Carol Downer, a leader in the feminist women’s health movement who drew national fame for her role in a case known as the Great Yogurt Conspiracy — so named because she was charged with practicing medicine without a license for dispensing yogurt to treat a yeast infection — died on Jan. 13 in Glendale, Calif. She was 91.
Her death, in a hospital, was confirmed by her daughter Angela Booth, who said she had suffered a heart attack a few weeks earlier.
Ms. Downer was a self-described housewife and the mother of six in the late 1960s when she joined the women’s movement and began to work on the abortion committee of her local chapter of the National Organization for Women. Years earlier, she had had an illegal abortion, and she was determined that others should not suffer as she did.
A psychologist named Harvey Karman had refined a technique for performing an abortion by suctioning the lining of a women’s uterus. It was safer, quicker and less painful than the more traditional dilation and curettage technique, and he was using it to perform early-term abortions and teaching doctors how to use it.
Ms. Downer and others thought the technique was so simple that it could be performed without medical training. They learned to practice the procedure themselves.
Lorraine Rothman, another member of NOW, refined Mr. Karman’s device into a kit she patented called the Del-Em, which included a flexible tube, a syringe and a jar. Doctors called the technique a vacuum extraction. The women called it a menstrual extraction — it was also a way to to regulate menstrual flow — as a kind of linguistic feint.
Ms. Downer set out to explain its use to a group of women at a feminist bookstore in Venice Beach. As she later recalled, when she began to describe the technique, which involved inserting the tube into the cervix, she realized that she was losing her audience. They were horrified. This was the era of back-room abortions, when women were dying from unsafe procedures, and here she was hawking what seemed to be an even more suspect practice.
So she changed tactics. She lay down on a table, hiked up her skirt, inserted a speculum into her vagina and invited her audience to look. The conversation veered from do-it-yourself abortions to an anatomy lesson.
The women had never seen inside their own vaginas — it was not the habit of male gynecologists in those days to educate their patients about their own anatomy — and it was an “aha” moment for Ms. Downer. Like many women around the country — notably those in the Boston Women’s Health Book Collective, who would go on to produce the self-help bible “Our Bodies, Ourselves” — she became determined to teach women about their reproductive health.
She and Ms. Rothman toured the country demonstrating cervical exams — and menstrual extraction. They so impressed the prominent anthropologist Margaret Mead that she declared the practice one of the most original ideas of the 20th century.
“The idea of women being able to control their own birthrate is fundamental. It goes right to the heart of women’s political situation,” Ms. Downer told The Los Angeles Times when Ms. Rothman died in 2007. “We both wanted to turn the whole thing upside down. We wanted to make women equal with men.”
They opened their first clinic in Los Angeles in 1971. The next year, the police raided the place and confiscated, among other things, a tub of strawberry yogurt. As the story goes, a clinic worker protested: “You can’t have that. That’s my lunch!”
Ms. Downer and a colleague, Carol Wilson, were charged with practicing medicine without a license. Ms. Downer’s crime was her yogurt treatment, and Ms. Wilson’s was that she had fitted a woman with a diaphragm. Ms. Wilson was also charged with performing a menstrual extraction, conducting pregnancy testing and giving a pelvic exam. She pleaded guilty to the diaphragm charge and received a fine and probation.
Ms. Downer decided to fight the yogurt charge. Using yogurt to treat a yeast infection, her defense claimed, was an old folk remedy, and in any case a yeast infection was so common that it did not require a doctor’s diagnosis. The jury agreed, and as Judith A. Houck, a gender and women’s studies professor, recounted in “Looking Through the Speculum: Examining the Women’s Health Movement” (2024), the male foreman sent Ms. Downer a note of appreciation.
“Carol — You’re not a downer, you’re a real upper!” he wrote. “Good Luck!”
The Great Yogurt Conspiracy helped popularize women’s clinics, which were sprouting up all over the country. Though many in the women’s health movement were also working to eliminate gender bias in the medical profession, particularly with regard to reproductive health, and to help those who needed it most gain access to medical services, Ms. Downer remained leery of what she felt was a patriarchal institution incapable of reform. She was not convinced that change was possible.
She and others went on to found the nonprofit Federation of Feminist Women’s Health Centers, and she continued to research the ways women could manage their own fertility.
Yet many feminists, abortion rights supporters and medical professionals were more than uncomfortable with Ms. Downer and Ms. Rothman’s teaching; they were deeply opposed to having laypeople practice the procedure.
“Carol Downer demonstrated a very reckless form of courage and defiance,” Phyllis Chesler, the feminist psychologist, activist and author, said in an interview. “I had a problem with the paranoia around the medical profession, and although I of course harbored a similar distrust, I didn’t think it was safe or wise to put abortions in the hands of amateurs.”
In the years after the Roe v. Wade decision guaranteed a woman’s constitutional right to an abortion, vacuum extraction, the technique devised by Mr. Karman, became the most common surgical procedure used by doctors to end a pregnancy. It still is, said Dr. Louise P. King, assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. The technique, she added, is safe when practiced by a medical professional.
“There are risks and complications if it’s done wrong, notably uterine perforation,” she said in an interview, “which is what we train not to do. I’m fully in support of those who want to take control of their health and their lives, and it saddens me to think people might have to turn to these methods without the help of professionals, that they might not have access to these professionals.”
In 1993, Ms. Downer and Rebecca Chalker, an abortion counselor, published “A Woman’s Book of Choices: Abortion, Menstrual Extraction, RU-486,” essentially a consumer guide to abortion.
Le Anne Schreiber, writing in The New York Times Book Review, called it “a print hotline in a time of government-ordered gag rules” as well as “a warning sign.”
“When so few doctors perform abortions,” she wrote, “when so few medical schools teach the techniques, when so many states seek to impose so many restrictions, women reluctantly begin to take risks that other people call choices.”
Carollyn Aurilla Chatham was born on Oct. 9, 1933, in Shawnee, Okla., and grew up there and in Glendale. Her father, Meade Chatham, was a clerk in a gas company; her mother, Nell (Stell) Chatham, was a secretary.
Carol studied sociology at the University of California, Los Angeles, but dropped out during her first year when she was pregnant with her first child. Her husband, Earle Wallace Brown, stayed in college and worked as a cabdriver and then a special-education teacher before contracting tuberculosis.
The family spent a year on welfare, an experience that Ms. Downer later said politicized her. Unlike most welfare recipients, she and her husband had additional support. They lived rent free in a house owned by her parents, and they received financial help from his parents and fellow teachers.
“I began to gradually develop a radical political consciousness,” she said in an oral history conducted by the Veteran Feminists of America in 2021. “I mainly learned that no one survives on welfare without some kind of informal support network or a hustle.”
She had four children and was separated from her husband when she became pregnant, and decided to have an abortion. It was 1962, five years before abortion was legalized in California and 11 years before Roe. While the procedure was performed by someone with experience and was medically safe, she received no anesthesia so that if the place — an office with no furniture beside a table — was raided by the police, she could get up and run.
In addition to Ms. Booth, Ms. Downer, who lived in Los Angeles, is survived by two other daughters, Laura Brown and Shelby Coleman; two sons, David Brown and Frank Downer Jr.; eight grandchildren; and several great-grandchildren. Her second husband, Frank Downer, whom she married in 1965 after her divorce from Mr. Brown, died in 2012. A daughter, Victoria Siegel, died in 2021.
Ms. Downer went back to school in the late 1980s. After earning a degree from Whittier Law School, in Costa Mesa, Calif., in 1991, she practiced immigration and employment law.
“There’s a through line from Carol Downer to the current reproductive rights and reproductive justice activists,” said Dr. Houck, the author of “Looking Through the Speculum.” “Hers was a form of activism where women could use their heads, their hands and their hearts.”