Doulas have offered non-medical support to pregnant people for decades, but less known is the help these "women of service" give to those undergoing terminations.
The Doula Project in New York has supported women through terminations since 2007. A volunteer-run service, it helps people who choose abortion or experience foetal loss.
Media co-ordinator Sarah McCarry has worked as an abortion doula with the project since 2012. She says the service provides free, compassionate care across the pregnancy spectrum.
“We work with low-income birth clients as well as people choosing abortion and people experiencing lethal foetal anomaly or miscarriage,” she says.
The doulas help clients through physical support, such as holding their hand, emotional support and offer pain management and relaxation techniques.
“Some of us do primarily birth work, some of us do primarily abortion work, and many of us do both,” McCarry says. “For our abortion work, we partner directly with providers, so we're already in the clinic and integrated into our clients' experiences.”
The concept of an "abortion doula" or "full-spectrum doula" – any doula who works across the spectrum of pregnancy outcomes – has risen to mainstream consciousness only recently but is rapidly spreading.
“Most people have heard of birth doulas but are surprised to find out about our abortion work,” McCarry says. “There are a number of other projects similar to ours starting up or already working around the United States, so I do think awareness is growing.”
The Doula Project served 1000 women in its first 18 months and has expanded every year since it was founded, supporting 3500 people last year with about 50 full-spectrum volunteer doulas.
McCarry says feedback from clients has been "overwhelmingly positive".
“For many people, abortion is a difficult decision, and it can be particularly painful for people who are terminating wanted pregnancies because of lethal foetal anomalies.
"We're very lucky to be partnered with wonderful, pro-choice providers, but having a doula in the room whose sole role is support and empathy can be hugely important to our clients. Even our clients for whom abortion was not a difficult or painful decision often appreciate just having a supportive and empathetic person present during their abortion.”
McCarry has not received any negative feedback to her work and says: “I can't imagine what objection someone would have to the idea that all people deserve compassion and support at difficult times in their lives.”
In Australia, the work of full-spectrum doulas has not become as formalised or widespread as in the US, but there are doulas who offer the service.
Emma Fedigan, a birth, post-natal and loss doula in Perth, has been a member of Australian Doulas for the past five years. In that time she has helped women through diverse experiences, including a stillbirth and termination.
“The stillbirth and the termination, as emotional and traumatic as they were at the time, were beautiful, raw and eye-opening experiences,” Fedigan says. “They made me realise that this is exactly what I want to do regardless of whether it be a sleeping babe, a termination or a live birth. They all deserve the same support and understanding.”
Fedigan says she treats terminations with the same care and empathy as a birth. “As a doula, supporting a loss, I go in and do what I would do for anyone who is birthing or needing support: listen, be with them, open up my heart and let them do what they need to do.”
Fedigan says Australian Doulas is in the process of trying to make the public more aware that it supports women through losses and terminations, though not every doula offers the service.
“We acknowledge that supporting terminations isn't for every doula in our organisation, but we are all aware of how precious the woman's experience is and that she is just as deserving of non-judgmental support as any birthing woman. Also [with the] different reasons for terminations – medical or personal – some doulas might be happy to support one but not the other.”
Fedigan hopes that eventually the stigma attached to terminations and losses will lessen.
“Loss or termination shouldn't be treated as a taboo subject. There is no shame at all in either. I am pro-choice, and as women we need to understand that we should start supporting each other and stop the shame surrounding termination, loss and miscarriages."