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Doulas are trained professionals who provide physical, emotional, cultural, and educational support on a variety of health care issues in their communities. As the United States faces a dire maternal health crisis that disproportionately affects women of color, doulas can help bridge the gap in the quality and compassion of care people receive and disrupt the cycle of harm caused by a racist and biased health system. Doulas such as Raven Freeborn are a vital source of community care and fierce advocates for birthing people throughout the prenatal, birth, and postpartum periods.
Raven Freeborn entered the field in 2017 as a full-spectrum doula—a person who provides care and support to a person at all stages of pregnancy—and discovered that birth work is part of their life’s work and mission. Raven’s work is deeply rooted in ensuring Black, Indigenous, and other people of color, as well as queer and transgender people of color, are uplifted, valued, and put first. In working at the intersection of reproductive justice, gender justice, and economic justice, Raven said they see how attacks on abortion are part of a larger, coordinated, and strategic attack on peoples’ bodily autonomy that especially affects people who are historically and systemically oppressed, such as Black and queer people, people with disabilities, and people with limited English language proficiency.
Since the overturn of Roe v. Wade, Raven said they have observed that abortion restrictions disproportionately affect such groups—one reason why mifepristone is critical to reducing the systemic inequalities and barriers to health care that historically oppressed groups face. Raven notes that medication abortion offers an option for people to exercise choice from the safety of their homes and communities. But the legal challenges to mifepristone threaten to worsen inequities, as people who could access an abortion earlier must wait until further along to have a surgical procedure, which is likely to more severely disrupt their lives.
Raven regularly navigates hospitals and other forms of medical support with great attention to a patient’s experience. Raven said that, for abortion doulas, this work is often unpaid and comprises a volunteer infrastructure that is invisible to those outside the field. Amid increasing legal challenges, Raven notes that abortion doulas often continue to provide the invisible infrastructure of care—with a lot more risk of criminalization for people who self-manage abortions.
The ability to access abortion care in one's community is a practice of autonomy that supports the inherent dignity of an individual and their respective cultural or ethnic processes. Access to medication abortion specifically ensures abortion health care is available earlier in gestation, which mitigates future challenges in the logistics … of coordinating a surgical abortion.
Doulas often operate in an invisible infrastructure of care while advocating for and uplifting community members who are often overlooked and left behind by the current health care landscape. It’s well past time for health policy to benefit and work in conjunction with people on the ground for better outcomes for everyone.
Read more health care professionals' stories on caring for patients without the constitutional right to abortion
Doctors, doulas, and nurse practitioners detail their experiences since the overturn of Roe v. Wade and their fears in the rapidly evolving legal landscape of abortion care.