Hannah Matthews isn’t a physician that provides abortions. She’s not an activist rallying protesters, nor a politician working to enact policy change.
Her role in the reproductive rights movement is sitting next to someone on the couch, holding their hand, as they go through a medication abortion. Or helping them wash their hair in the bathroom after hours of cramping from passing a pregnancy. Or checking in on them with a home-cooked meal a month after their abortion.
Matthews is an abortion doula, someone who provides emotional, physical and practical support to a person having an abortion. “Care worker is my role in the revolution,” Matthews writes in her new book “You or Someone You Love: Reflections From an Abortion Doula.”
Matthews, who’s also an abortion clinic worker, writes about her work as an abortion doula in Portland, Maine, and how everyone’s abortion experience is different. Some people’s decision to get an abortion is emotional and tough, requiring more support after, while others’ choices are easy. Some people have the resources and privilege to easily access an abortion, while many others struggle to find funding, child care or time off work. But the common thread is that abortion itself is common, regardless of how many people talk about it.
“There’s this failure to recognize that abortion is happening all around us, at all times, in people’s lives. It’s so common. It’s so frequent. It’s so normal,” Matthews told HuffPost. “Truly, at any moment you or someone you love will need abortion care or support. That’s just a fact.”
The book title is reminiscent of the now-iconic phrase: “Everyone loves someone who’s had an abortion,” coined by Renee Bracey Sherman, an abortion rights activist and founder of We Testify, an organization dedicated to the representation of people who have abortions.
HuffPost spoke with Matthews about her new book, her experience as an abortion doula and how everyone, whether they realize it or not, knows someone who’s had an abortion.
What is an abortion doula?
An abortion doula is someone who provides emotional, physical, spiritual, financial, logistical, practical support to someone who is having an abortion. Or even sometimes indirectly to someone who is supporting someone else through an abortion. That is my definition. Everyone has different definitions for their own work.
Actually, the reason I wrote this book was to help folks understand that anyone really can be doing abortion doula work. There are some wonderful trainings, but you don’t need a medical degree or certification.
A lot of folks actually have moved away from the term doula because it’s very gendered and it comes from the ancient Greek word that means, basically, female slave. So it’s very gendered and it’s associated, for some folks, with chattel slavery. But in Ancient Greece, doulas were women who would gather around and support other women who were often giving birth or managing a miscarriage.
That’s fascinating. I don’t know how many times I’ve said “doula” and I had no idea about the word’s origin.
I love the title of the book: “You or Someone You Love.” Can you talk to me about how you came up with it and the meaning behind it?
The title was born from this frustration that abortion was being discussed as something that doesn’t touch most people’s lives — both by folks who were anti-abortion and also folks who were pro-abortion but carried a lot of stigma around what abortion actually is.
Because people — especially cis[gender] men or people who are older — haven’t been told directly by the people they love that they’ve had abortions, it doesn’t occur to them that those are the people they’re talking about when they talk about people who get abortions. It’s like, “Well, you’re probably actually talking about your sister, your college roommate, your child, your best friend.” That’s who you’re talking about, not strangers who you have seemingly limited compassion for.
It really humanizes abortion care.
It does. Just earlier this week, I was at the Maine Statehouse supporting folks who were giving testimony about their abortions they had after 24 or 25 weeks of pregnancy. They were giving the most personal, intimate, wrenching testimony. They were almost all crying, just really baring their souls.
And then they would finish their testimony and some anti-abortion lawmaker on the judiciary committee would raise their hand and ask some incredibly offensive hypothetical question. They’d be like, “Whoa, so what if a healthy unborn child was aborted?” They kept bringing it back to this straw man hypothetical because they are not able to engage with the human being in front of them and the reality of what abortion is.
“There’s this failure to recognize that abortion is happening all around us, at all times, in people’s lives. ... Truly, at any moment you or someone you love will need abortion care or support.”
Can you talk to me about your work as an abortion doula and how you’ve supported people through their abortion experience?
It looks different for every person and every pregnancy. Sometimes it’s really as simple as someone sends me a text like, “Hey, I really need help funding this abortion.” Or someone needs a ride to the airport because they have to fly to another state to have their abortion. Things like that.
And then sometimes it’s spending seven or eight hours with someone or sometimes them and their companion from beginning to end of their actual abortion experience. Or I’m coming to their home to make them dinner as they’re passing their pregnancy, if they’re having a medication abortion. Sometimes, I’m not with them as they have their abortion because I’m watching their kids or helping them figure out logistics remotely.
It really can be incredibly intimate ― probably the way folks imagine a birth doula. Just providing them with a lot of physical and emotional support up close. Sometimes we exchange a few texts or a few calls and that’s it. So, it can be a huge spectrum of what people need, what’s possible for them, what’s safe for them and what my capability is at that moment because I do have a 2-year-old.
How does abortion doula work fit into the reproductive justice framework?
Abortion is part of my family’s creation story, and I know an essential part of every community’s ability to thrive and stay safe and healthy. For example, Hoosier Abortion Fund in Indiana also has a diaper program where they distribute diapers to their communities. Indigenous Women Rising has an abortion fund and a breast pump distribution program. So when you look at who understands these connections, it’s generally pro-abortion folks. And it’s almost always because we’ve been led by and learned from women of color, especially Black and Indigenous women.
You write about the differences between an abortion doula and clinic staff, and you make a very important distinction about what happens when you’re working in the clinic versus when you take off your scrubs and name tag and can just be a community abortion doula.
What’s that dichotomy like?
It’s interesting. There are some clinic workers who really bristle at the concept of abortion doulas because they feel that it kind of implies that abortion is inherently traumatic or dangerous, which it’s not. And also because they feel like it implies that they’re not providing sufficient emotional support.
The fact of the matter is for many, many reproductive health clinics, the staff that are working for the clinic have very little capacity. They don’t have time; they don’t have resources. They are seeing many, many patients. The clinic workers themselves are exhausted and stretched very thin. So even though they are often providing really beautiful holistic care and support for all of their patients, they are on the clock and they are limited in terms of what they can do.
As a clinic worker, there were so many patients who I wished so badly I could call a week after their abortion and see how they’re doing or stop by their house with a dinner for their family or something like that. But, you know, HIPAA exists so you can’t do that as a clinic worker. That’s good that those barriers are in place.
But as a doula, it’s just so much more fluid. You’re only really bound by that person’s boundaries and wishes and desires. A month later you can check in with them if they want, or you can be a resource for them as they process and heal. Some people take a long time to process what is happening and to grieve their abortion or to even figure out how they feel about their abortion at all. As an abortion doula, you get to continue to support them after they leave the clinic.
It sounds like it allows you access to more intimate or more private parts of that person’s life if that’s what they need or want.
You started writing this book in 2021 and were still writing when the Supreme Court overturned Roe v. Wade with the Dobbs v. Jackson Women’s Health Organization decision in June 2022. What was it like writing this book when that decision came out?
I had just finished my first draft when the actual decision came down. I was at work in the clinic the day Dobbs came down, and it was one of the most painful days of work I’ve ever had. Everyone was stepping into a medical supply closet to fall apart or taking a break to go scream in the back alley behind the clinic and then come back in to see the next patient.
It wasn’t a day of shock because we had known it was coming. It was a day of grieving, but we didn’t have time to grieve.
Three days after that, I went back into the draft of the book and had to change certain things. I went into the section that I wrote about abortion care in Alabama and I had to change all the present tense to past tense. I had to change “abortion is legal in Alabama in these circumstances” to “abortion was legal in Alabama.” It was so devastating.
You wrote about your own abortion experience — how your medication abortion didn’t work at first, how you needed funding — and all of the anxieties that came with that. Medication abortion is very safe and effective, so the fact that you had to get follow-up care isn’t common.
What was it like sharing your abortion story? Were you worried about how people would perceive it?
I don’t even know if I knew this or could articulate this at the time, but I feel really strongly that one of the reasons for our deep discomfort with talking about our own abortions and what abortion actually is and can look like is this pressure from both sides of the political spectrum to fit neatly into a box.
If you’re anti-abortion, there’s this pressure to paint all abortions as very traumatic and shameful, secretive and dangerous, painful and distressing. Then I was finding in my own communities, for a lot of pro-abortion folks, there’s a lot of pressure to make your own abortion no big deal — just positive and easy. And that only contributes to this flattening of abortion experiences into one thing, which is just not the case.
While it wasn’t a big deal for some people I know who had abortions, others have different experiences. And I feel really strongly that people should be able to say: “Here are all my emotions, here are all the different facets of my experience.”
My abortion, in many ways, was logistically very easy and it was very community supported and very safe. I was very loved and I could share about it very openly, and those are all things that made it a thousand times easier. And my body did not have an easy time during my abortion experience. And I still feel a lot of grief and sadness about my abortion. And it was absolutely the right choice for me and my family. And I’m so relieved that I had it and that I don’t have an infant right now.
It’s all of these things and we have to hold them all at the same time.
You write about how the “cultural powers that be have wrestled control of the narratives around who has abortions, and when and why they have them. Implicit in those narratives: who deserves to have abortions, and when and why.” That feels very central to the discussion the country is having right now around abortion.
Tell me more about that and this idea that, often unknowingly, we as a culture prioritize who gets to have an abortion and whose abortion is perceived as right or wrong.
We’re seeing it a lot with these abortion bans that are being floated with exceptions for rape and incest or in the case of a life-or-death situation. But exceptions are bullshit. They don’t actually work to protect any of those people that they claim to be privileging and prioritizing. And they explicitly communicate to us that you only deserve an abortion if you have suffered enough.
Even many self-avowed pro-choice people perpetuate this idea, often people from older generations or cis white folks who may not be in touch with a lot of the work that’s happening on the ground.
Reproductive justice teaches us that abortion is connected to the right to parent and to give birth. What’s really horrifying is that we perpetuate this same myth onto people who have children. We explicitly communicate to each other that you should only be able to have children if you have the acceptable number of children, if you make the acceptable amount of money to support those children, if you’re white and have an Anglo last name. We decide and communicate who is allowed to parent and who is allowed to give birth safely and with resources.
What do you want readers to take away from your book?
I really want folks to come away feeling safer and more equipped to talk about abortion. I want them to be curious about the ways in which they can fill their own communities’ reproductive justice needs — because they can.
When we talk about what abortion care and support work looks like in our communities, that’s something that is as old as the communities themselves. And it’s something that will go on for as long as there are people.
This interview has been lightly edited and condensed.
Hannah Matthews’ book “You or Someone You Love: Reflections From an Abortion Doula” is on sale now.