Medical Students as Medication Abortion Doulas During the COVID-19 Pandemic

Last year, our MSFC chapter was presented with an exciting opportunity to begin a medication abortion doula training program under the guidance of Dr. Marit Pearlman Shapiro, a then-first-year family planning fellow. Dr. Pearlman Shapiro began a surgical abortion doula program as a medical student at Icahn School of Medicine at Mount Sinai in 2013, in which medical students were trained to provide emotional, physical, and informational support throughout a patient’s abortion procedure. She proposed starting a similar program in Hawaii, and we were able to recruit 12 medical students during our first semester!

We held our very first training session in January 2021. We provided an overview of medication abortions and contraception, discussed challenging scenarios, and participated in a values clarification session led by 3 of MSFC’s experienced student leaders. As tele-doulas, we have had the chance to support patients through the bleeding and cramping of medication abortions, encourage women feeling weighted down by religious beliefs, and provide comfort for those facing their abortions alone. Of the 194 patients offered this service in the past months, 37 (19%) were interested in participating in the program. All were contacted by one of our medical student tele-doulas by text message for support during their medication abortion.

Dr. Pearlman Shapiro and the students who took part on the The Doula Project

Our goals for The Doula Project have been two-fold. First, we wanted to provide support for women undergoing medication abortions, which can be both emotionally and physically taxing. This was especially important to us as the COVID-19 pandemic imposed significant social isolation. The majority of trained abortion providers in Hawaii are concentrated in urban areas such as Honolulu, making access particularly limited for neighbor island patients. In addition, the COVID-19 pandemic created another obstacle for women to access in-person abortion services. Medication abortions provided remotely via telehealth have provided a solution to both of these problems. Second, we wanted to present medical students with a unique opportunity to interact with patients during a time when clinical experiences were also limited. We hoped that through these interactions, medical students would strengthen their knowledge of abortions, build clinical skills in communication and patient advocacy, and increase their comfort and willingness to provide abortion care in the future.

With a promising first semester, we are now planning a second training session this Fall and intend to sustain The Doula Project as a student-driven initiative through future classes. We also hope to share what we’ve learned with other chapters who are interested in starting a doula program of their own.

If you’d like to connect with Morgan or Dr. Pearlman Shapiro for more information, reach out to [email protected].