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During a particularly challenging shift, nearly every patient I supported spoke Spanish as their first language, and very limited English. I speak some Spanish, but I’m nowhere near fluent in the language, which made verbal communication a little bit spotty. Even though every one of them was patient with me as I fumbled through conversations, and forgiving when I simply couldn’t find the words I wanted to say, I began to feel like I wasn’t giving them the quality of support that they deserved. I couldn’t tell them that they were strong, that they were brave, and that they would get through this. The best I could do was small talk.

I also relied heavily on touch; rubbing shoulders, holding hands and stroking hair. Even though these are things I almost always do when supporting a patient, somehow being in this language limbo of sorts made me feel like everything else I was doing was less than adequate.

As the end of the day approached, the last patient I was to support spoke only Hindi. As it happens, this patient was having a particularly difficult time. Without much time to think about what I was going to do to make her feel comfortable and supported, she began trying to communicate her feelings to me. After some time and effort, I understood that she was afraid of feeling pain during the procedure. I understood that she felt conflicted about coming to the decision of having an abortion; that even though she was set on having the procedure, part of her felt as though she was losing her baby.

Even though a doctor came by to help her understand that she would be anesthetized during the procedure and would not feel any pain (she was there for a second trimester abortion) her fear did not subside. For the majority of our time together, she squeezed my hand and looked to me for a reassuring nod or smile as I gently massaged her shoulders.

Although these same measures of comfort had seemed insignificant to me earlier that day, they did not seem insignificant now.

Her fear and anxiety seemed to grow more potent as she lay on the operating table, waiting for the procedure to begin. At this point our eye contact was constant, and our hands were tightly clasped together. I made my expression calm and knowing, trying to convey to her that she would be all right and that I was there for her. She was looking at me with such focus, and I know that she understood my meaning.

When it came time to say goodbye, she wrapped me up in a tight embrace and once again focused on my face. Her expression read relief. I left her feeling as though I had made a difference in her experience. I felt like I had helped. I also left her with a different perspective on my own experience with the patients who had preceded her. Not only had I underestimated the potential of touch in doula work, I had discounted the power of my presence as a doula alone. I was reminded that even though I hadn’t been able to say all I wanted to say to the patients I supported that day, I had been there and that is not insignificant.

I didn’t know that my patient was seeking to terminate a pregnancy resulting from rape. She wouldn’t allude to this until we were in the recovery room. In the waiting room, she conversed with the other patients before the procedures started. She had a contagious, off the cuff sense of humor; witty and somewhat crass. She was a true storyteller. When it was her turn, I sensed she was anxious.

In the operating room, she tried desperately to let her humor suppress her nerves. Beyond the context of why she chose abortion, the room itself would not allow for calm. Machines beeped and buzzed, lights blinked, surgical instruments sat ready on the table. As a doula, there is always a temptation to take these things away and I tried all the little tricks to do so. As the procedure began, I talked a little louder about her job and her kids to distract from the sounds in the room. I tried to position my body to block her view of the instruments. Ultimately, these gestures were unsuccessful in calming her. She became quiet. She closed her eyes and her face tensed. She was uncomfortable and unable to relax. Her clenched muscles were making the procedure more difficult and therefore longer. Our hands were clamped together and her eyes were squeezed shut. I could feel that she was in pain. I put my face right up next to hers. I could feel the wetness of her tears.

You are stronger than this is hard.

That is what I said to her.

"You are stronger than this is hard" is a mantra I learned as a birth doula so the connection to abortion work is not immediate. In birth work, doulas are taught to empower their clients. To teach and remind them that their bodies are designed to carry and birth a baby. We hope that after birth they feel more empowered in their bodies and in their physical and emotional strength. We believe that the experience of birth can provide that.

But what if we believed experiencing an abortion could provide some of the same things? If there is anything I have learned from birth work, it is that the mind can empower the body; that the narratives we have about our bodies shape our experiences within our bodies. Yet this is implicitly true in abortion work as well.

As an abortion doula, I am only with the patient for about twenty minutes. When I am with clients, I am usually quiet. I am a witness and a listener. Many clients tell me stories. About a child’s fifth birthday party, about studying for a graduate exam, about first meeting a partner. Sometimes I hear stories of how they became pregnant, of why they chose abortion. I am present in their lives for a comparatively short amount of time to all that came before and all that will come after the abortion procedure. There will be other birthday parties, tests to take, and first dates.

I have discovered that doula work is not about what you can take away from their abortion experience. You cannot dim the lights and hush the sounds of the room, you cannot soften the voices of the medical staff, you cannot take away the pain. Instead, a doula adds. A doula adds a smile, a hand to hold, encouraging words, or just a steady, silent presence. And, perhaps most importantly, a doula can add a narrative about strength in experiencing our choices, whatever those choices may be.