Achievement of the goal of aiding a woman in her self-fulfillment is clearly difficult to prove, but from my perspective is the greatest contribution of the self-help clinic. Women who have participated in self-help groups report feelings of strength, a sense of self-worth, self-confidence, and an ability to be more assertive. Simple consciousness raising techniques are used by the women as part of the group's dynamic. For example, if a woman discusses a doctor-patient encounter and finds other women have had similar experiences, as a group they will question why there is this similarity and how such an interaction affects their ability to get treatment. Or the process of gaining knowledge may serve to demonstrate to a woman how little she really knows about this part of her anatomy which is so intimately intertwined with society's perceptions and expectations of her and through which comes her principal involvement with the medical system. She soon asks why she is ig norant and frequently, as did the women in my survey when they could not answer the questions, expresses anger at her sense of helplessness.

The lesson of this collective action in the self-help clinic is clear and demonstrates why the women's health movement of which it is a part is indeed a political movement struggling to change power relationship. The self-help clinic and the women's health movement are not just personal solutions for an individual woman's health problems-though that is obviously a valid reason for their existence: they are tools for inducing

collective thought and action from which radical social change can grow.

WANTED: Energetic women, interested in learning more about themselves (mainly physical selves) and sharing information on women's health and health issues as they relate to our lives. Last year the Cleveland Feminist Self Help Collective organized discussion groups with women from such diverse areas as Bedford, Hudson, and Tremont. We have also facilitated discussions for women interested in continuing self-help education, discussing natural birth control, menopause, vaginal health, and sexism in the medical profession. We visited the Detroit Feminist Women's Clinic and have shared the experience of a home birth. The next Self Help workshop will be November 15 at 7:00pm at WomenSpace. This is an introductory slide show and discussion. A four-week self help group will follow. Any women interested in attending Self Help Collective meetings may join us Nov. 6 at 8pm at 1637 Eddington (up) for our next meeting. We are still planning our projects for the year and would welcome your energy and ideas.

MIN UBU

A DES daughter about her feelings

OCPS

writes

For years my mother worried about my taking birth control pills. Finally, when I was 25, she told me why: she had taken the artificial hormone DES (diethyl stilbestrol) for 8 of the 9 months she carried me. She told me that she had subsequently read an article which said something vague about an increased risk of cancer among the daughters of pregnancies in which DES has been taken. She hadn't told me because she didn't like to think about it.

I didn't like to think about it either, but I did some reading. I found some articles which said that the rate of clear-cell carcinoma, a rare vaginal cancer, was higher among DES daughters than in the general population. I read a case history in a women's magazine of a 22-yearold woman, also a DES daughter, who had had a vaginectomy as a result of DES-induced cancer, and who had spent 9 months with her legs in a frame, waiting for the skin they had taken from her inner thighs to build an artificial vagina-"for my husband"-to grow back. I decided I'd rather not think about it either. and relegated the whole thing to the back of my mind. But I read everything I came across that had to do with DES, and it was all bad news. And vague news.

When I went back to college, however, the woman gynecologist at the health service there convinced me that it would be worth finding out exactly what the DES effects on me had been. I still didn't want to face it, but I made an appointment at a clinic in Pittsburgh that has the equipment to do a colposcopy. Opinion seems to vary on how to detect the cell abnormalities that characterize DES daughters, 'but a colposcopy is generally recommended. It's an intravaginal exam which uses a colposcope, a sort of on-site microscope that examines the cells of the vagina and cervix.

Once I had acknowledged the fact that my prenatal DES exposure did have something to do with me. I suddenly had to deal with my feelings of terror and rage. "I like my vagina. I'm used to it. I use it all the time, and I don't want anyone to take it out. If they take out your vagina, what do you do when you have a period? I bet they give you a hysterectomy, too. But if I don't get an artificial vagina like that woman in the article, maybe it won't hurt so much. And then I couldn't be raped either. No, that won't work. What rapist would believe me when I said I didn't have a vagina? Oh, god, they'll mutilate me, and it's not my fault."

But I had trouble figuring out whose fault it was. When my mother took the drug, the medical profession still thought it prevented miscarriage. I couldn't be angry with my mother. Besides, she was having enough trouble dealing with her guilt; she didn't need my anger.

too The obstetrician who prescribed the DES was acting in good faith, too, and was a woman, too. I did feel anger toward the drug companies who had marketed this useless stuff that had left me with a sizable chance of being castrated, but I didn't know what to do with it. So I just worried.

The colposcopy itself was not nearly as bad as I had expected, although it was expensive The price quoted was $15. but that turned out to be the cost for someone who had no abnormal cells and thus needed no biop sies. My total cost ended up to be $75 The doctor who performed it was a woman, and she took the time to explain to me the precise risks I ran, as well as how our reproductive systems work, and why women need pap smears so often

It turns out that every woman's cervix is lined with columnar cells, a sort of glandular tissue. The columnar cells, which are the shape their name suggests, are constantly in the process of metamorphosing into squamous cells: flat cells shaped like a fried egg-around the edges of the glandular tissue in the process of change, the cells run a reasonable risk of going haywire. and the cells that go haywire have a fair probability of becoming cancerous. DES daughters have extra columnar tissue on the outsides of their cer vixes and in their vaginas-called adenosis-and thus more cells are in process of changing at any moment. If the abnormal growth is caught early, a little piece of tissue can be excised and no terrible consequences will result. No vaginectomies if it's caught early! And the clear-cell carcinoma turned out not to be such a big threat. Apparently there have only been about 300 cases ever, including all the DES daughters who have contracted it.

My colposcopy produced good news right away. I had no adenosis, except on the outside of my cervix. and the only adenosis you develop is the adenosis you're born with. I did have some abnormal cell growth (hence my expensive biopsies), but eventually that turned out to be okay, too. I feel a lot calmer about my own chances now, but a lot of rage still remains. At the school health service, a nurse-practitioner told me that students as young as 16 are DES daughters. That means that doctors were still prescribing the drug, to pregnant women ten years after it had been shown to be ineffective. And, too, many women are having to find the money for colposcopies somewhere when they had no say in the conditions that produced their situation.

There is currently a DES action group. DES Action Project. 360 Kent St., Brookline, Mass. 02146, which is exploring options available to DES mothers and daughters. They deserve our support, and give support back. Class-action suits have been brought, and are be ing considered. in several areas to get the companies who marketed DES to bear the costs of colposcopies for the women who were affected by their carelessness. We need to talk with our mothers and with each other to combine our rage and produce action. DES is still being prescribed as the "morning-after" pill, even though the FDA has finally recognized that it is too dangerous to feed to cattle. It is time we did something. Barb Moody