Alternative Means for D&Cs (Dilation and Curettage): Tara Taha
Reproductive health has been a hot topic in the United States for decades, with restrictions placed and lifted off in tune with the views of the legislative body’s sentients to the topic. My second presentation focused on NIPTs (Non-Invasive Prenatal Testing) and included the topic of D&C (Dilation and Curettage); however, I think with the political tone that has now latched itself onto abortion, that the focus should be shifted onto D&C.
The surgical procedure of D&C has been around since the 19th century. It was created in tandem with the first curette (see Figure 1) to address abnormal uterine bleeding and remove tissue of the uterine lining.
Figure 1: Sharp curettes Diagnostic Dilation and Curettage
However, my post is not only to educate my peers about the procedure, but also to provide a ground for discussing the ethics of the invasive procedure as a replacement for abortive procedures that were previously available, such as D&E (dilatation and evacuation) and how it has been reserved for only a subsect of women; I say the “ethics” of D&C, not to try to spark a “political discussion” surrounding the support for/against abortions, but rather because it might be utilized, in private, by those same lawmakers who oppose (safer) abortions for all women.
Previously, D&C was used as a procedure for abortions prior to the passing of Roe v. Wade, and one of the organizations conducting it in that manner was called The Jane Collective (see Figure 2). The Jane Collective was an underground service by the CWLU (Chicago Women’s Liberation Union) that preformed over 11,000 abortive procedures, commonly in the form of a D&C, to (mainly) women who came from low-income backgrounds and women of color who could not afford the trip to New York, where abortion was legal. It was not an exclusive club who turned down women in need, and surprisingly did not (intentionally) discriminate to those same women.
Figure 2: the Jane Collective Advertisement
To learn more about the Jane Collective, I have attached articles and a YouTube video below:
I also highly recommend watching The Janes on HBO if you would like to further delve into how abortion was accessible in the form of D&Cs prior to the ruling of Roe v. Wade!
The use of D&C as an abortive measure for women of color and low-income women would surely carry into the present, right? Unfortunately, it has become quite the opposite. D&Cs have become a thing of the past as a procedure for abortion and has reverted to its original use of addressing miscarriages, abnormal uterine bleeding, and the removal of tissue of pregnant or non-pregnant women. It is even one of the most common invasive procedures performed. With the overturning of Roe v. Wade, many procedures relating to reproductive health, such as D&E, have been made illegal in many states. This means access to abortion has been completely halted and barred, for some. So, who gets the pass to such a procedure? Wealthy, often white, women are the exception to this, with treatments and procedures carried out under the cloak of D&Cs.
Wealthy women can have a pregnancy terminated behind the private, tight-lipped offices of an OB-GYN, permitting they are able to afford such silence. D&Cs are commonly carried out, because of the fact that they can be classified as a procedure for health and not listed as an abortive procedure. Not only that, but D&Cs and D&Es are procedurally the same, with the exception of the method used to remove tissue (scraping vs. suctioning).
Poor women, often of color, are criminalized for abortions, while these wealthy white women are able to skirt around the restrictive laws and pay their way to appear “lawful.” This brings up an ethical dilemma that quickly needs to be addressed: is it fair to carry out D&Cs, even if it is only available for only a sub-sect of privileged women? Surely it would be worse to deny ALL women of the procedure for the means of an abortion?
Of course, the answer is that all women should be able to have access to the safest means of reproductive care, procedures, and abortive measures. But in our current political climate, it seems this answer will only be achieved once the bipartisan demographic in the three branches of government is shifted back to a party that supports reproductive health. So how do we tackle this dilemma now? We must first knowledge the messy truth of who abortions is available to. It is clear that the bills restricting abortion are meant to criminalize those who do not have the financial means to disguise the procedure. As long as profit is the motive of these OB-GYN offices, safe D&Cs cannot be performed for everyone, regardless of their socio-economic backgrounds.
Who exactly gets to dictate what is a legitimate procedure and what is not? Lawmakers, of course. Attacks on the procedure of D&Cs have been halted for the time being out of the blue, in states like Texas and Montana. Supposedly, it was dropped as a result of public backlash, but it could be because these lawmakers who support these restrictive bills, realize that their wives, or mistresses, still need a way to terminate a pregnancy that they do not want the women to carry out, for the sake of reputation and being seen as a hypocrite.
To learn more about the D&C procedure, as well as the restrictions imposed, articles are attached below for your convenience:
Of course, it is very hard to find data to indicate the amount of D&Cs that are performed for the sake of an abortion, rather than a miscarriage or for non-pregnant women. This is because, of course, the initial attraction to such a procedure is because it is not disclosed what exactly has been removed, and filed under general health categories, rather than abortive means to the state. Because of its private nature, the discussion around D&Cs are a form of abortion can be a curse or a blessing to the cause of reproductive health. On one hand, if it was available to all women, and not hidden behind a paywall, it could be extremely beneficial and accessible to those living in this current political climate, who want a safe abortion. But if this cause is found out, then the procedure, as a whole, might be banned, and this would be a detriment to anyone, even non-pregnant women, who need the procedure for the “original” means. Women and healthcare workers around the country must be wary, and cautious when approaching alternative means to reproductive health; you never know what surgery or healthcare could be attacked and restricted next.
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