The Doulas. Mary Mahoney

ha. Ha, ha, ha, ha, ha.

      Many doula trainings emphasize “the doula business” as part of their core curriculum. That’s not our story. Maybe it goes without saying that we started a nonprofit for doulas because we found out quickly that asking people for money was not our strong suit. Moreover, the New York City doula “scene” was becoming saturated with doulas, many of whom were attempting to make a living from it. More importantly, we—along with many of our doulas—feel strongly that the “activism” aspect of our work, including not asking low-income clients for money, is what drives us.

      But let’s be clear. Doulas as a population aren’t the 1 percent. We don’t know of any doulas who are making loads of money in their work, nor do we know any doulas who got into the work because they were looking for fame and fortune. We don’t disagree that it’s work that deserves to be paid—it does. It’s more a question of who pays: the client, a nonprofit organization, or a larger institutional structure, like Medicaid or insurance companies.

       Part 2

       Doulas for Doulas

       Before and After

       Kat and Kim

      Kat stands in the doorway and calls her client’s name, “Kim?” The waiting room is packed with people, some here for STI or pregnancy results, an annual GYN exam, a colposcopy. Or, like Kim, an abortion.

      Kim stands up and raises her hand, her smile a thin line. Kat walks her to the exam room, located in the back left corner of the downtown Brooklyn Planned Parenthood Clinic. She shuts the door securely and confirms Kim’s last name and date of birth. “I’m your doula, Kim. I’m here to make sure you’re comfortable today.” Kat’s low, silken voice hints of her youth spent in North Carolina. She wears her brown hair short and close to her pale face, accentuating large, expressive eyes that startle and disarm at once. “I’m not medical staff, but if you have any questions, you can ask me. If I don’t know the answer, I’ll help you find someone who does.”

      Kim looks around the room, dark eyes open wide, only half listening to Kat. She gives Kat a short nod, holding her purse protectively in front of her. Kat continues, “Let’s get changed, okay? First, take off everything from the waist down. Since you’re not having conscious sedation, you can keep your shirt on. Gown on and open in the back, and booties over your feet; they can be a bit tricky to get on. Your clothes can just go back in this plastic bag.” Kat hands Kim a clear bag, stuffed with the gown and booties, snapped together at the top with white handles.

      Kat pulls the cheerful patchwork curtain closed around Kim and waits quietly on the other side, listening to the rustling of clothes moving against the stiff paper on the procedure table. She sits on a black plastic chair tucked in the corner and stretches her long legs, turning her ankles in slow circles. She is tired, having spent the majority of her week on the cardiac unit at the hospital where she is employed as a nurse. Kat has been a doula since 2010, taking several shifts a month at Planned Parenthood’s Bronx and Brooklyn sites alongside her nursing job. She has served hundreds of pregnant people, heard hundreds of stories, and been exposed to the many things that come up during and around a first trimester abortion. She knows all the motions of doula care by heart, but she never just goes through the motions.

      “Okay,” Kim says. “I’m ready.”

      Kat pushes the quilted curtain open and back against the wall. The rest of the room is revealed to her once more. There is a familiarity in these surroundings, like home, everything in its place as if she could move around with her eyes closed and find what she was looking for. Kim stands next to the light pink procedure table. To her right is the nurse’s computer, where stats will be tracked throughout the abortion, and a supply table is an arm’s length away, overflowing with gauze, flushes, needles and syringes of various sizes, bandages, cotton balls, tape, and tourniquets.

      Across from Kim is the doctor’s computer, keeper of the clients’ medical records and the room’s source of music, a Pandora station playing Michael Jackson. When the doctor swivels on her stool away from the computer, she will find her tool cart, prepped meticulously by the medical assistant. Beside the cart is the electric vacuum aspiration machine, a common instrument of pregnancy removal that uses an electric pump instead of a manual one and makes a louder noise than the manual vacuum aspirator. A blood pressure machine rests near the head of the procedure table, cords gathered into the basket hanging from its side. There is one frosted window and a swinging door that leads to the scrub room. When Kim lies down, she will look up and see Kat’s favorite detail of the room, a ceiling light fixture that looks like the sky.

      Planned Parenthood is a freestanding clinic, which means it operates outside of a hospital setting. Freestanding clinics can be public or private establishments, and because they are not connected to a hospital, they typically refer any clients with medical issues to hospital-based abortion services. They are often subjected to more antichoice protesting than a hospital-based setting would be and are also more likely to be affected by Targeted Regulation of Abortion Providers (TRAP) laws. In New York City, while there are regular groups of protesters at several clinic sites, the occurrence is much less common, as are TRAP laws. Freestanding clinics tend to be less bureaucratic than hospital-based clinics, and procedures can frequently happen the day of consultation in states where no other restrictions apply.

      Kat straightens the blue-and-white chuck on the procedure table as Kim self-consciously clutches the opening gap on the back of her gown and climbs on. Kat drapes a blue sheet over her legs, covering her nakedness. Kim plays awkwardly with the booties, trying to open them. “How do these . . . ?”

      “You just wanna pull the front tip over the toe and the back over the heel so they cover the bottom of your foot, like this,” Kat shows her. Kim is wearing black-and-white knit stockings that reach nearly to her crotch. “These are amazing,” Kat says.

      “Thank you,” Kim gives her a hesitant smile. She is not ready for small talk. Kat rolls the doctor’s stool over and sits down so they are at eye level, a doula move meant to reduce the power level. She reflects on the interaction today, “One of the most valuable things about [our role] is the one-on-one time with the client previous [to the procedure]. Because they have that reference point, they know who we are and that we are gonna be there the whole time. Because we’ve told them we’re gonna be there the whole time.”

      “How are you?” Kat asks.

      Kim shrugs, “Okay.”

      “Do you have any questions?”

      Kim exhales, looks up at the ceiling then back at Kat. “Is it gonna hurt?”