The Run Around

The collective was formed, the funds raised, and the training scheduled.  All the Spectrum Doula Collective needed, then, was a clinic to work in. 

There enlies the problem.  Although there are many abortion providers in the central-NC area, very few are willing to open their doors to our version of doula support.  One clinic manager in particular told one of our members that they "don't bring in outsiders to do [their] jobs." 

I cannot get upset by the obvious anxiety clinic workers feel when approached by someone who is, let's face it, an outsider.  Decades of threats, picketing, harassment, vandalism, anthrax attacks, bombings, arson, and shootings have shaped the way the American abortion clinic has to operate by necessity.  They can't just open up their doors to each request for volunteers: to do so could very well open a clinic up to all kinds of infiltration, breach of client confidentiality, or worse.  It makes sense that medical care providers in general would be uneasy about perfect strangers entering their most confidential areas, and the nature of abortion itself compounds these worries astronomically. 

However, I can't shake this idea that the abortion doula would be "doing the jobs" of clinic workers.  This is something that birth doulas have to face when working in a hospital environment.  Though my personal experience working with hospital staff has been overwhelmingly positive, there is a kind of unresolved idea that doulas accompany women who don't believe they would otherwise be taken care of.  Some labor and delivery nurses harbor contempt for the doula, as if the doula is there to "correct" whatever care the nurse is there to provide.  Though the duties of the labor and delivery nurse are completely out of the doula's scope of practice, this remains one of the most common myths about doulas.  (This is not to say there aren't some "bad eggs" out there who mess with the Pitocin drip, adjust and read fetal heart monitors, even perform vaginal exams!  This is indeed not the job of the doula, and any doula who performs such a task indeed be censured by her certifying organization.)

There's something to be said for the fact that both clinics that have seemed receptive to our project proposal are manged by those with a history in labor and delivery.  These are people who have worked with doulas before, and they have both had good things to say about the profession.  If only they could let their colleagues in other clinics know what we do and do not do!

Even if we did make it abundantly clear what the abortion doula does and does not do, however, I believe we would still be getting some amount of push-back from clinicians.  After all, what are we implying by offering emotional support to their clients?  Are we saying they don't do enough of it themselves?  Are we charging them with being unsympathetic?  Most of all, are we co-opting the belief of the anti-choice camp that abortion will always be an emotionally-trying experience??

Granted nothing is further from the truth.  Our core values state that we respect and value the protection of clinics and their staff members.  We have not (and will not) ever suggest that any clinic has failed to provide quality care to its patients without witnessing it firsthand.  However, even the woman who is most confident in the abilities of her obstetrician/midwife and nursing staff might desire the non-medical support of a birth doula.  Such would not be an indictment of her care provider's failure; on the contrary, this woman might simply desire something that doctors, midwives, and nurses are either not trained or unable to provide.  This is hardly a charge of neglect or bad health care: many families see birth as a process that, while decidedly medical in some respects, can run more smoothly when a trained support person accompanies the entire labor period. 

I hope we can convey to our community's clinics that volunteer abortion doulas can enhance, not replace, the care given by providers and staff members.  It truly takes a spectrum of expertise to work with the average abortion patient: there's the first contact, the options counselor, the nurses, the doctor, and anyone who provides comfort and after-care instructions in recovery.  Adding a volunteer who is specifically trained to provide support and nothing but support can only enhance the work provided by the team of clinicians.  Additionally, the unfortunate fact that many clinics in this country are under-staffed and over-worked means that the average clinic worker can only provide so much support to each individual patient.  This is not a charge of their ability to provide such support, however; it is a charge against those who have made one of the most common surgical procedures performed in the U.S. into an event riddled with silence, stigma, and shame.  And I guess really, that's the whole problem.