How Abortion Doulas Are Helping People Get More Empathetic Care

Sarah Prager
·9 min read

Monika Jurczyk/Adobe Stock

Ash Williams doesn’t perform abortions, but he has helped people through thousands of them. He’s an abortion doula, meaning he provides educational, emotional, and physical support to someone who has decided to end their pregnancy.

“Due to the bans and restrictions and the marginalization of abortion, the clinic staff don’t always have a lot of time and space to get to know every [patient], to listen to every concern, to listen to how this experience is impacting them,” Williams tells SELF. “This is where I come in.”

Williams works in North Carolina, where abortion is illegal in most cases after the first trimester. “People are traveling wherever they need to go to access abortion,” he says. “I’m seeing a lot of movement into the state, but also a lot of movement out of the state as people seek the support that they need after 12 weeks.”

In the aftermath of the Dobbs decision that overturned Roe v. Wade in 2022, abortion doulas are more important than ever, Williams says. “Abortion funds are saying that they’re running out of money, and there’s a lot of misinformation and disinformation about the impact of the bans,” he explains, adding that whenever there is a change in state laws that restricts abortion care, it can cause confusion and fear—which could delay or prevent some people from getting an abortion at all (or push them to end their pregnancy in another way).

And that can lead to dangerous consequences. People who are denied an abortion are more likely to experience poverty, debt, eviction, chronic pain and other health complications, anxiety, and physical violence from the person who impregnated them—not to mention the potentially deadly health risks of pregnancy and delivery. Research shows having an abortion is much safer than giving birth, especially for Black women, who face disproportionate maternal mortality rates compared to white women.

“A part of my job is to demystify abortion,” Williams says, “to give people good information about it, and to let people know what is fact and what is fiction.”

Here’s what you should know about abortion doulas, including the kind of services they can provide and how to find one who can best support you.

An abortion doula is not a medical provider or a mental health professional. They’re more like a well-informed friend.

Abortion doulas receive training in different ways, since there is no governing body that offers a license, degree, or official certification for the field. Some people practice as “full-spectrum doulas,” so their overall training encompasses abortion, fertility, miscarriage, and postpartum care—just about all the reproductive life transitions you can think of. If you’re having a hard time finding the support you need by searching for just an abortion doula, you could try looking for a full-spectrum doula to expand your options. (More on all of this later.)

Doctors, nurses, and other health care providers have to prioritize their medical duties when performing or counseling their patients on an abortion, but a doula is primarily there for emotional support, Vicki Bloom, a full-spectrum doula based in New York, tells SELF. (Bloom has supported thousands of people who have gotten abortions since 2010 through the nonprofit organization the Doula Project.) “Even when a practitioner’s really good, it can be very easy for them to get into patient mode,” Bloom says. The doula process, on the other hand, is all about “just being there for that person as a human being.”

If you go to a clinic for an abortion procedure—sometimes called a “surgical abortion,” though there is no surgery involved—an abortion doula might give you a ride to and from the clinic, explain beforehand exactly what to expect, and be with you during the procedure (a helpful option when a loved one is not allowed to). “In the room, we would help people get set up and then be physically up by their head during the procedure,” Bloom says. “We might be distracting them with talking, doing a lot of hand-holding, cooling off somebody’s brow if they were getting overheated, just helping them keep their body calm.”

They might also listen to and talk through your feelings about it, text you answers to basic questions that pop up, cook for you, take care of your kids while you get the procedure and recover, provide acupressure or massage for pain, or troubleshoot how to talk to the people in your life about what you’re experiencing. All this applies if you’re getting a medication abortion too: A doula can be there for you in all the same ways and more—which might even be extra crucial if you need to take the abortion pill regimen at home and don’t want to be (or just feel) alone.

But the atmosphere has started to shift in recent years. Bloom says she hasn’t attended in-person procedures since 2020, as many clinics stopped allowing support people in the room at the height of the pandemic. Instead, she largely helps folks over the Doula Project’s text hotline. Williams still provides a lot of in-person support but also has seen a move to digital platforms, largely due to COVID and other safety concerns. “I’m sad about the decline of in-clinic support because I know there will be people who choose to have abortions in the clinic,” he says, “and I believe that they deserve the best care that they can get.”

Abortion doulas can be helpful even if you have a support system—and step in when the situation is feeling extra sensitive.

Jill Gibson, MD, helped start an abortion doula program two years ago at Planned Parenthood Arizona, where she is the chief medical officer and medical director and performs abortions. Arizona has many legal restrictions on abortion, including a mandatory waiting period, a required ultrasound, a ban on abortions after 15 weeks gestation except in the case of a medical emergency, and parental consent for minors.

“We recognized that our patients and staff were feeling really, really stressed with this environment,” Dr. Gibson tells SELF. “Our patients were already feeling traumatized by having to go through such uncertainty, jump through hoops just to make it through the door, and we didn’t want that. We wanted our patients to be provided with care that reinstated dignity and humanity, particularly in the abortion experience.”

Dr. Gibson explains that while people getting abortions almost always feel very confident about their decision, the process can still bring up a lot of complex emotions, heightened by the stress and anxiety of wading through potential restrictions and protestors to get to a clinic, as well as the stigma about abortion they’ve likely internalized. What’s more, any form of reproductive health care can “create situations or power dynamics that reactivate a trauma experience”, as one 2021 paper aptly puts it, especially for Black, transgender, and otherwise marginalized people; abortion doulas are often trained in trauma-informed care, so they can step in to help create a space that feels safe and validating.

Abortion doulas don’t just benefit the patients in these scenarios—they also bring major relief to the clinic’s staff. “The people doing the intake, the people assisting with the abortions, the nurses pushing sedation and taking care of patients in recovery, and the physicians were absorbing a lot of the emotional energy that some patients who chose an abortion were demonstrating,” Dr. Gibson says “The doulas came in as intermediaries to absorb some of that. We found that to be really helpful for our staff. Not only could they then focus on the actual clinical tasks they needed to do, but they didn’t have to bear the weight of that emotional stress and energy that can often surround providing abortions.”

How to find an abortion doula you vibe with

There are many types of abortion doula training—mostly offered by nonprofit organizations—and while there is no “official” standard, any abortion doula you hire should have completed one. The trainings often last one to three full days and, at the very least, should cover basic medical information about different types of abortions, as well as emotional and physical support techniques.

Again, there is no licensing body regulating abortion doulas or a centralized certification program to become one, so finding the right support person for you depends on whether you feel their training, vibe, cost, and values align with what you’re looking for. Abortion doulas often offer their services free of charge (they might even help you fund your abortion if necessary). If they do have a fee (which could start around $200 or so), ask if they have a sliding scale.

Some clinics offer abortion doulas for free through their own programs. If your clinic doesn’t, you can ask them for a recommendation or look through these directories:

If you’re having an abortion in the US, there are free hotlines you can text or call to get confidential, anonymous emotional support or medical information:

  • The Medication Abortion Hotline provides 24/7 informational and emotional support by text for anyone having a medication abortion. (Bloom says that the most common question she answers via the text line is whether the amount of bleeding or cramping that a person is experiencing is normal.)

  • The Miscarriage & Abortion Hotline is staffed by health care professionals who can answer questions and provide support by phone or text.

  • Exhale Pro-Voice After-Abortion Textline offers emotional support for people who have had abortions, as well as for their loved ones and care professionals.

  • Connect & Breathe is an after-abortion talk line staffed by trained volunteers who are there to listen.

  • All-Options Talkline gives you space to talk about past or current experiences with abortion, pregnancy, adoption, parenting, pregnancy loss, or infertility.

  • The Faith Aloud Spiritual Care Line offers support by phone if you’re dealing with spiritual concerns around your abortion. Their counselors come from and are trained in multiple faiths and they support all pregnancy choices.

As abortion doulas continue their work during a legally tumultuous time, you can donate to abortion funds, clinics, and nonprofits to keep this work free or low-cost. “I want people to know that they should support our work,” Williams says. “We’re filling a really critical gap in abortion care.”

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Originally Appeared on SELF

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