Call lor calm over abortion suggestion

Press, 11 May 1979, Page 15

Call lor calm over abortion suggestion

Menstrual regulation is an alternative to present abortion procedures which should be considered calmly in the light of overseas experience. This is the opinion of Mrs Barbara Smith, a professional counsellor and activist in the Christchurch women’s movement.

Mrs Smith quotes an editorial in “The Lancet” in which menstrual regulation is described as simple, safe, and rapid when performed by a notouch technique, usually without local anaesthesia. The advice of Miss Marilyn Waring, the Government member of Parliament for Waipa, that

women learn the menstrual extraction method if they were unable to obtain legal abortions in New Zealand has aroused much debate. Some New Zealand feminists are already following the American example and practising menstrual regulation. Barbara Smith visited a feminist Self Help Clinic in Los Angeles last year. She was told that menstrual regulation had been practised there and at women’s health centres across America since 1970. Some groups of American feminists use the method as a form of very early abortion, others as a regular means of shortening the menstrual period. The method is also used as very early abortion in some American hospitals. In 1975 half of all the pregnancy terminations in the West Pennsylvania Hospital were, according to “The Lancet,” performed as menstrual regulations, mostly by nurse practitioners. Only eight per cent of all terminations there were after 14 weeks of pregnancy. Many comments on Mis,s Waring’s advice to women have stressed the possible dangers involved. Mrs Smith believes that if done under proper, sterile, supportive circumstances menstrual regulation is a

safe, simple procedure. Menstrual regulation can be used to overcome both legal and religious obstacles to abortion. It is practised in about a third of the Latin American countries, and in Asia. Evacuation of the uterus usually takes place no more than 14 days after a woman’s first missed period. Pregnancy may then be suspected, but not proven.

In several South American countries where abortion is illegal an abortion is legally defined as having taken place only if the

By

woman is proven pregnant. In New Zealand law the intent to perform an abortion is a crime unless the legal grounds have been met.

Mrs Smith has results of research at a Vermont women’s health centre whose menstrual reflation is often performed by physician’s assistants. Under' Vermont law a layperson can become a licenced physician’s assistant after two years’ training. She considers that the results of the survey of 1004 menstrual regulation patients from 1973 to 1975 show a very low complication rate. “None of the complications were life-threatening,” she says. Fears of puncturing the uterus and pelvic infection have been among the most frequently-raised objections expressed by New Zealand doctors and others since Miss Waring’s statement. Much of the comment Mrs Smith regards as alarmist. At 3.5 per cent, pelvic infection is the greatest complication factor shown in the Vermont centre figures. This compares, according to Mrs Smith, with a 2 per cent rate for the Auckland Medical Aid centre when it was operating.

LEONE STEWART

“The rate there was exceptionally low for New Zealand because the staff were extremely skilled. 1 would expect the Vermont figures to be lower now than in the survey period because that was very early days for them,” she savs.

As for puncturing the uterus, Barbara Smith considers that the equipment she saw at the Los Angeles centre is designed to eliminate that risk.

Her preference in New Zealand is for properly set up. self-contained abortion units staffed by doctors.

"But if the law is restrictive, menstrual regulation is a lot less damaging to a woman than carrying a baby she doesn’t want to full-term.”

However, Mrs Smith emphasises that she does not advocate women buying the American menstrual extraction kits for their own use. Her major concern is that women could become careless about sterilg procedures. Menstrual regulation should, she believes, be carried out by women only in feminist-style health centres. There it is part of a “total package” of self-help and education about reproductive functions and difficulties. Self-Help Clinics in America teach women about “everything from vaginal disorders to selfexamination.” Barbara Smith sees this as a means of removing the “mystification of women’s reproductive system by a male-dominated medical profession.” The medical procedures are so full of mystique that women are frightend of their own bodies,” she says.

The Los Angeles centre which Barbara Smith visited is run by a team of 75 women, 25 of whom

form the steering committee. Wages are low, and the hours long, but the women generally live collectively and the centre provides many benefits, including child care.

Professional, medical back-up is provided by sympathetic doctors, who do the abortions from which the centre raises its funds.

“Women who have abortions are encouraged to stay and learn about their bodies, and about contraception. As well as routine self-examination procedures, some skilled women are taught menstrual extraction.”

Self-Help Clinic literature shows diagrams of simple abortion equipment used in China, taken from the Peking Jomal of Nursing, March 1966. Abortion by suction apparently originated in China.

A contributor also recalls an early menstrual extraction technique used by her grandmother and other folk doctors in New Orleans and the surrounding bayous and countryside.

In an authoritative study, “Abortion,” published in 1977 by Cambridge University Press, the authors claim that menstrual regulation, like marriage, is what the individual chooses to make of it. “In parts of Latin America or the Moslem countries of Asia, it could become, or is already becoming, a politically acceptable reality in situations where routine abortion is unacceptable.” They argue that emptying the uterus before the woman knows for certain that she is pregnant profoundly changes the emotional, legal, and ethical aspects of early abortion. It is misleading, they maintain, to equate menstrual regulation with terminating a 24-week pregnancy.

“Ethically, it is the least challenging form of abortion.”