Abortion: don't DIY
American 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
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