Abortion Doulas: Care Work as a Theory of Change

In You or Someone You Love: Reflections from an Abortion Doula, Hannah Matthews reminds us that there is so much more to abortion access than just the law.

An abortion doula, Grace, holds hands with a patient during an abortion procedure at abortion clinic Falls Church Healthcare Center in Falls Church, Va., on Nov. 24, 2017. (Carolyn Van Houten / The Washington Post via Getty Images)

On the Friday morning in June that the U.S. Supreme Court overturned Roe v. Wade and rescinded a fundamental right for millions of Americans, the focus was understandably on the law. Did the Dobbs decision immediately make abortion illegal? What kinds of healthcare could abortion clinics continue to legally perform? What laws would Republican state legislatures pass to control and coerce reproductive decisions next?

And now, a year later, much of the focus remains on the law. In my inbox everyday appears Jessica Valenti’s excellent newsletter “Abortion, Every Day,” which gives a researched rundown of the daily legal developments on abortion and reproductive healthcare. When I turn on the TV, law professors are pasted all over cable news trying to explain the deleterious effects of the latest court case or state law on reproductive rights. Even now, when the law has failed in nearly every way to protect reproductive rights, legal analysis remains the primary lens through which abortion is covered.

That’s understandable—the law is the reason many fewer people have been able to access abortion since last June. The law is the reason a woman in South Carolina was arrested for allegedly inducing an abortion with medication. It is the reason women have been forced to reach near-death conditions, like going into sepsis, before doctors could legally perform abortions to treat life-threatening pregnancies.

And yet, in You or Someone You Love: Reflections from an Abortion Doula, Hannah Matthews reminds us that there is so much more to abortion access than just the law. As an abortion doula and clinic worker, Matthews is a care worker, and she discusses the role care work can provide as a theory of change within the reproductive health space.

Care worker is my role in the revolution,” she wrote.

Shifting our attention to the importance of care work and networks of support for expanding abortion access, Matthews weaves in real abortion stories with resources for accessing reproductive healthcare, along with occasional affirmations and acts of kindness.


The book, then, is an act of care in and of itself.

It opens with Matthews’ own abortion story, an act of vulnerability and openness that invites in and builds trust with the reader. Though you might expect a straightforward, even celebratory abortion narrative from a proponent of abortion rights like Matthews, she delivers something much more meaningful.

Writing with remarkable clarity and honesty, Matthews describes the mix of emotions her abortion brought up for her, as well as the ups and downs of undergoing a vacuum aspiration procedure after an ineffective medication abortion.

“The two abortion processes my body went through were absolutely necessary, and they were healthy and safe, and they were made possible and even joyful by my communities. … I’m so grateful for them. They were beautiful and positive experiences,” she wrote. “And also? I grieve them. I have felt deep sadness, physical ache and the deep hollowing of loss. And that’s okay for me to share.”

The rest of the book encompasses a diversity of abortion experiences across race, faith, gender identity and circumstance.

In one story, Matthews shares the experience of Tessa, a former member of Students for Life. Once staunchly anti-choice, Tessa grew frustrated with the militancy of the group and eventually identified as pro-choice. Still, she described feeling grief after her own abortion, saying, “As ardently pro-choice as I am, I still felt that there was something of a soul when I got the abortion.” While some might react with frustration at the hypocrisy in Tessa’s story, Matthews is assiduously nonjudgmental and compassionate in her telling of it.

In another story, Matthews consoles a trans man through his abortion by describing the tacos waiting for him after the procedure (“salt-sprinkled tortilla chips and warm queso, plates of citrusy, garlicky elotes and a fat margarita.’”). There are many more stories like this in the book as Matthews is often telling them from her experience being the patient’s care worker, whether as a doula or clinic staff.

In a chapter titled “Abortion is Care,” Matthews described her role as an abortion doula.

“As a doula, I answer only to the person I am supporting. They write my job description and my employee handbook, though I may help to give them some of the language and parameters and ideas required to do so. Together, that person and I, we make our own rules, our own space for something singular, something new, something that may be strange, or beautiful, or life changing, or all of those things, or none of them.”

She brings this same approach to caring for the reader. As Matthews acknowledged, her book “exists because of, and in conversation with, the abundant, essential, beautiful, and borderless bodies of work by [her] countless teachers and heroes, and the various movements they lead.”

Crediting luminaries like scholar Rickie Solinger and activist Loretta Ross, Matthews provides the reader with tools to understand both their personal experiences and the broader political landscape, like the reproductive justice framework or the role of abortion storytelling from groups like Shout Your Abortion and We Testify.

Care worker‘ is my role in the revolution.

Hannah Matthews

While the narrow focus on the law has left out too many people in the fight for reproductive autonomy, Matthews shows us how centering care work and community networks offers an opportunity to make abortion more accessible for those who need it most. Whether it’s through clinic staff, abortions funds or organizers providing logistical support, Matthews wrote, “A patchwork of needs and abilities necessitates a patchwork of care and support.”

Though Matthews effectively made the case for recognizing the importance of care work in the aftermath of Dobbs through storytelling and information sharing, the book is not ultimately a work of advocacy. It’s a demonstration of the power of care work and an attempt to re-imagine how we might shift our priorities considering how a near-singular focus on the law has, in part, led to a world in which abortion rights can be decimated by five people on a court.

Even there, though, Matthews does not proselytize. She instead provides the necessary tools to consider how care work can fit into the continuing fight for reproductive justice and invites us to imagine our own visions for the future of abortion care: “What will community abortion care and support look like for you? Where will you carve out some space for its presence in your own life? Forget the abortion care we need. What is the abortion care we dream of? How can we, together, imagine, and invest in, and create, and sustain that dream, in our own communities?”

Editor’s note: Last summer, the Supreme Court overturned the longstanding precedents of Roe v. Wade, representing the largest blow to women’s constitutional rights in history. A series from Ms., Our Abortion Stories, chronicles readers’ experiences of abortion pre- and post-Roe. Abortions are sought by a wide range of people, for many different reasons. There is no single story. Telling stories of then and now shows how critical abortion has been and continues to be for women and girls. Share your abortion story by emailing myabortionstory@msmagazine.com.

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Marisa Wright is a student at Harvard Law School and a graduate of the University of Michigan.