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Tuesday
Apr302013

Abortion doulas and abortion stigma: finding the link

By Poonam Dreyfus-Pai, BADP Co-Director

Attending the Civil Liberties and Public Policy (CLPP) conference in Amherst, MA is something of a rite of passage for young abortion activists. For years, when I lived in New York, it was described to me as a mecca for those interested in talking about abortion care, provision, and support – a pilgrimage that many of my colleagues made every year.

‚ÄčEarlier this month, I attended for the first time. It was also my first time presenting. The annual conference, “From Abortion Rights to Social Justice: Building the Movement for Reproductive Freedom,” is hosted by Hampshire College, a liberal arts school with a decidedly progressive bent (for example, the bathrooms were labeled “self-identified men” and “self-identified women”). For 27 years, the conference has brought together researchers, advocates, clinicians, non-profit staff, community organizers,students, and community members to discuss and create strategies for achieving reproductive justice. For my part, I was there to discuss my experiences working as a full-spectrum doula with the Bay Area Doula Project and researching abortion stigma with ANSIRHInterestingly, these two ideas – abortion doulas and abortion stigma –were continuously linked in numerous presentations.

Why such a salient link? I’ve been an abortion doula for four years, and I would argue that the abortion doula movement arose directly as a response to abortion stigma. I wanted to research abortion stigma because I saw it in front of me constantly: stigma that not only prevented people from reaching out to their families and partners for support, but also reinforced the perception that they were somehow bad, and deserving of pain and unhappiness. I was interested in how to conceptualize stigma, and how to create an evidence base that would allow for services to reduce it.

Abortion stigma perpetuates the idea that people who have abortions have something to be ashamed of, which makes people less likely to seek out social support. Studies have shown that abortion stigma – not the abortion itself – negatively impacts a person’s emotional wellbeing and their relationships. It also serves to divorce a person’s experience of an abortion from the full continuum of their reproductive experiences. For example, we know that one in three women will have an abortion during the course of her reproductive life. We also know that most women who have abortions are also mothersBut because people worry about what their health care providers may think or say, people may not divulge that they’ve had past abortions or unintended pregnancies, which can pose various health risks.

Abortion doulas are individuals who provide compassionate, continuous presence before, during, and after an abortion experience, and employ many of the same pain management and comfort techniques used by traditional birth doulas. Those that began the “full-spectrum doula” movement believed that people who have abortions deserved the same kind of compassionate support that traditional doulas offer to people in labor. This work explicitly acknowledges that abortion stigma – the inferior status of and prejudicial attitudes faced by people associated with abortion – has made it difficult for people to believe they deserve compassion, let alone focused, free support throughout their entire abortion experience. By listening to people, providing empathy, massage, and breathing techniques, abortion doulas can normalize their experiencesbroaden social support for these individuals, and hopefully reduce some of that sense of inferiorityIn so doing, we are fostering a culture of support, and expanding the quality of care that people should come to expect when pregnant, regardless of the outcome.

The CLPP audience was, excitingly, already sold on the value of full-spectrum doulas in combatting abortion stigma, as evidenced by the sheer number of individuals who identified as abortion doulas, full-spectrum doulas, radical doulas. At a time when new anti-abortion legislation is introduced every day, it can be challenging to think about new ways to combat rampant abortion stigma. But what we know is this: the lived experiences of people matter, and the more that we can bear witness to their abortion experiences and support them, the more we are breaking down the structures that keep abortion stigma in place.

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