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In April 2020, a month into covid-19 stay-at-home orders, Hannah Taleb, an abortion doula with Tucson Abortion Support Collective (TASC), was driving a client to an abortion clinic in Phoenix in the early hours of the morning. According to TASC, there are only two abortion clinics in Tucson, and only one of the clinics is able to do surgical procedures, leaving appointment slots to fill up quickly.

On the two-hour drive to the abortion clinic, the two women wore masks with the windows rolled down. Her client cried as the heaviness of the moment dawned on her, Taleb said, so she pulled over to the side of the road and comforted the client, offering to talk.

“She was like, ‘Well, we have to get there,’” Taleb said. “I tried to put on nice music. I was very upset afterwards. I felt like I failed that person.” From mandated masks to social distancing, the pandemic made it more difficult to provide emotional support, Taleb said.

An abortion doula is a person who provides emotional, informational and logistical support to a person who is seeking or having an abortion. Abortion doulas often work independently, in a collective or within abortion clinics to provide services to clients. Many abortion doulas finance their work through donations from supporters, which allows many to offer free services to clients. Abortion doulas with independent practices offer varying rates based on the requested service. During the pandemic, their roles have shifted; they have had to help abortion-seekers navigate the ever-changing laws that put specific limitations on how abortions can be conducted.

Hannah Taleb in Tucson in July 2019. (Hannah Taleb)
Hannah Taleb in Tucson in July 2019. (Hannah Taleb)

Indeed, the covid-19 pandemic shifted how people were able to access abortions. Many clinics shut down amid stay-at-home orders, and in March 2020, some states deemed surgical abortions “inessential health care,” making the procedure briefly unavailable in certain places. State and federal legislation also placed restrictions on medication abortions, making it more difficult for those who quarantined at home or wanted to self-manage their abortions.

Before the covid-19 pandemic, abortion doulas were generally allowed to be present in the room with the client when the procedure took place to provide emotional support. However, abortion clinics have largely limited the number of people in the clinic, from check-in for appointments to surgical procedures.

Yamani Hernandez, executive director of National Network of Abortion Funds, said legislative restrictions on abortion increased the need for support for abortion-seekers. “There needs to be some mechanism for supporting people who need help,” Hernandez said. “Otherwise, people will be stuck and forced to carry pregnancies that they never intended to carry.”

Hernandez credits abortion doulas, especially those who support abortion-seekers on a local level, for organizing and providing necessary care. Hernandez is a volunteer with the Chicago Abortion Fund and said she regularly witnesses the impact that abortion doulas have in providing practical, emotional and financial support to abortion-seekers.

“When people are navigating all of these logistical challenges, that is probably the most stressful part. They want to get the procedure and move on with their life and they’re having to do flights and trains and planes, talk to strangers and crowdfunding,” Hernandez said. “I think having a supportive voice and partner in navigating all of that and accompanying people through the complicated logistics is really invaluable.”

Back in March 2020, Melissa Gant, another abortion doula with TASC, helped a client pick up pain medication after an abortion due to a severe fatal fetal anomaly. An hour before they arrived at the pharmacy in Phoenix, Arizona Gov. Doug Ducey (R) announced the state’s stay-at-home orders.

“The shelves were bare. There was just this frantic energy. Everyone was trying to get their prescriptions, so there was a crazy wait,” Gant said. “[I just tried] to be present and calm and stable for her in this moment while all of this uncertainty was happening around us.”

According to Gant, this is the essential service of abortion doulas: “We are walking with them through whatever they’re going through at that moment, and supporting them in whatever way.”

Melissa Gant in Tucson in May 2021. (Family photo)
Melissa Gant in Tucson in May 2021. (Family photo)

For abortion advocates, the pandemic has introduced new obstacles — and not only because of unknowns related to accessibility. A number of state legislatures have also tightened abortion restrictions. Last month, Arizona passed a law banning abortions for people seeking the procedure if the fetus has a genetic abnormality. The bill contains some provisions that include criminal charges to abortion providers and abortion-seekers and granting “personhood” to fetuses after conception. The bill also bans receiving abortion medication through mail, even after the Food and Drug Administration lifted the requirement for abortion medicine to be dispensed in person during the covid-19 pandemic.

Many other states passed legislation during the covid-19 pandemic halting and restricting surgical and nonsurgical abortion procedures, effectively shutting down abortion clinics. According to the Guttmacher Institute, so far in 2021, eight abortion restrictions and bans have been enacted into the state legislatures. Also in 2021, legislators introduced more than 384 antiabortion provisions, which include abortion bans and restrictions. Many antiabortion activists have seen these legislative changes as huge wins. Earlier this month, the Supreme Court announced that it would hear Dobbs v. Jackson Women’s Health Organization, a case that will determine whether Mississippi’s 15-week abortion ban is constitutional.

State laws aren’t the only barrier to abortion access during the pandemic, according to advocates. Many abortion-seekers also lack access to funds to obtain an abortion. With millions of jobs lost because of covid-19 shutdowns, many people lost their source of income, making it more difficult for many seeking abortions to afford one. About half of the people who seek abortions live below the poverty line. The cost of an abortion can vary by state and by stage of pregnancy, but the average cost of surgical and medication abortions at 10 weeks of pregnancy can be more than $500. The average cost of an abortion at 20 weeks can range from $500 to more than $3,000.

Yemisi “Yemi” Miller-Tonnet, an abortion doula from Atlanta, organized with Access Reproductive Care-Southeast in March to raise funds for people who can’t afford to access an surgical abortion or abortion medication. During the pandemic, Miller-Tonnet also worked the front desk at an abortion clinic on the weekends. She said many of the people who came in seeking an abortion told her they struggled to access funds for the procedure.

“It’s important to realize that folks have families. They might have two other children at home or they might be in school or they have other expenses that are important to their survival,” Miller-Tonnet said. “They might be the sole breadwinner. It really can stretch people thin to come up with $500, $1,000. Of course, the longer you wait, the more invasive the procedure can be and the more expensive it is. So it definitely puts people in a tight spot.”

Yemisi “Yemi” Miller-Tonnet taken in October 2020 in Atlanta. (Patricia Villafane)
Yemisi “Yemi” Miller-Tonnet taken in October 2020 in Atlanta. (Patricia Villafane)

Miller-Tonnet fundraised on social media and in person to help ARC-Southeast reach their goal of $60,000 to be able to distribute the money to people seeking abortion services.

As the future of abortion rights hangs in the balance, Taleb believes that abortion doulas have offered invaluable care to those who have sought abortions in the pandemic.

“The things that people need are so basic,” Taleb said. “And we have been able to build up to be like, ‘We have money and we have rides.’ And sometimes it’s not more complicated than that. This person feels strong and ready in their decision, and we were able to just offer them the tools they needed to step into autonomy in their own lives.”

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