Abortion caregivers and companions: The age of the full spectrum doula is here

We have a secret in our culture- It’s not that birth is painful it is merely that women are strong.

Doula is a Greek word meaning a “woman caregiver” or a “woman who supports other women”. Other terms such as labor coach, monitrice, childbirth companion and labor assistant are also used to define this nurturing woman. She is not a doctor, nurse or midwife and is not involved in any medical decisions.

Doulas provide knowledgeable emotional support and are able to advocate for their clients, especially in hospital settings where medical interventions are more likely to occur. They are trained in and have understanding of the usual medical interventions so that they can explain to the expectant mother what is happening around them so as to relieve tension or anxiety. She forms a bridge between the medical staff and the expectant mother also acting as a buffer to unwanted intrusions.

What is a full spectrum doula?

Recently the role that focused on pregnancy and birth has now extended to women having miscarriages or abortions, this is known as a full-spectrum doula. This inclusion has sparked a debate on whether this implies that women getting abortions would need something as “touchy-feely” as support and if this is yet another way of normalizing a procedure that pro-lifers find unpalatable.

Martinez; a doula and co-founder of the Tucson Abortion Support Collective (TASC); believes people have a right to be supported in their reproductive choices, and that she won’t be deterred in offering that support. “History is filled with the repeated colonization and violence of women’s bodies, particularly women of color, by men,” she said. “And women have always helped each other birth babies and end pregnancies at home and in community. As long as birth has existed, so has abortion.”

Read: Abortion is not going away, no matter how much you gag it

In today’s society most women are pro-choice not in the support of abortion but in the protest of the policing of women’s bodies. Regardless of which side of the divide you fall under in the pro-choice/pro-life debate the fact is abortions are a result of a systemic failure by society towards its women. The concept of an abortion doula sprung up most directly from a confluence of reproductive justice ideology and natural birth philosophies. As reproductive justice activists remind us, the choices women make about reproductive health are greatly affected by circumstances which are constrained by socioeconomic status, race, gender, sexuality, nationality, legal status, etc.

Abortion should be a choice. Cartoon: Damien Glez

Due to the duress that comes with making the decision to undergo the procedure many women have ended up dead or butchered; a full-spectrum doula would demonstrate human compassion and provide guidance during an intense time. Like a birth doula, abortion doulas focus on the whole person, considering prior health issues, relationship dynamics, and stress when offering physical support for example a heating pad for pain management, stretching through the cramps, or finding a way to distract from the pain.

According to Miriam Zoila Pérez, who wrote a primer about “radical doulas,” she refers to the role as “a person who gives support to all the realities of pregnancy: miscarriage, lethal fetal anomaly, stillbirth, abortion, and even adoption.” For the past decade, full-spectrum doula work has been gaining momentum in the birth worker and pro-choice communities. In 2007, Mary Mahoney, Lauren Mitchell, and Miriam Perez, all birth doulas and reproductive justice activists in New York City founded The Doula Project to serve people seeking abortions.

Read: On abortions: Empathy over judgement

Pérez wrote in her book “I love the way The Doula Project highlights how we provide support regardless of the pregnancy outcome. It also makes sense to me because a person who starts out their pregnancy planning on a birth might instead end up with an abortion, a miscarriage, or an adoption. Why would we turn them away if the outcome changed?”

Will the role endure?

Some birth doulas have been reluctant to consider the needs of women terminating pregnancies as at all similar to their patients carrying them to full- term. In fact many pro-choice doulas, doctors, and nonprofits are extremely unwilling to acknowledge how difficult and painful many women find abortion. To pro-lifers drawing any more attention to the messiness of the procedure and the decisions surrounding it would mean potentially undermining the work they have done so far especially in their youth abstinence programs.

Overall the role has been met with a lot of opposition but the hope is it will endure and catch on because for women going through something that is so morally and physically exhausting and confusing, it is important to be seen, to have their emotions and physical struggle being recognized and acknowledged in a world that is much too ready to turn its back.

Whether the concept and role could be applied to the African context and for the African woman is unfortunately another matter altogether… Would Doula Non-Profit organizations and Societies most of which are in South Africa such as Doulas of South Africa (DOSA) Women Offering Mothers Birth Support (WOMBS) or even the overall continental Alliance of African Midwives (AAM) which has grown from 6 to 35 countries assimilate such a concept?