{"id":237425,"date":"2010-01-27T07:00:00","date_gmt":"2010-01-27T12:00:00","guid":{"rendered":"http:\/\/www.rhrealitycheck.org\/blog\/2010\/01\/27\/raising-unheard-voices-compassionate-care-across-spectrum-pregnancy"},"modified":"2010-01-27T16:22:12","modified_gmt":"2010-01-27T21:22:12","slug":"the-doula-movement-making-the-radical-a-reality-by-trusting-pregnant-women","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/237425","title":{"rendered":"The Doula Movement: Making the Radical a Reality by Trusting Pregnant Women"},"content":{"rendered":"
\n

\n\tThis article is the first in a series on reproductive justice issues\u00a0 developed in partnership between RH RealityCheck<\/em> and the Pro-Choice Education Project<\/a>.\u00a0\u00a0\n\t<\/p>\n<\/blockquote>\n

\nThree years ago I became a doula. Early in my training, I
\nbecame part of a conversation that focused on providing doula support for all
\nof a pregnant person\u2019s choices, including abortion. Since that time, I have
\nserved more than 100 pregnant people as part of The Doula Project in New York
\nCity. The project was founded on the idea that pregnancy is a spectrum and that
\nas female-bodied people we may experience any and all of the possibilities that
\nspectrum contains in a lifetime. Within that, we should also have access to
\ndoula care for each of our pregnancies.\n<\/p>\n

\nThe Doula Project has served over 500 pregnant people since
\nthe fall of 2008, guided by the mission of providing free compassionate care
\nand emotional, physical and informational support to people facing birth,
\nabortion, fetal anomaly, or miscarriage. The foundation of our project is built
\non meeting pregnant people where they are, something I’ve taken with me from
\nworking four years in the reproductive justice movement. This connects to our
\nbelief that pregnant people should be trusted to make the choices that are best
\nfor them and that their experiences and the memories of those experiences
\nshould be honored.<\/span>\n<\/p>\n

\nDoulas hold a unique position in health care as non-medical
\nlay people who are there solely for the pregnant person. The birth doula
\nmovement has certainly grown over the past few years, and innovative and
\nradical projects have expanded care for pregnant people who might otherwise not
\nreceive it, such as young mothers and women in prison. During this time, The
\nDoula Project has been building on a new model of doula care: one that supports
\npregnant people having abortions and choosing adoption.\n<\/p>\n

\nDoulas in Abortion Care <\/span><\/strong>\n<\/p>\n

\n
\nCompassionate care and emotional support are not new to the practice of
\nabortion. Counselors and patient advocates have been serving as ‘doulas’ for
\nyears, providing a hand to hold and an ear to listen during procedures.
\nHowever, many clinics do not have the resources to provide this intensive
\none-on-one care. The Doula Project began its services with this in mind, as a
\nway to support not only pregnant people seeking abortions, but the clinics
\nproviding them.<\/span>\n<\/p>\n

\nMany components contribute to the well-being of a pregnant
\nperson terminating a pregnancy and different medical staff supply different
\ncomponents of care. The doula’s primary role is to serve as a continuous
\nuninterrupted presence before, during and after each client’s abortion, and to
\nprovide various emotional, informational, and physical comfort measures. This
\ncan include massage, hand holding, reassurance, providing clarity around
\nprocedures and birth control methods, or engaging them in conversation. Each of
\nthe support measures we offer and how pregnant people react to them vary from day
\nto day and depending on the procedure taking place. I can highlight the diversity
\nby giving an account of my most recent day in the clinic with four patients who
\nwere having 2nd trimester abortions.<\/span>\n<\/p>\n

\nSince patients are normally under general anesthesia during
\nthis procedure, doulas spend the majority of our time with them before they
\nenter the operating room. The first woman I supported that morning was in her
\nearly 30s, Spanish-speaking, religious, and scared. I spent my time with her
\nholding her hand, wiping her tears, and telling her it was going to be ok and
\nthat she would be safe, in my own broken Spanish. My next client was having
\nstrong cramps from measures that were taken to dilate her cervix, and so I gave
\nher a lower back rub and massaged a pressure point on her hand. After her
\nprocedure, at her request, I went to the waiting room to tell her husband and
\nsister that she was fine and would be discharged in a couple of hours. The next
\nwoman I met mostly wanted to be alone, so I checked in with her every few
\nminutes to see if she needed anything and pulled the curtain closed around her
\nbed. My final patient was a gregarious, talkative young mother. I brought a
\nwarm blanket and a hot water bottle for her cramps, and spent the next 30
\nminutes with her talking about her future job prospects, different kinds of
\nbirth control she might like, and just joking around.<\/span>\n<\/p>\n

\nFrom my experience, this is a pretty average day in the life
\nof an abortion doula, with varying levels of intensity. Meaning, pregnant
\npeople need us for different things, sometimes to provide real physical comfort
\nrelief or answer a question about their procedure, sometimes to tell a good
\njoke or listen to them talk about something that’s going on in their lives, and
\nsometimes just as a person who doesn’t forget that they are there, who checks
\nin on them. To be clear, some of our clients don’t know what doulas are when they
\nmeet us.\u00a0 <\/span>They can be hesitant to
\nengage with us, especially in a public hospital like the one our project is
\nlocated in where a patient is likely to talk to 15 different people in a matter
\nof hours. However, we have not yet had a pregnant person opt out of our doula
\nservice. We attribute this to the ability of doulas to build trust quickly and
\nmeaningfully with clients and to engage with them on their terms.<\/span>\n<\/p>\n

\nAfter serving as an abortion doula, talking to other
\nabortion doulas, providers, health professionals, and the pregnant people we
\nserve, it is clear there are many benefits doulas bring to providers and to
\npeople having abortions. Providers have shared that with doula support,
\nprocedures can be less complicated and therefore quicker, due to the patient’s
\nrelaxed state. In addition, they have mentioned that it can be easier to
\ncommunicate with a patient and check in on their well-being during a procedure
\nsince the doula is so connected to the patient’s needs. Pregnant people we have
\nserved have told us that we help them feel more physically comfortable, safer,
\nand more informed and in control of their experiences.<\/span>\n<\/p>\n

\nDoulas in Adoption Care<\/span><\/strong>\n<\/p>\n

\nI met Marci Lieber, a Community Outreach & Advocacy Coordinator
\nat Spence-Chapin Children and Family Services, when The Doula Project was still
\nknown as the Abortion Doula Project, and we were mostly focused on providing
\ndoula care in an abortion context. Spence-Chapin is a pro-choice and pro-birth
\nmother adoption agency in New York City, and within a few minutes, Marci began
\nto share some of the horrific stories of their birth mothers\u2019 experiences on
\nLabor and Delivery floors: nurses and doctors not respecting the mothers\u2019 wishes
\nto have the baby taken out of the room following the birth, or just the
\nopposite, nurses not letting the mothers hold or breastfeed their newborns
\nsince they were choosing not to parent, as well as doctors and nurses
\ninflicting unnecessary medical interventions on them. Among these accounts, the
\nhardest part of all was to hear that these mothers were completely alone during
\nthese experiences.<\/span>\n<\/p>\n

\nMost people face similar issues in giving birth, such as
\nwhere they are going to deliver, how they will deliver, and with whom. For
\nthose choosing adoption, these issues can be even more complex and barriers in
\ntheir lives can make them nearly impossible to resolve. For example, most of
\nthe mothers we’ve worked with don’t shop for doctors, midwives, or hospitals.
\nThey go to the one closest to where they live, the one that takes Medicaid, and
\nthey aren’t given any information outside of what their doctor tells them. Thus,
\nthey are pretty much at the mercy of wherever they happen to end up. I asked
\nMarci, \u201cDoes Spence-Chapin have doulas?\u201d Marci said they didn’t but that she
\nwas committed to making it happen. Within 2 months, The Doula Project had
\nformed a partnership with Spence-Chapin, and we were at our first birth with a
\nyoung Tibetan woman choosing adoption.<\/span>\n<\/p>\n

\nIncidents that occurred during this woman’s birth spoke to
\nall of my worst-held fears going into the experience. Namely, that some
\ndoctors, midwives, and nurses don’t trust a laboring woman who is choosing
\nadoption. To begin on a positive note, this birth mother ultimately had a
\nvaginal delivery of a strong and healthy boy. I had the opportunity to meet his
\nadoptive parents and speak to them about the strength of their new child’s
\nbirth mother and the grace with which she delivered. What I left out of this
\nconversation was the heinous treatment she was subjected to within the
\nhospital’s doors. She experienced the cascade of interventions, which is not
\nuncommon to many women’s birth stories: pitocin (which theoretically helps
\nspeed up labor) leads to epidural leads to c-section. What was different for
\nthis particular woman was not only a complete language barrier but, perhaps
\neven more significantly, a complete cultural barrier. She was terrified of having
\na c-section – it was the one thing she told me could absolutely not happen. Her
\nunderstanding of a c-section was that it meant either she or the baby would
\ndie. When the doctor told her she must get one (with little explanation as to
\nwhy) and she refused, she was branded a murderer. Hospital administration was
\ncalled into her delivery room and they told her that they were going to force a
\ncourt-ordered c-section on her. This was after hours of being denied a medical
\ninterpreter and 40+hours into her labor. The statement that most reflects the
\nmedical professionals’ attitude toward her that night was by a nurse who said,
\n"Just because you don’t want the baby doesn’t mean he should
\ndie." <\/span><\/span>\n<\/p>\n

\nI don’t want to give the impression that mothers choosing
\nadoption have the same doomed experiences as the one I’ve shared. Many mothers choosing
\nadoption do, in fact, have the support of their family and friends and positive
\nbirth experiences. Our doulas work with those who need extra support and feel
\notherwise isolated in their pregnancies. And it is their experiences that I
\nintend to raise awareness about. I also want to emphasize that mothers choosing
\nadoption are not helpless victims of the medical system. The Tibetan woman ultimately
\nhad the vaginal delivery she wanted because she was a strong advocate for
\nherself.\u00a0 <\/span>Even though many of the
\nmothers we work with claim to not know the first thing about childbirth, they
\ndo come to us with a birth plan, if only in their heads. Our job is to help
\nthem articulate what they feel is best for them, give them further information
\nabout the process, and serve as a silent but strong advocate for them in the
\ndelivery room.\u00a0\u00a0 <\/span>\n<\/p>\n

\nConnecting to the Doula Model of Care<\/strong><\/span>\n<\/p>\n

\nOne of the first things we discuss with new volunteers is
\nwhat a privilege it is to be in these rooms. To bear witness to such important
\nmoments in people’s lives and to be the one person they might remember among
\nthe sea of faces is really gratifying.\u00a0\u00a0Doula Project Co-Founder and
\nCo-Coordinator, Lauren Mitchell is often blown away by the power of a doula’s
\nquiet presence. "You can’t speak for your client, even if what’s going on
\nis the opposite of what she wanted – you’re not in control of the room. But you
\nare in control of what you are giving your client, and that is an informed ally
\nand a deeply empathetic presence. When you’re a doula you have to acknowledge
\nhow to be ‘human’ even when you want to be more than that. What keeps me going
\nis the feedback from the clients that the space that I’ve created for them is
\nunique and extremely important."<\/span>\n<\/p>\n

\nWe’ve
\ncontinued relationships with several of our clients: some we go to the movies
\nwith, some are interested in joining the project or getting trained to be birth
\ndoulas, and some even speak on behalf of our organization. Ultimately, we believe
\nthat providing pregnant people with the resources, tools and the support they
\nneed can lead to empowering birth and abortion experiences that can affect the
\nrest of their lives and even have a positive effect on their communities. One
\nof the most common things I hear, other than \u201cThank you for being here.\u201d is \u201cYou
\nhave such a cool job, I want to be a doula.\u201d When people feel taken care of,
\nwhen they know what it’s like to be treated well, they want others to feel that
\nway. It’s a model of care that people feel deeply connected to and one which
\nthey have the personal resources to provide to someone else.<\/span>\n<\/p>\n

\nIf
\nyou are interested in connecting with The Doula Project you can visit our
\nwebsite at www.doulaproject.org<\/a>. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

This article is the first in a series on reproductive justice issues\u00a0 developed in partnership between RH RealityCheck and the Pro-Choice Education Project.\u00a0\u00a0 Three years ago I became a doula. Early in my training, I became part of a conversation that focused on providing doula support for all of a pregnant person\u2019s choices, including abortion. […]<\/p>\n","protected":false},"author":4743,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-237425","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/237425","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/4743"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=237425"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/237425\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=237425"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=237425"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=237425"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}