Abortions happen. Everybody who has one deserves the respect and comprehensive care before, during and after. Abortions doulas are people who can provide emotional support and advocacy. This article is about why this profession is important and more people should know about them.
All real names have been replaced with false ones for the protection and privacy of those interviewed.
Access to safe and legal abortion is a human right. In a recent ruling by the United Nations (UN) Supreme court, the UN made a stance in favor of people’s access and right to a safe and legal abortion. In the United States, the 1973 court ruling Roe V. Wade made an important decision to interpret the 14th amendment to also apply to abortion access on a state to state basis. Even today, abortion is not accessible everywhere, and more people are going without proper medical care. In this constant political and social struggle for health care that honor’s someone’s choice, few discussions on abortion focus on the aftercare and support folks who have an abortion need. Because of social stigma, some people who have abortions go through the medical procedure alone. And often, they are left to process the emotional and physical care that follows the procedure by themselves. Birth workers have recognized a need for this type of aftercare, and the concept of an abortion doula was created.
The term doula comes from a greek meaning of “women helping other women”. This has since been changed to be more inclusive of doulas of all genders. However when most people think of the word doula, they associate the term with childbirth. In more recent years, radical and pro-choice doulas have paved way for a type of birth work that encompasses various pregnancy outcomes. This continuum or “spectrum” of educational, emotional, and physical evidence based care includes childbirth, still births, cesarean births, miscarriages, adoption, surrogacy, and postpartum care.
There has been a lot of research around the positive outcomes of doulas as labor support. Even the World Health Organization (WHO) states that a labor companion like a doula can positively impact the birth outcome. The American Congress of Obstetricians and Gynecologists (ACOG) states that having a non-medical interventions such as continuous labor support (like a doula) brings down cesarean rates.However little research is done on the benefits of having a doula present through the abortion procedure.
Having support is an important part of any surgical procedure. In most cases, when someone is getting surgery, they reach out for help whether it is a ride to and from the hospital, educational support, meal prep, or just someone present to be there during recovery. Many people who experience abortions do not reach out for extra support due to social stigma, or lack of knowledge about the types of support available to them. Belle, who I interviewed for this piece, discusses her experience:
“Aftercare was awful. I never saw anyone again after [the procedure]. They gave me lots of pain meds, more than necessary, that's it. I didn't know my breasts would swell and leak. I didn't even know that the pain would continue after the abortion. I wish I had had someone in my corner that I could question. Even being there, I wish someone would have told me "this is about to happen".
A study presented at the American College of Obstetricians and Gynecologists Annual Clinical Meeting in 2015 discussed the positive impact that a volunteer abortion doula program had on patients who received the abortion procedure. “Women who received doula support universally reported positive experiences with the verbal and physical techniques used by doulas during the procedure, and most women who declined doula support subsequently regretted not having a doula.” (Chor, Lyman, Tusken, Patel, & Gilliam, 2016). These abortion doulas provided emotional support, education and companionship through each procedure. This is especially useful, the study states, because many clinics do not allow family or friends to be with patients throughout the procedure.
Ella, an abortion doula who completed a Full Spectrum Doula Training in 2015 shared her reasons to why she wanted to become a doula.
“I wanted to pursue doula work and became very passionate about being an advocate for abortion care and the right to control a pregnancy.”
Ella continues with her definition of an abortion doula,
“An abortion doula is a comforting presence, an ally, and solely a support system for someone who is obtaining an abortion or abortion related services. To me, this means a variety of things. It means from initial contact with your client or patient you are providing compassionate, confidential care to the extent of their comfort and needs throughout the entire process before, during, and even after if the client has given you permission.”
An abortion doula can not only help the client get to and from the clinic, but also help facilitate a safe space for the client to access their care privately, by providing information about protesters, and asking the client what language they want to use when referring to their procedure. The role of a doula often takes on an advocate as well.
“I want to make sure I am providing the best care while understanding the necessary background details of the patient- Do they have any experiences with doctors that are traumatic they would like to disclose? Have doctors used language consistent with their identity and gender? In what ways can I provide comfort if they are misgendered by a medical professional? Have they had a pap smear before/ and or speculum insertion? Any previous abortions? Pregnancies? What is the demographic of my client? (abortion laws are different all around the world as we know, people come from different backgrounds of extensive thought about abortion). Culturally do they have a disposition? All of these factors play a possible role in their decision. I try to gather a comprehensive understanding. Would they prefer a female MD over a male MD? Transportation? Money for the procedure? Do they need help signing up for health insurance? What outside resources can I offer such as Backline, the CAIR Project, etc. This are all initial things I consider and try to hone in on.”
This comprehensive understanding gives the client a space for their identity and choices to be respected.
In event of an abortion via medication, pills are taken to terminate the pregnancy and induce contractions. This option of abortion is good for folks who want to labor in privacy, in their home. An abortion doula in these instances can provide education on typical amount of blood loss, help keep track of medicine taken and advice on pain management. They can also provide physical support, by offering massage, making sure the client is hydrated, helping them through their cramps, and making sure the client isn’t experiencing any abnormal symptoms throughout the process. The doula can also provide emotional support the days and weeks following, affirmations, as well as continuing education. There is little research on private abortion doulas impact on people going through abortions. Alice, an abortion doula, discussed the type of support they would of liked through their procedure,
“I decided to go with a method where I could go through the labor at home. I liked the idea of privacy and being able to lay in my bed. The clinic kind of freaked me out, so I opted for the other procedure. I had little emotional support from my partner, but while I was in pain, sweating, bleeding, cramping and crying he wasn’t there. I wished he would of been there. Even just to hold my hand. I wish I knew abortion doulas were a thing. I would of hired one in a heartbeat. Telling me that I would be okay, or what I was experiencing was normal. To hold my hair back while I threw up. I bled and spotted for the following month. I remember being worried that something went wrong. I wasn’t given a number to call for questions. Only for emergencies.”
Finding an abortion doula is not always easy. In more rural places there may not be full spectrum support. But if you or someone you know wants a doula to help them through their procedure, there are some resources you can reach out to. There are many more resources, please comment to add more!
Radical Doula
https://radicaldoula.com/resources/
Full Spectrum Doula
http://www.fullspectrumdoulas.org/resources/
Abortion Gang
Everybody deserves support. You have a right to make your own decisions when it comes to your body. You have an option to get support. Abortion doulas will not only validate those choices, but help you throughout the process to make sure you’re given the respect, emotional and physical support, and care, even if it is just a hand to hold.
Written by: Dylan Pugh, The Seahorse Doula, 2017
Special thanks to Mychal Balazs (CD), Doula Dallas Newbury for editing and those who shared their stories and experiences with me to write this piece.
Works Cited:
Chor, J., Lyman, P., Tusken, M., Patel, A., & Gilliam, M. (2016). Women’s experiences with doula support during first-trimester surgical abortion: A qualitative study. Contraception, 93(3), 244–248. doi:10.1016/j.contraception.2015.10.006
Safe prevention of the primary Cesarean delivery. (2017). Retrieved February 22, 2017, from http://www.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery