Our book is a narrative about doulas and miscarriage, stillbirth, adoption, and abortion. The chapters that follow give voice to the kind of pregnancy that people don’t want to talk about, the kind that is considered painful, shameful, and complicated—and, therefore, is silenced. From KCl (potassium chloride) injections in the twenty-fourth week to court-ordered C-sections in the forty-fifth hour, from tears of grief to joyful relief at the end of a first trimester abortion, it is through personal narrative that these experiences are humanized.
Though understanding systemic oppression is crucial to the way we approach doula care, we believe that individual stories have the ability to pierce the veil covering systems that affect millions of people; they are unique but universal. We recognize that in telling the stories of our doulas, we are also telling the stories of our clients. The nature of our role means that our stories have become intertwined. As we wrote this book, we had hoped to reach each of the clients in these stories so that we could include their perspectives on the experience. When we had no way to find some of them, we struggled with including them in the book. While it’s common for direct-care professionals to incorporate “case studies” into their writing and change identifying information, this practice made us uneasy.
Ultimately we consulted with trusted colleagues in the field—particularly those who have experience helping others tell their abortion stories—about how to navigate our concerns. Reproductive justice advocate and writer Renee Bracey Sherman, author of Saying Abortion Aloud, a guide to abortion storytelling and supporting storytellers, says:
Sharing stories, especially abortion stories, can be an ethical gray area. Doulas want to and should be able to share their experiences of supporting people through their abortions. It’s powerful to hear firsthand how to show up for someone else with compassion. However we must remember to put the needs of the patients first—we must prioritize their confidentiality, rights, and desire to share their own story on their own terms. But stories build community and alleviate isolation. That’s how they serve the movement—by reminding people that they are not alone.
Storytelling, we learned, has an adhesive quality; as we share our stories, we move beyond a partnership between doulas and their clients and start to include everyone. Doulas do not approach their role in isolation. An entire lifetime has inspired us to become caregivers. When we do this work, we think about our families, our friends, the people we love. For clients, it is often the same. Melissa Madera, former full-spectrum doula and founder of The Abortion Diary Podcast, reminds us that the ethics and anxieties of storytelling reach clients, too—because telling a story means your narrative is documented as a kind of truth. As people describe their own experiences with abortion during Madera’s interviews, they raise concerns about talking about their loved ones. They frequently ask her, “Do you think it’s okay?”
When writing this book, with a few exceptions for which we received consent, we’ve intentionally made the dominant story and point of view that of the doula. Why is it important that we tell the stories of doulas? Because doulas are caregivers, and caregiving takes a toll. Stories from the caregiver perspective are often left out of conversations; we are supporting actors to the client’s leading role. When we sign on to be caregivers, we are giving up a part of our identities for the sake of another person. Our work means that we are engaged in a deep intimacy with other people daily—the grief and joy of our clients, the doctors we work with, and each other.
As we were collecting oral histories, we realized that people rarely, if ever, have the opportunity to share their stories. The process became mutually therapeutic: we were given the privilege of listening and holding the stories for those who spoke, and in turn they often felt emotional release in letting their stories go. When we spoke with Madera about this, she articulated the symbolic gesture that happens in these exchanges, “You release the story to me, you create space for relief, and I take the story away with me, and in that way I become a part of the story, too.”
So much of doula work is that transference of story and the transference of emotional burden that goes with it. Physician David Grimes has written at length about the emotional transference exchanged between patient and provider during abortion. According to Grimes, in the act of providing the abortion, the provider accepts and takes away the patient’s emotional burden. This book represents a narrative version of that exchange—doing doula work all day, every day, means that we become filled with stories. At the end of the day, we do not just bear witness to someone else’s story, we become a part of that story and that story becomes a part of us. We try to receive emotional burden for as long as we can, but the relief of that burden comes with our own sharing. It’s cyclical. We found that writing this book became more than a process to document our stories—it was accidentally therapeutic. Ultimately, writing and listening to these stories and to one another gave us a new space to give and receive compassionate care.
How to Read This Book
Our hope is to bring readers into the world of care where we exist. We want to engage you with the narratives of our beginnings, our moments of greatest success, and the places where we’ve learned our most valuable lessons. To do this, we have woven together our own narratives as the Doula Project founders with those of other doulas, former clients, medical providers, and allies.
In order to gather the stories of those who have helped shape the organization, we conducted dozens of interviews. Many were done in the tradition of “oral histories.” A few of these oral histories would become the basis for entire chapters in the book. For these histories, we spent time gathering intimate details and engaging the storytellers in sensory exercises to craft a rich and accurate narrative. We then read the text aloud with them, inviting them into the editing process. We have used first-person narrative, third-person narrative, and direct quotations to write this book—following the style of creative nonfiction, a genre that merges literary elements with factual, biographical information.
We have changed the names of some of our clients, allies, and partner organizations, as well as certain locations where stories take place. We’ve also changed the names of most of our clinic sites to protect the availability of their services. (When it comes to abortion care, fame rarely brings anything good.)
We believe you will get the most out of the book by reading it in order from front to back. Descriptions of medical procedures and interventions, laws and policies, and introductions to recurring doulas are sequenced in this manner. Should you need this book as a reference guide, however, we have also created multiple sections with different topics so that you can easily flip to what interests you most—doulas supporting other doulas, birth stories, or direct-care activism, for example. In every section, multiple themes are covered, ranging from adoption politics to ambivalent feelings about abortion to provider burnout and more.
This book is the creative memoir of an organization—a story of what it means to be a doula, a story about giving love and getting it back through this rare, uniquely beautiful exchange. At its core, it’s a story about humans trying to take care of each other in a world where that often gets lost. Those who have ever cared for anyone will relate.
Part 1
The Beginning
A Great Idea
The Abortion Doula Project was a great idea.
It was one of those brilliant shining stars that catches your eye from high above, the kind you want to reach up and grab with both hands, make a wish on. And this was it in all its profound simplicity: people having abortions should have continuous and nonjudgmental physical, emotional, and educational support just like people giving birth. For one year, between the summers of 2007 and 2008, we