Abortion Doulas’ Experiences and Perspectives on Abortion Care in Ontario, Canada

Introduction : Abortion is decriminalized and common in Canada. Despite the regularity of abortions in Canada, access is uneven. Historical and ongoing experiences of medical racism, ableism, homophobia, transphobia, trauma, and other forms of discrimination can make it difficult for individuals to access abortion services and receive affirming, respectful care. Canadian medical schools dedicate minimal time to abortion training, and many providers report feeling ill-equipped to work in the abortion field. Many of the barriers people face when accessing abortion are rarely addressed in mainstream medical curricula. Abortion doulas (AD) work from a holistic and anti-oppressive perspective that could help strengthen abortion provision training. ADs have a unique angle on abortion care, as they create close relationships with patients and observe practitioners in the clinic. This study explores the perspectives and experiences of Ontario-based ADs to understand gaps in abortion care and abortion provision training. Methods: Participants located in Ontario were recruited through prospective sampling. The primary researcher identified and contacted abortion doulas and full-spectrum doulas in addition to abortion and full-spectrum doula organizations, who provided their emails online via personal or organizational websites. This study utilized semi-structured interviews and an inductive content analysis approach. The primary researcher developed codes, subthemes, and themes during the interview process. Once the researcher had conducted all interviews, they established three overarching themes. Results: Six doulas participated in the research. The majority of the sample size identified as white, with more than half being women. Three participants identified as LGBTQIA+ and two as non-binary. Almost all the doulas were full-spectrum or had a history of assisting with birth. The data generated three themes. The themes included (1) ongoing and nuanced communication, (2) autonomy, anxiety, and access for medical abortion, and (3) inclusive and affirming abortion care. Conclusion: This research initiates an investigation into abortion care and abortion practitioner training from the standpoint of ADs. By centering the insights of Ontario-based doulas, this study emphasizes the value of holistic, patient-centered approaches. The findings provide knowledge about the condition of abortion care in Ontario and suggestions for improvement.