A New Kind of Pregnancy Support

Debbie says:

Clicking around the blogroll, I found an interesting link at Feministing to an extensive and well-written article by Miriam Perez. It seems that some folks have expanded the concept of the doula (“the only person involved in the birth process solely focused on the emotional and psychological status of the mother”) to extend support to women having abortions.

This strikes me as an astonishingly good idea, so much so that I was 1) surprised that it was new to me, and 2) brought up short by just how much we have let the anti-choice folks frame not only the abortion debate but the abortion experience.

Part of what fascinates me is the stark contrast between changing expectations for birth, much of which I see in my own friends’ lives …

Doula care is expanding across the United States as more people become familiar with the concept and more women seek out their services for labor and delivery. This expansion continues as a part of the wider movement to change the standards of maternity care in the United States (by lowering intervention rates, increasing midwifery care and educating women about birthing options).

and changing experiences with abortion:

As the number of providers decreases (it has dropped 37% since 1982) and the number of women having abortions continues to go up, clinics and abortion providers are overextended and under-resourced. Not only are many providers not well equipped to provide adequate support, but the procedure itself can also be a painful one, during which many women are fully or at least partially conscious. Raquel Valentin, Practice Manager for the Family Planning Division at Beth Israel Hospital explained, “Many first trimester abortions are being done with local and moderate sedation. This means that the women are still awake and emotional.” The decision to use moderate sedation is based on both the women’s choices and the higher risks associated with full anesthesia but can result in an experience that can be both frightening and, at times, painful.

Certainly, the anti-choice faction is responsible for the reduction in number of care providers. (Shoot a few doctors and threaten others and you’re going to lose some treatment options. As is pointed out later in the article, “Medical students aren’t being trained to do the procedure, yet the need for abortion services remains steady.” It doesn’t sound like the reduced anesthesia is intended as cruelty, though it could certainly be experienced that way.

The Birth Sisters, an existing doula program at Boston Medical Center (BMC), is in the process of adding abortion to their already comprehensive list of support services offered. The program, fully funded by the hospital, provides women with support from the early stages of their pregnancy through the postpartum period, often from doulas who can provide culturally competent services to the burgeoning Latino immigrant population served by the Medical Center.

You gotta love that “fully funded by the hospital” part!

There’s lots more–what is being done, who is doing it, how it’s different from existing follow-up care, and so forth. Even before I read the whole article, I thought, “Wow! I bet this will reduce abortion rates where it’s available, and now I think it’s even more likely:

Dr. Nilda Moreno, an OB/GYN and member of the Birth Sisters program, explained, “We don’t only want to provide emotional support but also contraceptive support. We want them to have all the information to prevent unintended pregnancies.” Dr. Moreno also explained that the training will be similar to what counselors at Planned Parenthood receive, but with a special focus on emotional support. In addition, they also plan on providing support to women having medication abortions, who usually go home and pass the pregnancy on their own.

Perhaps most exciting of all, for those of us who are starving for an end to the nasty polarities of the abortion debate, is this:

Last Spring, Lynn [Paltrow] and National Advocates for Pregnant Women hosted the Summit for Health and Humanity of Pregnant and Birthing Women in Atlanta, Georgia. What transpired was a gathering of abortion advocates, reproductive rights activists, midwives, doulas and birthing rights academics. Not everyone in the room was in support of abortion. Not everyone in the room understood the benefits of natural childbirth. Lynn explained in her article on TomPaine.com, “Participants moved beyond the divisive abortion debate to find common ground in the experiences of pregnancy and the increasing limitations to care and support that all pregnant and birthing women face.” The Birth Sister’s Compañera project, along with two other similar abortion doula projects (one in New York City and another in Washington State) arose from conversations that began at the summit.

There’s lots more good information, and many more links, in the article itself. I especially appreciate Perez pointing out that not all women need emotional support around abortions, and that framing it as “pregnancy support” minimizes the abortion stigma.

‘m old enough to remember the bad old days of illegal abortions, and I’ve had lots of friends go through legal ones, some good or okay and others completely miserable. I have to say that this whole story, from the concept through the effort to make it available to low-income and non-native-English-speaking women, to the emphasis on contraception, to the potential reduction in polarities gladdens my heart.

feminism, pregnancy,abortion, doula, birth, women, health care, Body Impolitic

3 thoughts on “A New Kind of Pregnancy Support

  1. I had a local anesthesia (with no sedation) abortion through Planned Parenthood in the early 80s. I had good friends supporting me and the staff were also supportive emotionally as well as physically, but the staff were too busy to provide emotional support once I got out of the operating room. I imagine Planned Parenthood staff are even more busy these days.

    I did OK with the kind of support I had. But I agree that having a professional available to specifically take on a support role during abortion recovery is a good idea.

    Furthermore, if this role is cast as “pregnancy support” such practitioners also might be trained in giving support to women who have miscarriages. Maybe such training already exists but I know some women who seemed not to have a lot of emotional support resources available when that happened to them.

  2. I see this as a logical outcropping of the doula’s original role. They need to be prepared to assist woman with feelings of grief that surround a medically necessary abortion, why not also assist those who make that decision for themselves.
    I know my sister would have benefited greatly from more emotional support after her miscarriage and the D&C required thereafter.

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