Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, January 26, 1992 TAG: 9201260279
SECTION: HORIZON PAGE: D1 EDITION: METRO
SOURCE: JAN GEHORSAM COX NEWS SERVICE
DATELINE: ATLANTA LENGTH: Long
HOME ABORTIONS FAVORED AS LEGAL HOPES BEGIN TO DIM
In clandestine meetings, in living rooms and kitchens, bands of women are learning to take abortion into their own hands.Using glass jars, syringes and coils of aquarium tubing, they perform menstrual extraction - a suction method of abortion usually practiced by physicians.
Convinced that abortion will be widely outlawed, thousands of women around the nation are grasping cannulas - the slender tubes that suction the uterus - as a way of "taking up arms."
"In the battle of reproductive rights, this is literally how you feel: You are taking up the cannula," says Lynne Randall, executive director of the Feminist Women's Health Center in Atlanta.
"It's not like talking to your neighbor about abortion," she adds. "It's taking the next step."
Among proponents, there's a mounting sense of necessity: This fall, a federal appeals court upheld major provisions of Pennsylvania's abortion law - one of the strictest in the nation. (Last Tuesday, the Supreme Court agreed to review the Pennsylvania law that imposes waiting periods and other restrictions.)
That set the stage for the first direct test of the 1973 Roe v. Wade decision that established the right to abortion. If the Supreme Court overturns Roe, individual states could rapidly ban abortion or severely restrict it.
The number of abortion providers already has dropped dramatically, propelling women to perform abortions for one another, they say.
But among home-abortion opponents - even Planned Parenthood, the American College of Obstetricians and Gynecologists and other groups that support legal abortion - there is a mounting sense of danger.
Allowing laywomen to perform the half-hour procedure, they say, heightens the risk of incomplete abortions, uterine perforations, infection, sterility and even death from an undetected ectopic pregnancy that ruptures.
Legal authorities say these laywomen also are defying the law.
Performing an abortion without a medical degree is a felony in Georgia, punishable by 10 years in prison. The training sessions - in which women suction each other's menstrual flow - may also be illegal, authorities say.
But the state has yet to receive or pursue a complaint about the practice, said William Miller, joint secretary of the state's examining boards.
No American court has ruled on the technique, although laywomen have successfully performed as many as 20,000 home abortions in the past 20 years, said Carol Downer, executive director of the Los Angeles-based Federation of Women's Health Centers, a coalition of 20 feminist health clinics that promote the method.
Despite the medical, legal and ethical questions, home abortion - which can be performed until the eighth week of pregnancy - is unlikely to stop, concede even anti-abortion leaders.
On the contrary, the home-abortion movement has attracted a small but growing supply of recruits since the U.S. Supreme Court rendered its Webster decision in 1989, which gave states broader authority to limit abortion, says Randall, a federation spokeswoman. (In Webster vs. Reproductive Health Services, the court ruled by a 5-4 vote in a Missouri case that states may require doctors to determine through various testing whether a fetus at least 20 weeks old is "viable," or capable of living outside the womb.)
Enlistments frequently follow perceived setbacks - with the most recent wave reacting to the Supreme Court appointment of Clarence Thomas, seen as an abortion foe.
By now, 2,000 American women perform home abortions, with 50 practicing the method in Atlanta, Downer says. That hardly adds up to a mass movement, Randall concedes. But she predicts more women will volunteer as they learn about it.
Among the home-abortion trainees: homemakers, computer programmers, college students, women's rights activists and mothers who remember when abortion was illegal (and want skills to perform abortions for their daughters, if necessary), Randall said. They sign on quietly, by word-of-mouth, fearing harassment, attack or arrest.
Some were recruited by the widely circulated video "No Turning Back," which the federation financed after the Webster decision. Featuring chic narrators in dressy suits, a high-profile attorney and matter-of-fact footage of a menstrual extraction, the video pitches the method to the mainstream.
Other "enlistees" signed up after lectures or live demonstrations. Often the first introduction was "The New Our Bodies, Ourselves," a women's health manual sold in most bookstores.
Randall says she doesn't know who or where these women are - to protect their safety and her own. The federation acts as the network.
For the same reason, practitioners interviewed by The Atlanta Journal- Constitution spoke only with the guarantee that their names would not be published.
One woman, who called the newspaper at the suggestion of the Feminist Women's Health Center, declined to give a reporter her name. She said she had conducted several menstrual extractions - including one abortion - in Atlanta.
The woman, describing herself as a 26-year-old health educator, said she learned the procedure during a local self-help workshop - one of many held around the nation to help women gain control over their health. Initially she was a guinea pig, having her periods extracted while others watched. Recently she performed the abortion for a friend, she says.
"I was really honored that she asked me - that she trusted me," she says. "It was very exciting . . . when I realized I had performed a safe abortion and realized how much it meant to the woman who had it."
Many women, like her friend, are disenchanted with the medical establishment and choose to have friends perform their abortions in the comfort of their homes, Downer says.
Elizabeth, a 34-year-old production manager in an Atlanta advertising company, says she became a home-abortion activist by fluke. After watching abortion protesters mob Atlanta clinics during the 1988 National Democratic Convention, she became angry enough to begin escorting patients to the facilities.
After Operation Rescue demonstrators "prayed for me to die, spit on me and stepped on me," she learned menstrual extraction, she says. If abortion becomes illegal, "I think there are many women who will be prepared to perform them," she says. "I'm one of them. Absolutely."
But these women, who also have fought abortion protesters with bullhorns and placards, say their foremost goal is to keep abortion legal. They blame the anti-abortion movement for forcing women to learn to give one another abortions - a charge anti-abortion leaders reject.
"The pro-life movement is not making them do this, of course not," says John Willke, who led the National Right to Life Committee for 10 years. "It's the same thing as saying, `My wife was so unreasonable that she just made me hit her.' "
He maintains the home-abortion movement is not a serious effort to teach women how to do abortions, but a risky publicity stunt to win support for legalized abortion. "The pro-abortion industry is [trying] to frighten the general population into thinking they will be unable to get abortions," he says.
In fact, nearly 1.4 million American women underwent legal abortions in 1989, up 2 percent from 1988.
Operation Rescue founder Randall Terry, who began tumultuous protests at Wichita, Kan., abortion clinics last summer, calls home abortionists "sordid, confused people." But he sees their efforts as a sign the anti-abortion campaign is succeeding.
Indeed, although abortion remains legal in some form in every state, the number of approved facilities and physicians providing abortions nationwide has dropped 11 percent from 1982 to 1988 - from 2,908 to 2,582, according to the Alan Guttmacher Institute, which studies reproductive policy.
In rural areas, the number plummeted 51 percent - from 555 to 267 - between 1977 and 1988.
That means nearly a third of the nation's women live in counties without an abortion provider.
Nevertheless, Willke says it's hypocritical of feminists to endorse a method that will "kill women" after arguing for 20 years that doctors should do abortions. "There isn't a single responsible physician who has a good thing to say about this," he said from his Cincinnati office.
There's no question that the medical establishment condemns the practice. For instance, the National Abortion Federation, which represents doctors who perform abortions, calls it an unsafe, misguided effort, diverting attention and resources from the campaign to keep abortion legal.
But some prominent physicians, such as Grant Bagley, founder of the Utah Women's Health Center, say the method is as safe as their own.
Dr. Allan Rosenfield, an obstetrician-gynecologist and former chairman of the Planned Parenthood Federation of America, says that if Roe. v. Wade gets overturned, Planned Parenthood will have to reconsider its opposition to home abortion.
"I would rather have people trained to do suction [abortion] . . . than go back to other illegal methods of the past," he says. He and other health workers predict that if abortion is outlawed, desperate women will turn to unscrupulous or ill-educated abortionists - or risk serious injury or death from self-abortion "remedies," such as turpentine and knitting needles.
Women performing menstrual extractions rely instead on the pliable cannula. One end is inserted through the cervix; the other connects through a plastic tube to a sealed jar. Another tube leads from the jar to a syringe or a small hand pump. Gentle pumping creates the suction that empties the uterus.
Doctors seem to agree that the biggest risk from menstrual extraction is infection. Downer maintains that infection develops in up to 5 percent of menstrual extraction cases, which is about the same for women who get abortions from physicians. If problems persist, she says, the woman is advised to see a doctor.
The French-manufactured abortion drug RU486 remains the best hope if abortion rights are overturned, these women say. But abortion opponents' pressure has kept the drug virtually banned since 1989 in the United States - even for research.
So The Federation of Women's Health Centers backs political efforts to bring RU486 into the country - but teaches menstrual extraction because it eludes control.
Women always will have access to cannulas - or they can make them from the plastic tubes in spray bottles, Randall says. The equipment always will be easy to acquire, sterilize and hide, she says.
She likens menstrual extraction to cardiopulmonary resuscitation - something women need to know but hope they never use.