Friend of Jane

Before Roe v. Wade, a group called Jane practised menstrual extraction, a simple technique that can be done easily and comfortably at home. Menstrual extraction, as the link above explains, is basically exactly what it sounds like: it is the removal of the contents of the uterus. Why do this? Women do it to avoid lengthy, messy periods. They also do it as a form of abortion. Laura Kaplan's book, The Story of Jane: The Legendary Underground Feminist Abortion Service, recounts Jane's work. Acoording to Kaplan, abortion by menstrual extraction can be performed up to 7 weeks after a woman's last menstrual period (which would be, if memory serves, up to 5 weeks into a pregnancy). In the four years that Jane was active, Kaplan writes, the group provided over eleven thousand abortions.

And, before you ask, the group had an incredibly low number of problems: they did good follow-up with their clients. (I couldn't find the exact figures when I was looking today, as the book isn't organized around data but rather around the chronology of the story, but I know they're in the book somewhere.)

Ever since I read this book in the late '90s, I've been thinking that the problem with abortion politics is that we've allowed not just decisions about abortion, but abortion itself, to be taken out of the hands of women. We need to take it back. The natural childbirth movement has worked to demedicalize childbirth, challenging the medical definition of childbirth as a problem that needs medical intervention, and after years of criminalizing midwives, the medical establishment has decided that, hey! Guess what? Midwife-attended births have a much lower risk of complication and C-section and episiotomy and tearing - and, not coincidentally, less use of epidurals for pain management - than do births not attended by midwives. (And home births? They have the least number of complications of all births, though it's not clear exactly why - it has been suggested that moms who choose to have home births have low-risk pregnancies anyway, or that they are especially well-educated about or at least more likely to follow best prenatal health/nutrition/etc. practices, or that they take an active role in their labor/delivery, or that midwives know a few things that medical doctors do not (let's hear it for no episiotomies!).) Anyway, in a similar vein, we need to demedicalize early abortion and put both the choice and the practice directly into the hands of women.

I can hear you all gasping. I'm not saying this is a perfect solution, necessarily. But, like midwife-attended homebirths, menstrual extraction has had a pretty darn good track record. It works because trained women working together in groups perform the extractions. The success - by which I mean both complete extraction and also lack of infection or any other problems - of such a procedure rests not only on the women actually doing the extraction, but also on the woman having it done. She needs to take responsibility for her own care and to carefully follow instructions for what to do afterward, what to watch out for, etc. This means trusting women to make the best decisions about their health and their bodies, which is, after all, exactly what the pro-choice movement advocates in the first place.

As we wait in SD to see if Governor Rounds will sign the abortion ban into law - and what the Supreme Court will do about it - I can't help but think that a ban on surgical abortion has the potential to do what Planned Parenthood, NARAL, and the legalization of medical abortion have not: to make medical abortion, rather than surgical abortion, the norm. Mifepristone is available legally in the U.S., despite the fact that most people don't know about it and that some pharmacists (and pharmacies) won't provide it. And medical abortion is safer than surgical abortion, both because earlier abortions are safer than later ones, and because medical abortions are not invasive procedures. And for those who don't know about or can't get mifepristone, there is menstrual extraction, which can be performed even earlier than a pregnancy test.

So, while we struggle to keep abortion safe and legal, I would like to see us also promote alternatives. Planned Parenthood and NARAL have worked to mandate that EC (emergency contraception) be available in the ER (for survivors of rape, in particular) and in the pharmacy. Let's also start learning how to perform menstrual extraction safely.

Because no one else should get to control our bodies - at least, not without a fight.

Click for more information on menstrual extraction and "self help."