THE WHATS HOWS AND WHYS OF MENSTRUAL EXTRACTION
by Rebecca Chalker

In Los Angeles in 1971, before Roe v. Wade legalized abortion, a small group of women began observing abortions in an underground clinic. Carol Downer, then a housewife with six young children, was one of those women. "We quickly saw that early pregnancies could be terminated safely and simply," Downer remembers. "We learned that the new suction technique being used in that clinic was less traumatic, and less risky, than the standard dilation and curettage (D&C)." In a D&C, the walls of the uterus are scraped with a sharp metal curette; in suction, a cannula, a flexible, plastic straw-like tube, is inserted into the uterus through the cervical canal, and a hand-held syringe (with the needle removed) is pumped. The uterine contents are suctioned through the cannula into the syringe.

At about the same time, Downer went to the clinic with a young woman who was going to have an IUD inserted. Downer was permitted to watch. "I was just bowled over by how accessible the cervix (the entrance to the uterus) really is," Downer says. Suddenly, what she had observed in the clinic jelled. "I realized that if we just had some essential information about our bodies, we wouldn't have to put up with back-alley abortionists anymore."

The next time Downer went to the clinic, she "appropriated" a plastic speculum, a cannula and a large syringe and took them to her consciousness-raising group. That night the group discussed abortion laws, the lack of availability of abortion, and marveled at the new equipment. Then, not knowing how anyone would respond, Downer volunteered to demonstrate how to use the speculum. "When people saw my cervix, they instantly understood the potential of the new abortion technology," she says.

Lorraine Rothman, a school teacher in Orange County, just south of Los Angeles, and herself the mother of four children, was at the meeting. "We knew that the suction equipment had enormous potential, but I thought it needed improvement," Rothman remembers. Rothman had a scientific background and had worked in a chemistry lab. She took the device home and came to the next meeting with an improved model.

In the new model, the uterine contents passed through the cannula into a tube, and then into a collection jar, instead of going directly into the syringe/pump. Rothman, who dubbed her device the "Del-Em," points out that it's more uncomfortable for the woman having the extraction when the pump is connected directly to the cannula.

The group now had the technology not just to terminate pregnancies, but for genuine reproductive control. "If a woman got her period and didn't want it, she could get rid of it. If she didn't get her period, perhaps because she was pregnant, she could have an extraction and end the pregnancy," Downer observes.

Over the last two decades, perhaps 1,000 to 2,000 women have learned how to do M.E., and an estimated 20,000 procedures have been performed in which pregnancies have been terminated Ñ a tiny number compared to the 1.5 million abortions performed each year.

Suddenly and unexpectedly, on January 22, 1973, the Supreme Court announced its decision in the case of Roe v. Wade, making first-trimester abortion a decision between a woman and her doctor, and second trimester subjected to minimal regulation by the states. Two months later, Downer and Rothman borrowed $1,500, hired a doctor and opened an abortion clinic in Los Angeles. Shortly thereafter, they opened a number of other clinics across the country forming the Federation of Feminist Women's Health Centers, an association of independent, women-owned clinics that provide abortions, birth control and well-woman gynecological care. At the centers, the suction technique rather than curettage for first-trimester abortions remains the method of choice. Downer and Rothman continued to share information with women who were interested in learning about menstrual extraction (M.E.), but with clinics to run and other critical issues in women's health to consider, M.E. went on the back burner.

When the Reagan/Bush Supreme Court allowed significant restrictions on abortion in its Webster (1989) and Casey (1992) decisions, women in the prochoice movement, including Downer and Rothman and many of their colleagues, began to wonder what they were going to do if Roe were overturned. At this point, the concept of M.E. and its practical potential began to take on new resonance.

WHY MENSTRUAL EXTRACTION IS A GOOD IDEA By Rebecca Chalker

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Rebecca Chalker is an internationally known abortion counselor and an active speaker on women's health issues.