A few weeks ago I came across a piece in The Atlantic, “On Being an Abortion Doula.” I read the headline over and over. It was one of those moments where you’re both shocked to hear something exists and can’t imagine it not existing because it’s such a good idea that of course it does.

The piece profiles a New York-based collective called The Doula Project, who offer “full-spectrum” doula care; that is, they provide the traditional services of a doula to women in all stages of pregnancy, including those who do not intend to see the pregnancy to term. Like birth, abortion can be a stressful and confusing time for a woman—there are a lot of medical, physical, and emotional options to consider, and advice being hurtled from all sides. It’s a lot to take in, which is where a doula’s help can come in handy. While searching for a local abortion doula to interview about this topic, I found Ness Fraser’s powerful blog post, “Abortion: The Elephant in The Room.” In it, she notes that termination is not really discussed, in the birth community or the world at large.

Ness, who has been a doula since August 2012, writes, “I support a woman’s choice to do what she feels is right in regards to the goings on inside her body — and for me, the idea of telling a woman that I respect her right to choose where and with whom she gives birth (because she knows what’s best for her) while also telling her that she must stay pregnant against her wishes is a form of cognitive dissonance that I’m frankly not at all comfortable with.” We got in touch to talk more about feminism, abortion care, and what it means to be Pro-Choice in the birth industry.

SDTC: So, first thing’s first. Can you tell us a bit about yourself and your practice? How did you decide becoming a doula was something you were interested in?
Ness Fraser: For as long as I can remember I’ve been fascinated with birth. I used to take time out of playing as a kid to watch A Baby Story every day. When I was in college, I became more interested in feminism and through that discovered that there were women who supported other women through pregnancy and birth called doulas. Doulas don’t perform medical procedures, but they provide emotional, physical, and informational support to women during pregnancy, birth, and postpartum. After graduating from college I realized that what I really wanted to do was work with women in this way and became certified as a doula. It has been an incredibly rewarding experience for me to work with women during such an important time in their lives.

What does your job entail?
As a birth doula, I form a relationship with my clients throughout their pregnancies; sometimes that includes attending prenatal classes with them, but usually we meet several times to get to know each other and for me to get an idea of what their ideal birth would look like and to discuss how I can support them in achieving that. My client calls me once she’s in the birthing process, and I accompany her throughout that process until after the baby has been born. We meet once or twice postpartum so she can discuss her experience. There are doulas who specialize in this period (they’re called postpartum doulas), but I’ve chosen to focus on pregnancy and birth. My job as a doula requires really being there for women in their choices through the birth process and learning how to meet women where they are. Not everyone wants the same thing out of their birth experience, and it’s my job to support my clients in making informed decisions.

How do you think abortion care intersects with the responsibilities of a doula?
In both roles—as a birth doula and as an abortion doula—supporting my client is my top priority. It doesn’t matter whether or not I’d make the same choices for myself, or whether or not I think she’s making the right one. That’s really not for me to decide. What matters to me is that at the end of her experience—whether it be birth or abortion—that she feels she was given the information and support to make the best decisions for herself. I think for a lot of women having someone there who says “I have nothing invested in your choices, I will just be here to love and support you through this experience” is really valuable, especially when they might be getting advice from a million different people on what they should do. I don’t give my clients advice, I give them support, and I think those two things are very different.

When I first read the piece in the Atlantic, it seemed like such a good idea I was shocked it didn’t already exist everywhere. Why do you think there are so few doulas providing abortion care out there? Are there any in Canada?
While to my knowledge there are not any abortion doula collectives in Canada, I think it’s important to remember that women have always helped each other through these experiences. There are mothers, grandmothers, sisters, aunties, cousins, and friends across Canada who are sitting in waiting rooms, who are offering rides, and who are holding the hands of women who are having abortions. They may not call themselves doulas, but they’re certainly doing the work that doulas do. I know several women who quietly offer their services as abortion doulas without having larger affiliations with clinics or organizations. I want to be clear that I certainly don’t discount the value of male partners who often do take on a primary support role, but there are many situations where the partner isn’t around or isn’t supportive. In my experience, it is most often other women who step up to the plate to support each other when no one else will, and I find that to be something very special.

How would you like to see the discourse surrounding abortion, birth, and/or pregnancy in general, change?
Many people believe that because abortion is legal in Canada that that means women have access to care and have abortions without stigma. I wish this was the case, but it simply isn’t. There are still provinces and territories in our country that don’t fund abortion clinics through their healthcare systems or that don’t have abortion providers or that still require women to ask a panel of doctors for permission before she is allowed to obtain an abortion. There are also special considerations for access for people who are under 18, and people who don’t qualify for provincial health insurance. In the same vein, there are provinces in Canada without midwives. Legalization was a huge and incredibly important step for both movements, but we really do need to work to increase access to care for people who are living in rural and remote places. Ideally, I’d like to see midwives and nurse practitioners trained to provide first-trimester abortions (if they are comfortable providing that kind of care) as is currently happening in California.

I also think that it’s important to remember that there are people who would very much like to change our abortion laws. I encourage people to be politically active around these issues because those who are against abortion quite often are as well. Organizations like the Ontario Coalition for Abortion Clinics and the Abortion Rights Coalition of Canada are a great resource for people looking to get involved.

If a friend is going through an abortion, what are some ways to help?
Always start with listening. How is she doing? How is she feeling? What does she need? Being present is big. There isn’t one-size-fits-all advice to give here because women experience abortion in so many different ways. Being mindful of your language is really important, I think. One thing I see people doing often — and I think this is a response to the “don’t kill your baby” rhetoric we see so often from the anti-choice — is minimizing the gravity of a pregnancy by calling it a “clump of cells”. For some women, this is an okay way for them to talk about their pregnancies, but I know many women who have found this language to be insensitive and disrespectful of their experience. I really encourage people to listen to how women talk about their pregnancies (whether desired or not) and mirror that language. Some women need time to grieve after their abortions, and some don’t feel any attachment to their pregnancies — and both are okay! There is no one way to experience an abortion. It really is different for everyone, and the only way to figure it out is to listen. Don’t make assumptions. Ask questions if you’re unsure of her needs.

Lastly, any cool resources or projects you want to plug or shout out to? Go wild.
Oh, there are so many! The Doula Project in NYC is such an amazing resource for abortion doulas or for people who want to become abortion doulas. They’ve even offered to help with a training in Toronto if we can get enough people together. Ontario Coalition for Abortion Clinics often organizes rallies and events in Toronto for those interested in becoming politically active around this issue — and meeting some amazing, inspiring, long-time activists in the process. Abortion Rights Coalition of Canada also has a Facebook page that offers lots of info about the current climate around abortion care in Canada. Exhale is a really important resource for women who have had abortions and need some extra, un-biased, non-religious support. I had the privilege of working with a client last summer that I was connected with through Canadians for Choice, a non-profit organization that does important advocacy work including funding travel and accommodation for women who need financial support in accessing abortion. I was really blown away by their dedication to helping women. If you have extra funds, I would encourage you donate.