In-person later abortion accompaniment: a feminist collective-facilitated self-care practice in Latin America

Figures & data

Figure 1. Visual model of the in-person accompaniment process

Figure 2. Day of in-person accompaniment

Table

Location in Results Section	Spanish	English
Note: for context, some of the English surrounding the quotes is presented below.
1	One accompanier, for example, described the experience of accompanying as “de haber entrado al feminism, de haber conocido el feminism popular” (Paula, Argentina). Accompaniment, for Paula, was rooted in an understanding of the vulnerable, particularly those at risk of dying of an unsafe abortion, “ … de haber podido sentarme a discutir con las compañeras de los barrios, que es donde más vulnerabilidades hay, que son las primeras que corren el riesgo de morirse en un aborto clandestino o de estar forzadas a una maternidad obligatoria, donde las iglesias han hecho mierda toda la capacidad de libertad y autonomía de la femineidades.” (Paula, Argentina)	One accompanier, for example, described the experience of accompanying as “having become part of feminism, getting to know popular feminism” (Paula, Argentina) Accompaniment, for Paula, was rooted in an understanding of the vulnerable, particularly those at risk of dying of an unsafe abortion, “ … of being able to sit down and discuss with fellow women from the neighborhoods, where the most vulnerabilities exist, and whom are the first to run the risk of dying as a result of a clandestine abortion or of being forced into obligated motherhood, where the churches have destroyed any chance of freedom and autonomy for women.” (Paula, Argentina)
2	“Siempre pienso como el acompañamiento es una de las estrategias que tenemos para luchar por ejercer nuestros derechos digamos. Entonces, para mí es como un poquito de ampliar el acceso a ese derecho de la manera más segura, de la manera más cuidada y de la mejor manera posible, es acompañando.” (Juliana, Argentina)	“I always think that accompaniment is one of the strategies we have in our fight for our rights, let’s say. So, for me, it is like the safest way, the most cared for way and the best possible way to improve access to that right, is through accompaniment.” (Juliana, Argentina)
Screening for in-person accompaniment
3	An accompanier explained why it is important to have an ultrasound, “tienen que tener un eco para saber la ubicación de la placenta y saber que no haya peligro que tenga placenta previa que puede generar una hemorragia durante el expulsivo que eso sí es peligroso” (Vanessa, Ecuador).	An accompanier explained why it is important to have an ultrasound, “they have to have an ultrasound to know the location of the placenta and to know there is no risk of having a placenta previa which may cause bleeding during the expulsion because that is really dangerous” (Vanessa, Ecuador).
4	“Yo trato de informar mucho a la mujer sobre lo que va a suceder … me gusta hablarles mucho del tema emocional, de que si ella está segura de este procedimiento va a ser mucho más fácil. Nosotras apoyamos la decisión de la mujer sea cual sea, pero nos hacemos cargo solo en el caso de que ella decida abortar.” (Johana, Chile)	“I try to inform women a lot about what is going to happen … I like to talk to them a lot about the emotional aspect, that if she is sure about the process then it will be much easier for her. We support the woman’s decision no matter what she chooses, but we only take part in it if she decides to abort.” (Johana, Chile)
Preparation for the in-person accompaniment
5	For instance, one accompanier in Argentina emphasized that the space was not simply functional but, in contrast to clinical settings, it also needed facilitate an ambiance of harmony and comfort, “Que el clima sea de armonía, que si hay una música que sea una música baja, que haya la mayor penumbra posible, de respetar los momentos de silencio y de descanso de esa otra” (Paula, Argentina)	For instance, one accompanier in Argentina emphasized that the space was not simply functional but, in contrast to clinical settings, it also needed facilitate an ambiance of harmony and comfort, “that there is an atmosphere of harmony, if there is music that it be quiet music, that the lights can be dimmed, to respect the moments of silence and the moments of rest for that person” (Paula, Argentina).
Day of in-person accompaniment
Arriving at the site
6	The in-person accompaniments (outlined in Figure 2) usually began in the morning to ensure that both the accompanied person aborting and the accompaniers were well rested and able to put all of their energy into the process, “tenemos que empezar a la mañana, porque la mujer tiene que haber descansado … que ella haya dormido muchas horas y nosotras también” (Claudia, Argentina).	The in-person accompaniments (outlined in Figure 2) usually began in the morning to ensure that both the accompanied person aborting and the accompaniers were well rested and able to put all of their energy into the process, “we have to begin in the morning because the woman has to have rested … . to ensure that she has slept many hours and so have we” (Claudia, Argentina).
7	As one accompanier described it, “tomamos desayuno, si es que ellas no han tomado, tomamos todas juntas, así conversamos un poquito, vemos cómo se sienten, hablamos un poco de ellas, y ahí ya partimos con la dosis” (Johana, Chile).	As one accompanier described it, “we have breakfast, if they have not had it yet, we have it all together, that way we talk a little, we see how they are feeling, we talk a bit about them and then we start with the dose” (Johana, Chile).
Passing time, monitoring symptoms and managing pain
8	After taking the first dose of misoprostol, there were generally a few hours of wait time. Accompaniers took advantage of this time to further build a personal connection with the accompanied person and empower them as the protagonists of their own abortions by sharing personal stories and experiences of other people’s abortions, “buscamos empatizar con ellas, decirles la verdad, hablarles de nosotras como mujeres, contarles lo que nos pasó a nosotras, lo que les ha pasado a otras mujeres, decirles, recordarles en el fondo que las mujeres hemos parido y hemos abortado en la casa durante toda la historia de la humanidad” (Valentina, Chile).	After taking the first dose of misoprostol, there were generally a few hours of wait time. Accompaniers took advantage of this time to further build a personal connection with the accompanied person and empower them as the protagonists of their own abortions by sharing personal stories and experiences of other people’s abortions, “we try to empathize with them, to tell them the truth, to talk to them about us as women, to tell them what has happened to us, what has happened to other women, to tell them, to remind them that women have given birth and have aborted at home throughout the entire history of humanity” (Valentina, Chile).
9	Accompaniers catered to their needs and desires, as one accompanier described, “a ver si tiene ganas más de charlar, si tiene ganas de que la escuches, si tiene ganas de ver la tele o no tiene ganas de nada, de leer e irse a la pieza con el celular” (Andrea, Argentina).	Accompaniers catered to their needs and desires, as one accompanier described, “we see if she feels like chatting, if she just feels liked being listened to, if she feels like watching TV or feels like doing nothing, or reading or just going to into a room with her cell phone” (Andrea, Argentina).
10	“En todo ese proceso que siempre en general siempre hay muchas molestias, siempre hay mucho dolor […] Entonces solemos generar bolsitas de agua caliente, masajes detrás de la espalda […] tranquila con voz muy suavecita como darle contención, pero a su vez tampoco generarle mucha ansiedad a ella: “ya va a pasar”. Como eso, generar sobre todo un ambiente tranquilo y cálido para las mujeres y que si hay un momento de tensión lo llevemos adelante y que ella pueda relajarse y pueda volver a concentrarse en ella.” (Mónica, Argentina)	“During all that process in which there is always, generally always, great discomfort, there is always a lot of pain […] So we usually prepare hot water bottles, give them back massages […] calmly and with a very soft voice so that she feels supported, but at the same time, trying not to make her anxious, “you will get through this.” Like that, mainly to create a relaxed and warm atmosphere for the women, and if there is a moment of tension, she knows we will get through it and she can just relax and focus on herself again.” (Mónica, Argentina)
11	As one explained, “el masaje en la parte de la espalda baja, y también como al inicio del coxis con aceites de ruda, por ejemplo, aceites así … que puedan calentar el cuerpo, pero creo que el que más hemos usado es como masajes en los pies” (Paola, Ecuador)	As one explained, “a massage to the lower back, and also like at the beginning of the coccyx with Rue oil, for instance, oils like that … that can warm up the body, but I think the technique we have used the most is, like, foot massages” (Paola, Ecuador).
12	“Cuando ya están con mucho dolor empezamos a probar técnicas, si el guatero ya no funciona, empezamos a hacer ejercicio, masajes en la cola, en la espalda, o en la cara, como para relajar si es que están muy nerviosas. Hacemos terapia como de respirar y que ella vaya sintiendo su cuerpo.” (Johana, Chile)	“When they are already feeling a lot of pain we start trying some techniques, if the hot water bottle no longer works, we begin to do exercises, to give low back massages, face massages, so as to relax them if they are really nervous. We do like a breathing therapy so that she can begin to connect with her body.” (Johana, Chile)
The expulsion
13	“Una ya se va dando cuenta de cuánto va a faltar para el momento de la expulsión. Me parece que se les nota en la cara, se les nota en el cuerpo, en los síntomas, te describen el dolor y vos te vas dando cuenta que el dolor va encaminado o no hacia la expulsión también” (Juliana, Argentina).	“You start to learn how much longer it will take for the expulsion to happen. I think you can see it in their faces, you can see it in their bodies, in the symptoms, they describe the pain they are feeling and you start noticing that the pain is increasing, or not, leading up to expulsion too.” (Juliana, Argentina)
14	“El expulsivo es cuando todo está siendo mucho más fuerte. La mayoría de mujeres que hemos acompañado, sienten un dolor tan fuerte que es como, ‘ya no más’. Hay unos gritos de dolor terribles pero lo clave es que en todo ese momento preparatorio, profiláctico y de manejo de dolor las mujeres van entendiendo su cuerpo y lo van conociendo.” (Amelia, Ecuador)	“The moment of expulsion is when everything is much stronger. Most women we have accompanied, feel a pain that is so strong that it is like, “no more, please.” There are some awful cries of pain, but the key is that during all the moments of preparation, prophylactic and pain management the women get to understand their body and get to know it.” (Amelia, Ecuador)
15	“Yo digo que en el baño parece como si hubiera como un mundo aparte. Todo alrededor no importa nada más … es como en ese momento la mujer y la socorrista que está ahí apretándole la mano, diciéndole que todo va a salir bien, o acariciándole la espalda digo, como. Es eso, es como ellas dos solas en el mundo sin nadie más alrededor.” (Verónica, Argentina)	“I say that there seems to be a world of its own in the bathroom. Nothing around us matters any more … it’s like at that moment the woman and the accompanier, who is holding her hand, telling her that everything will be okay, or rubbing her back, it’s like, I mean. It’s that, it’s like they are the only two people in the world without anyone else around.” (Verónica, Argentina)
Hours, days and months post-abortion
16	After expelling the products of conception, accompaniers described their observation that relief and gratitude washed over people, “Yo veo que las mujeres tienen alivio porque ya termina todo este proceso de dolor, se dan cuenta que no pasó nada más, se alivian todos sus miedos” (Vanessa, Ecuador). She continued, noting that people typically recognized the key role that accompaniers played in enabling them to complete their abortion, “Ese momento cuando ya todo salió bien muchas nos abrazan y agradecen, sobre todo. Esa parte es súper gratificante” (Vanessa, Ecuador).	After expelling the products of conception, accompaniers described their observation that relief and gratitude washed over people, “I see that women are relieved because this whole painful process is over, they realized that nothing bad happened, all their fears are relieved” (Vanessa, Ecuador). She continued, noting that people typically recognized the key role that accompaniers played in enabling them to complete their abortion, “At that moment when everything turned out fine, many of them hug us and, above all, they thank us. That part is extremely gratifying” (Vanessa, Ecuador).
17	Another accompanier described a similar overwhelming feeling of gratitude and relief after the abortion is complete, “Hay un montón de gratitud de parte de las mujeres, en el momento en que ya terminó todo, es como la cara se nos transforma a todas, se respira otro aire, abrimos las ventanas, comemos algo y ese momento también, es como una enorme devolución a todas las horas previas.” (Juliana, Argentina)	Another accompanier described a similar overwhelming feeling of gratitude and relief after the abortion is complete, “There is a lot of gratitude from the women, at the moment when everything is over, it is like all of our faces change, we breathe a different air, we open the windows, we eat something, and at that moment also, is like a huge return on all those previous hours.” (Juliana, Argentina).
19	“Si las chicas se quieren dar una ducha como que se den una ducha, siempre hay comida preparada para cuando ellas ya están con deseos de comer. Les recomendamos siempre como que se queden recostadas por lo menos una hora antes de su casa, si es que se quieren ir a sus casas inmediatamente. Y cuando ya ellas se sienten en condiciones de poder levantarse, caminar, ponerse su ropa y regresar a sus lugares, también nosotras las acompañamos hasta cuando ellas se van, hasta el colectivo, hasta la micro si es que hay que acompañarlas.” (Ailén, Chile)	“If the girls want to take a shower they can take a shower, there is always food ready for when they feel like eating. We always recommend that they lay down for at least an hour before going home, if they are wanting to go home right away. And when they feel ready to get up, to walk, to put on their clothes and go back home, we also accompany them until they leave, to the bus stop, to take the minibus, if there is any need for us to accompany them.” (Ailén, Chile)
20	During the hours and days after the abortion, accompaniers continued to monitor for warning signs for possible adverse events, “vamos tratando de recaudar información respecto como a su salud, por ejemplo síntomas que ellas vayan teniendo, para que evitemos infecciones, o podamos detectar hemorragias” (Antonela, Chile).	During the hours and days after the abortion, accompaniers continued to monitor for warning signs for possible adverse events, “we try to collect information about their health, for instance, symptoms that they might be having, so that we avoid infections or we can detect hemorrhages” (Antonela, Chile).
21	People expressed a range of interest in ongoing communication with their accompaniers: “Hay mujeres que terminan el proceso y quieren cerrar una puerta y no quieren volver a hablar del asunto. Y hay otras mujeres que pasa un mes, dos meses y siguen llamándonos” (Valentina, Chile).	People expressed a range of interest in ongoing communication with their accompaniers: “There are some women who finish the process and they want to close the door and they never want talk about it again. And there are others who after a month, two months, they keep calling us” (Valentina, Chile).
22	Another accompanier described this, “a veces se generan vínculos súper grandes, entonces te están escribiendo, te mandan saludos por navidad o por año nuevo” (Marta, Ecuador)	Another accompanier described this, “sometimes a great relationship is formed, so they keep writing to you, they send you Christmas or New Year’s greetings” (Marta, Ecuador).
23	“[…] hay algo de la cosa ahí efímera e íntima que se construye ahí … que es eso, no tiene como otra definición. No es una confianza, una amistad, es una cosa de saber que están las acompañantes y de ellas sí de entregarse, pero a la vez hay una entrega de las acompañantes también ahí, hay un punto de vulneración de las dos ahí. Porque ella está muy vulnerable, ofreciéndote todo porque ya no sabe más qué hacer, y a la vez una ahí está también como vulnerable de ‘bueno, sólo te puedo sostener, como en la escucha y en la mirada y sosteniéndote la mano, no puedo hacer otra cosa.’” (Andrea, Argentina)	“[…] there is something a bit ephemeral and intimate that is created there … it is just that, there is no other definition. It’s not a trust, a friendship, it’s knowing that the accompaniers are there and that the woman can give herself over, but at the same time the accompaniers give themselves over to her too, there is like a moment of vulnerability for both of them there. Because she is very vulnerable, offering you everything because she does not know what else to do, and at the same time you are also vulnerable, like ‘well, I can only hold you, like, in the way I listen to you and look at you and hold your hand, there is nothing else I can do.’” (Andrea, Argentina)
24	“No solamente la presencia de las socorristas que tienen información o más información sobre un proceso de aborto en el mismo lugar que esa mujer que está abortando, sino todo lo que ocurre alrededor, cómo generar un espacio de cuidado y de confianza, eso para mí es fundamental.” (Paula, Argentina)	“Not only the presence of the accompaniers that have information, or more information, about an abortion process in the same place where the woman is having the abortion, but also everything that is happening around that, like creating a caring and trusting environment, for me, that is essential.” (Paula, Argentina)
25	“Yo siento que lo que yo trato de estimular siempre es la valentía, como: ‘lo estás haciendo muy bien, eres seca, tienes mucha fuerza, vas bien, respira, lo estás haciendo bacán.’ Como alentando al final como siendo una porrista del aborto ahí en el baño tratando de subirle un poco la moral a la chica y bajar la ansiedad obviamente y el miedo, como decirle: ‘Amiga lo estás haciendo bacán. Conéctate contigo y sigue haciéndolo tal como lo estabas haciendo.’” (Celeste, Chile)	“I feel that what I always try to boost is courage, like, ‘you are doing great, you are tough, you are strong, you are doing well, breath, you are doing excellent.’ Like encouraging her at the end, like being an abortion cheerleader there in the bathroom, trying to improve the girl’s morale and reduce the anxiety and obviously the fear, like saying: ‘Darling, you are doing excellent. Connect with yourself and keep on doing it like you’ve been doing.’” (Celeste, Chile)
26	“El sistema de salud público que tenemos es un garrón y que para todas las clases populares nos resulta un problema tener que recurrir al servicio de salud, y entonces, y sobre todo si estas clases populares son mujeres, peor, o travas, o lesbianas.” (Paula, Argentina)	“The public health system we have is awful and for all working class people it is a problem to have to resort to these health services, and then, and even more so for if the people from the working class are women, or even worse if they are transvestites or lesbians.” (Paula, Argentina)
28	“Como qué hacer cuando lloran, o sea, todas esas emociones que ellas sienten, saber que son legítimas y escuchar, es como mucho escuchar el acompañamiento, mucho, mucho, entonces como … atentamente, y saber, y reaccionar en base a eso también, ¿no? Pero, sí, o sea tampoco desde, así como … ‘Ay, pobrecita,’ sino como … Escuchar a tu par, que, claro, ella es la que va a abortar, tú le estás dando la información pero ahora ella también tiene la información, entonces tú lo que estás haciendo es medio guiando y resolviendo dudas si es que las tiene y acompañando” (Angie, Ecuador).	“Like what to do when they cry, that is, all those emotions they feel, knowing that they are legitimate and listening, accompanying is a lot of listening, a lot, a lot, so like … paying attention, and knowing, and reacting based on that too, right? But, yes, it’s also not coming from a place of like, ‘Oh, poor you,’ but rather … listening to your peer, that, of course, she is the one who is going to abort, you are giving her information but now she also has that information, which means that all you are doing is guiding and answering questions, if she has any, and accompanying.” (Angie, Ecuador)