Self Help Clinic Celebrates 25 Years

"Self Help," the ability to understand, care for, and make one's own decisions, is a cornerstone concept in the women's health movement.

The following article written by Cindy Pearson appeared in the March/April 1996 issue of "Network News," the newsletter of the National Women's Health Network. The article describes the early self help clinic where women learned about their bodies from their own experience and sharing with each other. NWHN is a national organization dedicated to women's health. This article is republished here with permission from NWHN.

On April 7, 1971, thirty women met together to talk about "breaking through" the abortion issue by working on women having control over their reproduction, rather than continuing previous efforts aimed at influencing hospitals, doctors and legislators. Twenty-five years later, the movement started that evening has not only had an enormous impact on abortion care in the United States, but has also affected the manner in which routine health care is provided to millions of women and the relationship that thousands of women have with their own bodies.

What happened at that meeting? Self Help Clinic began. Like many others at the 1971 meeting, Carol Downer was a reproductive health activist in her local NOW chapter. After a visit to a clandestine abortion clinic, she had gone home with a plastic vaginal speculum. At the 1971 gathering, she demonstrated how women could use speculums with mirrors and flashlights to see their own and each other's cervixes. Women took turns doing self exam and talked about the importance of doing self exam in a group setting where they could see the range of normal, healthy women's experiences. The group also talked about the new abortion equipment in use at some clinics -- a flexible plastic cannula attached to a syringe--and one member of the group, Lorraine Rothman, volunteered to modify it for safe use by non-professionals.

The techniques eventually developed by Rothman and Downer were entitled menstrual extraction, to differentiate them from abortion in the medical setting. Menstrual Extraction, or ME, was never envisioned as a service that lay women practitioners would provide to other women who needed an abortion. Rather, the early self helpers advocated that women join self help groups and practice extracting each other's menses around the time of their expected periods. If a pregnancy happened to be present, it would be extracted along with the contents of the uterus. The self helpers believed that their experience with each other, the modified nature of the equipment they were using, and the fact that they were ending pregnancies far earlier than was typical during an abortion would make menstrual extraction safe.

In order for self help and menstrual extraction to be the strategy that allowed women to "break through" the abortion issue, women everywhere would need to know about it. Helped along by the presence in Los Angeles of thousands of women attending a NOW (National Organization for Women) convention in August, 1971, self help began to spread across the nation. After distributing a flyer announcing just one hour-long meeting about self examination, the original self help group found themselves sharing self help with small groups of women non-stop throughout the entire conference. Leaving the meeting room with their speculums in brown paper bags, these women went back to their local NOW chapters and started spreading the word. In October, Downer and Rothman went on a six-week cross country tour (via Greyhound bus!), sharing self help and menstrual extraction with women everywhere from Wichita to New York City. Many long-lasting groups resulted.

Back in Los Angeles, a core group of about a half a dozen women had been working together throughout 1971. They had space at the Los Angeles Women's Center and held a self help clinic on Wednesday nights that was open to everyone. They also shared self help with women who dropped by during the week. At the same time, they began a program of referring women for abortions, which gave them the power to negotiate with physicians for better quality abortions--women were awake and supported by an advocate while a physician performed a suction abortion on an out-patient basis.

In the meantime, the authorities were investigating the self helpers. Using infiltrators, investigators hoped to catch the self helpers performing abortions. In fact, when they finally raided the Self Help Clinic, the only evidence of criminal activity they could gather was a container of yogurt used for vaginal yeast infections, leading to the movement's lasting description of this episode as the Great Yogurt Conspiracy. In December 1972, Carol Downer was acquitted by a jury of charges that she was practicing medicine without a license. Many years later, author Linda Gordon described this decision as establishing the precedent that women's genitals were no longer territory reserved for men.

Shortly after, as a result of the Roe v Wade Supreme Court decision, abortions could be provided openly and independent of hospitals. The self helpers quickly established the Los Angeles Feminist Women's Health Center, a woman-controlled clinic. Doctors were hired by the self helpers to perform abortions, and many other services were provided, including "well woman" care. A self help attitude permeated the health care offered and the health center served as a base from which to continue spreading Self Help Clinic. By 1975, there were nearly 2000 grassroots women's health projects across the country and it had spread internationally. Though these projects ranged from book-writing groups to women fighting against sterilization abuse, many were woman-controlled clinics influenced by self help, some explicitly in the Feminist Women's Health Center model, others similar, but less closely aligned with the FWHCs.

During this period, the women's health movement was at a high point of its influence. Abortion was as widely available and accessible as it has ever been, before or since. Information about women's bodies and the drugs, devices and procedures used on women became available to women through books and an enormously expanded market for feminist health journalism. Medical schools and individual physicians began to realize that the callous and insensitive treatment many women received had to stop and took steps to reform medical training (not to mention abolishing the unwritten quotas that had severely limited the number of women allowed to enter medical school). Dangerous drugs and devices were improved or taken off the market as a result of women's protests. Curbs were placed on sterilization abuse. Challenges were posed to the US practice of funding foreign birth control programs strictly for the purposed of population control, not to empower women to control their own fertility. Many women came to believe, in a way almost inconceivable during the heyday of physician control, that their bodies were their own to understand and to control.

Along with all the other strands of the women's health movement, Self Help Clinic played a key role in these gains. Like other elements of the movement though, by the late 1970s Self Help Clinic began to experience backlash. The strategy of establishing clinics to offer women good health care and to serve as bases from which to spread self help led many groups to spend endless hours fighting regulatory battles about clinic licensing and the definition of "medical" services and who was allowed to provide them. The economic hard times of the 1980s, followed quickly by the anti-abortion violence, left many clinics unable to continue providing services. Midway through the 1990s, relatively few women-controlled clinics exist.

However, the spark of Self Help Clinic is still alive. Several Feminist Women's health Centers worked together to create three women's health books, A Woman-Centered Pregnancy and Birth, A New View of a Woman's Body, and How to Stay Out of the Gynecologist's Office. These books are available from FWHC, in addition to information on self examination (you can also order your very own speculum!).

Menstrual extraction, which had receded into the background during the years in which abortion was relatively available, was widely discussed in the mainstream press when the U.S. Supreme Court considered overturning Roe v Wade, but instead narrowed it in the Casey and Webster decisions. Self helpers even reprised the 1971 tour around that time, sharing self examination and menstrual extraction with groups of women interested in maintaining control over their reproduction regardless of the Supreme Court rulings. Self help groups are continuing to meet, particularly on college campuses and in cities with direct-action women's groups. Self Help Clinic is very much alive in the lasting impact the women's health movement has had upon women, their sense of their bodies , and the way in which health care provided to women has improved over the past twenty-five years.

Cindy Pearson has been Program Director at the National Women's Health Network since 1987. From 1978 to 1985, she was a Director of a FWHC. She has been a self helper for over 20 years.

For more memories of the early FWHC years, see Sherry Schiffer's personal memoir of the Los Angeles FWHC.

If you live in Oregon, contact the Network for Reproductive Options at 541-345-5702 to find out when they are next presenting the "Self Help Slide Show" or to be more involved in sharing women's health information.

Learn Self Exam.

More than one third of the estimated 50 million abortions performed annually worldwide are illegal, and nearly half of all abortions take place outside the health care system, reports Population Action International.

Feminist Women's Health Center