SELF-HELP CLINIC Part II

Copyrighted 1971

Much has happened since we first wrote our Self-Help Clinic article last summer E.W. July, 1971. At that time, under Carol Downer's direction, we had been meeting for about four months evolving a concept that would have far reaching effects. Since early spring, first working within women's liberation cell groups, then expanding to community women's church groups, Y.W.C.A. groups, and then taking the concept across the country, we are pleased to announce that over 2,000 women (including a group in London, England begun by a Connecticut Self-Help sister), have been introduced to self-examination and the Self-Help Clinic concept. Little did we realize that first night when we all agreed to confront our physical hang-ups in a physical way, that we were all to share real sisterhood in a very meaningful way. Our grandmothers and great-grandmothers knew well the meaning of sisterhood. Mothers, daughters and aunts would meet together to share their womanly experience and be ready to help one another through their physical crises. Since grandmother's time, we have lost the closeness of sisters' experiences and helpful hands. This, along with being denied access to modern knowledge, has left us without knowledgeable good preventative health care. The Self-Help concept of self-examination is based on this reintroduction of sisterly sharing of experiences and knowledge in a commonsense, honest manner. Collective knowledge used within close sisterly groups that we call The Self-Help Clinic, have already had positive results as valuable preventative health care measures.

The Self-Help Clinic consists of 3 meetings; usually an evening a week for three weeks. These meetings deal primarily with learning self-examination with the help of all the sisters in the group. This is a very meaningful sharing experience for all, since we learn what is normal by having the opportunity to examine many women, under well-conditions. Occasionally we will have a sister who has a more serious problem and having caught it within self-examination, is encouraged to seek professional help. The Self-Help Clinic provides the opportunities for women to confront the many myths, misconceptions, and misinformation that we have been fed our entire lives. Being able to examine ourselves in a group situation gives us the first real concrete opportunity to compare the "text book" with reality. This is also the time when we learn to recognize cervical cap changes (in color, tone and other signs) in one another. Each woman during the first session has learned to insert her own speculum for the self-examination procedure and keep this speculum for continuous use. We also learn to give bi-manual (two hands) pelvic examinations by the 3rd evening. Looking at diagrams of our pelvic organs and being able to touch them and know their structure manually, gives us a far greater understanding of our bodies. We also spend the sessions reading and discussing a variety of written material, much of it brought in by the members of the group. We use the Birth Control Handbook as a major source for discussion and reference.

One major learning skill we have readily available is being able to recognize what is "normal". Since the meeting are primarily for women who want to learn about their own bodies, we have the perfect opportunity to see many, many normally healthy women. Contrary to clinics' and physicians' experiences (they have been trained and continue to work with patients suffering with some kinds of symptoms of illness), we are in the most fortunate position to learn to recognize what is a well-woman. By being able to recognize what is well and normal, we are better skilled to recognize that which is abnormal. It is interesting to note that Dr. Donald Ostergard of Harbor General Hospital in Torrance, Calif. * has been medical director for a similar program providing "book" and clinical training for women with similar non-medical backgrounds. His findings show that non-medical personnel with a high percentage of accuracy, can recognize deviations from normal. For example; Vulvar lesions, 89%, breast lesions, 85%, vaginal well muscle breakdown, 90% plus, uterine and surrounding structural abnormalities, 90%, antiflexed (elbowed backward) uterus, 90% plus. These are very high percentages of accuracy. Dr. Ostergard explains that his family planning patients are generally well patients who have come into the clinic for birth control information. His training program for the women paramedics stress normal breast and pelvic examinations. When a deviation from normal is found, the patient is referred to the physician. It is not important that the trainee recognize the exact nature of the abnormality. Dr. Ostergard's findings agree with our Self-Help Clinics' similar opportunities for well-women examinations: Women with varying non-medical backgrounds with sufficient training opportunities for examining well-women, can effectively recognize abnormal conditions.

How much better off we are, being able to recognize the unusual and to confidently make arrangements to get professional help; compared to remaining in ignorance until our problems have progressed to the point of seriousness and possible permanent damage. The Self-Help Clinic concept also helps us learn to take better overall care of our bodies. We stress breast examination and strongly encourage yearly Pap smears for cancer detection. We have found that, just like a sore throat, when we recognize an early infection or inflammation, some kind of personal care which includes lots of rest for our body, often connects the problem.

The Advanced Self-Help Clinics

One of the most exciting outgrowths of the Self-Help Clinics is in the development of advanced groups who have dedicated themselves to implementation and research. These groups feel that it is time that we women do the deciding on what we want in research areas on better health care for women. A large number of these women are guiding new Self-Help Clinics, sharing their experience with newer sisters to the concept, as well as perfecting their paramedic training skills. Quality libraries with up-to-date material and references on research into women's health needs, is another area of implementation. Another advanced Self-Help Clinic has published our "Ho To Start Your Own Self-Help Clinic" booklet which is available to anyone or groups interested in starting a Self-Help Clinic. There is presently a sizeable number of advanced, very dedicated and brave women who are determined to research out the possibilities of menstrual extraction. Let us here, clear up any misconceptions involving the experimentations being done within these advanced groups. And that is, menstrual extraction is not a euphemism for abortion. When the Self-Help Clinic means abortion we refer to it as abortion. This is a most important point. Our advanced groups must not be misrepresented if they are going to continue to work effectively for all women. These dedicated women, working and learning together are providing valuable information in the skills of menstrual extraction. Most of them seem to quite comfortable extract on the first day of their flow. We are told that a policy of these groups is that at no time is a sister allowed to experience discomfort. We are also told that it is almost unnecessary to mention the need for caution and gentleness, although both are major considerations in every case. Caution and gentleness seem to be almost instinctive.

While working within one of the advanced Self-Help Clinics, Lorraine Rothman found that the device that the group was attempting to use at that time needed vast improvement. It consisted of a simple syringe specially constructed to hold vacuum by the pull-back plunger; some plastic tubing; and a specially constructed small bored flexible cannula. (Neither the tubing used in manufacturing the cannula nor the finished cannula are available through laboratory or surgical suppliers. It is specially made by a large bio-instrument manufacturer and sold for a very high price.) Lorraine decided that since the syringe fell apart so easily causing air and fluid to back up into the uterus, she would devise another that would, 1) Provide a portable and continuous vacuum without back up worry, 2) Provide a syringe that need not be specially constructed, and 3) Provide a by-pass collection bottle which is a must since menstrual flows vary from woman to woman. She also realized the need to have ready access to the specially manufactured high quality, semi-flexible cannulas. They cannot be purchased at local lab houses, standard lab catalogs, nor can they be improvised out of the hardware store or drug store supplies. Lorraine's invention, tagged "Del'-Em", presently has a patent pending in hopes of keeping it within the women's movement as well as to encourage other women to put their heads and hearts to work for the movement. The semi-rigid cannula, which is a critical component of Del'-Em, when chemically sterilized, can be inserted through the undilated cervix. The cannula will bend to conform to the uterine walls without breaking or losing its flexibility and yet is not hard enough to damage the uterine lining. In addition, the cannula bore is large enough to facilitate removal of the menses. The research in these advanced groups is conducted under the guidance of medically trained personnel within clinical settings. They learn hospital and clinically acceptable sterile techniques under careful guidance. They also have access to the specially built cannulas and use only them. The women examine each other carefully to determine whether the procedure of menstrual extraction is safe for each. In this way they learn that a select group of women are eligible for the procedure. The following conditions, which are screened very carefully, are ineligible: Retroflexed (elbowed backwards) or antiflexed (elbowed foreward) uteruses, serious infections, polyps, extensive scarring, endometriosis and double uteruses. The Advanced Self-Help Clinics have also found that there is no way for a woman, by herself, to know her exact uterine conditions. Sisterhood is Safety: Safety is Sisterhood. In addition, continued research with Del'-Em indicates that group experience, knowledge, cooperation and sisterly concern improves the kit's efficiency. It would be irresponsible, here, to give step by step written directions in menstrual extraction. Just as in learning to sail a boat, it can't be done just by reading a book. It takes a seasoned sailor along to instruct with a properly outfitted vessel. The Advanced Self-Help Clinic groups, some of whom have been experimenting with Del'-Em for almost a year, know by personal experience that if this movement is to succeed, it will-only through SISTERHOOD. Groups of sisters learning from sisters and helping other sisters to fully realize their control over their own bodies is a very meaningful and workable concept. The idea of a "kit in each woman's private bathroom" is anti-sisterhood and anti-women's liberation. By being a select item for one woman only, within the confines of her own four walls, and without the collective help and support of her sisters, everyone and especially the movement looses. The concept of Self-Help stresses Sisterhood that makes possible the benefits from collective knowledge, collective experiences, collective training and especially the sisterly concern for one another. When it is necessary to travel for more extensive experiences or information, we do. Lastly, the Self-Help concept emphasizes competent medical backup and the use of safe equipment at all times.

We are seeing, today, unbelievable gains springing from this movement of sisterhood. We also forsee that it will take continued dedication by all sisters, vast investments of time, motivation, enthusiasm, and $$ for this movement to succeed. Throwing off the oppression of centuries takes total commitment and sisterhood.

The West Coast Sisters


* "Family Planning and Cancer Screening Services as Provided by Paramedical Personnel, A Training Program", by Donald R. Ostergard, M.D., AM. Assoc. Plan. Parent. Phys., Kansas City, Mo., April 5-6, 1971.

Racism and the Women's Movement

By Carol Downer

Originally Published in Women's Health Movement Papers on July 1980

Please visit Self Help is Global in Women's Health in Women's Hands!

In the Spring of this year, the Feminist Women's Health Center in Los Angeles, along with many women's organizations in Los Angeles, were approached by the Los Angeles Women's Building to respond to a questionnaire on racism. Each questionnaire was to be the basis for an article in Spinning Off, the Women's Building newsletter. Their group had been having discussions about racism, and they wanted to raise the issue of racism and how women's organizations in the women's movement are dealing with it. The Feminist Women's Health Center was one of the many groups that had an interview, article, or statement in the April/May issue. The article, written by Carol Downer, Delores Nola, and Becky Chalker, follows:

One of the most glaring racist characteristics of the women's movement is that most women, like all Americans, are abysmally ignorant of world politics. Many of us, for example, do not comprehend the impact of a trend, exposed by the Peace movement during the Viet Nam War, for the U.S. government to support policies which promote the domination of Third World countries and their resources by U.S. based, global corporations.

In response to this oppressive trend, Third World nations have united in the U.S. and have demanded that they be allowed to become industrialized, instead of simply supplying raw materials to industrialized nations. The Iranian people, whose self-supporting economy and agriculture was destroyed by a flood of U.S. corporations and a massive military build-up, have used the only means available to them to end U.S. interference within their borders -- take over of the Embassy.

In the post-Viet Nam era, the rise of oil prices, the devaluation of the dollar, run-away inflation, high interest rates and unemployment are all the results of the decline of American imperialism.

The rise of the Third World in the last decade represents the best hope that we have seen in our lifetimes for world revolution and for the eradication of capitalism and imperialism and their attendant evils, racism, classism, sexism, homosexism and ageism. While Western white male rulers shake in their boots and scurry around trying to prop up their positions of domination, all women have the opportunity to unite to destroy those institutions which have kept them second class citizens. American women have to get rid of the idea that they have something to lose by the demise of capitalism.

This is why we at the Feminist Women's Health Centers have a commitment to fight racism by working directly on Third World struggles and by making efforts to attract feminists of color to our ranks. We work to achieve our stated goal of struggling against racism, our own and that of others, on a day to day basis. All people who work in our organization must subscribe to these goals. We have open hiring and specific policies concerning job assignment, work space and firing. In our group, women of color have responsible positions and participate in decision and policy making.

To give an example of what we think fighting racism is, in the last year and a half, the Feminist Women's Health Centers in California and on the East Coast, made a major commitment to support the Iranian people's struggle to rid themselves of U.S. imperialism. Because of our work, we were invited after the Embassy takeover, to be on a delegation to travel to Iran in December to support the Iranian revolution, to oppose U.S. military intervention, and to demand the return of the ex-Shah. What we found there made us determined to return home and expose the 25 years of torture and political repression that the United States government wholeheartedly supported.

Our commitment included, in addition to sending 2 staff members on the arduous trip to Tehran, major outlays of money for long distance phone calls press conferences, air travel, duplication of materials, and a national speaking tour. These expenses have resulted in full-time staff taking partial salaries for an extended period. Carol Downer's participations on the tour also resulted in her being jailed for several days, after her stay of sentence for the W.A.T.C.H. Inspection of Tallahassee Memorial Hospital, was cancelled by Judge Charles McClure.

Various individuals and groups in the women's movement have bitterly attacked our trip as supporting anti-women governments, as wasting feminist resources and even as imperialistic, for us to impose our standards on Third World people. We regard these criticisms as absurd and as rationalizations to avoid taking an unpopular stand to support the determination to Iranian people to govern their own lives, by substituting, instead, either merely giving money, medicine, and clothing to Third World revolutionary struggles, or even worse, regarding women's individual career advancement as an exemplary feminist goal.

There is a women's movement and there is a feminist women's movement and the distinction is critical. Movement superstars like Betty Friedan, who rubbed elbows with the Shah of Iran in 1975 and bought the line that he had liberated women in Iran, and that the Empress Farah was somehow a "feminist," is an upper-class woman who is making her fame off the conservative, middle-class women's movement without offering anything of substance in return. Germaine Greer, a priviledged academic, who also traveled to Iran with Friedan, is another star who has gained fame, or at least notoriety, without returning anything useful. We need to banish these figureheads so that all women can struggle to know what true feminism is.

There is a feminist women's movement which has a global perspective with the specific goal, not of trying just to create a comfortable women's community, but of trying to change the conditions in the lives of all people.

We as feminists feel that white women have the right to fight for their liberation against their own oppression, but you can't fight your own oppression without fighting against other peoples as well. Our struggles against oppression are inseparable.

There are many reasons that women of color are not in the women's movement in large numbers: racism from within, pressure from without from their male peers, and because of divisive forces from the government and media. Many factors which are keeping women of color from uniting are not white women's fault, they are the fault primarily of the white patriarchy. Regardless, if the feminist movement does not come to grips with these barriers, and if we do not get women of color involved in some way, then we will become a quaint artifact of the 1970's and irrelevant.

However, the feminist movement shouldn't be judged too harshly, because we do not have all the power to control our lives. We are living a right-wing era, therefore, the women's movement is not broad-based. We've lost the benefits of large numbers of women doing consciousness raising. The movement has been side-tracked into single issues. We must be multi-issues. We can't just be pro-ERA or pro-women's art, or just anti-rape. Single-issue approaches ignore the broad political context of our oppression and racism flourishes in them.

Women of color and white women can fight together for common goals, but we can't ask women of color to abandon their brothers and their cause. For example, you can't forget the issue of police brutality against black men in this city. Separatism, or women of color working within their own organizations, but ultimately, we do have the same interests, we do have the same goals, and we must fight side by side.

Vicious racism, such as that found in most schools, factories and businesses in the U.S. does not flourish in the women's movement, but more subtle racism certainly is a problem, and will continue to be so, as long as the society is not fundamentally changed. We must fight against it in our every day relationships among each other, but even more importantly, we must recognize the roots of racism and work as an organization to attack its social and economic causes.