reproductive health pioneer harvey karman dies, age 84

Rest in peace, Harvey Karman, inventor of the Karman cannula, used for safer abortions and the diagnosis of uterine cancer. From the L.A. Times:

Harvey Karman, a flamboyant psychologist whose invention made a key contribution to women's reproductive health, particularly by making abortions simpler, cheaper and less painful, died May 6 at Cottage Hospital in Santa Barbara. He was 84.

[...]

Activist, inventor, educator and rogue, Karman was drawn to the plight of women facing unwanted pregnancy in the 1950s, when abortion was illegal. While training in psychology at UCLA, he started an underground abortion referral service and eventually performed abortions himself, for which he was convicted and sent to state prison for 2 1/2 years.

In the early 1970s he developed a soft, flexible tube, or cannula, for a device that was widely adopted in the United States and developing countries to perform early abortions. He freely demonstrated its use for doctors and other medical professionals and in 1972 was part of a humanitarian mission to terminate the pregnancies of 1,500 Bangladesh women and girls who had been raped by Pakistani soldiers. His cannula is still widely used today.

"Harvey Karman did more for safe abortion around the world than practically any other person in the world," said Dr. Malcolm Potts, Bixby professor of Population, Family Planning and Maternal Health at UC Berkeley, who accompanied Karman to Bangladesh 35 years ago.

"Karman's name is not known, yet his ingenuity and to some extent his courage has made safe abortion available to literally millions of women around the world."

Doctors later found other applications for the Karman cannula, including using it in the diagnosis of uterine cancer, said Dr. Philip Darney, chief of gynecology and obstetrics at San Francisco General Hospital.

The tube, which Karman never patented, is so inexpensive and easy to sterilize and re-use that it has "dramatically reduced healthcare costs in treating uterine bleeding, one of the most common reasons women come to the emergency room," Darney said.

update: As per my response in comments, here is the critique of Karman's "super coil" experiments (no, sorry, I won't be quoting anti-choice websites). From the same L.A. Times article above:

Karman also had many detractors, particularly because of his attempt to revolutionize second-trimester abortions with a device called the super coil, which was inserted into the uterus and expanded when exposed to moisture, causing a miscarriage. It caused serious complications, including hemorrhaging and infection, when it was used on about a dozen women in Philadelphia on Mother's Day in 1972.

"Harvey engaged in some very irresponsible experimentation on women's bodies," said Carol Downer, who co-founded feminist women's health clinics in Southern California in the 1970s.

The incident was investigated by the national Centers for Disease Control, where Darney worked at the time. Darney called the super coil a "bad idea" but added, "I don't think that offsets the importance" of Karman's other contributions.

Downer agreed, calling Karman "a real change agent" whose invention gave momentum to the abortion rights movement in the period before the procedure was legalized by the 1973 Supreme Court case Roe vs. Wade. "I would never take away from the importance of a lot of the work he did," she said.

This last part I will add in response to the comment that Karman thought of the Bangladeshi women he sought to help as "lab rats":

After the Indo-Pakistan War of 1971, when Bangladesh gained independence, he was part of a five-member team of abortion experts invited by the Bangladesh government to perform abortions on rape victims and train native doctors and paramedics in his method. Most of the victims were between the ages of 10 and 16.

"Many victims were actually being driven from their homes and villages by husbands and families who felt disgraced. And many committed suicide," he told the Los Angeles Times in 1972.

He said the team visited outlying villages and taught midwives, village chiefs, young girls, "anybody who wanted to learn," how to use the cannula for an abortion. The method is still used widely there, although it is called menstrual extraction because abortion is banned.

Karman "is responsible for saving the lives of countless women throughout the world through this innovative technology," Vicki Saporta, president and chief executive of the National Abortion Federation, a professional association for abortion providers based in Washington, D.C., said in an interview last week.

Along with advances in local anesthesia and suction equipment, his little tube, she said, was one of three major innovations that dramatically improved abortion care in the 1970s.

Karman spent much of the late 1970s and early '80s in Bangladesh, India and China, where he championed women's rights and safe, easy abortions.