In my work training doulas, Indigenous helpers, and other community birth workers, I’ve seen how personal biases can interfere with post-abortion care. Some birth workers even withdraw their care when a patient decides to terminate a pregnancy.
I always point out in my presentations that we are the caregivers. If we start out in a process where you’re with a family and they have a birthing plan, and then that person decides they no longer want to continue, you must still support them.
This lack of support leaves people isolated during one of the most emotional decisions of their lives. It compounds the stigma that so many already face when seeking abortion care. As caregivers, our role is not to judge but to walk with our patients—even when their decisions challenge our values.
Reproductive justice goes beyond the concept of choice. It’s about protecting every American’s constitutional right to decide about their body free from coercion, judgment, or barriers.
Community birth workers can fill gaps in post-abortion care, providing medical, emotional, and practical support. But it also means they must truly stand with our patients.
Gaps in Traditional Post-Abortion Care
Abortion care goes beyond the procedure itself to what happens afterward. Many patients who choose abortion are left to manage their emotional recovery with little to no support.
The consequences of this gap are profound. A research project called The Turnaway Study followed nearly 1,000 women over a decade, documenting the psychological toll of being denied abortion.
These women who were forced to carry unwanted pregnancies experienced more anxiety, lower life satisfaction, and a greater likelihood of staying in abusive relationships compared to those who were able to access abortion care. These outcomes don’t reflect the procedure itself. Instead, it reflects social barriers and a lack of support systems.
Even when abortion care is available, emotional support remains a blind spot. While most people experience relief after an abortion, those without adequate social or emotional support are at greater risk of heightened stress and self-doubt. Caregiver biases often make these challenges worse.
Community birth workers could help fill this gap, but for this to happen, we must address the biases that lead some caregivers to balk at providing post-abortion care.
A History of Serving Medical and Emotional Needs
For centuries, midwives and doulas have been pillars of care. They offer medical support and emotional and spiritual guidance at critical milestones in their patients’ lives.
In the Black community, midwives historically served as healers and spiritual leaders, maintaining social networks extending far beyond the birthing room. These Granny Midwives, as they were often called, provided safe delivery of babies when mainstream healthcare options were simply not available.
Community birth workers can meet patients where they are, providing wraparound services beyond traditional medical care. Studies confirm that doula-assisted births lead to better outcomes, including lower rates of complications, preterm births, and postpartum depression.
In abortion care, this role is also critical. Patients can experience relief, grief, and stigma after an abortion. Community birth workers who understand trauma and cultural context can help pregnant people from diverse backgrounds process their emotions after an abortion.
Expanding access to community-based birth workers is a tangible step toward addressing unequal access to reproductive care in marginalized communities.
A Foundation of Trust that Sets Aside Biases
True care requires humility. I urge trainees to approach each relationship as a partnership: You’re not there to direct or judge; you’re there to listen and support. This means advocating fiercely for a patient’s rights, even when their choices push against your personal values.
Bias can be subtle. It might show up as assumptions about a patient’s family structure, questions about reasons for seeking care, or suppression of the full range of medical options.
Community-based organizations like Mama Sana Vibrant Woman and Tewa Women United model anti-racist frameworks with humility and trauma-informed care for underserved populations. These approaches build trust and a patient-centered environment, particularly for those who have historically faced harm in medical settings.
A Caretaker’s Commitment to Continuity
Doulas and midwives can step in to address shortcomings in traditional medical systems. In my own work, I integrate a similar philosophy.
The World Health Organization (WHO) affirms patient-centered approaches that respect autonomy and overcome barriers. The organization’s abortion care guidelines recommend structured caregiver training to improve nonjudgmental communication.
I’ve seen how a commitment to continuity reshapes patient outcomes. Patients feel empowered when caregivers genuinely listen and stay present throughout their journeys.
This is not a task to take lightly—and it’s one that can save lives.
