Being An Abortion Doula In A Post-Roe World : Consider This from NPR You may have never heard the phrase abortion doula, but for years they have been working to support people navigating the process and experience of ending a pregnancy.

With Roe overturned, depending on where you live, figuring out how to obtain an abortion has gotten much harder. This could make the role of abortion doulas more critical than ever --- and more risky.

NPR's Michel Martin speaks with Vicki Bloom. She refers to herself as a full spectrum doula and provides a range of reproductive health support services, from helping clients create a birth plan, to being present at abortions, to providing information and emotional support.

We discuss what a abortion doula does and how that role might change in a post-Roe world.

In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.

Email us at considerthis@npr.org.

Being An Abortion Doula In A Post-Roe World

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I C: I just remember, like, holding it and, like, sitting there on the toilet and seeing it and just, like, starting to shake and everything.

MICHEL MARTIN, HOST:

It was two weeks after the leaked draft opinion from the Supreme Court on Roe v. Wade. IC was holding a home pregnancy test, and it was positive. IC see lives in a small conservative county in Pennsylvania and uses they/them pronouns. IC asked to be identified by these initials because their family and their partner's family don't know they had an abortion. They spoke to NPR producer Brianna Scott.

I C: I am a librarian. I'm recently graduated from college.

MARTIN: IC's plans are to work in an academic setting or a museum in the future. They've been applying to different jobs recently, preparing to potentially move out of state for the right opportunity. A pregnancy would have halted all of those plans.

I C: The week I knew I was pregnant was up there with some of, like, the most traumatizing things I've had to go through.

MARTIN: IC has been with their partner for two years.

I C: All I had to do was send the text was I took a pregnancy test, and that was it. And he picked up and he came right over. And we just, like, sat and held each other and cried for, like, two hours.

MARTIN: The decision to have an abortion was clear to both of them.

I C: My friend, she had told me getting an abortion was the biggest act of self-care I could give myself. So after, like, all the trauma I've been through, it was a really reassuring thing to hear.

MARTIN: In Pennsylvania, before a person can have an abortion, they first need to have a consent call at least 24 hours before the procedure to be informed about the details of having a medication or surgical abortion. IC cleared that hurdle, but the appointment they scheduled with Planned Parenthood was canceled at the last minute.

I C: Especially with all of this is the looming context of Roe v. Wade about to be overturned over my head the entire time. And so it's the panic of holy [expletive]. Am I even going to be able to have an abortion in time at this point?

MARTIN: They were finally able to get an appointment at a women's center and had a medication abortion. After taking five pills over two days, IC says it was eight straight hours of pain. Their partner tried to comfort them.

I C: Oh, I was just sitting there sobbing, like, in and out of sleep. Like, this just needs to be over. This is so painful - like, in so much pain. Just, like, waking up and screaming, like, I just want it to be over was, like, really miserable.

MARTIN: Throughout this entire process, though, IC also had the support of an abortion doula.

I C: I've never heard of an abortion doula. I knew what doulas are but never an abortion doula. And for some reason, like, it just didn't click that those exist.

MARTIN: Abortion doulas provide emotional support and information for those navigating the experience of ending a pregnancy. IC never met their doula face to face, only through text, but said it still felt very much like the doula was with them through the journey.

I C: The empathy shared in my experience and the understanding they had of my concerns and my body and, you know, just everything coming in and out of the process was a key component in how I healed and how I coped.

MARTIN: IC is talking about someone like Vicki Bloom. Bloom wasn't involved with IC's care, but she has supported about 2,000 other people through abortion over the course of her 10-year career as a doula.

VICKI BLOOM: Once I started doing the work, I actually found it to be extremely fascinating and extremely satisfying to do the work of meeting someone, connecting with them quickly, providing the support they needed in the moment and letting them go on and live their lives.

MARTIN: CONSIDER THIS - with Roe overturned, depending on where you live, figuring out how to obtain an abortion has gotten much, much harder. That could make the role of abortion doulas more crucial than ever and more risky. That's coming up. From NPR, I'm Michel Martin. It is Saturday, July 30.

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MARTIN: It's CONSIDER THIS from NPR. Vicki Bloom is a certified doula who has worked in the New York metropolitan area since 2010. She refers to herself as a full-spectrum doula. And just to define some terms here, she's not a midwife. That's a medical professional who oversees births. What Bloom does is provide information and emotional support for people experiencing the full range of reproductive health events, from giving birth to postpartum care to failed pregnancy care and abortion.

BLOOM: So basically, the idea of the doula model, where you're talking about one-on-one individual support for somebody while they are having an experience, gets moved directly into the abortion realm for an abortion doula. So an abortion doula is going to help that person out through the experience that they're having. They might help them out in advance to get to services, to plan for what they need. They might help them out afterward with comfort care and whatnot.

MARTIN: The concept of an abortion doula might not be familiar to many people. So I asked Vicki Bloom how the role came about and how it came to be accepted in the universe of health care providers.

BLOOM: Certainly, people have always looked for support when they're having procedure. And that support might have happened informally through a friend. It might have happened through a kind nurse or a kind doctor at a facility. It might have happened with people who are helping someone access abortion. But the idea of an abortion doula that sort of came in the realm of doula work came from birth doulas in about 2007 or so, who are really looking into ideas of reproductive justice and were really starting to think about the idea that the reproductive health life of someone may incorporate all different things in those lives. And that really the difference between someone who's going through a birth experience and someone who's having an abortion are a person having a different reproductive health experience but that the same skills would be useful to help that person and that that person might still need the same kinds of care in some ways.

MARTIN: How did you become a doula to begin with? And was abortion care always part of your practice?

BLOOM: So I had been doing lab work in a corporate environment until my child was born in 2003. And then after that I realized I wanted to really get back and be doing work in the community. And I was really drawn to helping people who were experiencing life transitions. And I ended up taking an intensive about birth doula work and coming out of that intensive saying, why haven't I been doing this all my life? And so I became aware of an organization in New York City called the Doula Project. When I connected with the Doula Project, I found out from them that it was a full-spectrum organization. That is to say that they did provide this care, but they also provided abortion care in a clinic context. And was that OK with me? And I came from the context where I'm pro-choice. And once I started doing the work, I actually found it to be extremely fascinating and extremely satisfying. As the political climate has changed and abortion has become more stigmatized in some ways and more difficult to access, I find that being in the role to help someone who is seeking abortion to feel OK, to feel good about themselves, to really feel like, you know, they're a person who deserves respect, has actually become quite important to me.

MARTIN: The first thing that comes to mind is how do people find you? Like, how do people even know that somebody like you exists?

BLOOM: The majority of people who work as abortion doulas do work as activists of some sort. So they're not necessarily finding private clients who are thinking, oh, I need an abortion, let me go get a support person. So many, many abortion doulas who are supporting people in a clinical context will be partnered with clinical facilities. So we are a resource that's offered in the room to that person in a facility the same way that they might get a social worker consult. And then that person just has it available. So even if they haven't ever heard of it before, they have this person available.

MARTIN: So when you first got into this work, did you see it as political? And I wonder what it feels like now to be an abortion doula in this moment when, you know, all these issues around reproductive health and care are so highly polarized, so politicized, you know, the volume is so high.

BLOOM: There's part of me that feels in some way it shouldn't be political. Because really what I am doing in my heart is sitting there and providing human care to somebody who needs human care. But obviously, considering the political climate in America and considering the restrictive laws that are happening in many, many states and that will probably continue to happen in certain places, you can't not be political in the sense that it's a political topic. And just being involved in abortion care is inherently political for where we sit right now in the United States.

But our activism is personal care for our organization. We are not a political lobbying organization. But it comes up and it comes up for people. When we talk to people who are having abortions, they are going to be coming in with whatever trauma, whatever thoughts they have that come from family, from TV, from friends, from perhaps protesters that might be outside the door. And they're coming with all of that. In them, they may be coming with conflict themselves where they feel that they need abortion care, but they also have some conflict in themselves around getting abortion care. And so they may need some help providing self-care that they need. So it's political because it's in the middle of politics. But ultimately, I feel like human care shouldn't be political.

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MARTIN: But as abortion bans are put in place across the country and states act to criminalize abortion providers and, in some cases, those who seek or obtain abortions, doulas who provide support could also become a target. Balancing the risks of being an abortion doula in a post-Roe world, that's coming up.

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MARTIN: Your work in New York, a state that has not made abortion illegal - but across the country, people who do the kind of work that you do could face criminal charges. I mean, there are many states right now that are not only criminalizing the people who actually perform abortions, there's an attempt to criminalize or at least expose the civil liability anybody who assists in any way. And that would be you. I just wonder if you and your colleagues have talked about that. And what are your thoughts about it?

BLOOM: Well, I will say that, yes, we are in a privileged place working in New York City where protections for abortion right now are good and are being reaffirmed. And we expect people to be traveling to New York City for care. But one of the things that really has changed that we were talking about, about the availability of medication abortion, is it's very private. And people can get pills and complete the procedure on their own. And with doula support, like things like a confidential hotline, it's blinded on both sides so that client doesn't know who they're talking to, and the doula doesn't know who they're talking to. They just know that they're talking to somebody who needs support in their medication abortion. And so there are some protections there. But I think the people who do this work just feel like it's important enough to do it, even though there are risks.

MARTIN: Are you ever afraid? I mean, abortion clinics have been bombed, as we know. People who have engaged in other acts of domestic terrorism are often connected to attacks on abortion clinics.

BLOOM: There are definitely risks of being a public abortion doula, and I've been public as an abortion doula for many years at this point. I have received nasty notes through social media. I have received a thing or two through the mail where people have figured out where I live. So there are risks, but at the same time, this work is so important.

MARTIN: I know - I can tell you that any time I've done an interview on this topic where I have not, like, condemned the person that I'm talking to, I've gotten, you know, hate mail from people saying, you know, how do you live with yourself? How do you - I mean, just even for talking about it in a manner that does not condemn the work itself. I mean, we've had - as you would imagine. And of course, we also interview people who do not agree with a right to access abortion care. So - and I just, you know - does that ever get to you? Do you ever think about that? How do you respond to it?

BLOOM: Well, I feel very strongly that reproductive health care - whatever the outcome a person is having from their pregnancy is reproductive health care - that is tied into bodily autonomy that all people deserve. I feel philosophically unconflicted about that. However, when I have spoken to people personally, sometimes when I don't want to have conflict, I may gloss over the details of what I do. I might focus on my birth doula work more than on my abortion doula work. You know, I think that people can be in philosophically different places about when life begins, about what can be a person, etc., etc. But the fact is, because those are philosophical questions, we cannot legislate them. We are never going to come to a coherent answer. And so we need to leave it to individuals and their medical teams and their personal support to think through those things for themselves.

And as a full-spectrum doula, not only am I very supportive of people who want to access abortion, I'm also very supportive of people who may want to have a baby who may not be supported in having a baby, like teen mothers, say. This is really the reproductive justice context, that people should be able to decide what happens in their reproductive life, both to have children and not to have children.

MARTIN: Vicki Bloom is a certified doula. She provides care across the spectrum of pregnancy, from birth to support with fertility issues, pregnancy loss and support for those who choose to terminate a pregnancy. Vicki Bloom, thank you so much for joining us and sharing this information about your work.

BLOOM: Thank you very much for talking to me today. This was lovely.

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MARTIN: It's CONSIDER THIS from NPR. I'm Michel Martin.

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