 (UTC)[reply]
Given that the balance of the article uses "woman" a number of times I don't understand why we would avoid the term in the lead. The discussion of the number of times papers use woman/women really would need to look at the specific examples to see if/why they didn't use "woman". Did they use an alternative word indicating gender/sex, did they actively avoid specifying gender/sex or was the topic specific in a way that gender/sex simply wasn't mentioned (blood profusion across the uterine wall as a hypothetical example). I think avoiding the word "woman" in the lead would violate the 3rd GNL example which specifically uses pregnancy as an example. Springee (talk) 06:56, 12 September 2023 (UTC)[reply]
This has come up again.
Could someone please tell me why it's really really really important to link (NB: link, as in Wikipedia:Manual of Style/Linking, not merely write the word out in plain old text) the word woman in that particular sentence?
If we feel the need to provide a link to Woman early in the article, could we please do that in the infobox's caption, or in the ==Terminology== section, or by introducing the word woman into the second sentence and linking it there ("A multiple pregnancy is when a woman is pregnant with more than one offspring, such as with twins"), instead of in the first sentence, where the blue "woman" runs into the blue "uterus", and makes it difficult to tell whether clicking on "woman" will take you to the article about women or to the article about human uteri? WhatamIdoing (talk) 05:00, 21 November 2023 (UTC)[reply]

Recommend adding section on epilepsy to Pregnancy > Diseases in Pregnancy

Epilepsy affects over 1 million people who can bear children in the U.S. [8]. A consortium of epilepsy and reproductive care providers have recently consolidated up-to-date research about epilepsy and pregnancy, including related to anti-seizure medications, on a website aimed at both patient and clinician audiences. The site aims to correct misconceptions about safety issues and risks associated with bearing children if you have epilepsy. Adding a section on epilepsy to the Diseases in Pregnancy section of the Pregnancy page would give people with epilepsy and their doctors a reliable place to start researching the implications of getting pregnant while managing epilepsy and medications taken to control it.

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Existing Text: N/A
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Suggested Text:

By closely working with their doctors, ideally well before pregnancy, people with epilepsy can have healthy pregnancies and healthy babies. People with epilepsy who are not receiving proper medical care may experience breakthrough seizures while pregnant, and their babies may potentially be adversely impacted. Choosing an anti-seizure medication (ASM) with a lower risk for teratogenicity and major congenital malformations, checking medication levels throughout pregnancy, and taking the lowest effective ASM dose can ensure positive outcomes for parents with epilepsy and their babies. [https://www.clinicaltrials.gov/ct2/show/NCT01730170 The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD)] study showed that with appropriate epilepsy care, people with epilepsy are no more likely to experience an increase in seizure frequency while pregnant than non-pregnant people are.[https://jamanetwork.com/journals/jamaneurology/fullarticle/2789145] [https://epilepsypregnancy.com/for-clinicians/seizure-control/]

Some anti-seizure medications (ASMs) have a higher risk for [[Teratology|teratogenicity]] and major congenital malformations. People with epilepsy should work with their doctors to select an ASM with a lower risk of adverse neurodevelopmental outcomes (e.g., lower IQ or [[Autism spectrum|autism spectrum disorder]]). They should also work with their doctors to identify the lowest effective ASM dosage that will maintain their seizure control. [https://epilepsypregnancy.com/for-clinicians/anti-seizure-medications/] [[User:RobertAtkinson|RobertAtkinson]] ([[User talk:RobertAtkinson|talk]]) 21:38, 30 October 2023 (UTC)

RobertAtkinson (talk) 22:03, 30 October 2023 (UTC)[reply]

Your organization's web site does not meet the requirements set out in WP:MEDRS for sourcing biomedical content. We cannot use it as a source, nor can we use the single studies you are otherwise citing. MrOllie (talk) 22:16, 30 October 2023 (UTC)[reply]
See also Talk:Epilepsy#Suggest updating text about pregnancy in Complication section. We might someday have an article on Epilepsy and pregnancy. WhatamIdoing (talk) 21:36, 1 November 2023 (UTC)[reply]

Stress

I've got some concerns about this new section. First of all, it's really long and goes into way too much detail (e.g., telomeres). Secondly, I think that some of it is probably wrong. For example, stress isn't technically a complication of pregnancy. Gestational diabetes is a complication of pregnancy; being stressed because you don't have the financial or social support you need is not a medical complication. I'm going to substantially shorten it. I hope we can find a compromise that includes stress in the article but doesn't rely on primary sources or creating stress by making readers feel like their normal and rational reactions to everyday life is damaging the next generation. WhatamIdoing (talk) 04:44, 21 November 2023 (UTC)[reply]

Well, nearly all of that was based on inappropriate use of WP:MEDPRI sources, or was needlessly detailed or verbose. It's much shorter now. Please see the edit summaries I left in the page history. WhatamIdoing (talk) 04:54, 21 November 2023 (UTC)[reply]
Trimming was appropriate. Also, it presently states The children of women who had high stress levels during pregnancy are slightly more likely to have externalizing behavioral problems such as impulsivity. We probably need a source to clarify this is correlation. It’s potentially confounded by other factors (e.g. genes from stressed parents are passed to offspring, or that stressed parents might live in stressful situations that their children are also exposed to). Zenomonoz (talk) 05:03, 21 November 2023 (UTC)[reply]
The source is cited at the end of that sentence. The abstract says "The magnitude of the prenatal effect size remained largely unchanged after adjusting for postnatal distress", so apparently they've already controlled for some confounding factors. I think what's missing is an idea of what level of stress 'counts'. Is this the level of stress like "pregnancy is uncomfortable and I don't know how we'll cope financially", or is it the one like "my husband was murdered while I was pregnant"? WhatamIdoing (talk) 01:23, 22 November 2023 (UTC)[reply]
Also do you think there is a bit of content that could be moved under single subheadings? There is a 'complications' section but 'diseases in pregnancy' is a separate section? Zenomonoz (talk) 10:31, 21 November 2023 (UTC)[reply]
==Complications== is the section for medical problems caused by the pregnancy. ==Diseases== is the section for people who have an unrelated medical condition and also get pregnant (like: if you already have an autoimmune disease, can you have children safely?). The latter might benefit from a clearer section heading. External stress might fit into the ==Diseases== section, but I'm not sure about that. WhatamIdoing (talk) 01:27, 22 November 2023 (UTC)[reply]
Good point. Zenomonoz (talk) 00:01, 23 November 2023 (UTC)[reply]
Yeah it definitely seemed to make some big claims without secondary sources, though I don't know the subject that well. Thanks for trimming. Pyrrho the Skipper (talk) 16:21, 21 November 2023 (UTC)[reply]
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