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Archive for March, 2010

When you are not an active participant fighting for or against legal abortion, people tend to label you as “neutral.”  This is inaccurate.  Unfortunately, another consequence of the abortion war is a total lack of language for anyone who has something to say about abortion that is not about legal rights.

Exhale has a stand and it is not neutral.  We stand with every woman who has had an abortion.  We stand with every woman who regrets her abortion, with every woman who live-tweets  her abortion, with every abortion-addict, and with those who are not sorry.  We take this stand because we believe every woman who has had an abortion can experience wellbeing and because every unique story should be heard with dignity and respect.

Our stand is also for one of transparency.  We will tell you the name of every donor.  You can read the name of every board member.  You can review  our service reports,  our program evaluations, and find our public presentations online.  We have nothing to hide. We want you to ask.  We hope you do.

You may not like what we stand for.  You may disagree with our mission.  You may challenge our strategies.

But, you will know exactly what they are.  You will know exactly who we are. What we really want is to learn with you, to listen to you, to engage in a dialogue with you about how to support every woman after an abortion and how to create a social climate that supports and respects her unique experience.

We are proud to, as Susan Dominus wrote in the New York Times, have led the way towards:

more honest discussions about the range of emotions that can accompany terminating a pregnancy. Exhale, a postabortion hotline based in San Francisco, states on its Web site that for women who have had abortions, feelings of “happiness, sadness, empowerment, anxiety, relief or guilt are common.” It is also states that of the five founders, most support abortion rights and some have had abortions.

The reality is, the more honest we are about the reality of abortion in women’s lives, the more we build trust, authenticity and value.  The more we have a chance to create abortion peace.

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If there was ever a political debate that demonstrates the need for abortion peace, certainly HealthCare2010 is that call.  What would be possible for our nation if abortion was no longer the center of conflict?  Despite the obvious benefits of peace, the abortion war, like all major conflicts, feeds itself.   We despise yet we accept the status quo.  We want a different result, but we shut down our curiosity and our creativity.  Abortion peace is not a challenge of possibility but one of imagination, of will, of risk-taking.

At Exhale, we are regularly told, “No, We Can’t.”  We can’t imagine peace.  We can’t work towards it.  We can’t raise money for it.  We can’t organize around it.  We can’t achieve it.

We can, we do, and we will because we are women who have had abortions and we stand with each other.  We stand together.  We stand for peace.

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*Guest Blogger*

Nat Okey, Exhale Volunteer:

As a counselor on the talkline, I have heard callers share about pain so great, that I lack the tools to address the scope of their problems.  It’s often impossible to make things better right then and there on the phone.  Their hurt is so immense, it’s like a Goliath who is standing in their path, blocking any progress or even a view of the way forward.

Whether it’s a survivor in a violent and controlling relationship who cannot leave her abuser and must hide her pregnancy and abortion, or a mother of two who just could not bring another child into the world, as a counselor, as much as I’d like to, I cannot “fix” their situation. What I can do is give them some tools to help them clear their own path forward: validation of their emotions and their strength, referrals to resources, and an anonymous and safe place to tell their story without judgment or retribution.

For anyone who is facing a Goliath of hurt and who has called our talkline, or is thinking of calling, you have more tools than you may realize, even if you feel small and weak in the face of your pain and your circumstances.

I have always loved the story of David and Goliath.  Little David was once small and weak and yet he faced the mighty Goliath, despite the fact that Goliath was bigger, stronger and equipped with better tools and weapons.  Little David knew he was strong though, and a strong person – like all the callers I listen to on our talkline –  can figure out the resources they need to help themselves.

David had his slingshot, so he picked up some rocks as they were all he had at that moment.  What do you have laying around?  A friend, a pet, a good movie, a park you can take a long walk in?  What kind of resources do you have available?

What about a pen and paper?  Imagine your hand as the slingshot, the pen and paper your rocks.  Write out your feelings. Write what you need to express.  Write to who you need to hear.  Your first attempt may fail, no words may come, or they may miss the mark, but try again and you’ll get closer. Or you can try watching a movie with your dog snuggled close. It probably won’t remove your Goliath of hurt by the time the credits roll, but your second and third and fourth attempts will get you closer and closer to that day.

So pick up your slingshot and your rocks.  You’re a strong person, or you wouldn’t be here looking for answers. You’re probably pretty creative too as abortion is an issue we can’t talk about freely in public right now, and you’ve found a resource that most people aren’t even aware of.  Give us a call, read or send an ecard, refer a friend or partner. Think of us – the Exhale counselors – as rocks.  We’re here for you to pick up.  We’re ready to help you fell your Goliath and move you forward.

Pick up the phone and call Exhale: 1-866-4EXHALE.

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Kristen Schultz Oliver, Exhale’s Director of Programs

Over the years I have witnessed the profound impact of kind, compassionate conversation that has been taking place on the Exhale After-Abortion Talkline. These are rare and significant moments where Exhale counselors are safe harbors in an otherwise tumultuous sea of judgment and stigma around abortion. And in the time since the talkline started, counselors and staff at Exhale have been in the privileged position to make observations about the “big picture” regarding women’s needs after-abortion.

We hear from thousands of women and men every year across this country, and while individual needs are unique and vary widely, there are some common questions we’ve heard. Some of our most often-repeated comments since we launched the talkline include the following:

“Am I the only one?”

“Does anyone else feel this way?”

“Do you know what it’s like?”

“I wonder what other women do afterward to feel better.”

Collectively these questions point to a need for women not to feel isolated in their abortion experiences. It’s one thing for a counselor to say, “You’re not the only one! 1 in 3 women by the time they’re 45 will have an abortion – over a million women every year in this country…” etc. It’s another thing entirely for the woman in question to understand this for herself – not just take our word for it – be able compare notes and share ideas with other women, some of whom likely know what she’s going through, because they’ve been through it too. Yet the stigma surrounding abortion often keeps women’s’ voices silent and hidden from one another, and many do not realize that a friend or family member has also had an abortion and might be able to relate to them.

Here’s the conundrum then: if you’ve had an abortion, how do you take that leap of faith and trust someone with your personal, private experience? You don’t need to be a scholar of abortion care or politics in this country to know that it’s not safe to talk openly about personal abortion experiences. It’s a mine field out there! The status quo regarding public dialogue and abortion in this country is such a vile, vitriolic thing that it turns my stomach to think about it. Even people you think you can trust don’t always understand – and it can be devastating to be met with complete incomprehension from friends and family, to say nothing of the name-calling and hate-spewing that happens in more extreme cases.

Exhale has been offering a vital alternative to that on our talkline, and the clearly identified need for women to share freely with each other steadily became a mandate for us over time. As a learning organization, we have always taken our responsibility seriously to not just observe but to adapt to meet the needs of our callers, and last year the time was ripe to put our pro-voice approach to the test in another forum. It was never a question of “if”, only a question of “how” to achieve a new mission-centered goal: to provide women with a trustworthy place and way to connect with each other directly around their shared personal abortion experiences. The technology to make it happen is now easily available, inexpensive and user-friendly, which meant the need, our expertise and the tools all came together in a lucky convergence.

And thus the Exhale Online Community came into being!

But I’m skipping the critically important preparation that took place before it launched in 2009. We did not undertake the creation of the community lightly. Over the course of many months, Exhale learned from experts, conducted research, and consulted with attorneys so that we could provide the most supportive, respectful, private online place possible. We clarified and refined our core values, we articulated our guidelines for interaction with painstaking detail, we developed protocols for moderating the community, and we built the platform and decided on community features. Perhaps most important of all, we decided to offer invitations only to our talkline callers and ensured that admittance to the community was by application only.

Why all this intention, deliberation and caution?

In our experience, a sense of trust and safety is absolutely essential to having honest and candid conversation about abortion. We would be remiss if we did not proceed carefully and thoroughly, given our in-depth knowledge of what people are up against around abortion. We also know that most other online spaces for people to talk about abortion do not foster trust and safety. Elsewhere online the topic of abortion is dominated by political tangents, rude and impolite comments, personal attacks, slurs and offensive comments and all kinds of harassment. For us, we had to take every reasonable precaution against this and instead have participation be rooted in personal stories and a genuine desire to engage with others respectfully.

The result of all this hard work? Unimagined, awe-inspiring success, beyond anything we had dared to hope.

I’ll explain: to begin with, success for us is first measured in the exceptional tenor and tone of interaction between community members. In order to evaluate that, we needed a generous volume of people joining the site at a steady yet manageable pace, with a high percentage of members contributing content. We also knew we were expecting people to interact in a totally different way about abortion, and not only did we call upon members to work with us in making the space as respectful and inviting as possible, we consistently modeled respectful behavior in our moderation.

As we referred callers to the community, they arrived in gradual waves, and from the beginning, community members’ stories and comments demonstrate a willingness to embody pro-voice values and abide by the guidelines we set forth. With long and compelling individual stories being posted, there are many details for other members to read and respond to. Members take risks in sharing intense emotions and vulnerabilities with each other, and many posts ask for advice, input, ideas, and support. Replies are consistently warm, generous, helpful, kind – even affectionate! There are also the most amazing expressions of gratitude from community members to each other, and to Exhale for providing the space.

It feels incomplete to list all of this here and not provide quotes and examples to support my claims, but one of the non-negotiable values on the community is confidentiality. Preserving this is a fundamental priority for us, and it is strictly prohibited to share members’ stories, experiences, photos or videos outside the community.

Such was my dilemma when I presented our findings at sex::tech 2010 in a panel on Innovation.  I wanted to be able to share what we’ve learned about the community without violating the confidentiality we’ve worked so hard to maintain.  Instead, I gave them, what I hope is, a sense of what it’s like to participate in the community:

The best way I can describe it is like a “trust fall”. This is an exercise in which one person stands in an elevated position and falls backward into a group of people who are expected to catch her. The falling person takes a risk and trusts that the group behind her will extend their arms and work collectively to keep her from crashing into the ground and hurting herself. One person alone could not bear the weight of the falling person – but when joined together, many people can catch her and remain strong.

The Exhale Online Community is like a trust fall to me. No one is dropped, and members are buoyed, held above the fray, embraced.

Moving beyond the analogy, Exhale is measuring our success in concrete terms, including this snapshot:

  • 102 members in first 6 months (July 2009 through Jan. 2010)
  • An average of 3-5 new members joined per week
  • 64% of members contributed content
  • Over 700 written posts (including blogs and comments)
  • An average of 11 posts per contributing member

It was a fantastic opportunity for me to share about the community at sex::tech, especially given that this was the very first time Exhale was speaking publicly about it, and only on the first six months of operation. One big take-away: many of the questions I received were concerned with expansion and increasing access to the community:

“What are your plans for growth?”

“Can health care providers refer patients to the community?”

“When will you be opening up the community to significant others?”

“With only about a hundred members so far, you’re barely scratching the surface. How do you intend to reach the over a million women each year who have an abortion?”

While the desire to have this kind of after-abortion support available to the masses is understandable, it’s not our aim to make this relatively small community available to everyone who has had an abortion. We know that each woman’s needs after an abortion are unique: some women will not need any special support after-abortion, others will find the support they need within their established network of friends and family, some will reach out and call our talkline for one-on-one support, and others will seek an online way to connect with other women. There is no one-size-fits-all approach.

For those seeking to create community around their abortion experiences, Exhale believes that the quality of conversation that takes place about abortion is paramount and must be well-established before we tackle quantity. That is where our focus has been, and that is where we have found success. Going forward we will take the lessons learned here – clarify positive values, establish guidelines for interaction, invite people intentionally, conscientiously moderate the space, start small, grow deliberately and purposefully – and continue to meet people’s after-abortion needs as we understand them. This will always be based in people’s real lives and individual experiences, with women’s voices front and center.

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Kristen Schultz Oliver, Exhale’s Director of Programs, presented at Sex:Tech 2010 on the “beta-phase”  of our private online community space for women post-abortion.  It was the first time we reported on our experiences and findings publicly and Kristen will have a blog post up about it soon here.  In the meantime, you can now download her presentation at the Sex:Tech website.

Ivory King of L’Atelier reported:

Kristen Schultz Oliver created Exhale, a site for women to support each other after abortions. The site runs on the Ning social network platform after extensive customization. Since removing all the public sharing features and external linking to Facebook and Twitter, it has become an anonymous sanctuary. Strict criteria is employed to create a completely supportive environment where only women who have had an abortion can join. No politics, rudeness or personal attacks are allowed, and personal stories, mutual support and gratitude proliferate.

And co-panelist Nancy from Where is Your Line? reported:

Using the Twitter back channel following my second panel “Reducing Stigma Through Social Networking” I was able to track the points and themes that stood out the most for people. This panel highlighted Whereisyourline.org alongside the work of Exhale a private and secure online space for women to discuss abortion, and the St. James Infirmary Clinic a for sex workers by sex workers health clinic. This was a space to talk about stigma and how peers talk and support each other. Some thoughts that floated around (sorry @mkeagle, they’re mostly yours!):

Yesterday we talked about the challenges of accessing closed online communities; Exhale is pointing out some real positives. (@mkeagle)

Expect to hear more from Exhale in the months ahead about our ongoing work to use social networking to reduce stigma.

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Exhale promotes support and respect for each person’s unique experience with abortion.  Our talkline is just one of the countless ways to provide a woman who has had an abortion with the opportunity to feel supported and respected.  Our e-cards are another way.   Our zine just one more.   Our hope is that each woman  finds what it is she needs to experience wellbeing after an abortion, whether she finds it through Exhale, a friend, her priest, a self-help book, or through the work of organizations like The  Doula Project.

The Doula Project provides free compassionate care and emotional, physical, and informational support to people across the spectrum of pregnancy. They are made up of 20 volunteer doulas and work in partnership with Spence-Chapin Children and Family Services and the Reproductive Choices Clinic of a Public Hospital in New York City. Since 2008, we have provided doula care for more than 1,000 pregnant people.

I had the opportunity to interview Mary Mahoney, a founder of the The Doula Project, which was recently featured in Bust Magazine.   I was interested in learning more about her experiences working with women having abortions, the role of doula’s in promoting wellbeing post-abortion, and the changes they are working to accomplish.

Here is what she shared.

Me: Tell me what led you to found The Doula Project.

Mary: “I initially became a doula because I wanted to learn more about pregnancy, my own body, and how abortion rights and birth rights are connected. I had been working in the reproductive justice movement for about a year at that point, and I wanted to dig deeper into what holistic reproductive health really means and how it affects our entire lives. When I met the other founders of The Doula Project, I realized how much bigger my doula work could be, that I could actually help develop a movement that brings together birth and abortion, direct service and social change. Our mission of ‘supporting people across the spectrum of pregnancy’ inspires me on many levels. In a direct service sense, it means we get to work with women who are giving birth, having abortions, choosing adoption, and experiencing fetal loss. In a political context, it is a way for us to make a statement that these reproductive health experiences should not be isolated from one another.”
Me: What have you learned – about women, about yourself, about abortion – by being a doula to women undergoing abortions?

Mary:  “Some people in the reproductive health and rights movement have asked us, why do you assume women having abortions need emotional support? In the beginning, that question scared me. I thought, Is that what our project is doing? Are we setting the movement back in some way by thinking that this is an emotional time for a woman?

Two years later, our project has served more than 1,000 women having abortions, and I can say that there is no simple answer to such a simple question. What I’ve learned is that everyone experiences abortion, and pregnancy for that matter, differently. Someone recently said to me, ‘I love the spectrum of pregnancy framework because it makes me remember that these women are experiencing pregnancy, not just abortion.’ I think when a woman has an abortion, in that moment when that decision is made we forget that she is a whole person. So I’ve stopped making generalizations or trying to predict how a woman will react before, during, or after her abortion because each person’s life looks different, even within a shared physical experience. And I stopped being scared of the movement when I started getting to know the individual having the abortion. Nearly all of the individuals we’ve encountered in the clinic have benefited from doula support, whether on an emotional (which can have a variety of meanings), physical, or informational level.”\
Me: How does your work promote a woman’s wellbeing after an abortion?

Mary: “When we started the project in 2007, we envisioned a big part of our role occurring outside the clinic, after the abortion. We would visit our clients in the recovery room and give them our phone numbers. We talked about setting up a doula phone line so clients could easily reach us whenever they needed. What’s been interesting is that our communication with them after their abortion is minimal. This could be for any number of reasons, including that they don’t need further support, that they have friends and family to talk to, or that they don’t want to revisit the experience in any way.

Aside from direct care post-abortion, I think having a doula present during a procedure gives women something that is missing from many medical experiences, particularly reproductive health experiences, and that is feeling in control of what is happening to their bodies. Doulas can serve as an amazing vehicle for empowerment by giving women tools to self-advocate in a medical setting, meeting them where they are and on their terms, and offering a strong, empathetic presence. Our hope is that if women are empowered during their abortions they will feel more in control of their reproductive health after their abortions.

On another note, we are currently working with a nutritionist and herbalist to provide women with a post-abortion wellness guide. It will include suggested foods, drinks and herbal remedies to help soothe and comfort a woman in the weeks after her abortion. Building up our post-abortion services is definitely a goal of ours in the coming year.”
Me: What – if any – role have you seen loved ones play in supporting a woman through an abortion?

Mary: “As a doula for terminations, my contact with a client’s loved ones is usually minimal. At our clinic, loved ones aren’t allowed into procedures rooms, and only under certain circumstances can they visit the recovery room. I tend to get a little insight into the support of family and friends from the clients themselves, and while it is not uncommon for a woman to come to a procedure alone, many of our clients have the support of at least one person in their lives: sisters, moms, partners, and friends. I learn about their relationships on a pretty superficial level so I can’t really answer how deep that support goes with much authority.”

Me: What kind of changes does your project hope to accomplish in the world and what do you need to get there?

Mary: “The Doula Project’s vision is to create a society in which all pregnant people have access to the care and support they need during their pregnancies and the ability to make healthy decisions, whether they face birth, miscarriage, stillbirth, fetal anomaly, or abortion. To help facilitate this, we operate under two main priorities 1) growing our local work and supporting our community of doulas and 2) creating a national movement of doulas who work across the spectrum of pregnancy.

For us to accomplish change on a broad level, we need doulas and medical professionals around the country to embrace our mission of providing compassionate care to people across the spectrum of pregnancy. We are currently creating a replicable full spectrum model for doulas to follow in their own communities. We are developing start-up guides, a training toolkit, and grassroots fundraising and volunteer management resources. We think it is still possible to create a sustainable volunteer run organization and that, with the right tools, activists all around the country and world where abortion is legal will be able to provide this service to their community. We are talking to doulas in several different cities right now and helping them get started. The Seattle/Olympia area, L.A., Greensboro and Asheville, NC and Atlanta, to name a few, have already organized groups of abortion doulas and are looking for clinics to offer their services to.

We are also holding a National Radical Doula Meet-up with RadicalDoula.com (Miriam Perez) next summer to help doulas working across the spectrum of pregnancy connect and to train new activists on our model of care. This is an area of our work in which having a background in the reproductive justice movement has been so priceless for me: the aspect of communities connecting to and supporting other communities to make radical change.”

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