Anita Rao
If you needed to get an abortion tomorrow, where would you go? We asked y'all that question on social media, and the majority of you said Planned Parenthood. The other largest cohort said, "I don't know." Honestly, when I turn the question on myself, "I don't know" is the first thing that came to my mind. I know that my health care plan only covers abortions in very limited circumstances. I know that, at least in this moment, I have legal access to an abortion in my state until partway through the second trimester. But for answers to all the other questions about how much it would cost, what it would be like or how to recover, I'd probably turn to Google. That is until I learned about the work of the people we're all about to meet today.
This is Embodied, I'm Anita Rao.
Abortion doulas are educators, guides and companions. And they've been at this work since long before the reversal of Roe v. Wade. They work independently, in collectives or as part of clinics to make sure people get the emotional, physical and logistical support they need — from driving to a clinic and paying for the procedure, to returning home and any questions that may arise during the after care process.
KáLyn Banks Coghill
Abortion doula work is liberation work. We act as almost like a liaison for those that are experiencing abortion. And we show up for them in ways to act as a support system for them.
Anita Rao
That's KáLyn Banks Coghill. They volunteer as an abortion doula with a Richmond Reproductive Freedom Project or RRFP in Virginia. KáLyn is also a writer, organizer, educator and doctoral student at Virginia Commonwealth University.
KáLyn Banks Coghill
I identify as a Black nonbinary disabled queer femme, and because of that, I have always been very interested in the ways in which I am protected as a Black person. And when I became an abortion doula, one of the main things I wanted to focus on is how can I protect a potential client, whether that be from protesters outside to just the protection of having someone to confide in when you're experiencing this extreme transition in your life.
Anita Rao
KáLyn is an expert in the practical aspects of abortion doula care, including providing transportation, childcare, meals and lodging. If you were to reach out for support through KáLyn's organization, you'd get assigned to someone like them as a point person after one or two other steps.
KáLyn Banks Coghill
We have intake coordinators who are staffed with RRFP. Twice a week, they open up the phone lines for people to be able to call, and then they assign volunteers to call the people back to see how much that the organization will need to pledge in order to help them pay for their abortion. They also discuss with them any travel arrangements or childcare needs or practical support needs. After that, they contact the abortion doulas and volunteers and they let us know something along the lines of like: Client A has an appointment at this clinic on this date at this time. Would anyone be able to pick them up and take them back to their hotel or back to their home? And then once someone confirms, you get put into a private chat where you actually get the name of the person that you'll be assisting and their phone number, and then you move forward with reaching out to them on your own.
Anita Rao
So what does that look like from a relationship-building point of view? You don't have a lot of time sometimes to make that personal connection with someone who you're going to support, but you're about to be helping them through this really intimate experience. So tell me a bit about how you build that connection.
KáLyn Banks Coghill
Simply just introduce yourself. And a lot of people are very receptive to abortion doulas because they know that we are acting as a buffer between them and all of the horrible things that people think about abortion. So when you are introducing yourself to a potential client, you want to just make sure they understand that you are here to serve them, like this work is for them, this work is not for you. So you have to make sure that when you introduce yourself that you are kind and you are compassionate, and that when you are riding with them in your car, that you're having conversations with them that are not always focused or centered around the fact that they're going to have an abortion. Sometimes people, like clients I've had in the past — they just want to talk about what's going on on television. They want to talk about what movies we've seen recently. Sometimes they do want to talk about abortion, sometimes they don't. And then there's also times where they just want to be silent, and you have to respect that as well.
Anita Rao
That type of deep listening and personalized care can make a world of difference in a high stress moment, as we heard from some of our listeners.
Amanda
I got an abortion for an unwanted pregnancy in the early 2000s. Afterwards, I remember there were volunteers who helped take care of me and the other patients that day. And I remember one of them, going with me into the bathroom and helping me change the giant pad that they gave me, because I was so dazed and out of it. It was the best decision I've ever made in my life. But it was still hard. And I wish I had had some kind of support, somebody I could talk to who had been there or who knew what was going on.
Lynn
I encouraged my patients to write themselves a letter and to tell themselves all of the reasons why they had made that decision at that point in time. And to tuck it away somewhere safe, where if they needed it in the future, they could remind themselves of who they were and where they were in life and why they made this decision. The last pregnancy termination I performed, I was pregnant with my first child, and she was actively kicking while I did the procedure. After that procedure, I decided that I was not going to perform any more elective terminations. But I never, ever stopped thinking that there should be safe and legal options.
Anita Rao
Those were listeners Amanda and Lynn. Abortion doula collectives and support organizations have existed formally and informally for a long time. And they'll be the first to tell you that abortion access was already in a dire place before the overturn of Roe. As of a 2017 report from the Guttmacher Institute, nearly 90% of U.S. counties had no clinic providing abortions. In the past month, KáLyn and their colleagues have had to make shifts to respond to increasing demand. Their phone lines, open now twice a week, used to be open just twice a month.
KáLyn Banks Coghill
We've had so many more people who need services since Roe v. Wade. I personally have had a couple of clients who have traveled from the Deep South here to Virginia in order to get their abortions. I've provided childcare for clients who have had to travel with their children for days just to be able to get abortion care, and to experience having that reproductive autonomy, they would have to come to Virginia. And during my abortion doula training, one thing that one of the trainers said is that Virginia is seen somewhat as a safe haven for those who want to have abortions. So we've always had people travel to Virginia, even before the overturn of Roe v. Wade. But recently, since the overturn, we've had an influx of people coming, especially from the Deep South here to get their abortions.
Anita Rao
So you mentioned a couple of things that are unique for people who are coming from states farther away. But I'd love to get a little bit more into those and how you all can and can't help support the needs of people who are coming in from out of state.
KáLyn Banks Coghill
Yeah, so because we are a local reproductive justice organization and abortion fund, fundraising and our fundraisers are how we fund abortions, right? So we've gotten an influx of funds from people ever since Roe v. Wade was overturned. But when I was the fundraising and sustainability coordinator for two years for the organization, it was very difficult, especially during the pandemic, to raise money because a lot of people were dealing with financial insecurities. And that plays a big role in how we're able to assist people who are traveling, right, because not only do they need help with getting here, they also need help with lodging, right. But also they need help with food, like some people have to use their money to travel, so they don't have money for food. So we have to be able to provide that for them as well, which can also be a barrier. Because we are a small organization, we have to be very unique with how we do things and a lot of times the abortion doulas and the volunteers, we will cook food for people, deliver it to their hotels for them. We stand in as childcare. I've sat inside of a Planned Parenthood while someone was getting their abortion to watch their child for them. We have to really get creative with the work that we're doing because of these barriers that we're experiencing.
Anita Rao
But at the end of the day, there is limited capacity, right? There's a limited amount of funds, there are a limited amount of people. So what do you do when you all run out of capacity to help? Are there other places that you're able to direct people, especially those coming from farther away?
KáLyn Banks Coghill
Yes. So we're able to reach out to other funds that are in Virginia. We also have community with funds in the DC area. So, when we need more funds and more pledges, which are just basically donations, we do reach out to those other organizations as well.
Anita Rao
Doulas like KáLyn get training on how abortion affects the body so they can help people know what to expect, whether that be a surgical procedure — or the two-part abortion pill regimen. They are also campaigners against abortion misinformation.
KáLyn Banks Coghill
There's going to be a continuation of a lot of misinformation about abortion care in general. And abortion access is going to be more difficult, right? So when we think about people who have access to abortion, we think about people who are not Black or brown, who are not living in the poorer parts of the United States. We think about people who identify as white cis heterosexual women who have access to money, and they are taking up appointments, right. But I do feel like there's going to be a lot of misinformation around unsafe abortions. And I noticed on Instagram that there have been a lot of activists talking about unsafe abortions, warning people against certain abortion remedies that are just not safe. And I think that a lot of abortion funds and reproductive justice organizations are going to continue to provide educational materials on that, so people can be as safe as possible.
Anita Rao
Yeah, I want to follow up on a couple of threads that you mentioned there. And the first is talking about people who have — who are historically marginalized by the healthcare system — in particular, Black and brown birthing people — and the experience of them kind of coming into a healthcare space to access abortion can be really stressful and challenging. I'm curious about how you help bridge the gap to create a more positive health care experience for those people in particular.
KáLyn Banks Coghill
Yeah, so all the clients that I've ever had have always been people of color. And our volunteer base has people from all different diverse backgrounds. But one thing that I like to do is to make sure that I make them feel as comfortable as possible and that I check my own ego and biases at the door. Because the work that I'm doing is not about myself. It's about the person who's getting the abortion. And I think that most if not all abortion doulas have that same mindset, where it's not about self in that moment — it's about that person.
Anita Rao
Are there way ways that you are encouraging more Black and brown folks to become doulas, to become part of this collective of people supporting people accessing abortions?
KáLyn Banks Coghill
Yes, I'm happy you asked that. I am constantly on my social media, talking about my abortion doula work, talking about how rewarding it is and how it's my heart work. I am constantly reposting podcasts, like Black Feminism Rants that talks about reproductive justice. I am constantly reposting resources and information about abortion doula trainings, because we do need more Black and brown abortion doulas in these spaces.
Anita Rao
One other aspect of inclusivity we need to talk about: language. Abortion has long been labeled as a women's rights issue. But transgender, nonbinary and gender nonconforming people also need access to abortion. How we talk about this as a collective — and what specific language we use — is very much at the forefront of KáLyn's mind.
KáLyn Banks Coghill
So I am a trained linguist, so dialects and language and words are very important to me. And I'm also a writer. So I am a firm believer that words mean things. And when we are talking about people who are getting abortion, we're talking about birthing people, not just women. And I think a lot of people are struggling with that. I noticed when Roe v. Wade was overturned, I got into quite a few heated debates with people that I was even close to about their use of the word "woman" and trying to explain to them that they are not just women getting abortions. And I think it's important for people to use the correct language because when you isolate people through language, it makes them feel even more isolated in a situation where they already feel outcasted. These people are going through a transition that is looked at as evil to some people, and you're not including them in the conversation when you choose to use language that excludes them. I also feel like there's going to be kind of like a stunting of growth within the education for reproductive justice if the language is not changed, and if people are not talking about reproductive justice from a lens that includes all people and not just women.
Anita Rao
Who is part of the conversation on abortion access affects how the future will look. This is true when it comes to gender and also spoken language. KáLyn mentioned that having Spanish speakers and speakers of other languages in the reproductive care network needs to be a priority moving forward for organizations like theirs and for clinics like Planned Parenthood. While Planned Parenthood is one of the most well-known organizations in the abortion care space, and one KáLyn works closely with the encourage people to also get to know and financially support the other players in their area. Whether that's a local doula collective, abortion fund or practical support organization. If you're not sure if you have an organization like that, there are multiple places online to find out. We'll link to some of them in our show notes. Online resources like this are super valuable. But virtual spaces can also be hairy for people doing abortion work. And it takes time and effort to stay safe and keep one's mental health intact.
KáLyn Banks Coghill
As a doctoral student, I study gender-based violence on Twitter. So I know a lot about the different protection methods that people take to protect themselves online if they're being, you know, attacked by trolls. So I make sure that I put those things in place for myself, whether that is blocking people, or making my page private if I have a tweet or something that goes viral that I don't want a lot of attention on. But also, as far as my personal self care, I do a lot of spiritual work. And I also do a lot of poetry writing and journaling. And I'll also make sure that I keep into close contact with my comrades who are also in the reproductive justice space doing this same work, because it's nice to be able to talk to someone who understands what you are experiencing and can provide you with that compassion and care when you just need someone to, you know, talk to you about the type of work that you're doing.
Anita Rao
As you think about moving forward doing this work and inviting others in to be abortion doulas, are there any particular experiences or stories that you reflect on or share to talk about the importance and the value of this work in this moment?
KáLyn Banks Coghill
Yes, so one of my most recent clients, and probably one of my favorite stories so far is they traveled from the Deep South here. It took them days to get here and they needed childcare. And I was willing to do it. And when they came — when they pulled into the Planned Parenthood parking lot, and got out the car, they had their child bring me some roses and a gift card for lunch. And it warmed my heart because I don't expect things from my clients, like I'm doing a service to you. But they were so grateful that we were able to provide them with that child care while they went through this procedure, and that we were able to show up for them in that way. And I love telling that story because I want people to understand that, like I said earlier: abortion doula work is the liberation work. As an abortion doula, we are liberating people by giving them access and community and support for something that can be very hard for them, and a transition that a lot of people do not agree with. And I think that, for me being able to tell that story and just talk about the connections that I've made with some of my clients in the short amount of time of helping them hopefully excites other people to want to become abortion doulas, or even just volunteer for their local abortion fund.
Anita Rao
I've been thinking and reading a lot lately about the future of reproductive health care for obvious reasons. And it certainly makes me feel more at ease knowing that there are people out there building these networks, because one of the themes that seems to be coming up a lot in conversations I'm having is uncertainty.
Deonna
I'm in my 40s and my tubes are tied due to a treatment for a fibroid. So I'm not really worried about pregnancy, but I am at a higher risk for ectopic pregnancy. And being in my 40s, I don't know if I would immediately understand what was happening to me, because I'm edging closer to perimenopause and my cycles are getting a little weird. I fear it could get really complicated if I had to seek treatment for an ectopic pregnancy, because the only treatment is medical or surgical termination. And my understanding is that even in more restrictive states, treating ectopic pregnancies remain legal, but there's a lot of space for confusion because the language is vague, and that potentially puts healthcare workers in a really weird place. I think the past couple months I've just worried that medical care for an array of reproductive health issues is going to be really complicated in this climate in many different situations for anybody with a uterus.
Linden
More than just women and girls need abortions. Transgender men need abortions, gender queer individuals need abortions, intersex individuals need abortions. And we are all valid and face enough discrimination in the health care industry. I myself use an oral contraceptive and without it, I would be in a lot of trouble as it protects me from pain, not just from getting pregnant. I also understand the intersection that access to contraceptives as well as abortion has with race and class. If you don't have access to health care and oftentimes contraceptives, it's easier to get pregnant and therefore require an abortion should you want it. I don't know. I am scared. But at the same time, I am tired of feeling hopeless.
Anita Rao
That was Deonna and Linden. While barriers to abortion access are continuing to increase, some folks like Linden are finding hope in a mobilized younger generation and the number of people working to get educated about reproductive care. One person involved in his education efforts is Raven Freeborn. They are a healing justice practitioner, community educator and full spectrum doula: someone who cares for people in birth, postpartum or abortion.
Raven Freeborn
My journey to full spectrum doula work really began through political activation. I was activated by the death of Erica Garner, who is the daughter of Eric Garner. And we know and have heard of the name of Eric Garner. When we think about our cries around I cannot breathe. Erica Garner, his daughter, responded to his murder with cries of activism. On December 30th, 2017, she died from preventable complications of pregnancy during her postpartum period. And so at that time, I was a birth doula. I had just finished my training as an abortion doula. But I really began to think about all of the outcomes of pregnancy — that includes termination and loss, miscarriage, abortion, adoption and so many others that we often don't name. But my journey really began with some political activation.
Anita Rao
Raven provides trainings for folks looking to become abortion doulas, and their teachings are steeped in the history of reproductive justice and abortion care.
Raven Freeborn
The history of abortion as healthcare really began as abortion as a community organizing measurement of togetherness and a practice within relationships of families and individuals. And so we see that in some of our literature that tells us that churches and clergy members were a part of abortion counseling in the 1960s. When I grew up in the in the reproductive justice movement, and folks raised me up, they used to say, "We know that there is a crisis, there's a concern when we have to go back to the basement of churches." And I really challenged that in my training, because even when we were thinking about organizing ourselves within the basements of churches, we were still losing a critical audience of people who were not welcomed by religious systems, who did not feel safe, or who did not feel that they could be seen in that provision of service.
So it's definitely community organizing, that's a pretty recent reach back into our history. But even further back, I tell folks that abortion has existed as long as pregnancy has existed. So what are the histories of our Southern granny midwives that come out of the Southern Black tradition and raising folks and creating for them practices for reproductive health and whole body health, right? So we can go even into that narrative, and to that lineage and think about who's helped us to maintain these practices within our local communities, because that's where health care was provided, right, is right at the kitchen table for some folks, and then in other places in the basement of the church. So that history is important to us when we're training to see where we've been and how we can take that same spirit, but really expand the reach of abortion as health care for folks.
Anita Rao
That's really helpful context. And I'm curious about how you bring that in to the moment when you are talking to people about being an abortion doula, especially around this concept of criminalization, which which you talk about the history of and then really looking at this moment now when we're criminalizing people who are helping people get abortions, as well as moving to criminalize people who are getting abortions themselves. So talk to me about that and how that factors into the work that you do helping educate people who want to support those getting abortions.
Raven Freeborn
I think that what really makes training for me as an abortion doula training different because I'm a student of justice. When we're in this training space, I bring in some of what I've learned from Mariame Kaba who helps us to understand that criminalization is the process of making an individual criminal by their behavior or their action, but I also talk about their thought processes. We have to deconstruct the stigma around abortion, where folks cannot even approach a choice to make a decision. They don't even feel like they have a choice. When we were thinking about the Roe v. Wade time, we're now in a post-Roe v. Wade world. But prior to that, when we did not have the level of restriction as we do on abortion right now, some folks couldn't even approach that decision from a place of having choice. Criminalization itself is a process where we see someone or something as illegal just by their behavior, action or their thought. And we have to bring that into our abortion work. Because if we're centering a reproductive justice framework, then we're acknowledging that increasing access, not availability, but actual access is our goal, to have safe and sustainable communities.
Anita Rao
So when it comes to that question of access, and whether or not you feel like you have a choice, or you make a choice, and then later you question whether it felt like a choice, it can all be dependent on how you experience the healthcare system, and how people react to you and your body in the healthcare system. And I want to talk about that and medical gaslighting and how you train abortion doulas on medical gaslighting and being able to feel affirmed in these healthcare spaces and feel like people are listening to you and taking your needs seriously so that you can access a range of choices about what you might want to do.
Raven Freeborn
Yes, yes. So witnessing and noticing, those are the two to me most critical tools that you can have in your tool bag. We can do a lot to comfort someone. But when we witness and we notice, we deconstruct what the medical industrial complex does against us in our bodies, and so to witness is to say to someone, "I was a part of that moment where a provider or a nurse or an administrator really dismissed your voice. I witnessed that. Can we correct or repair that in this moment, or would you like to move forward?" And when we're noticing something, we're calling attention to it in a way that is dignified.
So I think it's important that, you know, folks sit with doula itself as a bit of sacred work. And we — I believe that there should be dentists, doulas and tattoo doulas. I think we need doulas for everything, right. But doulaing is a bit of sacred work that is separate and different from advocacy and organizing. And so when we're in those spaces where someone is experiencing loss - they're terminating, they are receiving health care, however they are conceptualizing that moment - to notice is to be a part of increasing their dignity and say "I was a part of that," right, but not to disrupt that healthcare in the moment, if it's the central priority for that person's body.
Anita Rao
When talking with people like Raven and KáLyn who spend so much of their time in direct service of others, I'm always wondering, how do you keep going and keep sustaining yourself in this work? Who's taking care of the carers?
Raven Freeborn
When people are providing any level of care, we have to be really present with our reactions and give our most mindful responses. When we are doing this work, our ability to show up is going to change day by day by day. And so as that ability changes, how you show up to do the work changes as well. Embodiment practices, especially those that are centered in liberation, are really important. They further what folks call self care, I like to say it needs to be self preservation, or even self recognition, the ability to be aware of your reactions, and give the most mindful response that you possibly can. When you are under a level of load on your life that changes your ability to mindfully respond, you have to pause, you have to stop. And you have to then doula yourself, which is a really loving level of work that I think people need to have some tools in their toolkit to be able to do that.
Anita Rao
As we put together this episode, things continue to change each day in the abortion landscape. Voters in Kansas decided to keep abortion legal in their state, and the President signed an executive order on abortion rights. Things are going to continue shifting, likely even between when I'm recording these words and when you will hear them. For Raven, balancing what is known and what is uncertain as a task they are attuning themselves to in this moment.
Raven Freeborn
What I've been talking about with folks is what it looks like to be ungoverned, and some of that really comes from the history of reproductive justice work, where we are moving against and underneath a system that seeks to punish us. And so how do we allow ourselves to be ungovernable? And so I'm going to educate folks, I'm going to provide a level of care and I'm going to shift and pivot my own perspective on this issue to match the urgency of this most critical moment.
So it's no longer an option for me to have conversations with folks who are centering gender as a part of our work to further abortion access. We need to move beyond that. We even need to move beyond the language around abortion is an issue for people with the capacity for pregnancy, right. Abortion is healthcare for people with a uterus. Your capacity for pregnancy is actually not a requirement for me to consider you in access to abortion healthcare, because we know that ectopic pregnancy is a outcome of pregnancy that will then allow you to journey through loss and some level of grief, and some may call that a process of termination. So I'm here for that, right? I'm going to be ungoverned under that.
I'm not going to be restricted by the binary or the rigidity of what you want to hold on to. We're now in a post-Roe world. Roe was the floor. So I'm imagining the ceiling, which is beyond what a government system tells me it should be or what they imagined it could be.
Anita Rao
Embodied is a production of North Carolina Public Radio-WUNC, a listener-supported station. If you want to lend your support to this podcast and WUNC's other shows on demand, consider a contribution at wunc.org now. Incredible storytelling like you hear on Embodied is only possible because of listeners like you.
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This episode was produced by Kaia Findlay. Amanda Magnus is our editor. Audrey Smith also produces for our show. Jenni Lawson is our sound engineer and Quilla wrote our theme music. Until next time, I'm Anita Rao taking on the taboo with you.