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When Roe v. Wade was struck down in June, many immediately took to social media, offering to assist people who’d been impacted to get the care they needed. Unfortunately, those posts may have hurt more than they helped. Instead, becoming an “abortion doula” is a far more effective way to be of service. Here, we explain what the job entails, and how to get involved:

The social media posts suddenly popped up everywhere.

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It was June and the Supreme Court had just handed down its landmark decision in Dobbs v. Jackson, ruling that the United States Constitution doesn’t protect a person’s right to abortion. The decision, which overturned the 1973 Roe v. Wade case, as well as the 1992 Planned Parenthood v. Casey case, upended nearly 50 years of abortion rights, granting individual states complete power to regulate any components of abortion that were not protected by federal law. Immediately, “trigger laws” went into effect in states from Alabama, Arkansas, and Arizona to West Virginia, Wisconsin, and beyond, effectively banning or severely restricting abortion in 17 states.

Outraged and concerned, people looked for ways to help. Many took to social media sites such as Facebook to post a variation on the same message: “If you are a person who suddenly finds yourself with a need to go camping in another state friendly toward camping, just know that I will happily drive you, support you, and not talk about the camping trip to anyone, ever.” “Camping,” in this case, is a not-so-subtle coded message for helping someone access abortion care out of state. It may be a well-intentioned message, but reproductive rights workers and activists agree that it’s not the right way to go about helping those in need. Such postings are naïve at best and at worst, potentially dangerous.

“The ‘camping conversation’ is frustrating,” says Max Carwile, programs director for Abortion Access Front, an activist group that uses performance and humor to destigmatize abortion and provide aid to independent clinics. “I think we have this false idea that if we post something online then we’ve done our part and that people know to reach out to us. I wish I could encourage more people to think about what the pre- Roe era looked like without the Internet.”

Since the SCOTUS decision, there’s more of a need for doulas than ever.

If you’ve already protested, donated, and written letters to your representatives but are still looking for a more hands-on way to help, there’s a better option. You can become an abortion doula. Like pregnancy doulas, abortion doulas are people who provide support to patients before, during, and after their procedure—in some cases, that support can include transporting and finding housing for folks who need access to abortions out of state. Since the SCOTUS decision, there’s more of a need for doulas than ever—and not just in red states where abortion is limited or prohibited. The fact is, they’re vital everywhere.

“Clinics have realized the growing need for this sort of support and they’re finding creative ways to work that into their programs,” Carwile says.

Support on a Spectrum

The range of services that a doula can offer exists on a spectrum of physical, informational, logistical, and emotional care. And while their tasks don’t include medical advice—they’ll refer any medical questions to trained medical staff—they can offer support and hands-on assistance.

Some doulas transport clients to and from a clinic, and in some cases, sit bedside during their procedure. Other duties might include supervising aftercare or arranging for out-of-town lodging, childcare, and fixing meals. Those who undergo a medical abortion—a procedure that uses medication to terminate the pregnancy—can also use doulas, during and after taking what is often a two-pill dose. And since the fall of Roe, the role of abortion doula has been evolving. Some volunteers, for example, overlap into the world of “practical support organizations”—groups that, among other tasks, secure transportation and housing for those seeking abortions.

It’s nearly impossible to estimate how many programs exist or how many people are trained to work as doulas, and it’s not always obvious how to get involved.

“There’s no official terminology [for abortion doulas], and there isn’t an official certification you can go through to plug into your community,” says Carwile. Unfortunately, there is also no national network of abortion doulas in the United States, and there is no federal registry or database.

That said, there are at least three dozen abortion doula collectives currently operating across the country, and there are plenty of opportunities to become part of a growing trend that has deep roots in the women’s health movement and its midwifery communities. From Planned Parenthood’s affiliate training program to independent groups such as the Nesting Doula Collective, which serves BIPOC communities, there are options. And practical support organizations, which specialize in transportation and housing needs, are even easier to find. The website I Need an A is an online guide with a searchable directory that uses handy icons to indicate what services each offers, including long-distance travel, wage replacement, food assistance, gas money, and lodging.

 

Learning the Ropes

The country’s first formal doula collective, the New York-based Doula Project was founded in 2007 when a group of birth doulas realized there was another segment of the population—those needing abortion services—that needed similar care in terms of emotional support and both pre- and post- care. The collective, originally known as the Abortion Doula Project, eventually changed its name and broadened its focus to provide volunteers for every type of reproductive care and need. The group has even partnered with a pro-choice adoption agency to provide support for women who choose to carry a pregnancy to term but intend to relinquish parental rights.

Becoming a doula, says Mick Moran, projects coordinator and ’zine editor at the Doula Project, requires training on how to support a client emotionally and practically. “It’s important that people want to do this work because of their interest in reproductive justice,” Moran says. “We make sure the doulas are reflecting the communities they serve.” Former clients and those who live in the neighborhood they serve often make great fits, Moran says, but it’s not a requirement.

There’s no special skill set needed. “It’s more about your personality,” they say. “It’s about being able to provide loving, nonjudgmental support.”

This is why the Doula Project’s three-day training program covers everything from discussions on “value clarification” to workshops on how to engage in small talk with a stranger during what may be an emotionally complex situation. “It’s an important skill to make people feel comfortable,” Moran says.

Midwest Access Coalition, aka MAC, doesn’t offer doula training, but it does have a program to help people become an “emotional support person,” who functions in a similar way, with tasks ranging from talking on the phone to holding someone’s hand during a procedure. Such volunteers are typically trained counselors or therapists. The organization also connects volunteers to clinics in other states including as far west as Colorado, where members of the Colorado Doula Project can aid out-of-state patients.

CDP and MAC both also train volunteers to drive patients across state lines within the areas they serve. Another organization, Practi-Cab, based in Virginia, trains and certifies volunteers as abortion doulas to provide a safe and secure ride for folks seeking services in that state. And there’s even a group where activist pilots can volunteer to fly women to other states for abortions.

Because abortion funds such as the National Network of Abortion Funds don’t financially support doulas, most collectives rely on volunteers. Sometimes the volunteers are compensated for any costs incurred, and training is usually covered by grants or donations. The Doula Project provides its doulas with a stipend. “It’s part of our economic justice mission for them to not have to incur costs as volunteers,” Moran says, adding that they rely heavily on individual donations as well as assistance from partner clinics.

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Needless to say, the pandemic has changed the scope of care available through these interconnected organizations. “For the last two or three years, nobody [except patients] has been allowed inside clinics,” says

Alison Dreith, director of strategic partnerships at MAC. “Drivers haven’t been allowed; spouses haven’t been allowed. I don’t know if anyone has lifted these restrictions—I don’t think we’ll ever go back to pre-COVID [access] because it’s actually a safer experience for patients.”

To adjust, many organizations have shifted some accommodations to incorporate various telehealth options. The Doula Project, for instance, now has an anonymous 24-hour telephone hotline, staffed by trained volunteers, to offer support before, during, and after a medication abortion. “We’re all ready to get back into clinics, to be there in person, but they’re not ready for us yet,” Moran says. “Part of that is COVID and part of that is just healthcare capacity.”

Whatever or wherever the care, it’s critical for abortion doulas to be vetted, usually via background checks, and to go through an official training course. In other words, don’t go rogue—this is not the kind of volunteer work to undertake independently for various reasons that include appropriateness of caretaking, legal considerations, and privacy issues (more on that later).

“With a pregnancy doula you work with that person for months; they’re helping you prep for your delivery,” Dreith says. “With an abortion doula, however, that’s a stranger—you’re usually meeting them the day of the procedure, and that’s a different experience.”

The Need Is Everywhere

Even in states like California, New York, and Colorado, where abortion restrictions are sparse, abortion doulas are still a critical resource. The practical and emotional support is important and, in some areas, especially in rural communities, clinics are still difficult to access.

“It’s about being able to provide loving, nonjudgmental support.”

In addition to independent clinics and doula collectives, Planned Parenthood also offers abortion doula support via many of its chapter affiliates. In Virginia, for example, the Virginia League for Planned Parenthood fills a critical need by partnering with doulas who serve neighboring states. “You’re able to get care in Virginia but we’re the only state serving the whole South,” says RaeAnn Pickett, an abortion doula and communications director at Planned Parenthood Advocates of Virginia. “Once you go south of Virginia, there’s nothing—so all these folks are coming north.”

“Doulas can provide physical, mental, sociological, and non- medical care. It can be giving a massage or telling a joke— whatever the need is.”

Pickett, who independently trained to become a birth doula through DONA International, which offers training for birth and postpartum doulas, says her experience made her realize a greater need. “Historically, a doula has been anyone who was giving support,” Pickett says. “Doulas can provide physical, mental, sociological, and nonmedical care. It can be giving a massage or telling a joke—whatever the need is.”

When she heard that Planned Parenthood offered a pilot program for affiliate clinics, she knew the Virginia League had to act. They applied for a grant to fund the program, and in 2021 started training volunteers at a Richmond-area clinic. Now, each Thursday and Friday, the center staffs two volunteers at each health center—one in the morning and one in the afternoon. It also partners with other community reproductive groups who can provide logistical support for needs such as transportation.

Like others, Pickett also stresses that would-be doulas must go through a vetted training program to ensure that the client’s needs are always at the center.

“You’re working with a person who is pregnant, and they might be really scared—they typically have very complicated feelings,” she says. “Having a doula who can engage with the medical community and knows what to look for if there is trouble is important.”

Safety, Privacy, and Risks

While doula work can be a useful and personally satisfying way to contribute, it’s not without its risks. From legal and privacy concerns to burnout, doulas can face a number of challenges.

Isabelle Bibet-Kalinyak, a New Jersey-based healthcare attorney, cautions that abortion doulas must understand the laws of each state where they’re offering care, whether in-person or virtually. “No matter where you are, your [actions] fall under state law,” Bibet-Kalinyak says. “So far, a lot of doulas have flown under the radar, but the risk now is that there’s going to be more enforcement. We’re going to see people playing vigilantes, so [doulas] need to make sure they comply with all applicable laws.”

In Texas, for example, the state’s “Heartbeat Act” lets private citizens sue abortion providers or anyone else they suspect is “aiding or abetting” abortion after the six-week mark—an action that will likely apply to abortion doulas. Meanwhile, Republican senators in South Carolina recently introduced a bill that would, among other things, criminalize offering abortion doula services. The bill failed, but it’s a clear indication of how far conservative lawmakers will go to strip away reproductive rights.

The good news is that a doula can’t be extradited to another state for prosecution, Bibet-Kalinyak says, but an abundance of caution is necessary. (Again, this is where proper training with a legitimate organization that knows the laws is key.) Lawsuits, she adds, can be a pricey consequence. “If you’re dragged into a lawsuit, you can’t just ignore it,” she says.

This means privacy issues are key, particularly in digital or communication spheres. Typically, doulas avoid regular text messages, opting instead for encrypted messaging platforms such as Signal. “Digital safety is crucial,” Moran says. “People don’t realize how much their phones can track them.”

Organizations such as the Digital Defense Fund (DDF) and the Electronic Frontier Foundation (EFF) are good resources. The DDF, for instance, has tips on how to ensure mobile phone privacy, while the EFF offers a “Digital Security and Privacy Tips for Those Involved in Abortion Access” guide, which recommends “compartmentalizing your digital footprint” by never reusing passwords and switching out browsers or using them in “incognito” mode.

What if doula work doesn’t seem like the best fit for you? Or you do take it on and suffer burnout, which, Pickett says, is not uncommon? The good news is that, in reproductive healthcare, there’s still a need for volunteers in any capacity, within any scope. “More than ever, this movement has a place for everyone,” Pickett says. “People should not be afraid of what lane they might fit in.” Ultimately, she says, it’s about providing care and comfort in whatever way you can. “Traditionally, for hundreds of thousands of years, as long as people have been getting pregnant, there have been people supporting them,” she says. “Showing up to support someone regardless of how their pregnancy ends is the best and easiest way to make an impact.”

Illustration by Rachel Joan Wallis

This article originally appeared in BUST's Winter 2022-2023 print edition. Subscribe today!