Medicine: Unofficial Abortion

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Science-fiction writers, stymied by the laws of physics, turn to such literary devices as time warps to make interstellar travel possible. Now women, physicians and population-control advocates, dismayed by most states' strictures against abortion, have developed a procedure that offers a similar semantic solution. In a growing number of clinics and doctors' offices, a technique called "menstrual extraction" is being used to terminate suspected pregnancies before conception has been confirmed. Therefore an abortion in fact is not an abortion officially.

Menstrual extraction is essentially a vacuum-aspiration method in which the fertilized egg, if present, and the uterine lining are withdrawn by means of a tube inserted through the cervix. It differs significantly, however, from similar procedures performed in clinics in New York and other states where abortion is legal. Vacuum aspiration, as usually done, requires dilation of the cervix under local anesthesia. Menstrual extraction requires little or no dilation in most cases. Instead, a thin (diameter: 4 mm.), flexible plastic tube, or cannula, is inserted through the cervix and into the uterus, and most of the uterine lining is then removed by means of suction or a specially designed syringe.

No Proof. Nor is this the only difference. Vacuum-aspiration abortions are generally performed between the eighth and twelfth weeks of pregnancy, when tests can establish whether a woman is in fact pregnant. Menstrual extraction is designed to be done no later than six weeks after the woman's last menstrual period, when proof of pregnancy by ordinary tests is sometimes difficult to establish. In theory, a woman whose period is overdue may request an extraction in order to induce her period. In practice, she is more likely to be terminating a suspected pregnancy. Tissue examinations show that between 50% and 85% of the women who elect to have extractions are pregnant.

The procedure itself is not new. Doctors have used a similar technique to obtain samples of uterine tissue for 50 years. Harvey Karman, a Los Angeles psychologist, pioneered it as a less painful abortion technique ten years ago. Militant Women's Liberationists have been using menstrual extraction in small "selfhelp" clinics for more than a year as a means of preventing "male control" over their bodies.

Now, however, it is becoming medically respectable; more and more physicians are studying it as a possibly practical method of avoiding the legal and physical hardships of abortions done later in pregnancy. Dr. Julius Butler of the Harborview Medical Center in Seattle has performed nearly 100 extractions in the past several months, as has Dr. Edward Stim in New York. The procedure is also being done at Los Angeles County Harbor General Hospital in Torrance, Calif., and at several abortion facilities in New York.

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