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Karman cannula

Harvey Karman (16 April 1924 – May 6 2008)

 

Harvey Karman died in Santa Barbara, California, on May 6th, 2008. He spent part of his adult life in England, both during World War II and later practicing psychotherapy in London. Beyond some specialist gynaecologists, Karman’s name is not known, yet innumerable women have benefited from the safe abortion technique he developed. On average, every woman now in her fertile years will have one induced abortion – in Britain, with a relatively high use of contraception, it is one in three. At least two clinics in Asia have performed over one million abortions, each using the technique Karman, who was not a physician, invented.

 

Born as Harvey Le Roy Walters in Oregon, 26th April 1924, he was abandoned by his father, a Bible salesman, and took the name Karman from one of several step fathers his mother lived with as Harvey grew up. He left school at age 14 and joined the US Air Corps a few years later. Stationed in Norfolk, England as a serviceman, he wrote film reviews for Stars and Stripes. Under the GI Bill he studied theater arts and psychology at the University of California, Los Angeles. At a time when abortion was illegal on both sides of the Atlantic, Harvey began helping pregnant women from the campus find their way to illegal abortionists in Tijuana, Mexico. Some were well treated, others exploited financially and sexually, and yet others died. Harvey decided, to take the law into his own hands, literally. He needed a procedure that was not painful and where a woman would rest for a few minutes and then walk away, with no one knowing she had had abortion.

 

Vacuum aspiration abortion with an electric pump had been developed in China and eastern Europe some years earlier. Physicians, such as myself, were taught that the neck of the womb must be stretched (which causes severe pain) to accommodate a relatively large metal cannula, or tube. Not being a doctor, Harvey haden’t been told it was ’impossible’ to complete an early abortion with a cannula little bigger than a drinking straw. He purchased some plastic syringes and some slim, flexible plastic tubing. With a hot iron and a razor blade he fashioned what is now known as manual vacuum aspiration (MVA), or sometimes known by the more alliterative‚ Karman cannula’. For the first time in history, it was possible to do an abortion in the first three months of pregnancy, safely, on a conscious woman and with little discomfort.

 

MVA is now a method of choice among abortion providers all over the world. Harvey deliberately  didn’t patent his invention, never made any money out of it, and often did abortions free of charge. When he and I published his invention in The Lancet in 1972, we never guessed MVA would be used on an ever-increasing scale into the twenty-first century.

 

Harvey was the archetypal, sexually liberated Californian of the 1960s. Empathetic and funny, he could be exasperatingly laid back. He was driven to solve problems, whether huge and controversial, as abortion has always been, or mere inconveniences – I still remember the day I locked my keys in my car in central London and Harvey opened it with a bent wire in a nanosecond. But there was one problem even Harvey could not solve 40 years ago – how to do a safe abortion after the first 12 weeks of pregnancy. He invented a plastic coil which could be slotted into the womb and which if left in place for a day would initiate a late abortion. It was no better and no worse than other methods of late abortion at that time, and he did have one death. He faced several criminal charges for practicing medicine without a licence and for the abortion death. He was convicted but later pardoned.

 

While he lived in London, Harvey joined a humanitarian team put together by the International Planned Parenthood Federation to offer abortions to women who had been raped during the 1972 War of Liberation in Bangladesh. All who worked with Harvey respected his skill and his empathy for the women, some of whom were not more than 10 or 12 years old. The one positive outcome of this tragic episode was that MVA equipment was taken to every hospital in the new nation of Bangladesh. Today, large parts of this still poor country have achieved a two child family through purely voluntary family planning, backed up by MVA. Karman’s home-made invention has not only helped millions of women suddenly confronted with an unintended pregnancy, but who helped change the demographic trajectory of a number of countries.

 

Karman was married three times and he is survived by four children and six grandchildren. In 2002 he had a stroke and he lived in sheltered accommodation for some years before he died.

 

 

 

Malcolm Potts