Abortion How-To: The Ms. Q&A on Menstrual Extraction With Carol Downer

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“I had an unlawful abortion that was fairly a searing expertise. Higher than most girls’s as a matter of truth, however life-changing so far as my attitudes towards the topic,” stated Carol Downer, pictured right here holding a Del-Em Equipment, along with her cat, Pink. (Courtesy of Carol Downer)

Earlier than Roe v. Wade, girls developed methods to assist themselves get the care that states banned and most medical professionals refused to offer. Some used herbs, however many realized a method feminists referred to as “menstrual extraction,” utilizing a syringe, versatile plastic tubing and a mason jar to extract the contents of the uterus. On the time, medical doctors who supplied medically needed abortions used a way more invasive and painful process that concerned stretching the cervix and scraping the uterine partitions. Later, medical doctors adopted these aspiration methods developed by girls’s well being advocates.

Carol Downer was centrally concerned in forming the ladies’s self-help motion, which taught menstrual extraction and led to the invention of the Del-Em abortion equipment by Lorraine Rothman. In 1971, Downer and Rothman opened the primary self-help clinic—the Feminist Girls’s Well being Middle—in Los Angeles, which later turned a mannequin and inspiration for dozens of self-help clinics throughout the nation, together with in Oregon, Washington, Florida and Georgia.

The aim of the clinic was to “take girls’s medication again into [their] personal arms.” The self-help motion challenged the mystification, objectification and stigmatization of girls’s our bodies in addition to male medical doctors’ management over girls’s well being.

Ms. journal spoke with Downer about her experiences with menstrual extraction and the way it may assist girls after Roe.

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(Courtesy of The Federation of Feminist Well being Facilities)

Carrie Baker: How did you react when the Dobbs decision came down?

Downer: It was devastating. Not that I didn’t count on it. Truly, I used to be anticipating it a few years in the past. Roe has hung in there so much longer than all of us had predicted that it might. Nonetheless, it’s simply completely, completely, completely shattering. Everybody I’ve spoken to had the identical response. I’ve heard from folks I haven’t heard from in years reaching out to share their devastation.

We’re in a distinct world. American girls actually believed they’d these rights. They truthfully thought that we had made progress. That it couldn’t simply be taken away from us. Girls are waking up. We’re gonna have some actually harsh, heartbreaking instances.

Baker: Do you keep in mind the way you reacted when Roe got here down in 1973?

Downer: To all of us on that specific day, it was an enormous shock. Nonetheless, the truth that it was coming was not. We had a groundswell. I’m not talking of the second wave. I’m talking of no less than a 10-year, possibly a 20-year, buildup to Roe. The forces of the media, medical doctors, attorneys, ministers, employers—the entire nation—was abuzz. We have been very busy working round giving shows to folks locally who wished to learn about abortion. They obtained scared. They noticed that we have been on the march.

Do you know that “menstrual extraction” is talked about in Blackman’s Roe decision?

Baker: Wow! I didn’t know that.

Downer: He talked about it within the context of alluding to a number of technological issues that have been going down.

Baker: You coined that phrase, proper?

Downer: Sure. We felt they glimpsed the truth that they needed to shortly get in there and provides us this proper or we have been going to determine many of the emotions that had been inculcated in us socially and we have been going to tear all of it down.

Baker: What motivated you to work on this challenge?

Downer: I had an unlawful abortion that was fairly a searing expertise. Higher than most girls’s as a matter of truth, however life-changing so far as my attitudes towards the topic.

Getting Concerned in Menstrual Extraction

Baker: How did the self-help motion begin?

Downer: What it comes right down to so far as my very own involvement was this quite simple instrument referred to as a speculum, which is what medical doctors use to open up a girl’s vaginal partitions in order that they will entry the cervix, which is the doorway to the uterus. They use speculums to do abortions, for instance, or assist to ship a child or verify on the well being of the cervix.

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A speculum, a duck-bill-shaped gadget. (Wikimedia Commons)

Downer: In 1971, I used to be on the abortion committee of the Los Angeles chapter of the Nationwide Group for Girls. I got here involved with Mary Petrinovich, who was one of many three individuals who have been on the committee. Mary took me over to this little abortion clinic on Santa Monica Boulevard in West Hollywood. The clinic was run by Harvey Karman, who referred to as himself a health care provider, which he was not. Mary introduced girls from Riverside, the place her husband was a professor on the College of California, to get abortions.

Sooner or later we have been hanging round Karman’s clinic the place these unlawful abortions have been being carried out and Mary stated, “Carol, why are we letting this male physician do that? You understand, we may do that.” And sure, it had change into very apparent to us that was true.

Karman was utilizing a brand new process, a lot improved over the widespread D&C [dilation and curettage] process that was being executed on the time, legally and illegally. D&C procedures concerned scraping the wall of the uterus with a metallic instrument. It did the job. It was general protected, particularly if any individual had coaching. But it surely nonetheless had issues as a result of it used metallic within the uterus, which may puncture the uterine wall and trigger a life-threatening emergency.

I had a D&C with my unlawful abortion and it was extremely painful as a result of they stretched the cervix utilizing a collection of rods which are bigger and bigger to progressively open the cervix. That course of went on for possibly 5 or 10 minutes on the most, however it was pure hell. Then you’ll be able to hear the scraping—scrape, scrape, scrape, scrape, scrape. It’s very tough.

At the moment, when abortion was unlawful, conscientious medical doctors thought it was crucial to be tough as a result of they needed to assure that they obtained the whole lot out. As a result of when you walked out the door and went again to your group, whether or not it was in a neighboring city or in a neighboring state, you aren’t there to assist that lady.

Karman’s process averted all that as a result of he used a smaller tube that was versatile and he used this syringe to extract the contents of uterus fairly than scraping.

Conscientious medical doctors thought it was crucial to be tough as a result of they needed to assure that they obtained the whole lot out. When you walked out the door and went again to your group, you aren’t there to assist that lady.

Baker: Did Karman develop this technique?

Downer: That’s an open query. Undoubtedly some model of this had been developed in China some years earlier than that. After which I’ve examine a girl Dorothea Kerslake in London who had developed an identical kind of gadget.

It’s onerous to say what Karman’s particular person contribution was, however I can definitely let you know that he promoted it and was very instrumental in getting it popularized. His contribution was immense. He deserved to get the very giant, fantastic obituary within the LA Occasions, despite the fact that working with him on a private stage was like working with any male chauvinist man on the time.

Baker: Was Karman’s technique much less painful?

Downer: The girl feels her uterus clamping down. It’s uncomfortable, however not as dangerous because the D&C process.

Baker: How did you begin doing procedures your self?

Downer: Hanging round Karman’s clinic, we had picked up a number of the data that we would have liked. It wasn’t that he taught us. He didn’t. However he was very informal. He was very laid again himself and casual. So we’d gotten tips about the right way to make the tools as sterile as attainable and what to search for. And we’d practiced on one another, executed self-exams and executed uterine dimension checks. However there have been too few of us. Not more than six or seven of us.

We would have liked extra, so we positioned an advert for a gathering within the Everywoman’s Newspaper. In fact, we didn’t wish to say what we have been about. We put in a bunch of obscure stuff, however folks obtained the message and 30 girls confirmed up. On the assembly, my function was to indicate the tools to the ladies. So I obtained out Harvey’s tools, which by the way in which is now made by IPAS [International Pregnancy Advisory Service].

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Ipas Guide Vacuum Aspiration (MVA) Equipment with cannulas and syringe. Detailed instructions for the right way to use the Ipas MVA Equipment are here.

Downer: They name it handbook vacuum aspiration or MVA. They insert the cannula into the cervix, then connect the syringe and draw out the contents of the uterus. It’s utilized in clinics at this time. Some medical doctors favor to do it manually as an alternative of attaching it to a machine as a result of the machine may be very noisy and stress producing simply in and of itself. MVA is simply as environment friendly, simply as quick and simply as efficient.

At any fee, I took it out and I proceeded to exhibit it to them. This was 1971 and abortion was unlawful, no less than in lots of states, however it was authorized in California. It had been legalized in 1967, however it wasn’t accessible. We had all heard about folks dying from unlawful abortions. These girls have been simply sitting there within the store and I used to be displaying this tools and the way it works. However they simply obtained freaked out. I may see it. One lady was turning white.

So I stated, “Properly, let me present you one thing.” I had myself had a vital change by having seen a cervix. It had completely modified my notion. I went over to a desk in an alcove close by and requested them to come back on over. I obtained up on the desk. I had on an extended gown. I didn’t have on any underwear. I simply laid again and pulled again my skirt. There was a gooseneck lamp. I put within the speculum, introduced down the lamp and invited them to come back over and take a look at my cervix.

I had no concept how they have been going to reply. Right here I used to be leaping up on the desk exposing myself. Properly, they rushed over. And the remainder, as they are saying, is historical past. They took it for precisely what it was: a beneficiant sharing of private data for the good thing about different folks. And out of the blue we have been in an enormous dialogue. Folks have been wanting and saying, “What’s that?” Somebody requested, “How come yours appears to be thus far again?” And I stated, “Properly, I’ve a tipped uterus. And my medical doctors advised me that that’s why I obtained pregnant so simply.”

Mary provided to do a self-exam and different girls obtained up the braveness to do it additionally. One lady who obtained up, hers was tipped precisely reverse. She stated, “My physician advised me that’s why I obtained pregnant so simply.” The entire room laughed. These outdated physician tales. That simply popped the bubble that medical doctors all the time knew what they’re speaking about.

Then one other lady stated, “I’m on my interval” and folks requested, “Can we see that?” So she obtained up. When she put within the speculum, there was her cervix with little streaks of pink blood on it. She clearly was menstruating. The cervix is a knob-like construction. We took a bit swab and there was no odor. We realized at that time that this odor of menstrual blood occurred when it meets the air. It’s not the menstrual fluid itself. We immediately felt higher about it.

Right here I used to be leaping up on the desk exposing myself. Properly, they rushed over. And the remainder, as they are saying, is historical past. In just a few hours, these girls went from being paralyzed with worry to considering, “Hmm, I ponder what would occur if we use the Q-tip?”

Baker: What was your aim in displaying them your cervix?

Downer: We felt ashamed given all of the issues it’s referred to as, and the way it’s handled in a patriarchal society. What I didn’t know was how shortly these unfavourable emotions might be vanquished. That was the massive shock. Immediately. In just a few hours, these girls went from being paralyzed with worry to considering, “Hmm, I ponder what would occur if we use the Q-tip?”

I can’t overstate the distinction seeing our cervixes made in our lives on a private stage, but in addition on a world stage. World wide in all cultures, we’ve by no means run into any group of girls who weren’t delighted. They leap on the bandwagon instantly.

The entire room laughed. These outdated physician tales. That simply popped the bubble that medical doctors all the time knew what they’re speaking about.

Baker: What about seeing one’s cervix modifications folks?

Downer: Folks see the cervix as a really sophisticated factor, however it so occurs that, in truth, it’s easy. The fact is, it was hidden from them, and now it’s not. They see it’s not ugly. And see the truth that, how on this planet can that Supreme Courtroom sit up there and deny this factor to us? How can they get away with that? You’ll be able to assure that Amy Coney Barrett has not seen her personal cervix.

Baker: What occurred after that assembly?

Downer: Our subsequent assembly came about the subsequent week. A number of issues occurred.

First, we modified the objectives of the group from establishing an unlawful women-controlled abortion clinic (non-physicians and non-accredited clinic), to educating cervical self-examination in teams. We referred to as these periods, “Self-Assist Clinics.” Articles concerning the self-help clinics appeared within the newspaper Sister, which introduced our weekly conferences on the Girls’s Middle. 

Second, Lorraine Rothman, who had travelled in from Orange County for the April 7 assembly after seeing the Everywoman’s Newspaper announcement, went residence and designed a prototype of a tool that might be utilized by girls to do menstrual extraction, which she referred to as the Del-Em. Lorraine labored within the lab of her husband Al Rothman, who was a biology professor on the College of California in Fullerton.

How on this planet can that Supreme Courtroom sit up there and deny this factor to us? How can they get away with that? You’ll be able to assure that Amy Coney Barrett has not seen her personal cervix.

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A diagram of a Del-Em equipment, developed by Lorraine Rothman.

The Del-Em consisted of a set jar with two clear plastic tubes. One tube led to a four-milimeter versatile straw-like plastic cannula with holes notched close to its tip that we inserted into the uterus to aspirate out its contents; the opposite longer tube led to a plastic syringe, which we pumped to create the suction. Alongside the tube that got here out of the syringe, Lorraine inserted a one-way valve; this prevented the path of the suction reversing, inflicting air to enter the uterus. We examined it out, however it wanted a distinct container, as a result of the plastic one she used collapsed when the air was suctioned out.

Over the subsequent month or so, Lorraine modified the gadget. Throughout that point, underneath Lorraine’s steerage, we developed the ideas of menstrual extraction, during which we redefined the importance of eradicating one’s menstrual interval to incorporate taking out the contents of the uterus on the time it’s due or a bit late, whether or not there’s a fertilized egg in it or not.

We observed that after the fabric begins coming down the tube, it could possibly usually be seen whether or not or not the modifications that accompany fertilization have taken place. The fabric is extra pinkish, watery and clumpy and strikes extra shortly by way of the tube. The contents of an strange menstrual interval are often darkish pink, thick and gummy and strikes very slowly down the tube.

How-To: Menstrual Extraction

Baker: How did you do menstrual extraction?

Downer: Lorraine perfected this accessible method for strange girls to do it. The primary ability, frankly, that one has to study with the intention to be good at doing menstrual extraction is the right way to estimate uterine dimension to find out how far alongside a being pregnant is. To accumulate that ability, girls practiced on one another within the group when they aren’t pregnant.

Mainly, what occurs is {that a} minimal of two, however often three or 4 girls are concerned in doing a menstrual extraction. One lady guides the cannula. One other lady pumps the syringe. And one other lady holds a mirror for the lady who’s having the process so she will be able to see the fabric popping out of her uterus into this tube after which to the gathering jar.

The function that Lorraine added to what Karman had was a one-way valve to maintain from backing up. We used aquarium tubing and mason jars with a rubber stopper. It has been imitated by folks. I’m personally conscious of no less than half a dozen sorts of Del-Ems that individuals have made utilizing the identical rules and totally different parts, however it’s the identical factor.

A minimal of two, however often three or 4 girls are concerned in doing a menstrual extraction. One lady guides the cannula. One other lady pumps the syringe. And one other lady holds a mirror for the lady having the process.

Baker: How do you be sure to get the whole lot?

Downer: You’ve already examined the lady, so you may have an concept of how far pregnant she is and the way a lot materials you need to be getting out. I’ve seen many early abortions that might contain a number of syringes full of fabric. What occurs when tissue stays is that you just carry on bleeding. The uterus retains attempting to expel it. And oftentimes it turns into contaminated and that may be an issue. The answer, nonetheless, could be very easy. You get again collectively and also you end it, redo it.

However the important thing factor with self-help teams is that this lady is accessible. She’s not coming from one other state. You’ll be able to comply with up along with her. We relied on a friendship circle that we had. At the moment suction is the tactic of selection. Individuals are nonetheless doing D&Cs, however not often.

Baker: How far right into a being pregnant can you utilize menstrual extraction?

Downer:  We suggest going as much as six weeks after the date of the anticipated menstrual interval, nonetheless menstrual extraction has been executed efficiently after a few weeks extra. The truth is, the process has been utilized in unlawful settings as much as 10 weeks. In all people who we all know of, which have been executed in a state the place abortion was unlawful, the 10-week procedures wanted to be adopted up by a non-emergency journey to the native hospital to be accomplished. We don’t know of any issues from this process that couldn’t be remedied by a re-aspiration with the Del-Em or different vacuum aspiration abortion units.

Baker: Is doing menstrual extraction protected?

Downer: Menstrual extraction could be very protected.

Baker: Is it straightforward to learn to do menstrual extraction?

Downer: It takes effort and it takes spending some weekends and free time studying this stuff. But it surely’s doable.

Reflecting on Menstrual Extraction Self-Assist Teams

Baker: Had been folks in self-help teams giving one another abortions licensed medical suppliers?

Downer: They positively aren’t. I imply, it might be only a coincidence if there have been.

Baker: Have there been any authorized issues about doing this?

Downer: Over time, there have been just a few little conditions that developed. However nothing severe.

Menstrual extraction is a social occasion as a lot or extra as a bodily occasion.

Baker: How did the self-help teams work?

Downer: The true power of self-help teams is that we have been very comfy working with one another on this method. But in addition, we’re buddies. Everyone knows one another and have one another’s cellphone numbers and work collectively and belief one another. The ladies who come to us are pre-screened within the first place as a result of we already know them. We’ve her quantity, we all know the place she lives, we’re going to be maintaining tabs on her. As a result of the primary week is the vital time.

One in all our issues of getting ready to have the ability to supply that is to contact medical doctors that we all know who’re in our social circles, or nurses or whoever, in order that if one thing occurred, we may get some assist. Menstrual extraction is a social occasion as a lot or extra as a bodily occasion.

There was a gaggle in New Hampshire that went on for over 20 years. The ladies lived in a semi-rural setting there. They have been heterosexual. They did menstrual extraction each occasionally. Additionally they handled vaginal infections and different circumstances. There have been many residence treatments for all these numerous issues.

Baker: Why use self-help teams?

Downer: We depend on the medical occupation in methods which are fully inappropriate. I’m not saying we shouldn’t go to medical doctors, however when it’s one thing that you are able to do your self, why go to a health care provider? For instance, placing yogurt in your vagina for a vaginal an infection.

Baker: How did you popularize self-help?

Downer: Lorraine and I traveled across the nation educating folks how to have a look at their cervixes and the right way to do menstrual extraction, and teams fashioned across the nation.

Baker: Why did you name it menstrual extraction?

Downer: As a result of that’s what we did. We extracted the menstrual interval. That’s precisely what we did.

Menstrual Extraction At the moment

Baker: Are folks doing menstrual extraction at this time?

Downer: Sure, this has by no means stopped. There are self-help teams doing menstrual extraction. It’s very decentralized. At this level there are possibly 50 or 60. I run into new ones day-after-day. It began rising a number of years in the past, when Trump was elected. Folks foresaw the overturn of Roe.

Baker: How may any individual at this time learn to do menstrual extraction?

Downer: We’ve data on our web site at Women’s Health in Women’s Hands. We even have a chapter on menstrual extraction within the e book A New View on Women’s Body by the Federation of Girls’s Well being Facilities. And there’s one other e book Natural Liberty by the Sage-Femme Collective that has data on menstrual extraction.

Baker: Do you suppose menstrual extraction will improve now that Roe is overturned and states are making abortion unlawful once more?

Downer: Sure, I completely do. We should eliminate that angle of dependency on medical doctors for our healthcare and notice that it’s our physique. If we don’t study our personal our bodies, any individual else goes to be accountable for what occurs to us. It’s simply that straightforward.


For extra data on menstrual extraction, see:

Organizations

Books

Video

Provides

Speculums can be found on-line at medical supply companies for $1-5 (workshop on the right way to use a speculum, accessible from Embodywork at Take Back the Speculum!). Menstrual extraction kits can be found on-line, together with from navafresh for $62 and on Ebay (instruction to be used at Steps for Performing Manual Vacuum Aspiration Using the Ipas MVA Kit).


Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether or not you your self have had an abortion, or just stand in solidarity with those that have—to let the Supreme Courtroom, Congress and the White Home know: We is not going to quit the suitable to protected, authorized, accessible abortion.

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