A doula, traditionally, was trained to support a pregnant woman through her delivery, explained a facilitator from a group called D.C. Doulas for Choice. Traditional doulas weren’t medical professionals, but they could hold hands, offer distraction, supply heating pads. In a roomful of doctors and nurses focusing on the delivery of a healthy baby, a doula was focused solely on the emotional well-being of the mother.

But here at a weekend-long training at a Virginia abortion clinic in May, 25 women who’d seen the flier for abortion doulas arrived to see if they were right for the work. Half would finish training and become committed doulas.

D.C. Doulas for Choice, a volunteer-based collective, believed pregnant women needed equal support if they decided not to become mothers at all, the facilitator explained. And so, if the aspiring doulas in this room made it through training, and apprenticed through a series of shadow shifts, then this is what they were signing up for: To be in a surgical room with a woman through one of the most intimate emotional experiences of her life; to hold her hand while she has an abortion.

To be an abortion doula meant being a part of the pro-choice movement at its most granular, most personal, where philosophical debates fell away.

The training

Over the course of the weekend-long training program, volunteers learned the mechanics of the procedure (i.e. what each medical instrument did), went over a list of neutral phrases and topics and participated in role-play.

“We’re going to come up with a mission statement,” Lindsey, the facilitator, had said at training. A sentence-long definition of what this class of doulas wanted to represent.

“Nonjudgmental,” someone called out, and Lindsey wrote it on the whiteboard. “Client-centric,” suggested another. Lindsey wrote down everything, adding semi­colons, transforming the suggestions into an unwieldy sentence. “Anything else?” she asked.

From the back of the room, a doula named Grace half-raised her hand. (Grace, like other women in this story, is not being identified by her full name, because of the sensitivity of the topic.)

“A doula is water,” she said.

“Explain that?”

“Taking the shape of whatever role is needed,” Grace explained. “Like water.”

From the whiteboard, Lindsey nodded. “If someone getting an abortion calls it a baby, it’s a baby,” Lindsey said. “If she calls it a fetus, it’s a fetus. If she doesn’t say anything, don’t talk about it.”

She turned and wrote on the whiteboard: “A doula is water.”

An abortion doula’s work

An abortion was a five-minute medical procedure, and an abortion was a query into the literal meaning of life. It was the reason some people voted for presidents, it was a small collection of cells.

Nationwide, abortions were down, which some conservatives saw as a moral victory and some liberals saw as a sex-education victory. Even the Virginia clinic where the doulas primarily volunteered now saw a dozen patients on a busy Saturday instead of the 20 or 30 it once had.

Every possible thing that could be said about abortion had been said, but a lot had been said speculatively, because people with experience were too afraid to talk about it out loud.

Abortion was a secret. Abortion was almost always a secret.

“How are you feeling?” Tahira asked the first patient of the day as Grace sat next to her, observing, on the morning of her first shadow shift. She’d been assigned to shadow Tahira, a woman who’d been volunteering with D.C. Doulas for Choice for several years.

“Not great,” said the woman, curling her hands into the sleeves of her sweatshirt.

Twenty minutes earlier, Grace had turned off the “find my friends” app on her phone, so her parents — who lived in a conservative state — wouldn’t see her pull into an abortion clinic. She was a birth doula who became interested in becoming an abortion doula, too, after her own abortion experience. It had been a compassionate one.

She parked in the garage of an office park where protesters outside carried signs reading “Everyone deserves a birthday.”

Now she was wearing turquoise scrubs and sitting in a carpeted room that had a Bible on the table and a small fountain plugged into the wall.

“You’ll sleep just for a few minutes, but it will feel like you slept for hours,” Tahira told the patient, answering a question about anesthesia. The anesthesia wasn’t required, but a lot of women who came here requested it. “You’ll wake up, and you’ll have something to eat in the patients’ lounge. We’ll be with you the whole time.”

“Could I ask you a question? I’m bad with needles. When I wake up, will the needle from the anesthesia still be in my arm?” the woman wanted to know.

The woman didn’t offer why she was having an abortion. She didn’t say anything about her pregnancy. Tahira had explained to the patient that doulas were free, voluntary, and there to offer comfort. The patient had responded, “I could really use that right now,” and that was the only thing about her they knew.

A little while later, Tahira and Grace stood in the surgery room with the patient, a doctor, a nurse, an anesthesiologist. “Take a big breath, look at me,” Tahira told the patient as the nurse adjusted her feet and told her to scoot down on the table. The patient looked up at Tahira with big eyes. “Deep breaths, we’re going to do deep breaths,” Tahira said as the anesthesiologist injected the sedative. “I know this is scary, but you are tough.”

They had been in the room with her for almost exactly five minutes. The sound of the doctor’s medical vacuum was about as loud as a Dustbuster. There was blood in a tube; the doctor worked fast. Tahira and Grace stood with the woman in the baggy sweatshirt, while in the waiting room, there were six more patients to go.

Five minutes with the second patient: Talking about whether there was anything good on Netflix.

Five minutes with the third: Talking about workout regimens, whether it was better to go to the gym every day or let muscles rest.

Five minutes: “I’m so f — -ed up about this,” the patient said, rubbing her eye with her fist. “That’s okay, that’s normal,” Tahira said. “I’m so f — -ed up,” said the patient again.

“Grace is going to be the official hand-holder,” Tahira said to the next woman, deciding her trainee seemed confident enough to take the lead.

“How early did you have to get up to come here?” Grace asked the patient, knowing some women traveled hundreds of miles. The woman had gotten up at 5 a.m., she said, but she was used to it — her daughter was an early riser.

“Every kid I meet is obsessed with tablets,” Grace said. “Any shows she’s watching?”

“Scoot down,” the nurse said to the patient. “These straps are to help keep your legs from moving.”

Down the hall in the patient lounge, women whose abortions were completed sat in a row of recliners eating crackers and juice. They wanted to know whether someone could go out and tell their husbands that it was over. Whether they would be able to go pick up their kids and play laser tag later. Whether the other women thought God would forgive them. Why they had tears running down their faces when they didn’t feel sad.

“Because there’s a lot going on in there,” Tahira said, finding a tissue. “You’re feeling a lot of things right now.”

Grace held one woman’s hand, listening as she talked about her upcoming wedding. “You’re getting married?” a different patient asked. “That’s nice.”

“It was just the worst timing,” the bride said as she gestured to her stomach.

“I know it was,” the other woman said. “I believe you.”

One woman sat in her armchair and sobbed, and when a clinic worker told her the hard part was over now, she said she wasn’t sure whether that was true.

She was scared that the hard part hadn’t happened yet, she said. That the hard part would be when her family reacted and she was left alone with her decision.

As the women left, one by one, they carefully folded their blankets. They tossed their paper cups into a waste can and said, “Thank you, thank you.”

“You can stay as long as you want,” Grace said to the woman who didn’t know whether the hard part was over. It was a little after noon. She had seen seven abortions in less than four hours. “It’s okay to cry. That’s normal. You never know how you’re going to feel.”

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