'There's a huge fear': A post-Roe world leaves uncertainty for abortion doulas

·National Reporter and Producer
·5 min read

Mariah Brown’s job as an abortion doula in Alabama ended the same day the Supreme Court struck down Roe v. Wade.

Doulas, people trained to provide support to pregnant women, are often associated with birth and postpartum care, but they can also help with abortions and other health-related events. They do not directly perform the abortions.

As an abortion doula, Brown provided educational, mental and emotional support for women who decided to terminate their pregnancy. “I would sit in on some of those counseling services where the nurse and the doctor would go through everything that was going on,” Brown recalled to Yahoo News. “I would hold your hand, I would talk to you, I would breathe with you. I would pray over you, whatever it is that you needed me to do. My biggest focus was trying to maintain and be the person that I felt like I would need if I was going through the process.”

There were several people in the waiting room in the Alabama clinic when the television there broadcasted the Supreme Court’s decision to overturn the federal right to an abortion. Alabama promptly began enforcing its abortion ban in the state.

“At that moment, they get there, and they’re getting ready to start the process. And just to be able to find out in that moment that this is something that’s no longer accessible to you, it was heartbreaking,” Brown said. “And just knowing that not only were they not going to be able to receive those services, but that my work here ended as far as abortion care was concerned. It was heartbreaking, all over again.”

“We had people that had traveled from as far as Texas, where there had already been a law that had been instated where they were limited as far as access to care,” Brown said. “It was so overwhelming. Our entire staff had to take a break and take a step back. We all cried that morning.”

Alabama’s 2019 Human Life Protection Act, which was not in effect until the Roe reversal, makes it felony to perform an abortion in the state unless the mother’s health is in danger. There’s no exception for rape or incest.

The abortion care at Brown’s Alabama clinic immediately ceased to avoid criminal charges. “There’s a huge fear. Especially in this state, where you know that there’s an aiding and abetting law, and you’re not really sure about the full legalities or how far that goes. I don’t know if I could get in trouble for telling you which state to go to,” Brown explained.

Doulas in other states were also affected by the Supreme Court decision. Andrea Johnson, a volunteer abortion doula in Ohio, described to Yahoo News how her state’s new “heartbeat bill” changed the abortion landscape.

“In the state of Ohio, once the fetal heartbeat tone is observed, or is noticed by the doctor we can no longer provide abortion services. And so what we’re doing is providing care for them in other ways. So it might be providing information or funding to obtain services elsewhere,” Johnson said.

“I was actually on a volunteer shift when the Roe v. Wade decision came down formally and was publicly made known,” she said. “And so that was a very difficult day to be there on site.”

While dozens of Republican-led states have limited abortion access, other states have sought to provide abortion services to people from neighboring states. Doulas can be part of that as well. “Being able to help people through this transition can be very scary and sometimes sad and sometimes it can cause you to be angry. It can cause issues within your family and your friendship groups. I really wanted to show up for people in a way that they needed support,” said Kalyn Coghill, an abortion doula in Richmond, Va.

As an abortion doula, Coghill helps with transportation to and from appointments, and provides child care and practical support.

“Abortion does not just include abortion itself. It can be D&C [dilation and curettage, a procedure that removes tissue from the uterus] from something traumatic. It could be a stillbirth and needing a D&C afterwards. It could be miscarriage and there's still fetal matter within the uterus and the uterus still needs to be cleaned out,” Tracie Collins, CEO of the National Black Doula Association, a group that connects families with doulas nationwide, told Yahoo News. “Also now what is included is funding resources, areas where abortions can be safely performed and that the medical practitioner providing the abortion and the person receiving abortion are protected legally.”

After Roe v. Wade was overturned, North Carolina doula Ashley Davis saw a greater need for abortion doula work. “Now because of everything that’s going on, this is what’s needed,” said Davis, the owner of Dandelion Legacy Doula and Wellness Services, which offers multifaceted doula care including fertility, birth, postpartum and abortion care.

“Just because it did not end in a live birth does not mean that they’re not going to deal with hormonal changes that can trigger postpartum depression, postpartum psychosis, postpartum anxiety — all of those things can still happen,” Davis said.

As states continue to ban or restrict access, abortion doulas say they are facing an additional burden. “Now you have to really be mindful of the state laws. What states are banning abortions and how many people do they have on their calendars? They’re going to be canceling appointments and they’re going to need places to go. It’s intense, it’s intense to keep track of,” Davis said.