You Don’t Have to Be a Doula to Offer Abortion Support

Abortion is many things: pain, community, hope—and a social good, Hannah Matthews writes in her new book.

Photo of Hannah Matthews with her book You or Someone You Love
Hannah Matthews said the driving force for her book is to help people understand that when someone uses the word “abortion,” they could be talking about many things. Rewire News Group illustration

In her new book You or Someone You Love, writer, clinic worker, and abortion doula Hannah Matthews offers a picture of what abortion care looks like, and what it could look like if we dared to dream and invest in radical, compassionate community care. The book interweaves personal stories—including Matthews’ own abortion story—with the kind of frank information about abortion that many people have never heard. It also asks the reader to think about ways they can personally support people who have abortions, however small.

Matthews donated half of her book advance to abortion funds and says any royalties she earns will be donated in the same way. Rewire News Group sat down with Matthews to learn more. This interview has been edited for length and clarity.

Rewire News Group: The Supreme Court decision in Dobbs v. Jackson Women’s Health Organization dismantling the constitutional right to abortion came down in the middle of your work on this book. Did that change how it took shape?

Hannah Matthews: When I wrote the proposal, it was a totally different book. It was much more straight reporting. Much less personal, much less like memoir. And I felt, and I still feel, very self-conscious about taking up any space with my own story and my own interiority. I really had planned to be an observer looking in from the outside and giving other people a platform to tell their stories. It was fall of 2021 that I sold the proposal. I had just had my baby a few months prior. I do feel self-conscious also about how emotionally raw the book is. It’s something I really didn’t anticipate, but it’s kind of all I could do at this moment in my life. I always say it’s not the best book I could have written, but it’s the only book I could have written, and it’s the best book I could have written in these little eight-minute increments at this very strange time in my life.

When Dobbs happened, suddenly my book felt much less important. But at the same time I felt like, well, if I’m going to do this, let’s do it. Let’s just make it a memoir and I’ll write about my abortion. So it kind of intensified the process and took pressure off the process at the same time. I’ve actually been really grateful to work in direct care pretty much this whole time because I do feel like it takes a little bit of the pressure off. It keeps my priorities in check and it keeps my perspective in check. Who cares if someone made fun of me on Twitter? Who cares if someone doesn’t like my book? It doesn’t matter as long as today these 24 patients get what they need. It really helps me keep a healthier perspective about any creative work I’m putting out into the world.

RNG: The book also really shows all of the ways that abortion was complicated and very difficult to obtain for a lot of people even with Roe v. Wade in place, which is clearly something that a lot of people in the general public were not aware of.

HM: Or they just have such a flattened understanding. Most people have no time or capacity to actually learn the nuances of how abortion functions and what it looks like until they need an abortion, or someone they love needs an abortion, and then suddenly they’re like, “Whoa, this is so much more complicated than I understood.”

RNG: Absolutely. I think stigma plays a role in that, but I also think it is surprising and confusing the extent to which abortion has been siloed from the rest of the medical system. And so when somebody encounters that for the first time, it is really shocking.

HM: And there are so many parallels with birth and pregnancy, miscarriage, and pregnancy loss, where it just constantly feels like, whoa, why didn’t I know about this? It’s like this constant like unfolding of this like scroll that you never had access to and you’re reading it and you’re like, what the fuck?

RNG: Right. The book also starts with your abortion story, which is kind of a complex story. I guess this is a spoiler, but you had a medication abortion that didn’t work. Which is rare, but it does happen.

Were you worried about how people would perceive that story? So much of the time when we’re talking about abortion, we fall into sort of a trap where we’re emphasizing the safety and the efficacy, because antis are always saying that abortion is dangerous. And it is safe, it is effective, but I think that focus often doesn’t leave room for the people, even though there are fewer of them, who have those more complicated experiences.

HM: It’s such a double-edged sword. At work we have this conversation all the time about abortion care, but also about things like IUD insertions. How do you tell the truth about what this experience can look like without perpetuating fear and stigma and making people feel like this is something that’s dangerous and deeply unpleasant? The impetus for writing this book is to really help kind of add some more colors to this palette for people and really help them understand that when someone uses the word “abortion,” they could be talking about 45,000 different things.

I remember saying to my husband, how could this happen? And I remember him looking at the paperwork and saying, well, you know, it says this works 98 percent of the time. That means that for two out of every 100 people it doesn’t work. That’s kind of a lot of people if you’re talking about thousands of medication abortions. And I was like, oh shit. And a failed medication abortion or an incomplete abortion is something that is dangerous if you don’t have access to care. Having a safe place you can go to if you’re not sure is so essential, and that’s part of what they’re trying to take away from us. To make abortion more dangerous.

Especially now that we may be rolling out [misoprostol]-only protocols and efficacy rates and statistics maybe changing, I do fear that we are going to see a lot more failed medication abortions and I really want people to understand what that might mean for them and what care they can seek if that does happen. I think before I got pregnant I used to think it’s either beautiful and fine and you’re healthy and safe and feel great or there’s a medical crisis, and those are the only two options. But actually there’s this whole spectrum of weird, mysterious, unpredictable ebbs and flows. And so why shouldn’t abortion be different?

RNG: Right, it’s a spectrum. I think it’s so easy to want to leave out that nuance for the sake of trying to be clear, but that actually leads to confusion and mistrust when people feel like they were lied to.

HM: Totally. We have no space for the fact that bodies respond to things differently.

RNG: That’s something else I appreciated about the book. The chapters have titles like, “Abortion Is Pain,” but also “Abortion Is Community,” “Abortion Is Hope.” I feel like it really captures the full spectrum.

HM: I think part of what’s so isolating for so many people who have abortions, especially if they come from a very pro-abortion, progressive context, is that pressure to just speak about abortion as if it’s 100 percent positive all the time, and easy. And if they’ve had abortion experiences that aren’t positive and easy, they feel so alone. There is that feeling of like no, don’t give them anything. Don’t concede an inch of our beautiful fortress. And I think abortion is a social good. I think it’s wonderful. I work in abortion care, obviously I’m pro-abortion. But I think people should be listened to and that we need to hold space for every person who has an abortion. I trust them, and I believe them, and I listen to them.

RNG: Parts of the book definitely read as a call to action. As you were writing, who you were thinking about as being your readers?

HM: Writing the book was constantly having to come to terms with the fact that the people who I probably most desperately wish would read this are not going to. But I wrote this book thinking about my community, and my friends who are not working in the movement and who are kind of peripheral to it, but who truly feel despair and rage. The people who want to do something but are broke, and have kids, and have jobs, and have no time, and have no money. I want them to know that you don’t need to become a certified abortion doula. You can truly just give someone a ride to the airport. You can truly just make someone chicken soup after their abortion, or baby-sit their kids, and you’re doing it.

RNG: In the introduction you write about wanting everyone to envision not just the abortion care that we need, but the abortion care that we dream of.

HM: Yeah. And in order to get to care that we dream of, care that’s really loving and affirming and respectful, we have to get to a baseline of care that we can access, and care that we can ask for. And you can’t ask for something if you can’t say the word. We have to start there. And that’s where I think care providers owe so much to We Testify and other organizations and activists who are out here doing their work so that we can do our work in a way that’s not under the cover of darkness. We’ve made each other so uncomfortable naming things—body parts, medical procedures, sex. We work so hard not to name the things that we’re doing. Part of why I write is to just name things and hope that it helps other people feel okay naming things.

It’s actually important to me that the book’s not perfect, and that people will find things they don’t like about it, and people will find language that doesn’t resonate with them, because that is such an important part of being in abortion care work. It’s not ever going to be a room full of people who share your exact values and speak the same language. And we have to be okay making mistakes and learning. That’s also something I think that’s paralyzing a lot of people outside the movement. They’re worried they’re not educated enough. They’re worried they’re going to fuck up. But we’re all going to fuck up, and we’re all going to feel uncomfortable, and that’s part of it. This is not the moment to be worried about performing perfect social justice. This is the moment to be doing things, and taking action, and seeking out people to learn from so that we can invest in them, and partner with them, and collaborate with them.

RNG: Is there anything else you’d like people to know about the book?

HM: Just that I wrote it for you. Whoever you are, I wrote it for you. I wrote it for everyone who had an abortion. Everyone is going to have an abortion. Everyone who thinks, “Well, I agree with abortion, but I would never have one,” because once that was me, too.