Interview: Radical Doulas Mary Mahoney and Lauren Mitchell

by Michele Zipp

Radical thought and action is so very necessary, and not only in times like now, when the administration is so backwards and inept that it feels as if we are living in the matrix, but always. Living with radical thought and action are Mary Mahoney and Lauren Mitchell, full-spectrum doulas and authors of The Doulas: Radical Care for Pregnant People. A full-spectrum doula is a person who cares for someone through all pregnancy experiences -- birth, abortion, adoption, surrogacy, stillbirth, and miscarriage. And that support is vital.

Mary and Lauren are reproductive justice advocates who empower women, help so many deal with some of the most difficult times in life, and they do so with empathy, which is what they say will create change -- real change. We agree.

"Our ideals will take us so far," Mary and Lauren share. "We can have love for women and working for and with them will bring you strength, but we also must band together, as communities––far and wide––to make real change within feminism and the world."

That change is within us all. And the inspiring work that Mary and Lauren do furthers the narrative on women’s rights, human rights, and how our power becomes stronger as we are there for and with each other. Love. Kindness. Compassion. It’s as simple and as difficult as that.  

 Mary Mahoney & Lauren Mitchell: Radical Doulas.

Mary Mahoney & Lauren Mitchell: Radical Doulas.

The book, The Doulas: Radical Care for Pregnant People is a guide and also features personal narratives -- can you share more about what inspired you to write the book in this way and what part was perhaps most difficult to write or share?

Mary: We wanted the book to be readable, accessible, and relatable. We wanted to give people a different window into these life experiences, maybe one they hadn’t seen or heard before, at least not intimately. We wanted to really give insight into the procedure room, into the lessons we’ve learned as caregivers, and into the deep loving relationships we form with our clients. We know that personal narratives touch people and ingrain themselves in people’s memories. We also felt that using a storytelling approach would nicely parallel and honor the philosophical approach of doula work, which is to recognize that every person comes to you with their own individual, unique story, and that every pregnancy is different for every person.

The most difficult part of the book wasn’t being candid about the more politically or emotionally fraught outcomes of pregnancy, like second trimester abortion and stillbirth induction, it was working within the grey area of sharing other people’s stories. We were extremely careful and tried to include our storytellers as much as possible throughout the process. I would say the book pretty much wrote itself once we had collected the stories. Our storytellers gave us such unbelievably vivid details of their experiences and offered such raw, unbridled emotion. From there, it was just up to us to present it in the most accurate and respectful way.

Where does your strength come from, how do you summon it, when you have to be there for a woman during a most difficult time?

Mary: Ten years into direct care, I think I retain strength from different sources than when I first started. In the beginning, it was a lot of willpower and adrenaline and conviction that what we were doing was important and necessary. But direct care puts you face to face with the reality of people’s lives which are messy and complicated, especially when colliding with the healthcare and political systems. So my ideals and my will could only take me so far after a while. I think for me, and most full spectrum doulas you talk to, beyond love for women and the work bringing you strength, it’s the community you surround yourself with: other doulas and coworkers, the people you go home to. And on good days, it’s your clients and the medical providers who can give you strength. I definitely operate from a “knowledge is power” frame so as I became more confident in my role and learned how to establish personal and professional boundaries, it naturally became easier for me to be a source of strength for others.

Doula work is so soulful, so intrinsic, so powerfully meaningful -- you are there for a woman when she needs you most, essentially being her "village", her "tribe" -- how has this impacted you as a person?

Mary: In short, I am definitely a better person since I became a doula! Being a doula let me show a part of myself I had never let myself show before: someone who leads with kindness, someone who heals through touch, someone who accepts people as they are in whatever moment they happen to be in. The role, both as doula and cofounder, has taught me abundant patience. It has also taught me about my limits and about when I need to give a little bit less. Being a doula, and a caregiver in general, teaches you that the path to enlightenment is not perfection, it’s simply showing up every day and doing the best you can for another person and for yourself.

Right now, we need empowered thinkers more than ever to make real change, change for better. Within your work, have you seen injustices by women to women? How do you think we can change that, to further our bond, own power, and to also further intersectional feminism? 

Mary: What draws people to doula work is this incredibly unique opportunity to be kind to another person. Our entire purpose for being with a pregnant person is to offer compassion and love. That is a rare space to hold in this world. Of course injustices happen to women by women, every day. It’s part of living in the patriarchy. We are set up to compete, whether in career or love or home. I fall into that trap sometimes, like everyone. Privilege and power obviously play a huge part in creating spaces of injustice in whatever field we are in; feminist organizations aren’t safe from those dynamics.

I think we are making real inroads right now in strengthening feminism. Leadership that represents those most impacted is essential. I heard this quote the other day that I loved: “you don’t need to be a voice for the voiceless, just pass the mic.” The reproductive justice movement has been doing it for years – it is a movement led by people of color, young people, queer people, immigrants -- and the rest of the feminist world is, hopefully, starting to catch up. We need to stop cannibalizing each other in order to create a stronger movement. Loretta Ross, a founder of reproductive justice and major feminist thought leader, says that we should try calling people in instead of calling people out. I love this approach. It’s not about letting anyone off the hook, but it doesn’t lead with an attack. In order to nurture and retain all the new activists we are seeing right now, I think this approach is crucial. As much as everyone thinks they know, we can really only know our own life experiences, and for everything else we need to be okay with listening and learning.

What draws people to doula work is this incredibly unique opportunity to be kind to another person. Our entire purpose for being with a pregnant person is to offer compassion and love. That is a rare space to hold in this world. Of course injustices happen to women by women, every day. It’s part of living in the patriarchy. We are set up to compete, whether in career or love or home.
— Mary Mahoney

Do you think there is a war on women? How would you address that, if so?

Mary: There is always a war on women! But I think it’s difficult to fight a war on women when many women don’t see the war against them happening. The election was proof that plenty of women, particularly married white women, are quite comfortable with the status quo. Or if not comfortable, very misinformed about how policies work against them.

Because there is a war against so many people in our country, I think we can create change by coming together; all the individuals and communities that are being marginalized and discriminated against hold power in their sheer numbers and the passion they have to survive and find justice. We have a lot of people out fighting right now and it’s so inspiring to see and be part of.

Anti-abortion activists take on the term "pro-life" but to me, as a woman who is pro-choice, I want to reclaim "pro-life" because I feel those who are pro-choice are truly pro-life in it's core meaning -- we care about life, about our rights as living, breathing people. Being anti-abortion is anti-woman. What are you thoughts on that and how do you think we can help those who are "anti-abortion" see our side?

Mary: Full spectrum doulas have such an amazing perspective on this matter because we see both birth and abortion every day and live through the experience with our clients. We contemplate the life and death of the fetus -- some of us feel it is a life, some of us feel it’s not, some of us embrace whatever our client’s belief about her pregnancy is. I realized pretty early in my career that I see the fetus, at a certain gestational age, as a life. And my pro-choice stance never faltered because of it. In fact, I think I became a more spiritual and convicted person and interact with the work more deeply because of it. As you can imagine, pro-lifers have a bit of trouble grasping this view. But when we take the nuance out of the experience and make it black and white, we lose so so many people who’ve actually had to make the decision to terminate or parent.

As someone who is about to give birth and who has attended hundreds of second trimester procedures, I have a renewed energy to examine these stances and the hard lines we draw. Many pro-choice activists have said this in the past, but having a planned pregnancy and becoming a parent by choice has made me more pro-choice than ever.  Being pregnant is wonderful and terrifying and precious, under the best circumstances. I had difficult moments during my pregnancy where I had to fight against my insurance company, my providers, the crazy changes taking place in my own body. And every time I would think, what if I didn’t want this? What if this was being forced upon me?

I grew up in a pro-life community in Southern Indiana and work with many people in the city who are religious and, I suspect, pro-life. I’ve been speaking to pro-life crowds my whole career. I try to be sensitive and meet everyone where they are, particularly if I’m talking to another woman (men, honestly, I don’t have much patience for in this conversation). I’ve gotten serious pushback for making statements like, “if you are anti-abortion, you are anti-woman.” Because what we on the pro-choice side forget is that a lot of pro-life women really feel they have women’s best interests at heart – when they are referring them to adoption centers or cautioning them about the dangers of abortion – they really feel they are guiding them in the best direction. It’s very deeply ingrained in them, just like our pro-choice values are very deeply ingrained in us.

The Women’s March brought up what the “true definition” of feminism is and whether the pro-life stance can be part of that. Many brilliant feminist thinkers say you cannot call yourself a feminist while denying others autonomy over their bodies – which by voting against abortion access is essentially what you are doing. I was recently giving a talk at a liberal arts college in the northeast and a young woman approached me – she identified as pro-choice but was very concerned about pro-lifers being left out of the March and ostracized on her campus. She wanted to know “can’t we do better?” Common ground efforts have taken place in the past to limited success, during way less tumultuous times that what we face now. I told her that I don’t know if now is the time to bridge the two sides; everyone is desperate to protect their own at this moment. But if it feels safe to do so, I think speaking to pro-lifers can be effective and is necessary and there are ways to reach them, especially starting at the micro level, one-on-one. That is what we are trying to do with this book and our tour and why we are focusing a lot of our future travel on the middle and southern parts of the country. We think The Doula Project mission – which approaches both birth and abortion with kindness and unconditional support -- can create a bridge.

With The Doula Project, you are furthering the narrative, opening people's eyes that we need to supporting people through the spectrum of pregnancy. Can you talk more about your mission? And how The Doula Project came about?

Lauren: The Doula Project started in 2007, which was a period in the reproductive justice movement when a number of organizations were actively trying to get birth workers like midwives, doulas and obstetricians in the same space as people who have been fighting for abortion access.  This was not particularly original: SisterSong and a number of other groups had always incorporated pregnancy care and support -- regardless of the outcome of the pregnancy -- into their mission. But in 2006 and 2007 a number of conferences were put together with the specific intention to bridge the gaps between birth work and abortion advocacy.  

Mary, Miriam Perez, and I were all very involved in the reproductive justice scene, and had recently been trained as doulas. We found ourselves in the same room a lot, with a similar vision. We would hear conversations constantly about how birthing people deserved support and love, and how people who needed abortions deserved access, “on demand and without apology.” There was a disconnect between the two poles: where was the unconditionally loving support for people who were choosing to have abortions?

We started with a wing and a prayer and what we thought was a lot of good connections as “The Abortion Doula Project.” It would take us about a year before we were allowed access to an abortion clinic, which would radically change our identity. After doula-ing for a number of clients who were having abortion procedures to manage miscarriages or perinatal loss and anomaly, and a number of others who weren’t empowered by the word “abortion,” we got the sense that our organizational identity needed to shift. What sealed the deal was when we started offering support to birth parents who chose adoption plans, and from there, when low-income people started reaching out to us for low-cost or free birth support. So, “The Doula Project” we became.  

What inspires you to do this work? 

Lauren: The short answer: the clients and the community of doulas and caregivers. After doing a lot of policy and advocacy work, which often speaks to macro-level systemic injustices rather than one-on-one encounters, we wanted to do something on-the-ground, to get out of the office and into the places where people needed support. Events like the Civil Liberties and Public Policy Program’s annual conference, which kicks off with an Abortion Speak-Out where people talk about their experiences with abortion to break the silence, were instrumental in the creation of The Doula Project.  

We say this often: in life, people rarely get an opportunity to lavish one another with love and kindness, and especially when faced with the vulnerability of being at a doctor’s office -- let alone the vulnerability that can come with having an abortion or otherwise managing a pregnancy -- people are often hungry for it, whether it is being offered or received. For me, as for many of us, I also do this work because I like stories. I want to hear as much as my clients want to tell me. We want to offer that listening space, and to see our clients in their context: these reproductive experiences are part of their lives, but not the whole of it.  

Have you worked with women who felt ashamed of their decision and how have you helped them work through that? 

Lauren: The word I would use to describe how many of my clients have felt about their abortions is “fraught.” When I first started out as a doula, I often tried to adopt the language of policy and advocacy activists: words like “empowerment” felt important to me. This language remains important to me, but it’s implicit. When people are looking for reproductive healthcare, especially when seeking an abortion, it’s not necessarily “empowering;” it’s putting one foot in front of the other to do what you need to do.

I think of it as a bell-curve.  Some people feel empowered by their abortions (and that’s awesome!); some are devastated by them (not awesome). Most are in between: people feel relieved and exhausted. They are glad they could get the procedure but not happy to have needed it in the first place. All of these statements are generalizations, of course.

Because of the wide scope of our work, feelings of shame can come up in a variety of different outcomes: choosing to become a parent under imperfect circumstances, choosing to make an adoption plan, choosing an abortion, or having to deal with a miscarriage. The doula’s job in this case is to be consistent, clear, and loving. You are offering a calm and normalizing presence in the face of what could feel like a crisis. It’s that “normalizing” component of our work that I feel is so crucial, and yet it is something we take for granted as professionals in the field. We’re used to it: this is what our day looks like, for some of us all day, every day. But for that reason, our clients are appreciative of our presence: we’ve seen it before, and we can remind them that they aren’t alone.  

We can’t promise to take anyone’s pain away -- what we talk about in the book as being one of the most bitter pills of doula work -- whether it is emotional or physical pain. But we can serve as a lighthouse as people work their way through whatever shame or anguish they might feel, reminding them along the way that they deserve to feel beloved, and that they are worthy of it. 

Why do you think reproductive health is so hard for some to understand when it involves the whole spectrum of the kind of care we need? I'm speaking specifically to the after-care for a woman who has experienced the loss of a pregnancy. 

Lauren: Well, first and foremost, your question speaks to a logistical issue: the procedures and techniques that people need to manage miscarriages, or later-term pregnancy losses or lethal anomalies, are in fact the exact same procedures people get when they have abortions. No one talks about that -- and in fact, we didn’t even realize how many of our “abortion” clients would be in the clinic for miscarriage management until we started. The narratives surrounding abortion, birth, and miscarriage -- and, adoption, perhaps more than the rest -- are violently siloed from one another, as if they were all mutually exclusive. Most of our clients seeking abortions or having miscarriages were mothers already.  

In our work, the overlap of these reproductive experiences was intuitive, and our clinic site made it easily accessible for us to jump in wherever necessary. It also locked in the fact that our role is to go where we are needed, especially if someone is having a stillbirth, which is a terribly isolating experience for most people. One of the most powerful statements I had ever heard was from a nurse who was taking care of one of my clients immediately after her stillbirth induction, a situation where she chose to induce labor early because the baby had a lethal genetic problem. The nurse held my client’s hand and said, “You will have to be ready to forgive a lot of foolishness from a lot of people for a while.”  

The procedures and techniques that people need to manage miscarriages, or later-term pregnancy losses or lethal anomalies, are in fact the exact same procedures people get when they have abortions. No one talks about that.
— Lauren Mitchell

Truer words were never spoken. The loss of a baby can render many people speechless at best, and clumsy and insensitive at worst. Almost half of the births I’ve attended as a doula were stillbirth inductions, which became an accidental specialty. It’s a skillset that is important to pass on to other doulas because -- hopefully -- they won’t see it often, and therefore there’s not a lot of training around it.

While not all doulas view their work in this way, I feel that the work of the doulas in The Doula Project is an emotional labor. I have felt that the most during stillbirths, where the physical and emotional intensity of the experience is not only high, but very unique. Few people will be able to understand what it was like for the client to go through it, and so you, as the doula, are by her side to do a great many things, but above all, to hold the memory of the experience for and with her.

Fifty-three percent of white women who voted, voted for Donald Trump. These actions have terrible consequences, but they are also an indictment of the complicity that comes with privilege — when people are primarily worried about maintaining their own comfort.
We have to call selfishness by its name. We have to become better.
— Lauren Mitchell

How do you think we can best work together to get rid of these archaic notions that a woman shouldn't be in control of her own choices, her own body?

Lauren: Elect a new president!!!! Haha, just kidding. Not really.

Truth be told, this is a question I’ve been struggling with a lot since the election. Intersectional feminism notwithstanding, it feels like there is so much work to do on the ground to fight this administration that it’s hard to stop to breathe and figure out a cohesive organizing strategy, for any of the numerous issues that we’ve had to confront in the last few months. Personally, I’ve felt as if I am in a constant state of “activist triage,” wondering what needs my time and energy the most at any given moment. As many articles and internet memes have pointed out, it’s an excellent way to grind yourself to nothing, and it’s something I fear many of us will do if we’re not careful and intentional about our actions and our energy. Somewhere in between all of that, we have lives to live, too.

A number of organizations, like National Advocates for Pregnant Women, have worked to engage those who label themselves as anti-abortion by pointing out that it’s the same legislators who create laws that oppress pregnant people, whether or not they are seeking termination. Bills like Tennessee’s “Fetal Assault Laws” or other laws that give way to fetal personhood -- like the ones in Indiana that have gotten women arrested for having miscarriages (thanks, Mike Pence) -- or any law that makes it permissible for hospitals to obtain court-orders for c-sections for laboring women, are routed through abortion laws. Having open conversations that make it clear that reproductive health is tied in a number of ugly, legal knots is one place to start.

But these conversations need to be firm and clear, and we have to be prepared to put up a fight on all fronts: in policy, in direct care, on the streets, and in our homes. Fifty-three percent of white women who voted, voted for Donald Trump. These actions have terrible consequences, but they are also an indictment of the complicity that comes with privilege -- when people are primarily worried about maintaining their own comfort. We have to call selfishness by its name. We have to become better.

How do you think we can inspire change in our every day lives?

Lauren: One thing I’ve been thinking a lot about lately is how poorly we define empathy in our culture, in that often people look at it in terms of whether or not they can imagine themselves in the position of another person. At the same time, many people do not have humility toward the limitations of their imaginations, or are otherwise willing to reject or harm what they can’t identify with. I hope we can be part of a system that shifts the rhetoric of “empathy” to something that looks more like trust and acceptance: I don’t have to “completely understand” your decision or “get” all aspects of your life to trust that you need the service you are asking for.  

With that in mind, I believe we all have an ethical obligation to offer as much compassion and support to one another, as people, as our capacities allow. Part of that can come in an exchange of story, which builds community for the teller as much as it does the listener. And I hope that the book can be a part of a shift: we owe it to one another to listen with good, loving intention, to bear witness to experiences, to follow others—our clients—wherever they need  us to be, whether that’s in their greatest anguish or their most incredible happiness.

I believe we all have an ethical obligation to offer as much compassion and support to one another, as people, as our capacities allow.
— Lauren Mitchell