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Carollynn Aurilla Downer ( Chatham; October 9, 1933 – January 13, 2025) was an Americans feminist lawyer and non-fiction author who focused her career on abortion rights and women's health around the world. She was involved in the creation of the self-help movement and the first self-help clinic in LA, which later became a model and inspiration for dozens of self-help clinics across the United States.
The result of this first meeting of the Self-Help Clinic was the development of the concept of menstrual extraction and the invention of the Del-Em kit by Lorraine Rothman. This provided women with a less traumatic abortion option than the use of a metal tool to scrape the inside of the uterus, which was predominately used at the time. Downer and Rothman travelled across the country and many Self-Help Clinics were formed.Davis, Flora. (1991). Moving the Mountain The Women's Movement in America since 1960, New York: Simon Schuster. p. 232-233Morgen, Sandra.(2002)."Into Our Hands The Women's Health Movement in the United States, 1969-1990,"New Brunswick, New Jersey, and London: Rutgers University Press. pp.34,124 During this time, abortion, birth control and fertility information were not widely available to women. The menstrual extraction and vaginal self examinations that Downer pioneered with her team provided women with the means to learn about their bodies and take control of their reproduction. Barbara Ehrenreich described Downer and Rothman's efforts as "legitimizing the notion that we have the right to know and decide about procedures...that affect our bodies and our lives." In 1972 she also gave a notable speech to the American Psychological Association on September 5, 1972, in Hawaii, entitled " Covert Sex Discrimination Against Women as Medical Patients."
She and Rothman were leaders of a group that founded the Feminist Women's Health Center in Los Angeles in 1971. Equipped with vaginal speculums, they traveled the United States to share their information with women around the country. Downer and Rothman also promoted group meetings where they taught women how to self-administer cervix exams and provided them with information on a procedure called menstrual extraction. Downer and Rothman trained women how to suction out menstrual material on or near the time of the menstrual period; if the woman is pregnant, this constitutes a non-professional abortion.Gordon, Linda.(2002)."The Moral Property of Women A History of Birth Control Politics in America,"Chicago:University of Illinois Press.p.325Love, Barbara J.(2006)."Feminist Who Changed America 1963-1975,"Urbana and Chicago:University of Illinois Press.p.123Marieskind, Helen I.(1980)."Women in the Health System,"St.Louis, Missouri:The C.V. Mosby Company.p.292Morgen, Sandra.(2002)."Into our Hands The Women's Health Movement in the United States, 1969-1990,"New Brunswick, New Jersey, and London: Rutgers University Press. p.7, 22-23, 34, 124Ruzek, Sheryl Burt.(1978)."The Women's Health Movement Feminist Alternatives to Medical Control,"New York:Praeger Publishers.p.53-58Sage-Femme Collective.(2008)."Natural Liberty Rediscovering Self-Induced Abortion Methods,"Las Vegas, Nevada:Sage-Femme! p.64 When they came back from their trip around the US, Downer and her followers started a women's abortion referral service at their own clinic. In 1972, the police conducted a search of Downer's clinic/health center and arrested her and Colleen Wilson for practicing medicine without a proper license. Called the Great Yogurt Conspiracy, they were using yogurt inter-vaginally to treat a woman's yeast infection.Morgen, Sandra.(2002)."Into Our Hands The Women's Health Movement in the United States, 1969-1990,"New Brunswick, New Jersey, and London: Rutgers University Press. p. 130Ruzek, Sheryl Burt.(1978)."The Women's Health Movement Feminist Alternatives to Medical Control,"New York:Praeger Publishers.p.144 Downer was later acquitted of all charges.
Within 50 days of the Roe v. Wade Supreme Court decision, which ruled that women have a right to end their pregnancy, her group opened the Women's Choice Clinic in Los Angeles and Orange County. Over the next two years, other Feminist Women's Health Centers were established, forming part of the Federation of Feminist Women's Health Center in 1975.
From 1987 to 1991, Downer attended law school and worked for the Federation of FWHCs. Since then, she has practiced law, mostly in the area of disability rights. In 1981, she was the general editor of A New View of a Woman's Body, published by Simon and Schuster, and she was an editor of a companion book, How to Stay Out of the Gynecologist's Office, published by Women to Women Publication. In 1984, she and Francie Hornstein assisted Ginny Cassidy-Brinn, a Registered Nurse, in writing Woman-Centered Pregnancy and Birth, published by Cleis Press. But during the Reagan Administration, the anti-abortion movement grew, and the clinics were hit with protests. "The low point was 1985, when the clinic burned down, but we didn’t give up," Downer said. Many believe the fire was started by protesters. So these women began mobile clinics located in vans, which did screenings in a safe and secure location.
In 1992, she wrote A Woman's Book of Choices with Rebecca Chalker, published by Seven Stories Press. She has also served on the board of directors of the National Abortion Federation. Downer's book included instructions on how to practice early abortions more safely. The procedure requires the assistance of at least two experts. The book does not only tell readers to do abortions on their own, but it gives advice about when a woman should go to a medical practitioner to terminate early pregnancy.
Downer was promoting women's liberation, giving speaking presentations, and working on her next book in which she advances the belief that women's collective efforts to achieve their sexual and reproductive liberation is a fundamental strategy for social change. She was also working on the board of directors of the Feminist Women's Health Centers of California. This board operates eight Women's Health Specialist Clinics. She recently posted a video on YouTube about the history of her foundation and how she taught other women about the speculum abortion technique. She was also an immigration lawyer in the Los Angeles area.
Downer died on January 13, 2025, at a hospital in Glendale, California, after a heart attack two weeks prior. She was 91.
Downer and the practice of self-help gynecology had many critics, including those from within feminism. Some feminists felt shocked and offended at Downer and Rothman's self-examination presentations. Other feminists worried this practice would take attention away from the other efforts of the women's health movement, such as legislative and judicial reform. Some were concerned that the self-help groups themselves were merely an outlet for women to air their grievances of mainstream medical institutions and did not involve any real change. There were also those who worried that self-help gynecology would lead to an overreliance on it and would cause women to neglecting to visit their physician when experiencing serious conditions. To this, activists argued that self-help gynecology could be used in conjunction with mainstream medicine.
The clinic began in a back room in the Women's Center on South Crenshaw Boulevard and later, the clinic moved to a house in the same area so as to remain accessible to women who needed its services. Downer explained that the clinic's main goal was to "take women's medicine back into our own hands. The strategy was to take back the power over power over our own bodies, both everyday types of control which information and self-knowledge gives sic us, and we also want to acquire special skills and knowledge which will allow us collectively to independently provide our own health care." The center eventually became a symbol of the struggle to legalize abortion and had an active part in the public dialogue about reproductive rights.
The first clinic served as a blueprint for other self-help clinics established in other parts of California, Oregon, Washington, Florida, and Georgia. These centers led to the foundation of a decentralized coalition called the "Federation of Feminist Women's Health Centers" (FWHC). Within the coalition, they shared materials, wrote books, and met as a group to share ideas, education and provide support for each other .
Although controversial among feminists, Downer believed in the concept of organizational structure. Running a clinic required a bureaucracy, but to avoid the typical bureaucratic pitfalls of regular health centers, Downer and Rothman's clinic had an open structure that invited the maximum participation when making clinic policy. She wanted to make the structure of the clinic work for the staff and patients - not the other way around, and so, the clinic had collective control over the workplace and had no outside board of directors or separate management structure. Downer wanted to ensure the most comfortable and supportive environment possible - different from the bare environment at typical medical facilities run mainly by men. The environment in the clinic itself had decorations on the walls, colorful rugs and plants, providing a relaxed atmosphere, with comfortable chairs arranged in a circle to facilitate conversations. On the ceiling above the examination table, there was a picture of a pretty landscape to help create a calming atmosphere for the women during procedures. Downer and Rothman wanted to avoid the layout of traditional abortion clinics where the patient followed a standardized route into and through the clinic. Instead, patients sat at different stations with one another, giving them the opportunity to talk to each other. In addition, each woman was accompanied throughout her visit by a lay counselor so they were never alone. After the procedure, women returned to the waiting room so others could see that she was fine. This created a loop of peer support among patients during their time at the clinic, encouraging women to ask questions, see how other women were doing, and support one another.
Clinics also provided "well-woman" gynecology care and education, where women learned how to perform vaginal self-examinations and/or other basic gynecological self-help procedures in a group or one-on-one setting. Although clinic workers had varying levels of formal medical education, and some were entirely clinic trained, all exams and tests were supervised by a staff doctor. This allowed women to have some unique choices for their gynecological care. Women who needed routine medical exams were able to choose whether they saw a gynecologist or a layperson supervised by a doctor, would educate them in self-exam and staying healthy. Another option was to have a group appointment scheduled with several other women and, in addition to being treated by a doctor, they could also watch and learn from the examination and treatment of other women.
Downer was also charged with practicing medicine without a license - she had helped activist Z. Budapest put yogurt into her vagina (a common home remedy for yeast infections at the time), and for showing a woman how to do a self-cervical exam. LA Deputy City Attorney David M. Schacter was convinced that the staff members at the clinic had been practicing medicine and insisted that all the procedures should have been performed by a qualified doctor. He is quoted with demanding: "Who are they to diagnose a yeast infection and prescribe yogurt for it?" To the women at the clinic, Schacter's attitude hinted towards men's monopolistic control of women. Downer pleaded not guilty and went to trial.
Downer's main defense for the trial was that the law that forbade laypeople from diagnosing and treating others was too vague. She argued that "if the state truly did enforce this law, a person could not pass a sneezing friend a tissue or bring over chicken soup for a cold." She even asked a doctor involved in her trial if a mother diagnosing her child's illness would qualify as practicing medicine without a license, to which he replied: "Well, we can't do anything about that." Her feminist attorneys, Diane Wayne and Jeanette Christy, requested and received a woman judge for the trial, which was a major accomplishment given the scarcity of women judges at the time. Downer closed her appeal with the quote: "This trial is a direct threat to our rights to know our own bodies. We not only expect to win, but we also want to give emphatic notice to all who would deny us this right as we will control our own bodies."
Nine hours of deliberation later, a jury made up of three black women, one white woman and eight white men acquitted Downer of all charges. Her attorneys successfully argued that the law was too vague and if it was truly followed, Downer and others would not have even been able to discuss a cold with a friend or "offer her a tissue." They went even further to point out that "half of the mothers in the county could be charged with diagnosing that their children had the measles."
The case and trial set the precedent for other self-help clinics to operate legally. It revealed to the public how far authorities would go to eliminate the threat of self-help clinics - clinics which gave women control of their own health. Had Downer been convicted, it would have been a serious setback to the women's health movement.
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