3D print your own speculum
September 21, 2015 4:12 PM   Subscribe

Meet the GynePunks, activists who are making reproductive healthcare more accessible by using open source tools to make centrifuges, microscopes, and speculums.
posted by faethverity (33 comments total) 25 users marked this as a favorite
It's easy to build a basic microscope, and it's not really very expensive to buy a basic microscope, either.

It's damned difficult to do histology even under a really good microscope. Especially without a bunch of arcane stains.

It's not about tools. It's about skills.
posted by Hizonner at 4:22 PM on September 21, 2015 [1 favorite]

I opened the article and closed it upon seeing the picture. Speculums make me feel very ill. I have to honestly talk myself out of cancelling gyn apps because they make me anxious. And today, kind of nauseated.
posted by discopolo at 4:24 PM on September 21, 2015

Yes, but will the printed speculum be pre-warmed? Because if it's not, I'm out.
posted by Lynsey at 4:26 PM on September 21, 2015 [3 favorites]

This is pretty stupid. Are sex workers, immigrants or the uninsured going to have access to a 3D printer? Lack of access to speculums etc. ain't the issue. We have disposable plastic ones in the hospital where I work. It's not the tools that are missing, it's the talent.
posted by killdevil at 4:28 PM on September 21, 2015 [9 favorites]

Better healthcare that is accessible and affordable for all women everywhere, yes. Do it yourself gynecology, no thanks. There is probably a way to make your own surgical tools as well, but knowing how to use them is a whole other issue.
posted by mermayd at 4:30 PM on September 21, 2015 [2 favorites]

"But is it practical to use open source technology to take over one’s own health care, or even safe? So far the work is largely focused on diagnosis, and members of the collective are quick to note that what they’re creating is far from a comprehensive solution. It’s limited by some obvious factors—access to materials, a place to put them together, and the time to do it. But where the infrastructure does exist, and people are motivated to do so, it is very possible to establish some useful alternatives for self-care. As an example, Klau pointed to a pilot vinegar test program that’s lowered cervical cancer deaths by some 31 percent among poor women in Mumbai’s slums . . .

. . . One possible solution lies in decentralized and freely available bodies of medical knowledge, resources developed by and for the people who need them most. Exploring such solutions can also underscore the shortcomings of mainstream medicine. The fact that tens of millions of women must perform their own abortions each year attests to the need for a more inclusive system. Until that system arrives, providing better tools and resources can step in where the existing one already fails.

Oh, look, details from TFA that address objections to it! There's also a whole history of radical amateur GYN care in women's health centers that suggests that it's possible to learn the skills you need without being a professional of any kind.
posted by listen, lady at 4:37 PM on September 21, 2015 [15 favorites]

A lot of 'people' just think spending money on 'specialized women's healthcare' is excessive... "...and you only have to feed them just enough to stay alive."
posted by oneswellfoop at 4:59 PM on September 21, 2015 [1 favorite]

That hard drive centrifuge is brilliant! I'm sad that spinning hard disks are going away-- they're a gold mine of awesome parts.
posted by phooky at 5:08 PM on September 21, 2015 [1 favorite]

So far the work is largely focused on diagnosis,
Diagnosis is the hardest part, and the part that requires the years of learning and practice, to get the ingrained sense of what's going on and of what possibilities there are other than the ones you have in mind. Once you know what you're dealing with, it's easier, if by no means trivial, to figure out treatment, especially given the limited options you have if you're trying to do it on a shoestring.

Great, you can do a vinegar screen. That's what you can use that speculum for. Or a different speculum that you could improvise for a lot less than the cost of a 3D printer. Or a premade disposable that probably costs less than the filament the printer uses to print one.

What else are you gonna do? What are you going to use that centrifuge and microscope for?

I'm not going to go reread the article. If I remember correctly, it mentioned the vinegar thing like 3 times. One of those was in the context of randomly mounting a webcam on a speculum to let you do something you could do better, cheaper, and in a more "radical amateur" way, with your bare eyes.

Yeah, you can do a lot with basic knowledge, especially with a little experience and a sharp eye for classical signs and symptoms.

NO, you can't rebuild a whole clinical lab with basic knowledge. 3D printing a speculum that costs more and works worse than a commercial one isn't helping anybody. Turning a $50 Webcam into a slightly worse version of a $50 microscope isn't helping anybody. Turning a hard drive into a centrifuge gives you nothing without a whole lab around it. Having lab tools in general does nothing without a ton of skills that take years of practice to perfect, and a bunch of supplies that aren't cheap and tend to go bad.

You're not even going to do better than commercial lubes and sex toys.

Tinkering around with toys is great, but it's a hobby for the privileged. I share that hobby, or at least some very similar ones, which is one reason I know it's not a practical answer for the underserved.
posted by Hizonner at 5:09 PM on September 21, 2015 [8 favorites]

I await someone smarter than me to explain why this and similar initiatives illuminate a fundamental, privilege-based blindness that informs much of the hype about the transformative potential of 3D printing.
posted by ryanshepard at 5:11 PM on September 21, 2015 [2 favorites]

One reason we have such absurdly shitty healthcare in America is that higher wages (compared to European nations) were chosen over certain universal guarantees of benefits in the post-WW2 period, including universal health care. We have to be careful about policy outcomes not only because public policy affects peoples' lives, but also because once a certain policy path is chosen (especially on a contentious issue), it's much easier politically to keep going in that direction than to create a radical alternative. In other words, path dependency.

So while we have to do whatever possible to ensure women have access to proper reproductive health services, sometimes what looks like a short-term, ad-hoc fix for a complex issue ends up becoming the solution by some later date, because hey it's working, isn't it? We need universal single payer for everyone in America, with strict but fair price controls and no exceptions to treatment options for specific demographic groups, period.
posted by clockzero at 5:13 PM on September 21, 2015 [2 favorites]

There's a long history of women sharing knowledge amongst themselves. I'm reminded of Jane.
posted by jeweled accumulation at 5:20 PM on September 21, 2015 [4 favorites]

Survivalist gynecology, I guess?
posted by oceanjesse at 5:38 PM on September 21, 2015

Can you really 3-D print for cheaper than ordering in bulk, including the cost of the printer and the materials? Just glancing online, you can buy cases of speculums (speculi?) for surprisingly cheap, and they look more rounded than the ones in the article.
posted by Dip Flash at 5:50 PM on September 21, 2015

> Can you really 3-D print for cheaper than ordering in bulk

No, but it's harder to stop people from printing their own than to ban sales of medical equipment to lay people the way Texas has tried to stop the lay from access to the law. Defense Distributed wants to print guns not because they're better than cast and forged and milled ones, but because they're harder to ban.

United States v. One Package of Japanese Pessaries was less than 80 years ago.
posted by morganw at 6:02 PM on September 21, 2015 [7 favorites]

Dip Flash, in general you can't 3D print ANYTHING that's produced in a commercial plastic molding process for anything close to what it costs to buy in case quantities, or to pick up down at the store if the store sells a lot of them.

The advantages of 3D printing, as it stands today, are that you can make one of something (or a customized version of something) without tooling up to mass produce it, you can make a replacement for a no-longer-available part instead of throwing away the whole system, you don't have to use space or keep records to have stock of anything but the raw printing material, and you can have an object in a few hours' printing time instead of a few days' shipping time.

The disadvantages are that the whole thing has to be one material, or maybe two materials if you have a very fancy printer, the material properties often aren't really as good as other manufacturing processes can make them, the accuracy is limited, the surface is imperfect unless you postprocess it, the equipment can be a little finicky, and the second unit takes exactly the same time that the first part took.

So, yeah, the commercial specula(?) are going to be smoother and maybe stronger (unless the 3D printed one has more material in it, in which case it will be even more expensive and slower to print). The ones I've seen are transparent, too. The smooth surface is going to be easier to clean than the rough 3d printed surface, although I suspect one reason the medical world calls them "disposable" is that you still can't really sterilize them to the standard you might like.

3D printing is very much a one-off process or a process you use when you're far away from both production and shipping facilities.

About to post: morganw's point is a good one. You can 3D print something somebody else doesn't want you to have. Doesn't apply here, though.
posted by Hizonner at 6:04 PM on September 21, 2015 [1 favorite]

it's neat that these people are laying out blueprints and pathways for future generations to utilize these tools even if they're not very feasible now

it's weird how in most threads about 3d printing people get all excited about the future of gadgets or gidgets but the one about women's reproductive health is under attack for being naive?

I mean, of course it's naive. all of that tech stuff is. but it's weird that people want to shut out women in STEM from mainstream issues of feminism because of the medical shibboleth. like, yeah man, it hasn't been that long since male dominated medical science finally figured out that women were like physiologically different from men in more than just a few ways. it's important that more people are invested in women's health. but that doesn't mean that amateurs have to be locked out as a result, does it? like, are they mutually exclusive? are these people taking away NIH funding from someone or something? or are people just having issues with how idealistic they sound? because there's a constructive way to engage with that and then there's the 'burn it all down, fuck these guys' approach that's not quite as nice
posted by runt at 6:55 PM on September 21, 2015 [14 favorites]

You can 3D print something somebody else doesn't want you to have. Doesn't apply here, though.
Given the direction that women's healthcare is going here in Virginia, I would add a hyperbolic yet to that last sentence.
posted by introp at 7:14 PM on September 21, 2015 [5 favorites]

I find the spirit of this to be very cool. From the article:
"'This hacker mentality, for me, serves as a new way to understand the world around us, and gives us many tools to develop and generate our own technologies,' Paula Pin, an early GynePunk, told me over email. 'We understand our body also as a technology to be hacked, from the established ideas of gender and sex, to exploring the capacity to start researching ourselves, to find our own ideas and technologies, to help us be free, autonomous and independent from the system.'"
Also from the article, in the very first para: "Access to reproductive health care is key to the wellbeing of women around the world. But for countless underserved groups—sex workers, immigrants, LGBTQ, and the uninsured, to name a few—access often doesn’t exist." (emphasis mine)

Nice first post! I would've never known about this.
posted by joseph conrad is fully awesome at 7:16 PM on September 21, 2015 [5 favorites]

I think sometimes DIY is the only viable option, but I also think it has some really big issues, because it's tough for most people to sort through all the information and figure out what treatments are going to be effective for them, nevermind getting access to those treatments. There is a reason that healthcare is professionalized, and it's not just that evil healthcare providers want a monopoly on knowledge and prestige. I'm not opposed to DIY healthcare as a stop-gap in some instances, but I don't love the idea that it's an end goal. I think the end goal has to be to have universal access to competent, professional healthcare providers, as well as better education for potential patients. And in the meantime, we all do what we have to do to get by.
posted by ArbitraryAndCapricious at 7:23 PM on September 21, 2015 [2 favorites]

There is a reason that healthcare is professionalized, and it's not just that evil healthcare providers want a monopoly on knowledge and prestige

isn't that like a whole thing with Foucault and the medical gaze and basically the whole 70s to now ethics of medical care, though?
posted by runt at 7:45 PM on September 21, 2015 [2 favorites]

I'd think the most urgent innovation in this area would be an open source expert system for diagnosis.
posted by LogicalDash at 8:22 PM on September 21, 2015

LogicalDash - with few exceptions, gynecologic diagnosis isn't possible without examination (and remote examination isn't developed to the point we can open-source it.)

I think people are being too literal/small-picture about the 3D printing itself and are missing that this is a meaningful symbolic gesture. Cheap disposable speculums are a step in the right direction for self-care, but as therapeutic goods, their manufacture and distribution is subject to state regulation. It is not, unfortunately, paranoid or even a stretch to say that such regulation is being openly manipulated by those who want to control the bodies of people with vaginas and/or uteri - you have only to look at the legislative assault on Planned Parenthood and other reproductive/sexual health clinics. (This also has bearing on remote examination - one of the chief motivations of regulatory lobbyists against health care providers using such technology is that telemedicine is critical to providing timely supervised medical pregnancy termination to remote and rural areas.)

Of course 3D printing isn't cheap or widespread yet, but it will be. This is an extension and expansion of a feminist tradition that started in the 1970s with woman-centered health care, and it's very heartening to see young people developing technologies to put themselves in the driver's seat of their own care. I have faith that they will work at inclusiveness - certainly they're bound to do better than the status quo.
posted by gingerest at 8:47 PM on September 21, 2015 [4 favorites]

A DIY centrifuge is a pretty scary sounding thing to me - do these things get up to wall-destroying speeds?
posted by maryr at 8:54 PM on September 21, 2015

If it's based on HDD motors, then probably not, unless you're really trying (sorry, can't read the article, blocked from here). Or rather: speed maybe, torque not so much.
posted by pompomtom at 9:22 PM on September 21, 2015 [1 favorite]

BIO-reSEARCH is part of Pechblenda tentacles, mixed with AnarchaGland & GynePUNK biolabs research.

gynepunk's objective is to make emerge DIY-DIT accessible diagnosis labs and technics in extreme experimentation, down the rocks or elevators if is necesary. Has to be possible in a situated stable place or/and in nomadic mobile labs. Has to be able to perform as much as WE WANT, in a intensive way: smears, fluid analysis, biopsy, PAPs, synthesize hormones at will, blood exams, urinalysis, HIV tests, pain reliefs, or what ever WE NEED. Hack and build our own ultrasound, endoscope or ecography devices in a low-cost way. All this in a strict complementation with herbs and natural knowledges, oral traditions, submarine recipes, seeking with hunger generate superavit of DIY lubricants, anti-conceptives, open doula domains, savage caring of any visceral hands on technologies, as menstrual extraction, all elevated at maximun potential of common learning and radical self-body-power...!

gynepunk's objective is to make emerge DIY-DIT accessible diagnosis labs and technics in extreme experimentation, down the rocks or elevators if is necesary.

submarine recipes, seeking with hunger generate superavit of DIY lubricants

I kind of hope that this isn't actually representative of the thinking underpinning this endeavor

does "submarine recipes" mean something contextually comprehensible to anyone?
posted by clockzero at 9:58 PM on September 21, 2015

They're in Spain and Switzerland I think, so it's probably just translated or second-language quirks.
posted by LobsterMitten at 10:02 PM on September 21, 2015

FWIW, when "For-the-women-of-south-dakota.html" was published -- and before it was consigned to the Memory Hole, I grabbed a copy... LMK if you want to know the URL where a copy might be stashed.

When abortions are outlawed, only outlaws will have abortions...
posted by mikelieman at 1:45 AM on September 22, 2015

So we're one step closer to Shadowrun street docs?
posted by pseudocode at 1:58 AM on September 22, 2015 [3 favorites]

I'm somewhat surprised by the dismissive tone here on the comments page. They may not be doing it well, and maybe they are grandiose, but why is it so ridiculous for them to want to explore the idea of making women's health care something women can do on their own? Maybe they won't get there, and lack the medical training, but thinking that all women around the world have access to trained medical practitioners is naive. I live in a state where women in the southern part have to drive at least 2 hours to get a safe abortion. Not a small obstacle when you add in required childcare, loss of income, difficulty getting time off-- especially when it requires 2 separate visits here b/c of oppressive laws. Some procedures CAN be done without medical professionals (menstrual extraction, for example). And maybe this exploration will lead to innovation down the road.
posted by bluespark25 at 2:58 AM on September 22, 2015 [3 favorites]

Also, I didn't mean to focus on abortion only. The speculum with the light would be very useful for a colposcopy: medical diagnostic procedure to examine an illuminated, magnified view of the cervix and the tissues of the vagina and vulva. To name one thing.

Mentioned above, but where is the STEM/women should be engineers excitement and support?
posted by bluespark25 at 3:18 AM on September 22, 2015 [2 favorites]

With the potential for massive funding cuts to Planned Parenthood, and Somewhat Reasonable GOP Candidates (TM) like Jeb! saying we're already spending too much on women's health care, gearing up for a DIY movement doesn't sound like a bad idea.

If we're heading into a Margaret Atwood future rather than a William Gibson future, I'm grateful people are preparing.
posted by Cookiebastard at 7:35 AM on September 22, 2015 [1 favorite]

Tinkering around with toys is great, but it's a hobby for the privileged. I share that hobby, or at least some very similar ones, which is one reason I know it's not a practical answer for the underserved.

They're doing the best they can with the skills, tools, and resources they have available. Sure, the big issue is to fix systemic poverty, inequality, and health care. In the meantime, they'll do what they can with this.
posted by sebastienbailard at 9:34 PM on September 22, 2015

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