Doulas can help during abortions, but say they can’t get into Philly-area clinics

Kelly Kolb would love to be able to do the work for which she’s been trained: helping pregnant people get through abortions.

The problem, said Kolb, 50, a doula from Glenside, is that “most clinics where abortions are done don’t allow us in.

“If I can’t be in there, how can I help?”

Doulas (from the Greek for “female helpers” or “servants”) most commonly offer pregnant people guidance and education, as well as physical and emotional support through childbirth.

Many doulas are “full spectrum” like Kolb. This work includes “the whole birth journey,” she said: pregnancy, birth, miscarriage, bereavement over fetal loss, postpartum issues, and abortion. Some doulas are certified, licensed, and insured, but they’re not required to have medical training. Abortion doulas are not reimbursed by insurance companies.

Patients have said doulas are extremely valuable in supporting them with the psychological and emotional aspects of birth.

When the pandemic started, doulas were barred from abortion clinics. “And we haven’t been able to convince facilities to bring us back,” said Vicki Bloom, one of the leaders of the Doula Project, a New York City-based nonprofit that supports abortion patients nationwide with a 24-hour hotline open to pregnant people.

Beyond COVID-19, abortion doulas say, other factors are keeping them out of clinics. “It’s a charged atmosphere right now,” Bloom said.

After the U.S. Supreme Court rescinded the constitutional right to abortion when it reversed the Roe v. Wade decision last year, the fallout has made the always-fraught standoff between antiabortion activists and abortion advocates that much more heated, Bloom said. Abortion clinics have, in turn, become more vigilant about who’s allowed in their facilities, with many of them keeping out the very people who believe they can help, Bloom said.

Meanwhile, doulas say, the end of Roe has meant that many people wanting abortions must now travel long distances — often with children in tow — from states that have tightened abortion restrictions to unfamiliar cities to get their procedures. It would be helpful, doulas conclude, to be able to offer knowledge and comfort to patients who feel alone.

“We’ve got the skills, but not the ability to use them,” Bloom said.

On the scene since around 2008, abortion doulas are in a niche field. “Lots of people don’t even know we exist,” Kolb said. “And I have few ways to find patients.”

Many abortion doulas don’t get paid, believing the work is important enough to volunteer their time. These doulas often live off their earnings from performing birthing doula work, which can bring in $800 to $1,500 per person, or from doing postpartum doula jobs that can garner $30 to $40 an hour, Kolb said. She left a biopharmaceutical job to become a doula in 2015.

Bloom remembers the time when at least some doulas could station themselves alongside licensed physicians or advanced practice clinicians during abortion procedures.

“The reason the doulas were in there while the abortion was going on was strictly for the personal care of the patient,” she said. “Many would have conscious sedation and we’d help them feel calm as the abortion proceeded — holding their hands, getting a cool cloth for their head, breathing with them, distracting them, and just handling anything emotional so the doctor could do her job.”

These days, around 55% to 60% of the 8,000 patients who seek abortion care annually at Planned Parenthood Southeastern PA receive oral medication to terminate a pregnancy, according to president and CEO Dayle Steinberg. The rest undergo surgical abortion procedures.

“Because of patient safety, security, and privacy, we ask patients to come in by themselves for these procedures,” Steinberg said.

The current rule is that if a person seeking an abortion wants a doula along, the doula would have to be a registered Planned Parenthood volunteer who underwent training and had secured clearances to be in the facility, she explained.

“They must be known to us,” Steinberg stressed.

Thus far, Steinberg added, “No doula has enrolled as a volunteer at Planned Parenthood.”

For her part, Kolb said, “I never even heard of this registered-volunteer thing at Planned Parenthood” until a reporter told her.

Lana Colquhoun, 28, of North Philadelphia, is another full-spectrum doula who’s never been able to work as an abortion doula.

But she understands firsthand the vital role a doula can play.

“I had an abortion myself a while ago and couldn’t have my partner with me because of COVID,” said Colquhoun, who runs a doula business called City of Birthing Love, and describes herself as “Philly’s own queer, Black doula.”

She added, “I went to another facility [in Center City] where I watched the movie 13 Going on 30 three times waiting over four hours to be seen just so I could get a [medical abortion] pill to take home.

“A woman can feel really isolated and alone doing this, and it would be good to have someone with you to hold your hand and help you not feel scared or dirty because of the way some people can treat you.”

Bloom agreed.

“In the end,” she said, “pregnant people need abortion doulas during a tough moment in their lives just to love on them.

“Clinics may not want us. But we’d love to get back.”

Research shows that abortion doulas serve an important purpose for women regardless of whether their abortions are medical or surgical.

“There are urgent needs and opportunities for full-spectrum doulas to offer life-protecting services to pregnant people across the U.S. and globally,” according to a study in the March issue of the journal Frontiers in Global Women’s Health. “Coordination efforts for U.S. abortion care post-Roe v. Wade must include community-based doulas …”

To address the issue, the Cherry Hill Women’s Center (affiliated with four other Women’s Centers, including two in the Philadelphia region) hired an abortion doula last spring.

“This person is available before, during, and after procedures,” said Roxanne Sutocky, director of public affairs for all the Women’s Centers. “They’re helping us respond to increased need for abortions as more people come here since …[the rescinding of Roe],” she said.

Sutocky added, “We are probably the only ones in the region doing this.”