Monday, Aug. 28, 1989

Abortions Without Doctors

By Anastasia Toufexis

The Supreme Court decision to throw the abortion issue back to the states has thrown pro-choice supporters into turmoil. If, as many fear, abortion becomes tightly restricted or banned, what are women to do about unwanted pregnancies? Some feminists are proposing a radical remedy: women should master abortion techniques and perform the procedure for one another.

That idea is being widely discussed by women's groups and has already drawn sharp criticism not only from right-tolifers but from medical authorities and some pro-choice supporters. Promoters of self-help abortions are looking at several methods, including RU 486, the controversial French pill not yet available in the U.S. But most of the attention is focusing on menstrual extraction, a technique that can be used to end a pregnancy through the eighth week. At a recent meeting in Dallas, sponsored by the local unit of the National Organization for Women, more than 100 women saw a 30-minute videotape that showed how the procedure is performed with a $90 kit containing a glass jar, plastic tubing and a special syringe. "We're being realistic," says Charlotte Taft, an abortion-clinic director who spoke at the meeting. "When abortion becomes illegal, not many physicians will risk losing their licenses. If I have a choice between going to a group of caring women I trust or a stranger, then I'll take the women."

Advocates think the lessons will keep women from seeking back-alley butchers or resorting to the horrifying home measures, such as inserting coat hangers and douching with Lysol or Coca-Cola, that were common before Roe v. Wade made abortion legal nationwide in 1973. NOW's national headquarters in Washington takes no position on self-help abortions but has not discouraged its local affiliates.

First championed by women's groups in the early 1970s, when abortion was $ illegal in most states, menstrual extraction is a variation of the vacuum aspirations used in medical clinics. A thin plastic tube is first inserted through the cervix into the uterus. Then the uterine lining, along with an embedded fertilized egg, is suctioned out by pumping a syringe attached to the tubing. Proponents of the procedure insist that it is safe.

But medical experts are skeptical. Warns Dr. E. Hakim Elahi, medical director of Planned Parenthood: "It's a wrong notion that abortion is very easy." He and others fear that cursory instruction will lead to medical complications. "There's no way that watching a video and seeing someone demonstrate this is going to make self-help procedures safe," declares gynecologist Michael Burnhill of the Robert Wood Johnson Medical School in New Brunswick, N.J. Possible dangers: missing the tiny fertilized egg, lacerating the cervix, perforating the uterus, and spreading bacterial infection.

Many feminists call the effort politically misguided. They argue that it gives the wrong impression that abortion is already illegal and unobtainable. They are also concerned that it diverts attention from their battle to keep abortion legal. Whether that battle is won or lost, the pursuit of self-help abortions makes one thing clear, warns Patricia Ireland of NOW: "The demand for abortion will continue and will be met one way or another."

With reporting by Georgia Harbison/New York and Joseph J. Kane/Atlanta