As we were coming together in 2007, the birth doula community in New York City was at the cusp of an explosion of a new generation of doulas. In addition to the ongoing abortion debate, the heat of the “home vs. hospital” birth argument was at its zenith. Maternal mortality and C-section rates were on the rise and people were speaking up. Abby Epstein’s eye-opening documentary The Business of Being Born was released soon after we became birth doulas. Suddenly, it seemed that everyone had a “birth plan” and everything was “natural”—natural products, natural labors, and natural approaches to parenting.
Meanwhile, a few months prior to the NYC Birth Coalition meeting, National Advocates for Pregnant Women (NAPW) convened a conference that brought birth and abortion activists together in one room for the first time in most of our memories. The NAPW’s 2007 National Summit to Ensure Health and Humanity of Pregnant and Birthing Women offered a crucial platform for activists and was in some ways iconoclastic: it engaged with reproductive justice activists as well as with staunchly anti-abortion birth activists. It was trying to build alliances across political dominions in a way we hadn’t seen before—for example, it created contact between abortion providers and birth activists who feared that they would go to hell for sharing space with them. But as Lynn Paltrow, founder and executive director of NAPW, discussed at length with both communities, the “justification for locking women up and forcing them to have court-ordered C-sections stems from the same legal justifications developed for restricting abortions. [In other words] there is no difference in the legal theories used to restrict abortion and those used to justify forcing a woman to have cesarean surgery.”
In trying to connect both communities, Lynn describes the work of the NAPW conference as “pragmatic” because both communities were advocating for the same women—just at different points in their reproductive lives. She also hoped that bringing the two activist communities together would “detoxify the abortion debate by making it richer and more complex [and] by saying, you can’t just talk about ending a pregnancy.”
According to activist and scholar Marlene Gerber Fried, director of the Civil Liberties and Public Policy program (CLPP) at Hampshire College, “Historically, the frame of choice wasn’t about having children, but rather the choice not to. And while there was much overlap in individual players and organizations who worked between the two worlds, for decades they were usually very siloed.”
CLPP was also instrumental in bringing together voices from both movements at their annual conference. The CLPP Conference facilitates one of the largest platforms for activists, especially young activists, in the country, often influencing themes and ideas among organizers for the year to come. In 2007 a number of doulas were invited to speak at CLPP. Those talks followed the conference’s Abortion Speak-Out, a night where people share stories about their own abortions. The Speak-Out is known for being a beautiful space for those who come to listen and those who come to share. The Speak-Out would be a huge inspiration to us, in many ways a cornerstone of our compassionate practice, as we developed as an organization.
Between the burgeoning success of The Business of Being Born, the connection reproductive justice advocates were facilitating between birth and abortion, and a new activist-flavored onslaught of birth doulas saturating New York City, the timing for the Abortion Doula Project seemed perfect. We continued to formulate our mission.
Pérez says now:
In that first year of creating [the Doula Project], I remember a lot of exploring what it would look like to take the skills and role of a birth doula and apply it to the abortion context. I remember a lot of hypothesizing about what someone having an abortion would want from a doula. We were wrong about a lot of the assumptions we made, but it makes sense that we were wrong. We were really charting new territory.
With this new territory came several months of starts and stops. We were all young, busting our asses at our full-time jobs, navigating a city that left us worn to the bone at each day’s end. Weeks would pass, and the Abortion Doula Project would feel like nothing but a misty memory. One day, Pérez announced she was moving to Washington, DC, to pursue new personal and professional opportunities. Unsure of whether to proceed without her, the two of us (Lauren and Mary) met up to determine the fate of the organization. We decided that we were finally “gonna do this,” although we would now approach it as a duo.
To us, and to many others, the idea of providing compassionate emotional, physical, informational support was intuitive, whether we called it “doula care” or any other name. We knew that there were social workers, counselors, nurses, doctors, clinic escorts, and many others who were providing this care before “abortion doulas” became an official concept. In fact, there are some clinics like Preterm in Cleveland, Ohio, and Choices in Memphis, Tennessee, that hired patient support people as soon as they opened. But we also knew that at many clinics, offering adequate support at the time of an abortion could be a matter of luck and timing—whoever happens to be working that day, and whoever happens to have time.
So we figured the best way to support clinics and reach the most clients would be to partner with a clinic itself. Typically, in a traditional relationship between birth doula and client, a doula would meet a client outside the confines of a hospital and accompany her into the labor and delivery room without any official volunteer or staff status within that hospital. Abortion clinics, however, usually prohibit friends or family from joining clients in their exam rooms for procedures to ensure the safety of clients and staff alike. Moreover, we did not expect that an individual seeking a pregnancy termination would ask for this type of support given the stigma attached to abortion and the limited time period involved. Not to mention, people were barely even familiar with doulas for birth, let alone this totally new concept—how would they even know to ask?
We went in search of a clinic to pilot our project. We weren’t exactly sure where to start. We cold-called a few local facilities, sent some letters. No response. We spoke to midwives and obstetricians who tepidly expressed support but didn’t offer abortion services at their practices. We went back to what we knew—the reproductive justice movement. We traveled the country, speaking about abortion doulas at meetings and conferences, often connecting with Pérez along the way. As the months rolled on, it seemed that the Abortion Doula Project was destined to remain only “a great idea.”
Though not totally defeated, we were officially frustrated.
We knew feminist leaders, young and old. We had all the right connections in our field. Why were we turned away? Why couldn’t we find anyone to partner with? Why couldn’t we connect with the people inside the clinic walls?
This is when we first started to see the disconnect that often exists between the advocacy and direct-care worlds. Sure, we knew the executive director of Advocates for Youth in Washington, DC. That didn’t mean we knew the local abortion provider practicing in our neighborhood clinic in New York City. On top of that, we realized that even though politically “birthing justice” was under the umbrella of “reproductive justice,” birth and abortion were often clinically separated from one another.
Fortunately for us, there were a handful of other activists and national groups walking the line between advocacy and direct care. We discovered groups that, for years, had been promoting a message of care similar to ours. We began to connect with them.
Aspen Baker was a big supporter of ours from the start. As founder and executive director of Exhale, a postabortion hotline that promoted a “pro-voice” framework, Baker had spent years listening to the stories of people who had abortions and bringing those stories into the public sphere. In the summer of 2008, she asked Mary to speak about the abortion doula philosophy of care at a pro-voice event at the Guttmacher Institute in Manhattan. When Exhale was being developed, the founders had briefly considered training doulas before deciding on a talk-line. Baker remembers “feeling really excited and really proud and really supportive of the idea [of abortion doulas] and glad that someone else was going to make something