Autumn Reinhardt-Simpson is a chauffeur; a librarian, digging up resources and information; a covert operative, helping clients circumvent unsupportive partners; a therapist; and a friend.
Her actual job title is abortion doula.
That phrase might seem like an oxymoron — although she does sometimes support those who end up choosing to go through with a pregnancy — as doulas typically work with those going through childbirth.
But Reinhardt-Simpson says the role is the same in that it’s all about protecting the client’s well-being.
Unfortunately the stigma in regards to abortion care is such that people have to turn to a complete stranger like me.
– Autumn Reinhardt-Simpson, abortion doula
“I’m here to support the choice that’s best for you and your family, not the choice that’s going to support my ideological preference or some sort of religious goal,” Reinhardt-Simpson says. “I try not to impose too many of my own views, I just ask a lot of questions.”
Her day gig is a PhD student in religious studies. On the side, she supports people through what (for some) may be a stressful or painful experience. For free.
“I think doula work is really important because as a society we’re not very good about taking care of each other. If people were just there for each other, what I do would be obsolete,” she says.
“But unfortunately the stigma in regards to abortion care is such that people have to turn to a complete stranger like me and trust that they can help them and get them through this.”
Abortion access, while legal, is not guaranteed
Reinhardt-Simpson is from the U.S., where many states have recently enacted controversial laws to restrict access and where upward of 90 per cent of counties don’t have a single abortion provider.
Across the border in Canada, where she now lives, abortion has been legal since 1988 but access — especially for those who live outside major centres — is far from guaranteed.
She’s had more than 50 patients since she moved to Edmonton in 2015, and each case usually starts the same way. A phone call from a person with an unwanted pregnancy.
From there, her role branches. Sometimes it’s as simple as offering information about the process or as complex as arranging to bring people to Calgary or Edmonton, sometimes from hundreds of kilometres away. She’ll drive the patients herself, or connect with a non-profit partner to pay for their plane tickets.
Once, that even meant picking a woman up from her work and whisking her away for the appointment, so her disapproving family wouldn’t realize she had gone.
She helped another patient deal with a mother who worked in the medical field and would use her access to snoop through her daughter’s medical records, looking for evidence of procedures.
It also means searching out domestic violence supports and connecting clients with their local food bank.
“I’m not just interested in getting them in for the abortion. I’m interested in supporting them totally,” she says.
Only 3 abortion clinics in Alberta
In Alberta, there are only three abortion clinics. Two are in Calgary and one is in Edmonton.
Dr. Jillian Demontigny is a family physician in Taber, a town 300 kilometres south of Calgary.
She’s one of just a few who will prescribe the abortion pill Mifegymiso in the southern part of the province.
In the town, it’s not uncommon to drive past anti-abortion billboards, like one with the slogan “Life is a precious gift,” written above a group of children’s smiling faces.
She says only about one in five of her clients is local, with the majority coming from nearby cities like Medicine Hat or Lethbridge.
Most of Demontigny’s clients have been outright refused services, or referred by a doctor who either wasn’t able to — or had objections to — providing the pill.
“We need a better system. We need to motivate doctors to provide medical abortions, so Mifegymiso can be prescribed by anybody who would like to do so safely,” she says.
Physicians who have a religious objection to prescribing the pill in Alberta have the obligation to refer their patient to someone who can provide the service or to a resource that will provide information about options.
Dr. Juliet Guichon, a medical ethics specialist at the University of Calgary, says that’s not enough and argues it should be the system’s job to connect patients to services.
“It’s important that patients have access to legal services, whether it’s contraception, abortion, transgender surgery, medical assistance in dying,” she says.
“It’s not the patient’s fault she couldn’t access the service in Lethbridge or Fort McMurray.”
I’ve just never been OK with the idea that we let people suffer.
– Autumn Reinhardt-Simpson
Part of the issue, Reinhardt-Simpson says, is that many American anti-abortion groups send money to affiliates in Alberta to fight access.
She wants Canadians to be less complacent about a service they may take for granted until they need it.
“[My rural clients] know how precarious access to abortion is,” she says.
“And the thought of being just one ride away from having to carry an unwanted pregnancy to term is terrifying.”
She says she dreams of the day that her phone stops ringing because people in need are supported by their friends, family or medical provider.
But until that day happens, she’ll still pick up, every time.
“I’ve just never been OK with the idea that we let people suffer, and we let people suffer alone. That’s not to say people having an abortion are always suffering,” she says.
“But the fact that we intentionally inflict suffering on people seeking abortion care and then we tell them to go off and deal with it on their own, it just doesn’t sit well with me.”