This post is part of the Dialogue series, “When Abortion is Illegal“

Shortly before Roe legalized abortion in 1973, feminist self-help activists developed menstrual extraction. Many feminists believed that by working in groups to learn about their own bodies, (cis)women could control the provision of much of their own healthcare. Menstrual extraction (ME) involved emptying the contents of the uterus into a Mason jar using a suction device made from a syringe, a cannula, tubing, and a one-way valve. As I describe in Revolutionizing Women’s Healthcare: The Feminist Self-Help Movement in America, practitioners saw menstrual extraction both as a way to relieve discomfort from a period and as a way to terminate an early pregnancy. Practicing menstrual extraction in a group setting was of the utmost importance; this was not a one-woman procedure to be performed alone.  After Roe legalized abortion, most menstrual-extraction activists focused on providing abortions in a clinic setting.

Self-Help Amid Anti-Abortion Backlash 

In the face of renewed anti-abortion efforts, self-help activists have periodically revived ME.

After Roe, abortion providers faced extreme anti-abortion activism at their jobs (including large protests and blockades, harassing phone calls, bombings, arson, and even murder of clinic employees) and contended with new restrictions from state and federal governments. In 1989, Justice Antonin Scalia made it clear that he would “reconsider and explicitly overturn Roe,” if given the opportunity.  

Self-help activists swiftly began a campaign to reintroduce menstrual extraction. One group produced a video, No Going Back: A Pro-Choice Perspective, which contained three minutes of a real menstrual extraction and footage of the self-help group explaining how it worked. They distributed hundreds of copies of No Going Back; the group sent forty-six copies to various media organizations, and major news outlets including the New York Times and Newsweek, covered the story. Local papers, television, and radio programs described the process of menstrual extraction and advertised film showings in feminist circles around the nation. Cynthia Pearson of the National Woman’s Health Network said, “Supporters want women, especially the poor, to be able to obtain abortions if the procedure becomes illegal.” (Dudley-Shotwell, 111). 

Although careful to articulate that keeping abortion legal was their main goal, self-help activists taught menstrual extraction as an alternative in case the option of abortion in a clinic setting became unavailable. Another activist stated, “It was designed to let the Supreme Court know that there are a certain number of women in society who have access to the technique of early abortion, and who are going to teach other women that technique.”  Self-help activists relied on NOW’s vast network of feminists to both spread the word about menstrual extraction and encourage media attention.

One NOW representative said, “NOW has for the first time in history called for civil disobedience. We are profoundly committed to not having our rights stripped from us. But we’re prepared to do what’s necessary to ensure we don’t go back” (Dudley-Shotwell, 116).  

The Return of Menstrual Extraction?

In the wake of Dobbs ruling, some have begun to ponder reviving menstrual extraction. What would be the value of ME now that “medication abortion” is widely available for early abortions? In late 2021, the FDA announced that abortion pills would be permanently available by mail. If abortion pills are accessible, menstrual extraction might not be the best option for termination-seekers in a post-Roe world.

What about those who cannot access medication abortion? A number of states are working to pass laws restricting mailing the pills. People living in a state where they cannot get them via telemedicine are already having to travel to another state to do the tele appointment, sometimes in their car. Could a network of skilled menstrual extraction practitioners, especially in locations where medication abortions become unavailable, increase the safety of “underground” abortion? Maybe. However, access to ME, like access to abortion generally, was shaped by location, class, and race. As self-help activists insisted, this time-consuming procedure is meant to be performed in a group setting with other women intimately familiar with each other’s bodies and cycles. As women of color activists have argued for the past several decades, women of color and poor women were unlikely to have time, access to childcare, or even transportation to regularly participate in a self-help group that could allow them to use menstrual extraction safely.

The very thing that gynecological self-help activists prized about menstrual extraction – the necessity of relying on a familiar group of other feminists to do the procedure- was an obstacle to many.  Advocates should consider how to better address these racial, class, and geographic barriers in their attempts to create a network of people capable of performing menstrual extraction.

Disobedient Hands

In the digital age, it is easier to share information about ME than it was in the 1980s. Simultaneously, digital surveillance may heighten the risk of sharing information about abortion. In the 1970s, ME activists insisted that this procedure was a means of controlling one’s period, not an abortion procedure, and was therefore not within the purview of the law. Referring to a hypothetical ME practitioner, one group wrote, “She does not want to be pregnant. Her group meets; she and they extract her period, at which point she is not pregnant. Was she or wasn’t she? (Dudley-Shotwell, 23). Exploiting semantic distinctions and biological indeterminacy may be a useful tool for advocates training others in menstrual extraction.

While ME was never tested in court, similar feminist self-help practices were. In 1972, Carol Downer and Colleen Wilson were arrested on charges of practicing medicine without a license after a police raid on their Los Angeles clinic. Downer stood trial because she had showed a woman how to do a cervical self-exam and recommended that she put yogurt in her vagina to fight a yeast infection. Portions of her defense may be instructive for those hoping to preserve and share information about ME in the 21^st century. Downer successfully argued that if the state of California truly enforced the law prohibiting laypeople from “diagnosing and treating” others, a person could not pass a sneezing friend a tissue, apply yogurt to a cold sore on a mouth, or bring over chicken soup for a cold (Dudley-Shotwell, 26-27).  Contemporary advocates may soon find that they will also need to call attention to the absurdities embedded in laws that seek to criminalize the sharing of healthcare information. 

Abortions are going to happen, legal or not. One use for menstrual extraction is its potential as a collective, performative act of civil disobedience. Teaching others how to perform and staging menstrual extraction could be a method of drawing attention to the fact that nothing will ever make abortion disappear.

If need be, abortion seekers will take the matter into their own hands.