Read this story in Spanish here
Many people probably don’t know what it means to be an abortion doula. They might be more accustomed to hearing the word doula associated with childbirth or related to the concept that in many Latin American countries, we have of midwives: women who accompany pregnant people during pregnancy, childbirth, and postpartum.
An abortion doula is someone who accompanies a person in the process of terminating their pregnancy. In North Carolina, there are more than 40 abortion doulas, a number that continues to grow as restrictions on abortion in the state become more limited.
Ash Williams is one of them. He speaks with the urgency of someone who knows that their knowledge is necessary, that their help is often not found, that accessing an abortion is expensive and also carries a risk.
Williams is a black trans man, a reference for the Abortion Doula Collective of the Mountain Area, in Western North Carolina. He knows firsthand the barriers that people like him have to break through to access an abortion in the southern United States.
In this interview, he will tell us about his work, why more abortion doulas are needed, and what can be done to guarantee reproductive rights in North Carolina.
ELNC: What inspired you to become an abortion doula?
AW: I had two abortions, and it was after that first abortion that I realized that I really needed much more information and many more resources, and I didn’t have them. So, I depended on people in my community who helped me raise the money. But it wasn’t just that: I also depended on my community to help me understand what I could expect.
We need more information and resources for trans people, for people of color, for undocumented people, for poor people. That’s why I wanted to become an abortion doula.
ELNC: How did the movement of abortion doulas arise?
AW: Look, in African and indigenous communities, we have always had this knowledge about how to take care of our reproductive beings. But due to displacement, slavery, and also sterilization, among other reasons, we have disconnected a bit from this knowledge. But these ways of knowing how to take care of ourselves have always existed in our communities, and what many of us are doing now is reclaiming that knowledge, learning more, and also trying to support people like us.
ELNC: What are the first steps when someone seeks your services as an abortion doula?
AW: One of the things I would ask is if they know what type of abortion they want to have since there are different types of abortion available. I would ask them if they might be interested in a medical abortion or a surgical abortion.
Many people who want to have an abortion already have an idea of what they want to do. I get to know what they want, listen above all, and then connect that person with resources. If a person told me they were interested in having a surgical abortion at an abortion clinic, I would share information with them about places where they can access a real abortion.
ELNC: Are there reliable abortion clinics in our state?
AW: There are places that we call fake abortion clinics or anti-abortion clinics. These are often religious-based medical institutions, which basically trap people. They make it seem like they allow abortions to happen, but when people actually get there, they are fed with many lies, myths, and falsehoods about abortion. So one of my jobs is to make sure people know where they can have a real abortion and get real support, without their decision being judged because that makes it much harder to make.
ELNC: Do you think access to abortion is harder for transgender people and people of color?
AW: Absolutely. I believe that BIPOC (Black, Indigenous, and People of Color), as well as queer and trans people, face more barriers to accessing quality care. Research already shows us that we face more barriers to accessing medical care in general. So, when it comes to reproductive care, that trend deepens even more. That’s why we organize in community trans, queer, BIPOC people, to help break these barriers and help navigate this path for those who need it.
Abortion rights in North Carolina: Key restrictions
Since July 2023, North Carolina has introduced stringent abortion laws, setting several critical restrictions in place:
– Abortions are now prohibited beyond 12 weeks of pregnancy.
– Minors must secure consent from a parent or guardian.
– A 72-hour waiting period, coupled with mandatory counseling, is required.
– Two visits to a healthcare provider are necessary due to consent and waiting period regulations.
Exceptions are made for abortions post-12 weeks in cases of rape or incest (until 20 weeks), severe fetal anomalies (until 24 weeks), and when the mother’s life is in danger (no time limit).
Following the Supreme Court’s reversal of Roe v. Wade, these changes significantly impacted North Carolina’s role as a previously accessible location for reproductive care.
The imposition of new restrictions compels many to seek abortion services outside the state or to consider abortion pills available by mail nationwide.
The cost of surgical abortions, which can be around $500, remains a significant barrier, emphasizing the critical role of abortion funds and supportive organizations.
For those needing services beyond 12 weeks, the choice of where to seek an abortion becomes more complex.
Options vary based on individual needs, with some requiring travel to less restrictive states like Colorado or Washington D.C. This scenario highlights the fragmented nature of abortion access across the U.S.
Abortion statistics and support
It’s reported that 1 in 3 women in the U.S. will have an abortion in their lifetime, with numbers potentially higher when including all pregnant individuals. Ash Williams, from the Carolina Abortion Fund and the Abortion Doula Collective, supports many in navigating North Carolina’s abortion landscape.
The Guttmacher Institute recorded 878,000 abortions within the U.S. health system in the first ten months of 2023, a surge attributed to increased travel for services, state expansions of abortion access post-Roe v. Wade, and the rising use of telemedicine for medication abortions.
Abortion doula training
Ash Williams leads an inclusive virtual training program for future abortion doulas, attracting global participants. The curriculum spans reproductive justice, abortion decriminalization, medication abortion provision, and financial support for abortions, aimed at educating a diverse group of doulas. For more information or support, the Mountain Area Abortion Doula Collective of North Carolina and the Carolina Abortion Fund are valuable resources.
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