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.

​Earlier 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 ANSIRH. Interestingly, 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 mothers. But 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 experiences, broaden social support for these individuals, and hopefully reduce some of that sense of inferiority. In 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.

Revolutionizing Doula Care Across the Country

The Bay Area Doula Project is proud to be part of the full-spectrum doula movement. That's why we love this map from Calyx Doulas in Portland, that shows how the movement is growing.

Want to join the movement? We're currently accepting registrations for abortion doula training.

Announcing In-Home Support for Medication Abortions

We are thrilled to announce that starting today, the Bay Area Doula Project volunteer doulas will be offering in-home support to those experiencing medication abortions.

While providing the obvious benefits of privacy, confidentiality, and comfort, medication abortions pose some challenges to patients who may require extra support during their experience. Our doulas are prepared to offer free in-home physical, emotional, educational, and spiritual support during the medication abortion experience. BADP has created a comprehensive model for providing in-home support after months of careful planning and training. To do this, we have consulted with medical experts, home-birth professional doula groups, and abortion access communities to ensure that it has responded to various practical concerns: for example, client contracts will be used to address issues of doula and client safety and legality of practice. The BADP has also created internal procedures to provide on-going guidance to volunteer doulas as they provide in-home support to clients.

For clinics:

If you are a clinic providing women’s health care in the Bay Area, and would like to offer referrals for our in-home support services, please contact info@bayareadoulaproject.org. While it will be up to the clients to initiate a request for doula support, the BADP would be more than happy to make a presentation to your staff about the services offered that could then be described to patients. 

For finding support:

Click here to find out how you can get support.

For doulas and friends:

Our potential to serve women in their home through medication abortion depends on our network of contacts. If you know of a site that could refer patients to us for MAB support, please contact info@bayareadoulaproject.org for outreach materials. Thank you so much for supporting our work!

Why full-spectrum?

By Sarah Whedon, BADP doula and blogger

The Bay Area Doula Project is a full-spectrum doula organization.  That means we support folks across the spectrum of their reproductive lives.  We want all people to have access to compassionate support through all the possible outcomes of pregnancy, as well as for sexual and reproductive health issues that don't involve pregnancy. 

But why does it make sense for us to bring these all together instead of forming an organization that focuses on a single issue? I see three major reasons: the people we serve, the volunteer energy we draw upon, and the issues involved.  Let me explain.

1. Clients. The population we aim to serve doesn't necessarily keep their reproductive experiences distinct.  A person giving birth is often a person who's had a miscarriage. A person seeking an abortion is often a parent who's experienced one or more births.  According to the Guttmacher Institute 60% of people seeking abortions are already mothers.  To a large extent, then, the abortion-seeking population is the birthing population. A full-spectrum organization can help to normalize that reality and to re-integrate a fragmented system.

2. Doulas. There are already so many great people who are bringing a practice of compassion and a knowledge of healthcare environments to their birth and postpartum doula work.  It makes sense to tap that pool of experienced doulas and support them in bringing their resources to other areas where support is needed, like abortion, miscarriage, and adoption.  Since there's already growing structural and cultural support in place for birth and postpartum doula training and work, we can build from that rather than reinventing the wheel. Many of the people who come to the BADP for abortion doula training already have vast experience as birth and/or postpartum doulas.

3. Interlocking issues.  Reproductive concerns which may at first blush appear to be separate are actually interlinked. When we take issues of reproductive justice in isolation, we can miss the bigger picture.  Here's an example: in certain cases a previous cesarean section can increase the risks of abortion, but nobody mentions that when a cesarean birth is being proposed.  In the U.S. we have "a current national cesarean section rate of over 30%, despite evidence that a rate of 5% to 10% would be optimal."  There's a movement to increase access to abortion and a movement to decease the cesarean rate, but the two movements rarely deliberately come together and see their common cause.  A full-spectrum doula movement can help to connect issues like this.

Of course doulas and activists can do a lot of good by focusing on a single issue, and everybody has to start somewhere.  The BADP started with a focus on abortion support.  However, as an organization it's always been situated within the full-spectrum framework, and that gives us a special kind of power to create larger change in reproductive health.

How we use social media

By Sarah W., BADP doula and blogger

In anticipation of this Thursday's Salon on doulas using media technology, I thought I'd share a bit about how we at the BADP use social media. Maybe it will help you think about how you use it for your own doula work.

When I joined the BADP nearly a year ago we had this website and a very quiet Facebook page. I volunteered to get the blog rolling because I already had some experience blogging and it seemed like a great way to spread the word about the work of full-spectrum doulas. After all, it was through a blog that I first learned about the movement.

Renee joined us last spring and brought a ton of fresh energy to our social media efforts. She breathed life into our Facebook page and started a Twitter account which is now one of the most active places where we spread our messages online.  When I asked her why she volunteers to do this for the BADP, Renee told me:

I joined the Bay Area Doula Project social media team to help spread the word about the great work doulas in the Bay Area and across the country are doing. I noticed that there was this great resource out there for women who are alone in abortion clinics and I want to make sure that they know there is support for them during their procedure. I also wanted to help create awareness around the doula movement and let folks know that there are alternatives to mainstream pregnancies and that you can have an advocate on your side, no matter how your pregnancy ends, whether it's birth, miscarriage, abortion, or adoption. I found social media to be an excellent avenue for people to share information with friends, families, and their communities quickly.

Kelly came to us with her experience blogging at The Provider Project and kicked the blog up from a once in a while thing to a place where we're posting something new every week.  Kelly appreciates how the internet can connect people to information they might not otherwise have access to.  She told me:

I grew up in a small, rural town in New Hampshire where there were not a lot of educational and supportive reproductive health resources such as the Bay Area Doula Project. As a budding reproductive health activist I felt extremely isolated throughout my teenage years, lacking a community of others with similar passions. In college I first learned about full-spectrum doulas from the internet presence of two organizations in the Northeast, The Doula Project in NYC and the Prison Birth Project in western Massachusetts, whose work compelled me to become a birth doula. Social media is an amazing avenue for people from all across the world to connect with, inspire, and consult with each other, whether they live in an urban area or a town of 1,000 people. It's my hope that as a member of the BADP social media team I can help someone feel like they have the support and resources to become a full-spectrum doula in their community and understand that they are not alone.

Even though each of the three of us has our own official tasks, the team really works collaboratively. We discuss whether we want to share certain links. We edit each other's writing. We brainstorm together. And when one of us is busy with something else, we pick up the slack for each other. How do we coordinate all that? Mostly by email.

Personally, I've found the work to be very rewarding. I've increased my social media skills, met new allies, and been thrilled every time an individual has told me that something I wrote or posted touched them.

Sound like fun? Our team has room for more volunteers who've been through the BADP training (next one is coming up in October).  

Now your turn: how do you use social media to support your doula work?