What Does an Abortion Doula Do?

While the term “abortion doula” may not be widely known, these care workers have been around for a long time. Simply put, abortion doulas offer various forms of support to people as they go through the process of ending a pregnancy. With the recent overturning of Roe v. Wade, figuring out how to obtain an abortion has become harder in some parts of the country, which could make the role of abortion doulas more valuable than ever — but also riskier.

Sarah Michal Hamid, 21, is a self-described full-spectrum doula, and provides a range of reproductive health support services in Los Angeles. Below, she gives an inside look at what these trained professionals do.

Everyday Health: What inspired you to become an abortion doula?

Sarah Michal Hamid: I started working as a birth and postpartum doula in 2021. I became interested in this because when I was 16, I had an unplanned pregnancy and suffered an incomplete miscarriage. I needed to take misoprostol, a medication, to shed the tissue completely because the risk of infection increases if you don’t do something to extract all the material from the uterus. So technically this would be considered an abortion. It wasn’t difficult for me to obtain the medication because I went to Planned Parenthood, but being alone in this experience was very difficult.

In college I focused on women’s studies with an emphasis on women’s health. I got interested in reproductive justice and health access while working as an intern at the Hawaii State Commission on the Status of Women, on a report related to gender inequities during the COVID-19 pandemic. I began talking to midwives who were affected by the pandemic and seeing an increase in cesarean births. Before this, I didn’t really know about birth work. I decided I wanted to be part of the solution because I knew the pain of having to navigate reproductive health situations alone.

EH: What kind of training did you have?

SMH: I did intensive training sessions that were taught by existing doulas, nurse-midwives, and ob-gyns. And I started working with the Community-Based Doula Program through the Healthy Mothers Healthy Babies Coalition of Hawaii, doing prenatal, birth, and postpartum doula work, mostly with low-income women and people of color. Seeing the full spectrum of reproductive experiences is affirming for me because I believe people deserve their freedom and to be empowered to take charge of their uterus.

But I was noticing there were different needs in the people I was supporting outside of the Community Based Doula Program — teens and women in their early twenties. Because I’m outspoken, people would come to my dorm room [at the University of Hawaii] and ask me questions about reproductive health care. I started providing abortion doula support to people in my dorm — it really was a grassroots beginning — and I realized there were not enough people doing this kind of work. That’s when I decided I wanted to work with young people in need of abortion and reproductive loss support in addition to doing prenatal, birth, and postpartum work, so I trained as an abortion doula with the Youth Abortion Support Collective at Advocates for Youth, which is based in Washington, DC.

EH: What kinds of support or assistance do you provide as an abortion doula?

SMH: The role of an abortion doula is to be there before, during, and in the aftermath for people who are having abortions. I offer virtual support as well as in-person support. Sometimes I drive them to the clinic for an abortion and support them when they get back in the car. That’s often when they need someone to hold their hand. As an abortion doula, I’m able to provide practical support for the physical, emotional, and psychological symptoms that are related to abortion. If someone took medication and they are vomiting shortly after taking the medication, they are less likely to have a complete and successful abortion. We want to make sure a person’s abortion is effective and that they don’t have to worry about something beyond what they have to.

Emotionally, this is a big choice — it’s something people need support through, so I do somatic breath work exercises with clients to ease their pain and stress levels. The physical discomfort of an abortion is very alienating for someone who does not want to be pregnant — that’s a very stressful situation — so post-abortion, we focus on relaxation and rest. I have different coloring pages so clients can create art out of a moment they feel they should be ashamed of. Sometimes, I’ll offer light massage or cook a nutritious meal for them.

EH: What’s the most interesting or challenging part of this work?

SMH: The hours are odd because emergencies and emotional moments come at all times of the day. I am on-call for my patients. As far as challenges go, safety is a huge issue. Abortion doulas who are vocal on social media deal with a great amount of harassment online and in person. I’ve been providing information online and on Instagram, especially evidence-based research about reproductive health care. I have received online harassment from anti-abortion people — the volume, the sheer number shocked me. In some cases, it escalated into other types of harassment, including threats. There are very real safety and practical issues you should take into consideration before you do this [kind of work].

EH: Are certain populations experiencing greater repercussions from the overturning of Roe?

SMH: Black and brown people in the South are most impacted by abortion restrictions, and the same is true for low-income and LGBTQ+ folks. And it’s difficult for trans men to obtain abortions. But the truth is, abortion access is abysmal even in a blue state.

EH: What do people often say to you in the course of your work?

SMH: The number one thing people tell me is that they’re scared. They also say things like, “I’m not ready to become a parent,” or “My partner hits me,” or “I cannot afford a child.” We do not have the infrastructure in our healthcare system to normalize the reality that people can get pregnant and not want to have a child.

I tell clients, "I hear you, I see you, and you don’t have to have a baby just because you can get pregnant." I really don’t care why people choose to obtain abortions. If people go in for breast implants or a nose job or another elective procedure, we don’t ask them if they’re really sure they want to do this or if it will affect their ability to be a parent in the future. We shouldn’t ask for abortion.

A number of clients I’ve supported have been raped. People have a wide array of experiences and traumas that have shaped them. People deserve to have competent support when they experience these difficult situations. When people don’t have access to the care they need, our society suffers on an individual level and on a collective level.

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