This community-engaged study examines abortion and family planning doula services,
attitudes toward these services, abortion stigma faced by abortion doulas, and doulas’
recommendations to improve access to care.
From October 2020 to February 2022, academic researchers and a community-based maternal-child
health organization conducted a cross-sectional, mixed-methods study with full-spectrum
doulas in Georgia, where maternal mortality is high but abortion and contraceptive
access are restricted. We interviewed and surveyed 20 doulas about their scope of
abortion and contraceptive care, their personal attitudes toward family planning,
and experiences with abortion stigma.
Our sample was diverse by race/ethnicity (45% Black/African American, 40% White, 5%
Latinx, 10% other) and services provided (85% birth, 60% postpartum, 40% full-spectrum,
35% abortion, 45% family planning). Participants reported positive attitudes toward
abortion and contraception (Stigmatizing Attitudes and Beliefs=22.29 on an 18–40 scale;
adapted Sexual and Reproductive Health Stigma Scale=8.6 on a 6–13 scale). Among abortion
doulas, abortion provider stigma was moderate to high (average Abortion Provider Stigma
Survey (APSS) score=24 on a 17–27 scale), and resilience was moderate (average resilience
score=7 on a 4–11 scale).
This study contributes two main findings: first, family planning and abortion care
training are needed and desired by doulas of all kinds. Second, abortion stigma is
being experienced by abortion doulas. As contraceptive and abortion care is further
restricted, doulas may serve as a vital link to family planning services. Increasing
doulas’ capacity to provide contraceptive counseling and abortion care is feasible