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January 21, 2019

'Unconditional support': A day in the life of an abortion doula

It is controversial work providing compassionate support to the lonely and stigmatized

Women's Health Abortion
01212019_holding_hands_Flickr Sarah Reid/via Flickr Creative Commons


Clare is a “full spectrum doula” who specifically focuses on supporting people having abortions. She chose this profession because of her own abortion experience.

“I felt very much alone,” she remembers.

Even though Clare, who asked to be identified by her first name only, knew she wanted an abortion from the onset of her pregnancy, she did not receive “any support from medical providers in finding out about what abortion options were available.” She felt ignored, silenced and “even shamed” by her gynecologist for the choice she'd made. Why?

The intensity of the abortion debate in the United States fuels a heady stigma associated with the topic. According to Clare, this stigma “tells us we must keep quiet about our decision to terminate a pregnancy.” So, she kept quiet. Like her initial care providers, she didn’t discuss her experience. But their silence and shaming didn’t stop her. Clare had choices.

As an upper middle-class, white woman “living in a community that has supportive view of abortion,” Clare knew she came from a privileged place to make choices. She could “switch doctors” when she felt unheard. She could travel. She had the means to seek out and choose an abortion provider. Not all people wanting abortions have these options. Given that “abortion is a loss experience” for many, the stigmatized silence combines with grief and this heady combination brings much suffering. Even trauma.

“My hope is that having a doula there to validate your experience, challenges, and identity, [people] may avoid some of the trauma that can happen in interactions with the medical system,” Clare says.

I am a birth and death doula. I understand what it is like to hold space for people in moments of intense transition, change, life and loss. I’ve never held space for abortion. Yet, as a doula, I know that there is a growing movement to combine the profoundly healing skill set of holding non-judgmental, compassionate space with the work of being present to people who choose, for whatever reason, to terminate their pregnancies.

This is controversial work even in the doula community, which is a diverse community in terms of individual views on politics and religion. Not all doulas would want to hold space for abortions, or believe doulas should hold space for them. But all of us, doulas included, benefit from having a deeper understanding of what abortion doulas actually do. Wherever we may fall in the spectrum of “What do you think about abortion?” it benefits us to have a vision based on clarity.

So what does a day in the life of an abortion doula look like? How and why did this adaptation of the doula role unfold? For the past five years, Clare has worked with the Baltimore Doula Project in Maryland. My following conversation with her provides important answers.

AMY WRIGHT GLENN: First of all, what is a “full spectrum doula”?

CLARE: A full spectrum doula is someone who supports people throughout the full spectrum of pregnancy or reproductive health experiences. Usually this means pregnancy, miscarriage and pregnancy or fetal loss, abortion, birth, and postpartum. For me, full spectrum doulas must support folks through abortion to truly call themselves full spectrum, since abortion is one of the most common outcomes of pregnancy.

While we know 1 in 4 women of childbearing age will have an abortion, this statistic comes to life when you hear hundreds of individuals' stories. Our clients are mothers, young teens, hardworking women, women who've just recently given birth, deeply religious people, and anti-choice people. All kinds of people choose abortion, and we support them all unconditionally.

I consider myself both a full spectrum doula and an abortion doula. I like to use the term abortion doula because naming abortion is always powerful in fighting stigma, and also because the majority of my doula experience has been with supporting people having abortions.

AMY: What training do you have?

CLARE: I was trained as an abortion doula in 2014 by Baltimore-based doulas who used curriculum shared with us from The Doula Project in New York City and DC Doulas for Choice, in Washington, D.C. These were two of the early “abortion doula collectives” or programs providing abortion doula support via partnerships with abortion providers.

The term “abortion doula” began when doulas Miriam Zoila Perez, Lauren Mitchell, Mary Mahoney and others recognized the need for doula support through abortion. They founded The Doula Project in NYC and detail their process behind this journey, the pushback they received, and their experiences as abortion doulas in their book, "The Doulas."

AMY: What do you study?

CLARE: Abortion doula training includes learning about the procedures and medical processes of abortions (usually taught in trainings by a physician who provides abortions), the legal landscape and barriers to abortion access, stigma around abortion and cultural experiences that make can make abortion more difficult, and comfort measures and support techniques.

Most abortion doula trainings and organizations come to this work with a reproductive justice lens, meaning that our work is inherently intersectional and comes to this work understanding that it's not as simple as "choice," but understanding the social, economic and environmental barriers to true bodily autonomy and the ability to have children, not have children, and parent those children in safe and healthy communities.

AMY: What principles of doula work do you bring to your support of women choosing to terminate pregnancies?

CLARE: We call ourselves doulas because our goal is to hold space for people throughout their abortion experiences, with no motive beyond being present with the pregnant person and providing them with compassionate care. While we work in the medical setting, our goal is merely to support and comfort our client.

Like all doulas, we provide educational support (what to expect during the procedure, what type of abortion options are available), physical support (massage, hand-holding, breathing techniques), and emotional support (positive affirmations, active listening, validating statements, normalizing feelings). The range of emotions someone having an abortion may experience is infinite, but even those who feel joyful to terminate their pregnancy may not feel they can discuss their choice openly with anyone in their lives.

AMY: Describe a day in the life of an abortion doula.

CLARE: When we arrive at the clinics, we work with medical staff to meet each client, make sure we receive informed consent for doula services. If they choose to have a doula, we get to know them and any concerns they may have, and then remain by their side throughout the abortion procedure providing comfort measures, which usually lasts only 3-5 minutes for a first trimester pregnancy.

Afterwards, we help clinic staff make sure they are comfortable, have a snack and a blanket, and get connected with their ride home, and give them our contact information if they would like to follow up with their doula afterward.

AMY: Are you hired by women seeking abortions? Do you volunteer?

I volunteer with the Baltimore Doula Project (BDP), a non-profit organization in Baltimore providing accessible full spectrum doula care to our community. We partner with three local abortion providers to provide abortion doula support in their medical settings. BDP trains doulas to provide support in local clinics, and to support people at home who may be experiencing medical abortion.

• • •

At the end of my interview, I asked Clare what she would you want people to know about her work. Given that her “only goal” is to “provide compassionate, non-judgmental support” at a time when so many feel lonely, stigmatized, and unsupported, the slogan "Trust Women," Clare said, “really says it all.” While not all individuals terminating pregnancies are women (“trans men and non-binary folks have abortions, too”), Clare steadfastly affirms that each individual who has chosen abortion “is the expert in knowing what is best for them and their families.”

It is this powerful trust in, and support of, an individual’s expertise/wisdom to take the lead in her or his own journey, whether through birth or death, that distinguishes the work of birth and death doulas. Those drawn to hold space for abortion strive to do the same.

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