Integrating doula support into abortion care – program development, implementation, and women's views on doula support

Doula support, traditionally used during childbirth, has been adapted to help women during other reproductive healthcare experiences, including miscarriage, adoption, and abortion. As first-trimester surgical abortions are most commonly performed using local anesthesia without sedation, doula support may be particularly beneficial for women undergoing first-trimester surgical abortion. The Chicago Doula Circle and researchers at the University of Chicago partnered to create a volunteer abortion doula program for women obtaining first-trimester surgical abortions at Chicago’s public, safety-net hospital, the John H. Stroger, Jr. Hospital of Cook County. As part of a larger study assessing the impact of doula support on women’s abortion experiences, we sought to understand the acceptability of adapting the birth doula model for abortion care. We conducted semi-structured interviews with women who opted to receive or not receive doula support during first-trimester surgical abortion. Responses were coded in Atlas.ti® Version 7, and analyzed for thematic content. Thirty women were interviewed by phone within two weeks of their procedure: 19 opted for and 11 opted against doula support. Women opting in predominantly viewed doula support as acceptable during childbirth and during abortion and identified a need for social and emotional support during these reproductive experiences. However, several women who opted out expressed discomfort with drawing parallels between childbirth and abortion and questioned the role of doulas in abortion care. These findings indicate that while some individuals may find incorporating doula support in abortion care unacceptable, most women find value in extending this model into a spectrum of reproductive experiences.