10/3/99
3:54 AM BST
Ann BradleyAbortion: don't DIYAmerican feminist Barbara Ehrenreich insists that A Woman's Book of Choices, written by Rebecca Chalker and Carol Downer, is 'the most important book on reproductive rights ever written'. It isn't, although its British publication probably provoked more controversy among pro-choice campaigners than just about any book ever written.Most of the book is an account of what happens during different abortion procedures, and very interesting it is too. But the hot issue is the author's outline of how women's 'friendship groups' can perform early abortions at home using a technique known as 'menstrual extraction'. Menstrual extraction isn't new. It's been used in industrially backward countries for years because it doesn't require either complex surgical equipment, anaesthesia, or an operating theatre. It's a similar procedure to an early suction abortion, in that a tube attached to a suction pump is passed up the vagina, through the cervix into the womb. When the pump is operated to create a vacuum, it slurps out the contents of the womb, including the embryo or early fetus, if you happen to be pregnant. Some British doctors routinely used menstrual extraction until the 1970s, as a rather effective way of by-passing the abortion law. Before the advent of modern 'accurate-the-day-you-are-due' pregnancy tests, doctors could always claim that they didn't know the woman was pregnant until it was too late. But when the Department of Health ruled that menstrual extraction was unequivocally a method of abortion, and that ignorance of the pregnancy was no legal excuse, there was little opposition to dropping it. It had become widely accepted that menstrual extraction was a relatively inefficient abortion technique, because it has to be done so early that it is possible to leave the minute embryo intact. Ms Chalker and Ms Downer, however, think that menstrual extraction is a great procedure because it takes abortion out of the hands of the medical profession and makes it the property of women. This is such nonsense. The promotion of 'do-it-yourself' abortion techniques sidesteps the substantive issues involved in getting access to abortion. When politicians try to restrict abortion rights through legislation, or when services are inadequate to meet our requirements, we need to organise and campaign for the abortion services we need within the health service - not allow abortion to be driven underground into women's groups. It is bizarre to imagine that do-it-yourself menstrual extraction makes abortion available to women who would not be able to end a pregnancy through 'official' channels. The women who find it most difficult to get abortions are those who have no money, no contacts in the health service, and no knowledge of how to play the system. Working class women solidarise with each other in lots of ways, but touchy-feely mutual vaginal examination is not generally one of them. The only women I've ever met who are into peering at each others genitals (lesbian friends excepted) are middle-class, articulate women who, if they had an unwanted pregnancy, would have no trouble fixing up an abortion through a private clinic if they couldn't wangle one on the NHS. The only way to make abortion services adequate and available to all women is to provide them as part of the mainstream health service. Chalker and Downer assume that having an abortion procedure carried out at the hands of your 'friendship group' is preferable to having it done by a doctor. I can't think why. Most of us want medical procedures carried out by the most competent person to do the job. I value my friends very highly, but I wouldn't dream of encouraging them to extract my teeth, or set my broken bones, and I can't imagine why I would want them to carry out an abortion. I acknowledge that some doctors are not particularly sensitive, and some may verge on the incompetent, but at least they have a modicum of medical knowledge and, more importantly, access to what's needed when things go wrong. The Woman's Book of Choices claims that self-help procedures allow us to 'reclaim control over our reproductive lives'. They don't. They are a celebration of our lack of control. If women could enjoy efficient abortion provision within the health service, there would be no place for books like this. Abortion is undoubtedly 'over-medicalised'. The termination of pregnancy is such a simple, straightforward procedure that almost every society known to humanity has devised a way of doing it. Historical studies show that before abortion was legalised, the number of women who died or became ill as a consequence of 'backstreet abortions' was vastly outnumbered by those who suffered no ill-effects. But that doesn't mean we want to return to those methods. I want the best medical treatment that society has to offer. Reproduced from Living Marxism issue 51, January 1993
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