I arrive at the hospital around 9am, head up to the right floor, showing my volunteer ID badge to the security guard as I head toward the elevators.
I round the corner and enter the floor, delicately labeled Women’s Choices where the procedures will take place. I walk into the makeshift office/empty procedure room where the Residents/Doctors who will be performing the procedures sit debriefing the morning’s cases. I’m greeted by the Doula Project coordinator/Counselor at the hospital, and she debriefs with me about the folks on tap for the morning. While everyone is in for a first trimester abortion, the stories are different. Some are elective procedures, some are wanted pregnancies with medical issues–ectopic, fetal demise, etc.
I walk into the waiting room where the women are already wearing hospital gowns and socks, sitting nervously, quietly, waiting their turn. They are asked to arrive really early–7am–with the hope that it means most will be there by 9. I offer blankets, sometimes speaking in English and Spanish, sometimes using hand motions to communicate with patients who speak another language.
Everyone has been fasting since the night before, adding to the discomfort, tinging the air with acridity from hungry breaths. I sit, introduce myself to the patients, make polite conversation. Everyone responds differently, some want to talk, some want to sit quietly. Mostly I listen, try to remain attuned to the signals they send about whether they want company or silence.
Within a bit the first woman is called in. I go with her into the procedure room, helping her settle onto the table alongside the nurse. I stand by her head, holding her hand, patting her shoulder. No one is very talkative at this point–maybe a little apprehensive, and within a few minutes, groggy from the medications given via IV. The residents and doctors are friendly, mostly caring, mostly female.
The procedure itself takes under ten minutes, including set up and clean up. Mostly I’m a hand-holder, a breathing coach, a smiling face. Occasionally I translate directions from the English-speaking nurse to the Spanish-speaking patients. With women who don’t speak either, smiles, shoulder caresses and thumbs-up serve as communication tools.
Some brief suction, a quick examination of the contents by the doctors and the procedure is over. She’s carefully eased off the table and into a wheelchair and I walk down the hall with her to the recovery room.
This is where the real work, at least for me, usually begins. Tears might have begun during the procedure, and as she recovers from the anesthesia in recovery, they might continue. My biggest role so far as an abortion doula, in addition to hand holding and reassurance, has been listening. Sitting next to her in the recovery room and being an ear if she needs it. At least two of the women I’ve worked with so far have confided in me during that time–told me their story, why they were there, how they felt about it. Sometimes the emotions are about the procedure, but sometimes not.
I haven’t done much. Sat, quietly, listening. Providing reassurance, asking questions where appropriate. Saying all the things that every person deserves to hear: you are brave, you are strong, you are worthy.
By 1pm, the last person has gotten back into their street clothes, doctors orders in hand, and headed back to their friend/partner/family member waiting downstairs. A hug and a smile from me as a goodbye. Sometimes a thank you, sometimes words like “eres un ángel” (you’re an angel).
My involvement in abortion doula work started as an idea–a concept that I first heard from doulas and doctors in Boston in 2007. I was attracted to it from the beginning. Not only did it bring together two of my big interests–pro-choice and birth activism–it just seemed to make sense. Of course the skills of a doula would be transferable to other moments like abortion.
There are those who believe the two roles are contradictory. To those people I say: my goal during each is the same. I’m there to support the person giving birth/having an abortion/miscarriage. I’m not focused on the outcome, or the reason they are there. I’m focused on providing the best support possible. There is no contradiction there.
Until recently, my role in the abortion doula movement (or, as it’s called by many, the full spectrum doula movement) has been architectural. I’ve promoted the work of abortion doulas on this blog, and I helped to found The Doula Project, a New York City based organization that provides doula care to folks across the spectrum of pregnancy. I left NYC before that project had found a clinic or hospital partner, so I myself never worked as an abortion doula. Until now.
I moved back to NYC this fall, and was really excited to re-join the now booming Doula Project (2 sites, 40 plus doulas, amazing). I’ve loved being part of this movement in the architectural capacity, but when I came back I didn’t want to be involved in the leadership of the organization, I simply wanted to be a doula again.
It’s been a long time, for many reasons.
But I’m proud to say that I am back to being an active doula–this time around, a full spectrum one.
I started my first shift with The Doula Project at their hospital-based site. We currently work in one hospital and one clinic. I think the main difference between being an abortion doula and a birth doula is time. When I did birth doula work, the folks I worked with were in labor anywhere from 2 hours to 25. It was tough, being on for that length of time, not knowing when things would progress. Being a constant support person in a unscripted process.
The abortion process, on the other hand, is very predictable. Procedures are very similar, usually quick, a patient not staying in the clinic of hospital more than a few hours max. My abortion doula work so far has been with women having first trimester procedures, which are the quickest and easiest of the procedures one can have. That’s one of the things I like about abortion doula work–I can make time for it in my schedule, in my life, without having to be ready to drop everything for 24 hours for a long birth. It’s selfish, I know, but it’s been part of what’s allowed me to get back into it.
Because of the timing, I can work with multiple folks in one shift. While it’s a very different relationship you build with someone in a smaller amount of time, it feels good to be able to work with a number of people. Because the hospital I’m volunteering at only has between 2 and 6 patients in a given morning, I can often sit with the women in recovery for thirty minutes, even an hour.
So far, that’s been the time that has made the most difference. During the procedure, I’m sure my hand-holding and reassurances mean something, but afterwards is when the anesthesia starts to wear off and the emotions can come up.
Doing this work so glaringly reveals the deficiencies of our health care system. How little support doctors and nurses are able to provide, either because they are too busy, because they don’t speak the right language, because they are attending to process and procedure. Because they can’t bill an insurance company for simply listening. It also shows the deficiencies and injustices in our society. How many people feel mistreated in their lives, feel unsupported, feel unheard.
Working in this setting also shows how lucky we are. These folks have access to safe and legal abortion procedures from caring doctors. Because it’s a public hospital, they only have to pay what they are able, regardless of insurance.
I’m happy to be back in it, happy to be able to support folks in this important new way of expanding the doula model of care.