 Both Karman's procedure, menstrual extraction, and his cannula were embraced by activists Carol Downer and Lorraine Rothman, who modified the technique in 1971 and promoted it.The "self-help" abortion movement envisioned by Downer and Rothman never entered the mainstream in the U.S. before or after "Roe v. Wade".Physicians sometimes use a Karman cannula in early induced surgical abortion, in treatment of incomplete abortion, and in endometrial biopsy.