This week, I am deeply grateful to feature the profound insights of Lindsey Uhrig, who writes on her experience as an abortion doula as part of her work offering full spectrum doula support. From her vantage point, Lindsey has a deeply meaningful perspective and understanding and the process and experience of abortion, what happens when we don’t speak openly about it, and how to best support those exercising their right to choose. Lindsey’s words are below. 

I have crammed about 25 people in the open lobby of a privately run women’s health clinic in the  DC area. A clinic I have volunteered at for six years and was employed at for one.  A clinic that uses the term “women’s health” to describe its broad menu of gynecological services although most of what the clinic offers is abortion services; medical and surgical. The term women’s health acts as a thin veil to those that oppose this necessary and normal work and a subtle wink to those seeking services. The lobby is decorated with calm paintings, fake flowers and even an electric powered fountain. Affirmative phrases and sayings are scattered on the walls leading to the procedure rooms and leather recliners line the walls of the recovery room. To enter this space the 25 people sitting before me have walked through a discrete building into a doctor’s office making very obvious attempts at comfort and calm. The people I’ve gathered here are interested in becoming abortion doulas, serving the clients of this clinic on the day they arrive for their first trimester surgical procedure. The gestational age of the pregnancy is important for the state by state legislation that allows or denies these procedures to take place. For some patients the gestational age has been a looming deadline hanging over their heads determining if they will or will not receive medical services as their days have been consumed with state required doctor’s appointments, waiting periods and a search for financial support for a routine medical procedure often not covered under insurance. Although 1 in 3 women will find themselves seeking abortion services, the same 1 in 3 will encounter countless barriers to care imposed upon them by an overwhelming lack of services, lack of finances and lack of cultural support.

For the people I’ve gathered in this room, the idea of being abortion doula feels like a way to live their pro abortion politics, a way to heal from their own reproductive health experiences or even a way to expand their role as a doula in the birth world. It is my job to honor their intentions but to convey that the role of the doula, although intimate is not personal. That while they each have a unique story for why they came to this work, their stories must be left at home. To be a doula is to show up selflessly and to constantly remind yourself; it’s not about you. As a trainer of these new doulas, I will myself have to sit in this role; holding space for the budding support people I’ve gathered here, allowing them to process the training and the information I will offer them without telling them what is right or wrong, without judging them. This role can get sticky.

A great deal of the training is about dispelling myths about abortion care and learning what options are available to the patients we will encounter. Abortion care is clouded in secrecy. Its true nature only revealed by those who have had direct experience with the process. Many patients we meet have pre conceived notions of what they will endure based on biased media portrayals or horror stories told through the proverbial grapevine. It is our culture’s habit to shroud life’s natural and intense processes in this secrecy. We don’t witness and speak of the realities of birth and death and we have conversations of life’s processes often only in metaphor and flowery language. Real intimacy and intensity is not our go-to. When we do speak of the human body in the public sphere it is often with a lens of judgement. There are far too many sources out there to remind you you’re never eating the right thing, doing the right exercise or getting pregnant at the right time. According to these culturally imposed standards you can always be doing better. Those of us identifying as women often feel the brunt of this judgement to a greater extreme in the context of abortion care. We’ve been given the burden of pregnancy complications while existing in a number of systems that leave us choiceless and often voiceless, sometimes coerced and abused.

One of the myths of abortion care is the narrative of pain and suffering accompanied by compassionless care. A lot of patients are unaware that the procedure is quick, requires no incision or hospital stay and can sometimes be done under anesthesia. A first trimester abortion has a 1% chance of leading to perforation or laceration and a 1-3% risk of infection. Facts like these will be a crucial part of this training of doulas so that their presence in the clinic can reassure patients but also subtly begin to shift the narrative. Another common narrative is that of the young and helpless patient in tears and filled with doubt.  It has been my experience that there are as many smiles as tears, more certainty than doubt, and a great deal of patients that are already mothers. No, abortion care is not an easy process for all the people that I’ve encountered but it is a reality that most of us face with more awareness and strength than the common narrative gives credit. I teach the realistic narratives to these future doulas so that they can support the happy and calm patient as well as the nervous and sad one.  

Throughout my work, the one sentiment that I see repeatedly from patients is one of self deprecation. Given that we only speak of abortion in negative, scary or judgemental language, many patients see their abortion care as their personal failing. Whether or not they are politically or spiritually comfortable with the concept of abortion, many  experience feelings of self judgement. It will be the role of the doulas I’m training to sit with this  discomfort , to listen, and to offer perhaps a glimpse of self care. I stress the role of societally imposed self doubt and hate so that doulas know how vital their accepting presence really is. These doulas will be a friendly face that showed up to say “it’s all normal, you are a good person, this is OK”.

As we go through the training, myself and other seasoned doulas offer up common scenarios and role plays, we conduct exercises meant to challenge internal and unconscious biases of our future volunteers and we will teach non verbal and physical support techniques on how to hold space for the human experience. A doula’s skills are translatable in all situations. The way a doula supports a woman in labor is the same way they’ll hold space during an abortion, miscarriage, stillbirth, fertility issue or even through death and dying. Our role is not necessarily sympathy and often it is not even true empathy. t is unconditional, non judgemental, person affirming support. There will be time to feel with this person and sometimes we will feel deeply and in an all consuming way but our primary goal is normalizing an often challenging experience. It is to say: I hear you, I can’t fathom what you’re going through but I can listen to your experience, hold your story and bare witness to this process.  I can remind you that to be human is to be flawed, constantly changing and perfectly imperfect. 

My intention for each training I’ve led is to teach the unique role of the doula because if this role is done well, it has the power to create large change. In a healthcare system that claims to be based on the consumer, doulas can empower those consumers to speak their minds and demand more conscientious care. In a society that quiets stories of the human experience, doulas provide a listening ear and a louder voice for the experience of our fellow community members. By offering a space without judgement, doulas lead by example to create a world that is less divisive and more inclusive. A doula is described as one who serves and although this role has predominantly been seen as something simple or lesser than, I know it is the way to heal a society hell bent on individualism and judgement as the only path. 

So what will these new doulas actually do at the abortion clinic? I tell them that sometimes my days are simply filled with serving crackers and pouring apple juice for those waking up from anesthesia. I’ve spent whole days organizing bins of old scrub uniforms. I sometimes find myself with just one patient to serve. The job will have a lot of unglamorous parts to it. On some days, though our job will be to translate medical information into layman’s terms, encourage patients to ask questions and speak up on their own behalves, hold hands and stroke shoulders and remind people to breathe slowly. We will laugh and joke and wipe the occasional tear. We will normalize. We will not claim to know or understand what each patient will and does feel, it is not our role to tell them that it will or won’t be comfortable or uncomfortable. Our job is to validate whatever happiness, relief, sadness, guilt, ease, peace or pain that is felt. Our job is to show up.

Although the abortion procedures we will support are only 5-7 minutes in length, Our presence on an otherwise uncertain day might provide a bit of grounding and calm. As we begin the training day in that warmly lit and welcoming lobby at the health center, I feel overwhelmed with passing this torch on to so many new faces with new perspectives; I worry if all of this will translate. I struggle to find my own grounding and calm but I know, that no matter the outcome, I will leave this training as I always do, feeling reinvigorated and excited;  reminded of the emotional healing found in unconditional, non judgemental support.

Lindsey Uhrig

Lindsey has supported hundreds of families in the DMV area as a full spectrum doula, prenatal yoga teacher, birth educator, former clinical health educator and newly minted energy worker. Lindsey fell in love with birth work as a young raging feminist looking for a way to take the patriarchy down. After a brief stint coordinating international development programs in newborn and maternal health she began to understand the power and effectiveness of community health initiatives and the ability of individuals to create change . Seeing doula work as the greatest effort in direct service community health, Lindsey dove in to her training with a little apprehension and a ton of passion. Lindsey believes that the coercion and negative treatment of pregnant people is a humans rights issue and that reproductive health is an obvious arena to see systems of oppression collide and impact individual options. Lindsey is humbled to support people through some of the most intense moments of their lives

Professionally, Lindsey is certified through Lamaze to teach birth education, trained with DONA to continue to support laboring people and certified to teach prenatal yoga. She serves all people seeking support along the reproductive health spectrum. Lindsey gets to do fun things like help with doula trainings, guest lecture at community centers and universities and tell people they are indeed strong enough. Lindsey also serves as an acting member and one of the lead trainers for a collective of doulas serving abortion clinics in her area. Her other interests include travel, bargain shopping and the pelvic floor.