My First Entry in my Quivering Daughters Diary

Embarking on the Journey

through Hillary McFarland's new work, 

"Quivering Daughters: 

Hope and Healing 

for the Daughters of Patriarchy"

Thursday 24Jun10  

I started out the day and kept checking the door to make sure that the "UPS man" had not escaped my attention, and maybe he came and left my book at the door without knocking.  Hopeful that my book might arrive yesterday, I checked the UPS tracking number that I'd received from the bookseller by email.  It was in Pennsylvania at 7:36AM , at least a ten hour drive away at that point, so I was sure that it would not arrive that day.  (I was excited and obsessed enough to actually go to the UPS website to see where the book was.  Am I nutz?  Rhetorical question.. Please don't send me emails.  We already know.) 

I'd made several trips down the stairs to check my doorway for the book by the time the knock came!  The only time I've ever been this excited about something coming in the mail has been when I received my Nursing Board results in the summer of '86, and I kissed the mailman when I opened the letter!  I also watched the mail like a hawk for my engagement ring that my husband sent via regular post from half-way across the country in '88.  (He didn't insure it, and it took over a week to arrive.)  Rather than kiss the UPS man today, to express my excitement and gratitude, I gave him a pretty little gift box of Choxie candy that I'd picked up at Target (on clearance, of course ;). 

I’d called Hillary on the phone, as we’d arranged in advance to open our packages while we had each other on the phone, acting like excited, silly school girls.

It was very surreal.  I’ve been looking at the cover of the book, having seen at least one version of it before the final copy, so it is now familiar to me.  It seemed very familiar as a book, and I could hardly believe that I was holding the real book with the pages in between that familiar scene I’d come to know.   That felt weird.  Hillary and I had talked about the little girl in the photo, and I prayed for her and all those little ones like her.   You know those kind of prayers – one of those prayers were your heart just says a volume in an instant with a silent groan of travail that spills out of your chest and floods your arms and face with His presence mixed with your aching empathy.

I had to give it the general look, and it is beautiful.  The margins are modest, making room for the maximum number of printed word.  The print size is good.  The chapter titles look lovely.  The Table of Contents is clean and loaded with info which I like.  (Some books have six simple lines, and this has lots of meat, even in the Table.)

Hillary had me jump to the acknowledgments, and I skimmed until I came to the place where she mentions me, and it is lovely.  Then I cried a little, not much.  (But I cried at that awful '70s remake of King Kong with Jessica Lange and Jeff Bridges, so this is not unusual for me.)  I looked at the Afterword next with my name there on the page, and it feels odd.  I flipped around through it, and it was terrifying in a sense.  I’d sent that chapter to several book authors, doctors, nurses, counselors, and other mental health professionals for peer review, but there is still a sober feeling about one’s own words in a book.  I love the image of the dandelion blossom gone to seed as an analogy for our words –when they have been blown into the wind, who could collect them back again?  Though God remembers our every idle word, those in print seem different somehow.  It’s a sober and serious thing, and as permanent as a thing can be when it is in a book, written down.  May the wind carry those seeds and may they bring forth good fruit.

I read the recommendations just a page away from the book cover next, and they are all as excellent and as lovely as any in any excellent book.  I feel the same way about Pastor Wade Burleson’s endorsement on the back cover.  I join my heart to his words in prayer when I read them as he says, “Read it and weep.  Read it and think.  Read it and quiver no more.”  That is my prayer.

I then hopped off the phone with Hillary after we consoled one another, wondering how one can really address these serious problems in our little corner of the Church without intimidating some.  I’d heard Francis Schaeffer in an interview many years ago say that he would have likely have benefited spiritually if he had not spent a considerable effort addressing the more difficult aspects of living in a fallen world.   (As Jocelyn Andersen, author of “Woman Submit!” wrote to me recently and likewise explained, she would also rather be “kicked back under my Honey Bell tree sipping lemonade and writing fiction with no point to it other than to enjoy.”)  But as Schaeffer explained, he believed that God called him to address some of these more unpleasant issues that we Christians face in life, rather than focusing only and exclusively on the ideal.  He obeyed what he understood as his calling to be faithful to do what God had called him to do.  I also wish that I knew nothing of the painful elements of the pains faced by Quivering Daughters, spending all my days singing, playing the piano, and strumming my harp and bowed psaltery in the ecstasy of worship and communion with the Lord.

Hillary and I have bantered around with the idea that I am like a midwife to her in the effort to get this book to press, both of us childless in the flesh.  I’d heard that old character T.L. Osborne preach one Christmas season that as the Spirit of the Lord overshadowed Mary and conceived Jesus in her womb, so does the Lord place the seed of His Word in the soil our hearts.  In time, when the seed of that Word brings forth fruit, that which is born of us is of the Holy Spirit, too.  (I’ve blogged about this in Christmas posts.)  And I believe that God has blessed me with the honor of bearing fruit in the Spiritual sense, in many different ways, complete with labor and travail.  In this same way, I see the effort that I have made to bring the message about spiritual abuse like a birthing, and for Hillary, this book is like her child.  (If I could conveniently find that most excellent Ann Voskamp quote on the subject, I would post it.  Alas, you'll have to buy Hilary's book or read both of their blogs to find it.)

I tried to catch up on some other things before I sat down to read the book so that I would not be interrupted and could give the book my full attention.   I’d just read the beautiful Foreword by Elisabeth Esther (haunted by her “and yes, sweet one, it is abuse” comment, so aptly stated), and my husband arrived with mail in hand.  There amidst the junk was a beautiful invitation to the wedding of my best friend’s son.  My friend said a long time ago when her babes were small that I could take some credit for at least two of them for being so supportive of her and, at times, involved with the kids.  (She just gets to pick which two at any given time, depending on whether she’s unhappy with them!)

It was a silly thing said in passing to me, but it meant so much to me, without any little ones of my own.  I’ve watched this handsome and fine young man grow up from afar, and I am so proud of him and proud of his parents.   I am so touched and deeply moved that this invitation came on this very day, like a kiss from heaven.  I called my friend and wept, so glad that her son and her family became a part of this important day for me.  Today, on the day that I feel like a midwife who has finally attended to her duties and now has a chance to hold and love the incredible gift of wonderful new life she has helped a young mother bring into the world.

I thought again of a poem I recently referenced (“The Gift,” by Padraic Pearse) which states:

O wise men, riddle me this: what if the dream come true?
What if the dream come true? and if millions unborn shall dwell
In the house that I shaped in my heart, the noble house of my thought?

It is my best hope and my highest aspiration that if I cannot birth my own in the flesh, I want to sing the praises of the Lord for those blessed children promised to the barren.  May the houses that I shame in my heart be noble, a safe place for many precious souls.  I pray that I've also been a help to Hillary who does likewise with her book, creating a place of hope and healing for the daughters of patriarchy.

Isaiah 54  (The Message)

Spread Out! Think Big!

 ^1-6 "Sing, barren woman, who has never had a baby.
   Fill the air with song, you who've never experienced childbirth!
You're ending up with far more children
   than all those childbearing women." God says so!
"Clear lots of ground for your tents!
   Make your tents large. Spread out! Think big!
Use plenty of rope,
   drive the tent pegs deep.
You're going to need lots of elbow room
   for your growing family.
You're going to take over whole nations;
   you're going to resettle abandoned cities.
Don't be afraid—you're not going to be embarrassed.
   Don't hold back—you're not going to come up short.
You'll forget all about the humiliations of your youth,
   and the indignities of being a widow will fade from memory.
For your Maker is your bridegroom,
   his name, God-of-the-Angel-Armies!
Your Redeemer is The Holy of Israel,
   known as God of the whole earth.
You were like an abandoned wife, devastated with grief,
   and God welcomed you back,
Like a woman married young
   and then left," says your God.

I then went and reread the Acknowledgements section in Hillary’s book, from start to finish.  For the next thirty minutes or so, I tightly clutched the book to my heart with my arms crossed over it, praying, weeping, groaning.  I joined my heart with Hillary’s in a prayer for this to become reality for many, as she writes,

To my quivering daughter-sisters – you inspire me with your courage and bravery.  Every day I wish I could throw my arms around you; thank you for reaching, for asking, for searching.  Thank you for your faith, for seeking the narrow way that leads to life.  Thank you for loving truth, even when it hurts.  Thank you for living, even when it hurts.  For daring to step into the unknown so that He may become known.

And I also prayed again that Burleson echo:

Read it and weep.  Read it and think.  Read it and quiver no more.

 I have endured many deeply painful things in my life, and just recently, it seems like so many of them have not been for naught.  I want those griefs to be transformed and exploited for good, things which God can use for good to comfort others and save many.



Friday 25Jun10

All I'm ready to say for now after a cover to cover read because my heart is too full....

The book is perfect, save for my contribution which has a stupid typo that is in probably the worst possible place.  (Must have been asleep when I wrote that part.)  Yeah, well.  Keeps me humble, words that I jumble.  Sigh of wounded perfectionism.  Gotta go read a little Corinthians again, and chapter Ten, too.  I love the book, save for my typos.   A lovely child.   More to come....

Announcing Quivering Daughters!

Though I haven't seen the actual book yet, I just got word from Hillary McFarland that "Quivering Daughters" is now available to order online.  (I feel like a family friend, visiting a new mother, waiting to get a chance to hold the new baby after waiting so long to see the new little bundle of wonder.  How wonderful it is to think about who this new person God just brought into my life will be as I get to know them.)

Currently, Barnes and Noble has the best price, but Amazon also offers the book as well, and the selling prices seem to fluctuate for some unknown reason.  ???  Both sites offer free shipping for orders over $25, so why not order two books?

Addendum Note:  If you use a Discover Card and go through the Shop Discover page at the DiscoverCard.com website, at the time of this posting, you can earn a 10% Cash Back Bonus when you buy through Barnes and Noble.  The free shipping offer still also applies.

I haven't figured out how I'm going to go about making the offer, but I want to give away a few of the books to the readers here.

Probably in about a month, I will have figured out some creative way to have some kind of raffle or something.

Any ideas?

How Lawyers Lie With Statistics

Vision Forum willfully distorted statistics related to the true morbidity and mortality associated with ectopic pregnancy.  Ectopic pregnancy still remains the leading cause of death of all pregnant women in the first trimester of pregnancy.  It accounts for 9% of all maternal deaths in all pregnancy-related deaths.  In the case of death of pregnant women which includes non-pregnancy related death (unrelated heart disease or car accidents, for example), ectopic pregnancy still accounts for 6% of deaths of pregnant women.  

Despite these statistics, Vision Forum and Samaritan Ministries insist that ectopic pregnancy does not pose a significant health risk to women.  They have offered that 60-100 cases of live births resulting from ectopic pregnancies have been documented, but I can find no such reference to this rate of frequency.  One rate of frequency of "one in 60 million" has been offered to describe the rate of such births, and many falsely understand this as a probability statement when the probability for such births is actually ZERO.  I believe that the publications produced on this topic also capitalize on frequencies, using them as probability statements.  In the absence of well-rounded data presenting all the statistics, both Vision Forum and Samaritan Ministries manipulate trusting readers to accept a dangerous view of a very serious medical problem experienced by women of childbearing age.  Ectopic pregnancy, a deadly threat to women, should not be viewed as a game of chance.

Note how attorneys alter the way they present information to juries in order to make statistics seem either more or less impressive.  It is my hope that the reader will come away with a greater appreciation for the language of medical statistics and how numbers can be used to deceive the unsuspecting.

Excerpts from

The Psychology of Numbers in the Courtroom: 

How to make DNA-Match Statistics Seem Impressive or Insufficient

South California Law Review, Vol. 74, p. 1275, 2001

(emphasis mine!)

Consider the following four formulations of a one in one thousand DNA match statistic that might appear in a criminal case:

1. The probability that the suspect would match the blood specimen if he were not the source is 0.1%.

2. The frequency with which the suspect would match the blood specimen if he were not the source is one in one thousand.

3. One tenth of one percent of the people in Houston who are not the source would also match the blood specimen.

4. One in one thousand people in Houston who are not the source would also match the blood specimen.

These four formulations are legitimate, mathematically comparable ways to describe a one in one thousand DNA match statistic. However, they are psychologically different and their effect on jurors varies significantly. . .

The bottom line appears to be this: When the statistic is framed in the language of probability (e.g., 0.1%) in a way that highlights a particular suspect’s chance of matching by coincidence, it tends to be persuasive. . . . In short, DNA match statistics that seem impressive when presented one way seem insufficient when presented another way. . . 

The results dramatically illustrate that the persuasive power of DNA evidence may depend, in part, on how the match statistics are presented and framed. . .

Although the different ways of presenting the DNA match statistic offered here are legitimate, they may not be equally likely to produce a proper weighting of the DNA evidence. As noted earlier, previous research suggests that jurors underweight statistical evidence, including DNA evidence. This would seem to bolster the argument that evidence should be presented in s/p rather than m/f form because the former is associated with greater perceived weight for the DNA evidence.

On the other hand, studies also show that people reason better with statistical data that are presented as frequencies rather than as probabilities. People are not only more likely to reason in accordance with the logic of probability theory with frequencies than with probabilities, but a frequency presentation decreases the risk that people will subscribe to various statistical fallacies. . .

One reasonable solution is to employ frequency presentations in which efforts are made to discourage people from devaluing the DNA evidence on grounds of nonuniqueness. Alternatively, decisionmakers could be informed that there are different ways of presenting the same statistical information. . . 

This paper began with the assertion about the well-known power of DNA analysis in the courtroom. I caution that this power is a theoretical one. In practice, DNA analyses produce statistics that may or may not persuade jurors about whether a particular person is the source of a particular sample. 

The studies offered here suggest that the persuasive value of DNA evidence may depend as much on an understanding of the psychology of numbers as it does on the underlying science and the statistical expression of that science. 

~~~End of cited work~~~

Cindy suggests:

(That's why you should stick to obtaining medical advice from physician and nurses, making decisions about your health with your own physician.  It is best not to seek such information from an attorney with an agenda.)

Why an Average Can Be Misleading and How To Get Number Savvy: Vision Forum Myths About Ectopic Pregnancy as a Prototype

 

... Why I take issue with the misleading nature of the “1 in 60 million” rate of ectopic pregnancies that result in live births as quoted by Vision Forum and Samaritan Ministries.  

 Start HERE for some prerequisite ideas about how we can easily fall into "lying with statistics."


Start HERE for an overview of Vision Forum's aberrant stance on Ectopic Pregnancy

Briefly backing up…

Vision Forum and Samaritan Ministries cited a physician who stated that the chance of a live birth from an ectopic pregnancy was “60 million to one.”  I suppose that’s not Vision Forum’s fault for republishing this information, but I do fault Samaritan Ministries for disseminating the related information regarding healthcare statistics.  As an entity involved in the procuring and payment of healthcare, they have a higher burden of responsibility to communicate accurate information to their membership.

 But how would they know that the doctor actually used a “SWAG” ( what is referred to informally as a “Scientific Wild A_ _ Guess,” a term that is even part of the court record in the State of Texas, for an associate accidentally used it while giving expert testimony!  The Judge stopped him and asked him to define the term.).  The doctor quoted in an interview for broadcast to the general public did not know that his words were going to be used to forge policy and procedure in treatment in ectopic pregnancy.  In a peer reviewed journal within his field, his “guestimate” would have been rejected.  And Samaritan Ministries is not run by healthcare professionals and must have no capable actuarians evaluating their publications, so they would not have been able to evaluate the veracity of any of these health statistics.  Yet, these statistics were used as a community health improvement measure and an educational resource for their membership.

I planned on posting more information here from Darrell Huff’s book, “How to Lie with Statistics,” but I think that I can finish this subject up in one (or two) posts through the example of the psychology of a statement like “one in a million.”  What does that mean?  As our national debt grows, for example, we are forced to comprehend bigger numbers in our everyday lives.  I hope that this little walk thorough simple statistical concepts will give you some tools to help you not fall into traps set by manipulators or even by well meaning people who are just ignorant of the significance of  how some of these things work, particularly in healthcare.

In my field of nursing and in medicine and disciplines like psychology, before anyone can claim that one event has an effect or even a relationship to another event, we are all held to a standard of first trying to disprove our data.  Statistics give us tools that help us sort out mere chance from true relationship by putting data to mathematical tests.  A doctor might see an unusual number of people with a certain disorder, and he might think that his patient sample constitutes all people.

By applying statistics, we can use math as a tool to help us pull away our own blinders or can give us validation if our suspicions are correct.  In psychology in particular, math helps us take something very subjective in nature and makes it as objective as possible by developing tools which are validated first, and if they prove that they yield stable data that is both precise and accurate (Does it really measure what we want to learn about?), that data can then be used to help tell us important and truthful facts about a particular problem, The same rules and principles are those applied in all research, from whether a new wound product speeds healing to whether the lab instrument in my husband’s office is operating properly by accurately detecting chemicals as evidenced by a clean linear regression curve to whether drugs get approved for use by the FDA,

When dealing with populations of people, it should always be noted that generalizations, to some degree, are never true for an individual.  (Ha! Though there are those exceptions to the rule, too.  People are unique about everything, God’s “non-normative” creations.)  But, we can also gain much wisdom from understanding groups, much in the way I believe that the Bible talks about seasons.  We know and trust things about the seasons, and wisdom helps us make decisions.  In a way, the application of math helps us discern wise action and can give us keen understanding.

For the sake of the audience, I've cut a few corners, so a statistician will get a bit irritated a couple of oversimplifications I make.  If there are any people out there that do take issue with me, please help me out and write a post that I can publish here!

 In the previous post, we mentioned the mean, mode, and median.  Building on that concept, I want to show you what those numbers usually look like when plotted on a graph through simple algebra.  Most things having to do with human beings end up falling into a “Bell Curve” pattern, and I’ve created one to illustrate all live births from pregnancy.  The math is simple, but plugging the right numbers into the right places and collecting the data itself can be trickier.  But here is what all live births look like on a bell curve.

Now, looking beyond there, lets put our “million to one” or any average (sum of the values of n divided by n) on our bell curve.  When someone says only “a million to one,” that does not mean that your unusual case is one in a million, because any random one in that million is the same.  The statement really doesn’t say much about the unique nature of the more uncommon examples of things.  A baby born from an ectopic pregnancy may be one out of a billion to one, but every other one in that billion is also “one.”  So these statements are misleading.  In healthcare or any research, it is unethical to use these kinds of rates as probability statements in the way Vision Forum has done for the purpose of advising people regarding their health, because the number has not been scrutinized.  I’d actually planned to run a statistical test to show the rarity of ectopic pregnancy births, but I can’t even obtain numbers to be able to make the roughest of estimates in terms of proper statistics.

 Compare the value for the random mean or average and where it falls on the curve for all live births with where live births from ectopic births fall on that same graph.  One in a million is ANY ONE in that million, and when evaluating the rarity of these cases, it is highly unethical to use such a measure to make a meaningful statement about the rare case. We already learned in the previous post that means (averages) are misleading.  If I had turned in something like this (what Samaritan Ministries disseminated) in a paper in Nursing Research as an undergraduate, I would have failed the assignment.  But I believe that Vision Forum and Samaritan Ministries have misapplied statistics to their advantage to give trusting people a false impression about the safety of their recommendations regarding ectopic pregnancy.

Well, it looks like at least one more post is called for after all….

A little more to come.

Means, Medians, and Modes: Vision Forum Definitely Works the Psychology of Numbers to their Advantage at the Expense of their Followers

... Why I take issue with the misleading nature of the “1 in 60 million” rate of ectopic pregnancies that result in live births as quoted by Vision Forum and Samaritan Ministries. 

Link HERE if you haven't read the previous posts pertaining to Vision Forum, Samaritan Ministries, and their dangerous views on ectopic pregnancy.

I suspect that until I get caught up and do at least a rough chi-square analysis to demonstrate how these calculations work, the probability is actually zero and the actual cases of live births may be more one in some obscene number that’s so big, it has no meaning.  That’s why the probability when calculating these odds is equal to ZERO.

Let’s start with Don Veinot’s blog article which also takes issue with Vision Forum’s position on ectopic pregnancy to demonstrate how such large numbers can become meaningless quickly.

From "The Crux," 17Jun10:

Doug Phillips and Vision Forum take the view that the medical treatment which preserves the life of the mother, abortion, is not an option and cites the case in Canberra, Australia which trumpets the headline Mother Gives Birth to Girl After Nine-Month Ectopic Pregnancy, No Abortion

This may sound persuasive unless you actually read the article which clearly states:

Doctors are calling Durga a miracle baby and say the chances of both mother and baby surviving are a million to one.

Using this as a persuasive argument is like using the true story of Michael Holmes, Skydiving miracle: Man falls two miles (the jump is on video ) to prove that sky diving without a parachute is safe.

Technically, the "million to one" comment is just an expression of speech to convey the rarity of the incidence.  How many of people constitute a million anyway?  How many babies are born in the US?  In the world?  In a year?  In ten years?  In half of a century?  How many people does that add up to be, and how often are these babies born?  That incidence is much much greater than one in one million!

Sometimes numbers get so big that we don't really even understand what they mean.  We can develop ways of understanding very large numbers, and in healthcare, we often create and use an index that adjusts for individual variation.  In monitoring the pumping action of the heart, a person might have a cardiac output of 5 Liters per minute which might be normal for a six foot man of normal weight, but for a woman with a small build who is only five feet tall, a normal output might be only 3.5 Liters or less.  To adjust for these variations, we calculate an index by bouncing the cardiac output number off of body surface area.  Using the cardiac index, I have a better idea of how they are doing without knowing their own personal norm, though I am quite literally still monitoring their cardiac output.  Just as in statistics and in "hemodynamic monitoring," numbers become tools that help us discern reality and understand what is happening to us.  We have a responsibility to properly interpret and use this information properly.  Handling numbers properly should be of an even greater concern for the Christian, especially the Christian pastor or teacher.

Let me explain why these numbers can be misleading.  To arrive at the 1 in 60 million figure, I believe that I understand the physician's comment and where he derived his numbers.  (In a previous post, I gave the Vision Forum author the benefit of the doubt that the physician did state that there were 60-100 such babies that survived an ectopic pregnancy, though I cannot find it documented in the source mentioned.)  If you take all the babies born in the world in approximately 30 years and divide this number by 60, you do come up with a "mean."  But what does this "mean" really MEAN?

Darrell Huff in his excellent book, "How to Lie with Statistics" explains this problem quite well.  The physician has calculated the Arithmetic Mean or what is commonly called an "average."  It is the sum of the values of n divided by n, essentially.  But does this give us the type of information that we need in order to understand the frequency of ectopic births as the physician has done?  NO!  He's given an an arithmetic average.

Looking at the chart above, a picture tells us much more than prose can at this point.  In Huff's book, he describes a person who wants to move to a community, and the prospective person seeking to relocate speaks with someone who seems like a typical representative of the town in question.  But can just one individual give you the kind of information you seek?  If the community representative represents the median, this might prove helpful to you.  He is the true guy in the middle with equal numbers of people below and above him.  But if you likely fall into the category of with the mode (where most people fit), if you pay attention to the man who represents the average or mean calculated by how much money people make divided by people in the community, you will be quite disappointed if you move there.

The figure of 1 in 60 million is a number we can comprehend somewhat.  The city where Vision Forum is headquartered, San Antonio, broke a population of 1 million while I lived there a few years ago.  I can comprehend something of this number of people.  I can then imagine that sixty million is something like sixty cities that are this same size.  Surviving babies from ectopic pregnancy are so rare that I find this framework to be too generous, and the number is as misleading as the man in the figure above that makes $57,000 per year.

As stated in an earlier post, I want to keep investigating the matter to discover just how many documented cases of these births exist, and I will be happy to report and celebrate them.  Though the US still has lousy infant mortality rates in comparison to other countries which is always surprising to me, medicine has made many great strides and advancements while the incidence of ectopic pregnancy rises worldwide.  The statistics may well have changed and I'd be happy to report this here.  But at least the reader here may gain some insight into the problems I find with the way some of these numbers have been handled.

More to come.

Hey, Even I Lied With Statistics (By Accident!)

Ignorance, Stupid Error, and Willful Intent:  Vision Forum is still guilty of objectifying women and children

Christians often quote the Apostle Paul when he wrote to the Church at Rome that "God works all things together for good."  Today, I hope that my own error can be used for good, illustrating that statistics can be tough.  Though I am mortified and have sweat through two changes of clothing since I figured out what I did, I think that it illustrates a fine point in the discussion of how we can easily get turned around with statistics.  I hope that it demonstrates that we always have the option to "eat crow," and Winston Churchill once said that it makes for a more than adequate diet.  Where sin (missing the mark) abounds, grace does much more abound.  I hope that this is one instance where God can show His strength through my weakness and show glory through my shame (Ps 4:2).  This verse was of great comfort to me today:

If I must boast, I will boast of the things that show my weakness.

1 Corinthians 11:30-31

I expect that something similar to a portion of this post that now follows will appear on No Longer Quivering sometime in the near future, though I expand a bit more upon the subject here in my own corner of the internet.  If I had intended to be misleading from the start, I would have not included all of the numbers in the post where I first made the error!

. . . .

Vision Forum Ministries (the non-for-profit arm of Vision Forum) capitalizes upon connotation and summarizes their family and Pro-Life oriented Mission Statement by describing themselves as Christians who follow patriarchy as well as their created concept of “multigenerational faithfulness.”  Trusting people often fail to recognize the darker doctrines beneath the pleasant pictures connoted including "Protestant Exclusivism," their own version of Darwinian social engineering, and their view which defines daughters as a "dynamic means" for a man to "extend his influence into other covenantal family units."  The group's claims of an uncompromising Pro-Life status also beguile and mislead trusting followers while they concurrently recommend alternatives like stoning rebellious teens as well as the refusal of surgery for women carrying a life-threatening tubal pregnancy.

Properly attributing statistics and applying their meaning can be no easy matter, even if a person has been trained in their use.  Much to my own mortification, I realized today that I falsely reported the statistics related to a ten year estimated maternal death rate owing to ectopic pregnancy, misrepresenting it as an annual figure.

Based on the incidence of ectopic pregnancy maternal death which accounts for 6-9% of all maternal mortality, according to the Lancet's worldwide estimate for 2008, ectopic pregnancy would account for approximately ONLY 25,000 of those deaths.

Today, I "enjoy" the humble honor of catching my own demonstration of human error by reporting it myself.

But not so with some extremist groups.

When pointing out the unethical nature of the Vision Forum policy on ectopic pregnancy, Midwest Christian Outreach noted today that Vision Forum ignores errors, citing the example of their policy regarding the "unmitigated disaster" of woman's suffrage.  In response to pressure from critics, Vision Forum merely deleted and buried the documentation of their former position without any hint of redress.

I noted today that Vision Forum and Samaritan Ministries made another gross error in their reporting of live births resulting from ectopic pregnancy.  Both ministries published that 60-100 live births have resulted from these rare cases.  I found no such statement in the reference specifically footnoted in the original work (nor in the accompanying audio on the page), nor a statement of the necessary 50 year time frame for these births.  I suppose that this could be human error in the original work, but it does not account for failure to comprehend the meaning of the data in their other listed sources.  Could this presentation style used by Vision Forum's President, an Attorney, alter perceptions about ectopic pregnancy in the same manner that the psychology of numbers affects jurors in the courtroom?

Upon contacting organizations including several different Academies of Obstetrics and Gynecology, the National Right to Life organization, and data specialists within the CDC to verify the figure of 60-100 live births, none of these agencies had any knowledge of the existence of data supporting this suspicious claim.  Even with the willing cooperation of all of these professional groups, I have only been able to verify a rough dozen of successful, documented births to date.

. . . .

I plan to keep looking, seeking some services through the CDC for which I will have to pay a fee.  An arm of the CDC keeps data that does not necessarily make it into published statistics, but the process of obtaining this data is long and rigorous. So that information will not be forthcoming any time soon! (I chuckled when it was suggested to me that I focus on the 9% fatality rate for ectopic pregnancy from among all maternal death rates.)

I was greatly encouraged by the fact that everyone with whom I've discussed this matter at said agencies expressed great disdain that any Christian would recommend that women should refuse surgery for an ectopic pregnancy prior to tube rupture.  Professional people and Pro-Life people at these agencies expressed confusion and shock.

One physician noted to me on the phone that 95% of fallopian tubes do rupture in the case of tubal pregnancy, and I wondered if they were citing this study that I recalled when pouring over the data reported by the World Health Organization.  Samaritan Ministries published that the dangers of rupture are surprisingly moderate and occur in only 20% of cases, though more may rupture when seeking medical care, seeming to suggest that the morbidity experienced by women with tubal pregnancies is actually nosocomial or treatment-induced.  (In the post which will follow this one, I will talk about "cherry picked" data and seemingly innocent ways of presenting information.)

AND I spent some time on the phone with the National Right to Life organization today in my efforts to track down statistics on this matter.  I also expressed my concern that Dan Becker of Georgia Right to Life has been quoted in support of Doug Phillips' views and publicized as a speaker for Vision Forum's upcoming "Baby Conference,"giving the impression that Mr. Becker wholeheartedly supports the Vision Forum position and that National Right to Life does as well.    I was ASSURED informally and emphatically that National Right to Life In NO WAY supports the Vision Forum position on withholding treatment in the case of tubal pregnancy.

. . . . . 

Now we can get back to "How to Lie with Statistics" and why odds of 60 million to one as a statement of probability are likely too generous.

I am excited about the next few posts that I have planned.

I want to explain the difference between an average, a mode, and a mean, and how even simple statistics can be very misleading.  (And that's all without our plain old human errors like mine this week!)

Why We Get Tricked Into Lying With Statistics: Conditional Probability, Ecotpic Pregnancy, and Confirmation Bias

Calling All Statisticians!

Please, somebody, HELP me figure out the probability of a live birth from a non-tubal ectopic pregnancy.

In the next couple of posts, I hope to explain briefly just why people fall into the trap of “lying with statistics” as one of the trappings of our humanity as we try to understand truth and the nature of things. I think the matter of figuring out the true probability of delivering a live birth from a non-tubal ectopic pregnancy can not only give the reader a glimpse into the science of understanding behavior (some areas of psychology and health depend and revolve around science and factual truth), but it can teach us something about “confirmation bias” or seeing only what we want to see in the world or a situation.

As a Christian, we should seek truth in the Word of God and in our world, both in terms of relationships and in terms of the wisdom with which we conduct ourselves. Using math to test the truth of the ideas that we have about “the way things are” or how we understand the world can be invaluable. I’d like to expand upon the errors I see in the misuse (or the honest yet ignorant use) of numbers and probability to mislead people in this current discussion of ectopic pregnancy. To do that, I am going to have to give some examples, but I ultimately want to put out a call to statisticians to help me rightly discern how significant the numbers are to the Christian who wants to know the truth and wisdom in this area. I hope to frame out the problem, but in so doing, I think that the reader here will develop a deeper appreciation for the fact that:

Life is not always as simple as we’d like it to be.

I would like the reader to understand my concerns about how statistics have been used in this discussion, perhaps innocently though in a misleading way. I believe that this insight can give us a new window of insight into our own motives and how we think about things. I hope that this discussion brings the reader two big payoffs: (1.) we’ll figure out how common non-tubal ectopic live births really prove to be, and (2.) we can learn how to look more thoughtfully at the world from a broader perspective in a way that will ultimately help us resist undue influence and surreptitious manipulation. I am going to need some expert help in this area, but I can at least get us started by explaining how such matters can be framed and should be framed out in terms of statistics. In other words, I hope to show you how complicated life can be. (But that’s a good thing, because some things in life are very complicated.) Let’s take it a step at a time.



A Little Example of Innocent “Lying with Statistics”

A classic example from Darrell Huff’s “How to Lie with Statistics” (1954) pops into my head as a simple explanation of confirmation bias, wishful thinking, or seeing only what we want to see.  Though it does discuss some math here and there, the book makes for good reading for anyone who wants to understand how numbers and such can influence us.  In other words, it is not a math text but a discussion of how people can use math (or misuse it).  It's down to earth and presents the topic in a manner that's quite palatable if you haven't thought about setting up a math problem in a number of  years!  (I don't know why I never thought to put it in my suggested reading list, and I should.)

Speaking of psychologists…

Imagine that a psychologist that you run into at the gym twice a week says, “I am really starting to believe most people in society today are psychotic!” They well could be, if we all inhaled some toxic fumes from a local pharmaceutical plant. But what else could it be? Well lets say that Dr. Psyche, PhD spent ten years working as a career counselor in an affluent area and at a facility with lots of resources, with clients who were very advanced ($). He then goes back to school to specialize in mental illness and starts a practice in a psychiatrist’s office with a general focus (not a specialist in ADD or pain or OT). He just happens to get assigned schizophrenics, some narcissists, a borderline, and one patient with chronic pain. 80% of his patient load display psychotic symptoms, and these same patients have remained in his care for more than a year. Discussions in his office among his healthcare team involve the discussion of management of psychotic symptoms, and his continuing education interests all pertain to psychosis.

Do you see the potential problem here? His input is not balanced in terms of all possible subjects in life but is geared to psychosis, even within his profession. Most of the people he interacts with have psychotic features, and Lord knows the functional ability of his coworkers. (Psychologists can be just as unbalanced as everyone else can be.) And he went from an area of practice where people were more of a general sample of the general population, but actually, the subset of people that he worked with were higher functioning and had means. So the socio economic status of his previous clientele actually became another variable, and this pool of people was not truly a general sample of all people. Most everybody in our friend Mr. Psyche’s world is psychotic, the right side of his brain is especially attuned to look for indicators of psychosis, so it is true of his IMPRESSION that “everyone” is psychotic.

Seeing What We Want to See and the Limits of Our Field of Vision

It is easy to understand all the world as limited to only the group of people with which we interact, and we are wrong to do this. If you never saw someone wear a neck tie before, and you never saw a tie in your culture, it might never occur to you that ties exist. But on the other side of the globe, everyone could wear them. You would be wrong to say that no one anywhere wears ties.

Concerning the issue of ectopic pregnancy rates and their meaning, I’m auspicious because we do have numbers that we can use to arrive at some reasonable conclusions. We still have to consider the caveat of where we get our information and how reliable it truly proves to be, but we can get more specific. I would like to take you on a short journey into statistics land, enough to appreciate the general landscape. I at least know my way around a little and who/when/how to call for help when I am out of my element. And I hope that a reader here will either lend some assistance or will direct me to someone who can help us rightly discern the truth.

As I’ve said many times before, the truly miraculous thing about our brains and our minds is not our ability to realize truth. Our natural ability and tendency as human beings to run and hide from unpleasant truth or experiences often FAR outweigh our tendency to gravitate to things that are easy and pleasant. Duty and self-control require effort, and we tend to follow the path of least resistance and ease, just because we are human. If we understand this tendency, It helps us see truth more clearly. It helps us find wisdom and prevents us from double-minded windy ways of scattered thinking. And we learn to see the manipulator coming toward us (so we can see trouble coming, taking measures to avoid falling into traps).

Stay tuned.

Surgery for Tubal Pregnancy Deemed an Elective Abortion??? The Discussion of Vision Forum’s Fiat Raises More Questions

A Response to No Longer Quivering's
Vision Forum, Samaritan Ministries Take Extreme “Pro-Life” Position on Ectopic Pregnancies

In the name of “Right to Life” Quiverfull moms could lose their lives

Following the previous post about Vision Forum’s plans to advance their thesis regarding surgical treatment for tubal pregnancy before confirmed death of an unborn baby as the ethical equivalent of elective abortion, several insightful questions have been presented in different areas around the blogosphere including the NLQ Forum.  They are worth noting.

The discussion raised some interesting questions about the actual risk (morbidity and mortality) related to ectopic pregnancy as weighed against the chance of a non-tubal ectopic pregnancy producing a live birth.  Refer to this HERE at Under Much Grace which includes some great diagrams and statistics from sources including the CDC and Lancet.

Most notably, ectopic pregnancy accounts for 6-9% of all maternal deaths in the US. Assuming that these statistics also apply to other developed countries and those countries that do not provide state-of-the-art care to their citizens, this translates to a rough single year death rate 250,000 25,000 worldwide (in 2008 based on Lancet’s estimate) due to ectopic pregnancy.

And the odds of a baby from non-tubal ectopic pregnancy surviving the pregnancy? One in 60 million. That means that worldwide (assuming a general birthrate of 134 million annually for the past 30 years), only one such birth occurs every 6.7 years, based on a now current and somewhat stable global birth rate.

Vision Forum will laud one baby every 7 years while 250,000  25,000 mothers die in one year? Hmmm.

This information out of Lancet and from the CDC paints quite a different picture than Samaritan Ministry’s publications when they reproduced Vision Forum’s new dogma. (I think Vyckie’s karma ran over their dogma!)

Is it worth speaking out on behalf of women with ectopic pregnancy, even if it risks the downplay of the significance of the rare live births that result from viable ectopic pregnancies? What will the liberals say?

(I think that they will respect those who are trying to hold their own groups accountable. Liberals think we are hypocrites when we ignore our own problems while pointing out theirs! And they’re right to think so.)

 

What connection does the Schatz Family have to Vision Forum’s decree regarding ectopic pregnancy?

I believe that both issues point out Evangelical Christianity’s avoidant behavior regarding provocative issues that are not easily understood, are unpleasant, and might result in a loss of contributions from people who think it is unchristian to confront error. Rather than engage the serious natures of both these dilemmas, most ministries have completely ignored the matter. Rather than showing Christian compassion to what I am told is a fringe group that doesn’t equate to a “significant demographic,” suffering people who are precious to God are thrown away like so much inconvenient trash.

From "dangermom"

"Here's the thing about the Schatz's--they weren't a crazy family. They were right there in the mainstream of QF, doing exactly what the Pearls' book told them to do--to keep "switching" the defiant child until her will was broken and she submitted. They interpreted her cries as defiance, since she wasn't "whimpering" like the Pearls tell you to expect. All their Christian friends liked them and considered Mrs. Schatz to be a gentle, kind, loving mother. . .

But since the Pearls' advice is abusive and not Christian at all, a lot of children are severely harmed by it. And a few are going to die, until we get the word out there that it's an awful book that should be thrown out and never followed. Lydia will not be the last victim, unless conservative Christians rise up and throw the Pearls out of their midst.

The real kicker about the Pearls and their ilk is that if you believe them, you--loving, well-socialized, reasonable you--will accidentally beat your child to death out of love and duty."

Why is this decree such a big revelation? This has been the unspoken and understood message within the ranks of the group from the beginning because birthing conveys spiritual blessing as if it were a sacrament.

Manipulative groups that use spiritually abusive tactics have two sets of rules: the Formal Doctrinal Statements and the “Unwritten, Understood Rules” that are conveyed through rhetoric, propaganda technique, and social pressure/proof. This example demonstrates the rare transposition of a provocative vaguely implied rule into a formal one. (Cultic groups generally avoid making direct and definitive statements.)

Who takes care of the brood of children that the mother already has if she is required to die during childbirth?

It has been suggested several places that acquiring a new young wife has its aesthetic advantages as well as a fresh host wife with more robust fertility. Do other families help homeschool the children who survive their mother, or is that duty left to young siblings? Do they rely on the Duggar Buddy System?

“Does any one else suspect that this might simply be an excuse for fundies to trade in their aging, likely run-down-from-too-many-pregnancies wife for a newer model, without going against their own beliefs and going through a divorce? . . . Since ectopic pregnancies are often potentially fatal, might … advocate them since the patriarch could win the disgusting baby lottery, in that his older wife could die, giving him the excuse to marry another, probably younger woman to "care for his motherless children," whilst at the same time, giving him many more reproductive years?”

Why are women so expendable and less valuable than a terminal baby, essentially treated like a lesser being? Is it What are the chances that she’s carrying a male child, and will she get better treatment or worse treatment? Does this devaluing result from patriarchy’s defining of a woman as a being of lesser authority and is made for a man for man’s use in terms of her purpose (teleology) and her very essence (ontology)? Why must the mother be risked if the baby is already dying? Isn’t it better to save one instead of losing two people? Does the woman have a duty before God to honor the life that He gave to her, requiring her to live if she has a chance and her baby has none?

“[I]t makes me feel that what they call a "blessing" is what the rest of us call a "product"--something you crank out because you're supposed to, not because you anticipate pregnancy and childbearing and parenting with excitement, wonder, and joy. So they must manufacture these blessing/products just to fit in with their religious culture, whether they really want to be parents or not.”

Is it every allowable to abort a pregnancy that is literally killing the mother because of conditions like HELLP Syndrome or unmanageable Pregnancy Induced Hypertension? Who cares for these women if they are rendered without mental function? Is Vision Forum going to pay for this care? Who pays to care for the NICU expenses for those babies who are barely viable?

“Even though they say it's God's will, they are actually getting to be the ones playing God with their wife's life.”

How can Samaritan Ministries deny certain kinds of heathcare, apparently without accountability? Are they receiving funds from the government for “Faith Based Initiative” services? Are they not regulated by some outside organization?

Samaritan Ministries avoids accountability because they are classified as a religious ministry and enjoy the benefits of freedom of religion. Therefore, they are permitted to interpret ethics in any way they see fit without accountability to the government. Subscribers also basically sign their rights away after they are given informed consent about the policies which include the denial of any care believed to have resulted from sinful behavior. Their stringent requirements for qualification as a subscriber also include three services monthly (three Sundays out of every four). Could eating too much sugar be considered sin for a diabetic and coverage denied?

Vyckie Garrison reported HERE on the NLQ Forum that she contacted Samaritan Ministries when pregnant after having already delivered three previous children via Caesarian Section. She was told that a hospital delivery would not be a covered expense, but that Samaritan Ministries would pay for a midwife to aid with a vaginal delivery at home. (After THREE previous C-sections?????) Do they think that uterine rupture is not a risk in such cases, or are they counting on the woman croaking? They aren’t that important anyway. Was the pregnancy some kind of pre-existing condition? If it was, why would they have then paid for a home birth, as this should have also been denied.

Could Vision Forum or Samaritan Ministries be cited for practicing medicine without a license? Could VF possibly be in violation of tax codes due to too much overlap between their for profit division (www.visionforum.com) and their not-for-profit arm (www.visionforumministries.org)? How do they get around suing fellow Christians? Where do they get their funding? Hasn’t anyone tried to hold them accountable before?

Many have discussed their anger and their sense of spiritual disillusionment ~  as the topic elicits deep feelings like survival guilt that mothers have after miscarriage, for pregnancy is always a deeply personal matter for any woman.

“I didn't expect that they would try to make the world conform to their rigid doctrines but that is exactly what they are trying to do.”

Does Vision Forum offer much in the way of grief counseling, or do you just have to pay for your sin of being imperfect and managing to get the providence punishment in the form of a tubal pregnancy to start with? They are associated with those evil STDs! Gasp! Gothard does encourage “deliverance” (like an exorcism) and you can pick up evil from a Cabbage Patch Doll. Maybe you had a picture of a fly and a frog in your attic (plagues of Egypt) in your attic, right above your marriage bed?  Maybe it's a sin that is carried over from some great great Jezebel grandmother, because Vision Forum teaches that sin visits children to the forth generation.

All legitimate and astute questions!

Visit and discuss at the NLQ Forum!

How Vision Forum "Lies with Statistics" to Prove that They are Special to God: Women with Ectopic Pregnancy Consigned to Die

Please see my post on the No Longer Quivering Blog concerning Samaritan Ministry’s support of the Vision Forum position on ectopic pregnancy, something Vyckie entitled, “Vision Forum, Samaritan Ministries Take Extreme “Pro-Life” Position on Ectopic Pregnancies.”

LATE NOTE:  For math geeks, please see my disclaimer at the bottom of the page.

On the first day of my statistics class in college, the instructor held up a book that was not our assigned text, an old classic from the 1950s entitled “How to Lie with Statistics.”  Whenever he introduced a new topic, the instructor also presented an example of common mistakes made by many people, failing to appreciate the traps one can fall into when trying to prognosticate.  And my own research was good enough to have been the only undergraduate invited to present their research project at the Nursing Honor Society’s regional meeting in 1987.  And I continue to review data and participate in peer review within toxicology, having co-authored published research in this related field.  I’ve won two "Young Scientist" research awards as coauthor from TIAFT.  All that to say that I know a little bit about statistics -- particularly health care statistics after more than 25 years in the field.   I don't know that Vision Forum intends to lie with statistics, but they end up making classic and ignorant errors which results in the manipulation of their followers. (It might be an innocent result of confirmation bias.)   I think that their followers deserve informed consent.

I have not submitted this blog post for a stringent peer review, and many of these numbers are estimated.  That must be duly noted. (Peer review is vitally important when considering research information.)  I pulled this information from highly reliable sources in order to demonstrate why Vision Forum’s perception of the incidence of ectopic pregnancy does not reflect true morbidity and mortality rates in proper perspective.  I don’t really understand why Vision Forum would quote any statistics anyway if their reasons for their stance were purely axiomatic and based upon ethics.  Somehow their crunching of the numbers is not utilitarian, but mine regarding saving a mother from the life-threatening consequences of a pregnancy wherein the baby has a 0% chance of survival is seen as utilitarian?   It is dissembling at best.

Note these statistics about ectopic pregnancy displayed in the graphics.

(Source:  Highlights of Trends in Pregnancies and Pregnancy Rates by Outcome: Estimates for the United States, 1976–1996. (NCHS/CDC) National Vital Statistics Reports  2000;47(29):12)

What does all of this really mean?

In 1992, there were 108,800 ectopic pregnancies reported in the US.  98% of all ectopic pregnancies are tubal pregnancies. 

2176 of those pregnancies would statistically be non-tubal ectopic pregnancies (2% of the total number of ectopic pregnancies).

(Source:  Pregnancy-Related Mortality Surveillance --- United States, 1991—1999.  CDC.  Surveillance Summaries February 21, 2003 / Vol. 52 / No. SS-2.)

What About the Babies that Survive Ectopic Pregnancy?

The chance of a baby surviving an ectopic pregnancy is an estimated  1 in 60 million.  No tubal implantations ever survive.

This number is a “guesstimate”  for non-tubal ectopic pregnancy survival or what scientist friends of mine call a “SWAG.”  (It stands for “Scientific Wild A_ _ Guess.”)  There are so few babies that do survive, it is impossible to get truly statistically significant, reliable, and meaningful numbers that indicate how many babies survive ectopic pregnancy. All the reports are technically anecdotal only.

Kim Coghlan, a Vision Forum affiliate, reports that she has read that there are a reported 60-100 live births that have resulted from non-tubal ectopic pregnancies.  If we assume that these numbers reflect other improvements pregnancy outcome statistics, lets say that those reports have come from peer reviewed journals and reflect all cases that have been reported over the past 30 years.  (Pregnancy outcomes have improved dramatically since prior to 1970, so lets assume that these survival cases accumulated during this time period.)  If you bounce that off of our stable and current worldwide birth rate of 134 million/year, that brings the probability down to a chance of 1 in 50 million of all births.  But I’m going to use 60 million, since the physician referenced by Coghlan reported this number.

What is the significance of 60 million births?  What does this mean?

Roughly, there have been 4,020,000,000 births in 30 years throughout the world. (For the sake of this argument, based on an estimated 134 million births worldwide per year, give or take variations and population growth). 

With one baby surviving in every 60,000,000 births, one surviving ectopic live birth would occur on the earth at a mean rate of every 6.7 years.  (I did not consider the standard error of the mean, averaging out the mean number per year dispersed over 30 years.)

~~~~~

The babies that Vision Forum lauds face odds that would average out so that only one baby would survive a non-tubal ectopic pregnancy world wide, roughly, every 6.7 years.

~~~~~

How does that compare with the number of women who suffer morbidity and mortality every year as a result of tubal pregnancy?

In April 2010, the British medical journal, Lancet, published an estimated worldwide maternal death rate of 342,900 in the year 2008.  Ectopic pregnancies in developed countries are consistent with rates in the US. (They are rising like ours in the US have risen since 1970.)

(Source: Maternal mortality for 181 countries, 1980—2008.  The Lancet, Volume 375, Issue 9726, Pages 1609 - 1623, 8 May 2010  (Online posting April 2010.)

Death rates worldwide for ectopic pregnancy would total 205,740 20,574 to 308,610 30,861 deaths, as research has shown that since 1991, ectopic pregnancy accounts for 6-9% of all maternal deaths.

~~~~~

Let’s pick a midpoint figure and assume for the sake of clarity that 250,000 25,000 women died worldwide from complications of an ectopic pregnancy in 2008 based on the numbers from Lancet article and the 6-9% cause of death prevailing in the 1990s as determined by the CDC.   (See Addendum note below)

~~~~~

Kim Coghlan downplayed the incidence of ectopic pregnancy, pulling statistics that relied upon data which includes women who were treated surgically for ectopic pregnancy, life-saving surgery that she has defined as murder to argue that there are barely any deaths due to ectopic pregnancy.   I’ve found from the most reliable sources regarding vital statistics from the CDC that 55,600 women were hospitalized in 1991 in the US for ectopic pregnancy, and an estimated 250,000 25,000 women died in 2008 due to ectopic pregnancy, even with pre-emptive surgical treatment.  That’s a huge number of women.  She quotes one physician who says 70% of ectopic pregnancies don’t require treatment at all, and somehow, that’s supposed to magically negate the hard statistics on morbidity and mortality from the CDC and three peer-reviewed sources.  ?????

Samaritan Ministries republished her writings in their newsletter in 2008 to advise their members on health matters and to assist them in healthcare decision making.  I find this pretty deplorable, but how would they know that the information she presented was misleading and distorted?  Samaritan Ministries did not employ any staff or management with any training in healthcare when I investigated the matter in 2008 (though they can opt to contact a physician with whom they consult as needed).  I was trained, trained, trained to properly evaluate statistics and to defer to peer reviewed sources, never assuming that a single case study indicated anything for a population until it demonstrated statistical significance after stringent mathematical analysis.

If Vision Forum would like to follow a Luddite and pious mentality, that is their choice.  If a woman suspects or has been told that she has an ectopic pregnancy, at least this summary will be available for her to review.  The last surviving ectopic pregnancy I’ve noted took place in 2008, so we have a few years to wait until we can expect to see another one on the face of the planet.  If that woman wants to be a martyr for her already dying baby because a bunch of lawyers told her that she must, at least she has this resource to also consider, something to help her put matters into perspective. And I can rest knowing that I made the effort to put the matter into proper perspective.

For those who follow the Vision Forum mandate concerning ectopic pregnancy, maybe the outcomes will be more like those for ectopic pregnancy in the mid 1800s?

(Source for 19th Century Data:  Ectopic Pregnancy.  Author: Vicken P Sepilian, MD, MSc, Medical Director, Reproductive Endocrinology and Infertility, CHA Fertility Center  Coauthor(s): Ellen Wood, DO, FACOOG, Voluntary Assistant Professor, University of Miami School of Medicine)

 

How can Vision Forum honestly argue
that they are 100% Pro-Life?

LATE NOTE:  (I wanted to check with my resident expert for peer review before I posted this explanation.)

I have to address something here that I bantered around for the sake of argument to give some reference to what 1 in 60 million means.

I believe that this number is a gross exaggeration of probability. This physician did not calculate the odds correctly, and my instructor in statistics would eat his lunch. He arrives at a rough estimate based upon numbers of pregnancies bounced off of all pregnancies to figure out an incident rate. But this is not scientifically accurate.

What needs to be done to truly say anything meaningful (in terms of the rules of statistics) involves looking at the population subset in context to determine rules for that subset. What this physician is doing is making gross estimates, not determining probability. In other words, if you are going to make presumptions about probability for a subset, you have to look at the subset, not at the whole population.

He is wrong to look at all pregnancies to find probability. (I also would like to see hard data that documents these supposed 60-100 cases of ectopic pregnancies.) But assuming they do exist, to determine probability that is meaningful, you have to start with ectopic pregnancy numbers themselves.

Think about it. Ectopics occur in 0.003% of all pregnancies. We know definitively what those numbers are. We don’t have to extrapolate to arrive at them. Of that small number, 98% of those are tubal pregnancies and can never survive. What is 2% of 0.003%. It is not much.  It is from that group that the surviving babies arise.  You can't start with all pregnancies to make such generalizations about such a tiny group.

I’m to lazy to pull out the book and a calculator, but I suspect that the incidence is much greater than 1 in 60 million. It is probably more in the neighborhood of 1 in 120 million. (Lord only knows.) I think that 1:60 MIL is a gross overestimate of frequency.

That’s why it is more efficacious in the discussion to look at maternal death rates and how many deaths are attributed to ectopic pregnancy to make a rational statement about incidence. The population of deaths is larger, it can be evaluated and put to the test with mathematical tools to ensure that it is meaningful.

But I had to start somewhere…. Even with this gross overestimate, these odds are ridiculous.

17Jun10 Addendum:  Corrections in original post material noted with a strike through the error.  See this post.