Co-authored by Ian Ramjohn
Today, the US Supreme Court unanimously rejected a challenge to the abortion pill mifepristone, ensuring continued patient access to the drug by mail. Thanks in part to the work of Wiki Scholars course editors, the Wikipedia article on mifepristone is ready to inform the coming thousands of readers looking for additional context on the drug and the SCOTUS decision.
It’s no surprise that when news breaks, people turn to Wikipedia not only to understand key topics but also to make more informed decisions. With billions of views each month, the world’s largest encyclopedia covers nearly every subject imaginable, including healthcare content used by patients, policymakers, and healthcare practitioners alike.
When Justice Matthew Kacsmaryk of the district court for the Northern District of Texas temporarily suspended the US Food and Drug Administration’s approval of mifepristone in April 2023, the readership of the mifepristone article skyrocketed as people sought related information.
The judge’s decision relied heavily on two studies published in the journal Health Services Research and Managerial Epidemiology, which found that the drug could harm pregnant women who took it.
Although the papers have since been retracted by the journal due to unreported conflicts of interest on the part of their primary author and methodological concerns, and the US Supreme Court rejected the case (on the grounds that the plaintiffs lacked standing to sue), this case illustrates how individual studies, when taken out of the context of a whole body of knowledge, can create a completely misleading impression of the state of the field.
Cherry-picked sources are often used by activists to support their specific goals, but on Wikipedia, medical content is subject to special sourcing rules that strongly recommend relying on review articles published in the past five years. A properly-referenced Wikipedia article would never rely on a pair of studies that are, at best, outliers. These rules help ensure that Wikipedia articles reflect current understandings of medical topics.
But even with the best of intentions, Wikipedia articles can be out of date, and non-specialists may not know the current state of the literature well enough to catch error misstatements (either intentional or unintentional), which is why bringing subject matter experts to Wikipedia can be incredibly impactful.
In 2019, 2020, and most recently this spring, Wiki Education partnered with the Society of Family Planning to run a series of Wiki Scholar courses where expert members of the society improved Wikipedia articles related to women’s health, including the mifepristone article. In the recent course, an editor added a section on the use of the drug to medically manage early pregnancy loss, while two members of the 2020 cohort also made several small improvements. But it was a participant in a 2019 course who made larger – and more important – changes to the article.
This editor, who went by the username UCDEBS, separated the existing safety information in the article into a section on side effects. Crucially, for the sake of context, they were able to add information about how rarely serious complications occurred (only 0.04–0.09% of people using the drug had complications serious enough to require hospitalization) and added more information about the duration of side effects. In addition, they added important information about contraindications.
Ideally, people would get this type of information from their healthcare provider, but when access to abortion care is severely limited, women may need access to these medications under less than ideal conditions, making the availability of high-quality information online even more important.
Since the editor’s enhancements in 2019, the mifepristone article has been viewed nearly 1.5 million times, including the spike in readership following the April 2023 ruling in Texas.
And today, as readers explore the Wikipedia article seeking answers to questions about mifepristone, the impact of the information will soar once again.
Interested in learning how to add your own expertise to Wikipedia? Explore Wiki Education’s upcoming courses for subject-area experts.
So grateful that Wikipedia is structuring in this level of creative and rigorous production and review of critical articles that can provide life-saving information.