Pleasure, joy and positive emotional experiences in abortion escorts after 17 weeks of gestation

Katrina Kimport, Julia McReynolds-Perez, Chiara Bercu, Carolina Cisternas, Emily Wilkinson Salamea, Ruth Zurbriggen and Heidi Moseson.

Summary

Various studies show that abortion can be an emotionally difficult and stigmatizing experience. However, little attention has been paid to whether—and how—participating in abortion-related experiences can be a source of positive emotions, including pleasure, belonging, and even joy. The lack of explorations grounded in the possibility that abortion can bring pleasure and joy represents an epistemic erasure. Moreover, it reveals how the social sciences have often emphasized the negative aspects of abortion care in ways that produce or reinforce harmful associations. In this article, we explore positive emotions, pleasure, and joy connected to participating in abortion processes, based on interviews conducted in 2019 with 28 abortion accompaniers from Argentina, Chile, and Ecuador, who shared their experiences supporting abortions beyond 17 weeks of gestation. Abortion accompaniment is a response to unsafe or inaccessible abortions, in which volunteer activists guide those who need a medication abortion through the process. The interviewees describe how the practice of accompaniment fostered positive emotions by building feminist community, sharing intimacy among women, and witnessing the empowerment of the people having abortions. These positive experiences of abortion accompaniment are not separate from the broader marginalization of abortion—they are, in fact, rooted in it.

Introduction

Engaging in abortion care—whether as a provider, activist, or in other roles—can involve uncomfortable tasks and interactions (Ludlow 2008; Foster et al. 2020), as well as exposure to social stigma (Joffe 2010; Simonds 1996; Roe 1989; Martin et al. 2014; O’Donnell, Weitz, and Freedman 2011; Kimport and Freedman 2018; Cárdenas et al. 2018; Gantt-Shafer 2020; Giovannelli et al. 2023) and the risk of criminalization (Joffe 1995; Payne et al. 2013). However, it can also offer a sense of purpose, pride, and gratification (O’Donnell, Weitz, and Freedman 2011; Wolkomir and Powers 2007; Chiappetta-Swanson 2005; Fernández Vázquez and Brown 2019), and highlight the empowerment and autonomy of people seeking abortions in ways that can be deeply meaningful for those involved in abortion care (McReynolds-Pérez 2017; Bercu et al. 2022). Often, however, these positive aspects are presented as something that exists despite—or as a counterbalance to—the emotional, professional, and social challenges associated with abortion work, rather than as phenomena worthy of independent consideration.

In this sense, academia has not significantly considered whether—and how—participation in abortion processes can be an independent source of positive emotions such as pleasure, satisfaction, and even joy. As research increasingly explores the possibility (and the normative erasure) of people experiencing a “happy abortion” (Millar 2017; Wollum et al. 2022), this omission has become more conspicuous. The scarcity of studies on the possibilities that abortion involvement offers as a source of pleasure, joy, and other positive emotions aligns with what scholars have identified as a “joy deficit” in research on the life experiences of marginalized people (Shuster and Westbrook 2022). Drawing on case studies of transgender people, Shuster and Westbrook (2022) argue that joy is an understudied yet crucial element in the lives of those who experience social marginalization. It’s important to clarify that this use of the term “deficit” differs from how it is used in literature that critiques the cultural deficit model—preferring instead an asset-based framing—when describing groups and individuals who are not white, cisgender, heterosexual, or financially stable (for example, urban African Americans [Hunter and Robinson 2016]). Nonetheless, it draws from that same critique of academia’s tendency to focus on the shortcomings, struggles, and problems of marginalized populations rather than on their innovations, resistance, and creative adaptations to structural constraints. Indeed, Shuster and Westbrook’s analysis suggests that the joy experienced by transgender communities is inextricably linked to their condition of marginalization. Similarly, Higgins and Hirsch (2007) have pointed to a “pleasure deficit” in sexual health research, where most academic literature emphasizes risk and negative health outcomes from sexual activity, with a general absence of references to pleasure and its positive effects. In this article, we argue that there is a similar deficit in academic literature about people involved in abortion processes, claiming that this field has largely failed to start from the premise that abortion participation can generate positive emotions.

The paucity of research that starts from such a possibility represents a problem for the broader literature. As Shuster and Westbrook (2022) assert about joy in transgender people, the scholarly deficiency in exploring the pleasure and joy associated with abortion represents an epistemic cancellation. Vast numbers of research questions go unasked when the possibility of abortion-associated pleasure and joy cannot be imagined. Moreover, when the literature focuses only on some aspects of abortion and, specifically, on aspects that illustrate the negative and difficult characteristics of abortion, it runs the risk of essentializing abortion as negative and difficult. In this sense, one also runs the risk of participating in the production of what Baird and Millar (2019, 2020) call the performative nature of academic abortion studies. Baird and Millar have identified a tendency in the abortion literature from the social sciences to emphasize the negative aspects of abortion care in a way that may contribute to reproducing or amplifying a negative normative association with abortion. Even when such literature seeks to disprove narratives and constructions about abortion as negative and/or to identify causes for such negative consequences other than abortion itself (e.g., legislation), its effect in practice may be to crystallize them through repetition. Conceptualizing and studying abortion participation largely in terms of its burdens and negative effects, especially to the extent that these are presented as inherent to abortion, may operate as a normative constraint on knowledge, understanding, and discourse about abortion.

In this article, we work with evidence suggesting that participation in performing abortions can engender feelings of pride and gratification (Wolkomir and Powers 2007; O'Donnell, Weitz, and Freedman 2011; Fernández Vázquez and Brown 2019; Chiappetta-Swanson 2005) to study specifically the positive emotions, pleasure, and joy associated with abortion accompaniment. Abortion accompaniment is a response to unsafe and/or inaccessible abortions, in which volunteer activists guide those seeking abortion by phone, text message, or in person, relying on WHO-approved protocols according to stage of pregnancy (Bercu et al. 2022; Moseson et al. 2022; Braine 2020; Moseson et al. 2020). At the time our data were collected in 2019, abortion was illegal or difficult to access through the formal health care system in much of Latin America (Guttmacher Institute 2018) and fear of discrimination, criminalization, and abortion stigma resulted in additional barriers for those seeking abortion (Culwell and Hurwitz 013). It is important to note, however, that legal restrictions do not eliminate demand for abortions (Bearak et al. 2020; Ganatra et al. 2017). With the emergence of medication abortion, abortion accompaniment has emerged as a feminist and activist strategy to facilitate access to performing abortions even in highly restrictive contexts (Moseson et al. 2022; Jelinska and Yanow 2018; Veldhuis, Sanchez-Ramirez, and Darney 2022). Although there is no single abortion accompaniment practice (Atienzo et al. 2023), due to the feminist roots of this model, the practice focuses on the abortionist (Veldhuis, Sánchez-Ramírez, and Darney 2022; Assis and Larrea 2020; Duffy, Freeman, and Rodríguez 2023; Bercu et al. 2022) and seeks to achieve positive effects on these individuals, which have been empirically documented (Vacarezza and Burton 2023; McReynolds-Pérez et al. 2023)-this includes positive emotional effects (Wollum et al. 2022).

We seek to contribute to this academic literature through an analysis based on interviews with abortion companions from Argentina, Chile, and Ecuador, in which we explore whether and how accompanying abortions can be a source of pleasure, joy, and other explicitly positive emotions. Our research takes the form of a secondary analysis of data originally collected to study the experiences of in-person abortion accompaniment (Bercu et al. 2022)—a less common accompaniment practice (Gerdts et al. 2018; Zurbriggen, Keefe-Oates, and Gerdts 2018), typically reserved by accompaniment groups for people seeking abortions at later gestational stages (i.e., after 17 weeks) or who are particularly socially vulnerable (e.g., young people). Abortions accompanied after 17 weeks of gestation often involve commitments of several days, which can be physically and emotionally intense for everyone involved, and carry greater risks in restrictive contexts (Zurbriggen, Keefe-Oates, and Gerdts 2018). Focusing on a marginalized activity (in-person accompaniment after 17 weeks) within a marginalized practice (abortion accompaniment), we ask: in what ways is in-person accompaniment after 17 weeks of gestation a source of positive emotions, including pleasure and joy?

Methodology and materials

Context

This project focuses on the work of three support groups: Colectiva Feminista La Revuelta from Argentina, Con las Amigas y en la Casa from Chile, and Las Comadres from Ecuador. At the time the data was collected, abortion in these three countries was permitted only under very limited circumstances: when the life or health of the pregnant person was at risk, or when the pregnancy was the result of rape (with no gestational limit in Argentina; up to 12 weeks of gestation, or up to 14 weeks if the person was under 14 years old, in Chile; and only if the pregnant person had a mental disability in Ecuador). Chile also allowed an additional exception in cases where the fetus had no chance of surviving the pregnancy. ¹.

All three groups began by providing support via telephone or text messaging, and over time started to accompany some abortions in person, particularly those occurring after 17 weeks of gestation. The Colectiva Feminista La Revuelta is a feminist group that has operated a network for people seeking abortion since 2010. The group began providing in-person abortion support in 2016. Con las Amigas y en la Casa was formed in 2016 and started offering in-person support in 2018. Las Comadres has been active since 2015 and began accompanying in-person abortions in 2018. This study was carried out through a collaborative research partnership among members of the nonprofit research organization Ibis Reproductive Health (Ibis), key representatives from the three accompaniment collectives, and two researchers affiliated with academic institutions.

Call for applications

The details of the collaborative research partnership between Ibis researchers (based in the United States) and members of the groups from Argentina, Chile, and Ecuador are described in another publication (Bercu et al. 2022). In short, during a global meeting of abortion accompaniment groups in 2018, the three feminist collectives reached out to Ibis researchers to request support in documenting their model of in-person abortion accompaniment at later gestational ages. We formed a research team of 12 people, including four Ibis researchers and two or three members from each accompaniment group. The collaboration was intentionally structured as a partnership, aiming to reduce the hierarchical dynamics that often shape research teams, and instead creating a space for collective decision-making where power could circulate among all participants.

In early 2019, the research team invited a number of eligible participants to take part in key informant interviews about in-person accompaniment for medication abortions after 13 weeks of gestation (that is, beginning in the second trimester). Participants were over 18 years old and had taken part in at least two in-person accompaniments within one of the three support groups during the previous three years. Whenever possible, we invited compañeras with different levels of experience in order to capture a wider range of perspectives. All eligible participants who were invited agreed to be interviewed.

Data collection

We used a semi-structured interview guide that included questions about participants’ experiences with in-person accompaniment, how they became involved with the group, and their personal stories with the collective. The study was not specifically designed to capture information about pleasure or joy, but rather to allow participants to share their reflections on their accompaniment experiences in a broad and open-ended way. For the purposes of our analysis, it is important to note that the interviews encouraged participants to reflect on the most fulfilling aspects of accompaniment, its impact on their lives, what had most surprised them about accompanying abortions, what they had learned from the practice, and their wishes for what abortion care could be like in an ideal world. In line with Shuster and Westbrook’s (2022) methodological observation regarding the lack of questions about joy for marginalized subjects, we present in Table 1 the specific interview questions that elicited responses relevant to this analysis.

Four members of the research team—two companions from the accompaniment groups and two researchers from Ibis—conducted the interviews after receiving training in qualitative interviewing methods. In some cases, the interviewers had a pre-existing personal relationship with the interviewees. While this may have influenced the content of the interviews, we chose to include companions as interviewers due to the sensitive nature of the topics discussed, the importance of building trust between interviewer and interviewee (especially given the challenges outsiders may face in establishing that trust), and the specific access these interviewers had to potential participants. Since discussing positive emotions is not generally considered uncomfortable, we were not concerned that these personal relationships would negatively affect the data analyzed here. All interviews were conducted between February and April 2019 in Spanish, either in person or by phone, and lasted between 60 and 90 minutes.

At the beginning of each interview, the interviewer reviewed the consent materials, and the interviewee provided verbal consent. The interviews were audio-recorded and professionally transcribed verbatim. Participants received approximately 20 U.S. dollars as reimbursement for travel expenses, which were either distributed individually or donated to the accompaniment group. Recruitment concluded once we reached saturation on the primary research questions posed by the collaborative alliance (see Bercu et al. 2022).

In 2020, after the end of the survey period, Argentina legalized abortion up to 14 weeks of pregnancy. As of September 2023, the regulatory environment in Chile and Ecuador was the same as at the time of the survey. ↩︎

Table 1. Questions included in the interviews relevant to this analysis.

Original question in Spanish

What is the most rewarding aspect of your role as a companion in second-trimester abortion situations?

Can you tell me about your first second trimester on-site accompaniment? What was it like, what did you feel, what happened?

What does accompaniment mean to you?

What are the lessons learned or what has had the greatest impact on you from the women you have accompanied in the second trimester?

What has surprised you the most during the second quarter on-site visits you have accompanied?

In what ways do you receive support for your role as a companion?

The Allendale Investigational Review Board, USA, served as the review board for this international research and reviewed and approved the study protocols (approval number: IBISSECT09021018). We followed all local guidelines and regulatory procedures for human subjects research in each country.

Analysis

The first and second authors, both sociologists residing in the United States and affiliated with academic institutions, joined the project during the analysis phase, after data collection was completed. They contributed their expertise in qualitative analysis and their experience in the topic of abortion throughout pregnancy and/or abortion provision in Latin America. We analyzed the original Spanish transcripts through a team-based iterative coding process using MAXQDA software. Before analyzing the transcripts, the research team developed a deductive codebook based on the interview guide questions. After reviewing several transcripts, we updated and adapted this codebook to more accurately capture the main ideas and sub-ideas emerging from the interviews. Some team members then applied this updated codebook to all transcripts and regularly met with the full team to exchange insights about the data and identify patterns. Throughout this process, feelings of joy and positive emotions related to abortion accompaniment emerged from the transcripts and in several discussions among the research team.

Using joy and pleasure as sensitizing concepts (Charmaz 2006), the second author surveyed the coded data in search of fragments relevant to the themes of interest for the research. Then, the first author conducted a grounded theory-based sub-coding of all fragments related to positive emotions, with the aim of identifying general themes. In keeping with the collaborative principles of the partnership, throughout this process and during the production of the text, the entire team met to discuss the findings as they emerged, translating the summaries and materials into Spanish as required, including a professional translation of the draft text from English to Spanish.

For the publication, one of the authors - bilingual in Spanish and English - translated the quotes from the original Spanish into English. Two other bilingual authors reviewed these translations for accuracy. It is important to mention that most, but not all, of the people who had accompanied the interviewees identified as women and several interviewees mentioned that the gender assigned at birth and the gender binary do not adequately fit the ways in which all abortionists experience their gender. However, interviewees often used the word "woman" to describe the social category of people who have abortions. In this article, we use pseudonyms to refer to the participants.

The satisfaction of creating a feminist community

For all the interviewees, accompaniment is fundamentally rooted in feminist practice. However, several of them mentioned that feminism and the goal of living according to feminist values can be abstract and complex. In accompaniment, the interviewees identified a concrete practice that allowed them to embody and put their feminist convictions into action. Juliana, an Argentine companion, explains: “What else can bring down to earth everything we think, everything we believe, everything we are building from feminism in our ideas and feelings? Like, bringing it down to earth in this concrete practice of accompanying each other.” Accompaniment is, as Carmen, another Argentine companion, explains, “the way I found to live,” turning it not only into an activity but a way of life that gave her purpose and meaning. Others echo this feeling: Mónica, also from Argentina, explains that, far from being something secondary to the way she inhabits the world, accompaniment “harmonizes me with the world.”

Significantly, the interviewees do not live their feminist values in isolation: accompaniment is collective. By definition, accompaniment means not being alone - neither the abortionist nor those accompanying her - and usually two or three accompaniers are involved. This collective aspect of the practice differs from many other aspects of the interviewees' lives and is therefore something that some of them had to learn, which they found revitalizing. As Amelia, an interviewee from Ecuador, points out, comparing accompaniment with her daily work in which she works alone in a role of supporting others:

[My profession] is a very solitary job because I give support on an individual basis. When you work as part of a network, it is nice to know that the accompaniment is collective. I had to learn that in practice, that I was not making decisions alone.

In accompaniment, Amelia is part of a group of feminists. Maribel, another accompanier from Ecuador, describes it similarly, "I feel that we formed a good team. There was a great synergy, it was very nice."

Significantly, this teamwork includes activities based on feminist praxis, which the accompaniers understand as ways of contesting social norms. Valentina, a Chilean accompanier, explains that abortion accompaniment has a political objective "to facilitate access to safe abortion," but that is not all. Implicitly noting that the majority of escorts and those accessing abortions identify as women, she continues:

also aims to implement a different kind of relationship between women and to show us how to love each other, trust each other, be more loving to each other, be supportive and help each other, help each other do something that no one else wants to help us do.

For Valentina, part of the pleasure of participating in on-site accompaniment comes from the more generalized absence in her life of the feminist and collective caring values that accompaniers put into practice during accompaniment. As Amelia, the accompanier from Ecuador who worked alone, explains:

I think it is very gratifying to do it accompanied - in other words, to share the space between companions. I feel it is beautiful to be able to have these spaces of shared complicity, knowing that we are doing something that is on the margins [of society], that we are transgressing and that we are not doing it alone.

Moreover, this shared space is inclusive of people's lives and identities - escorts are not present strictly as providers of an abortion service but as whole human beings. Amelia continues:

We ended up sleeping next to them [the people who were performing the abortion], because you end up staying for more than 12 hours. So, you end up not only talking about abortion but about whether or not you like chocolate, or other things in life. That's beautiful and I think we need more of that, to be able to enjoy the company, moments of pleasure.

This completeness does not end when the abortion is performed. Vanessa, an accompanier from Ecuador, describes accompaniment as an activity and as a practice of continuous conversation: "When we finish an accompaniment, we talk about it and share knowledge with each other. Knowing that we are together." Through accompaniment, the interviewees are able to live according to their feminist values, which generates positive emotions.

Pleasure in physical intimacy

The interviewees also highlighted the positive emotional impacts of the physical practice of accompaniment, describing how accompaniment requires and fosters physical intimacy and trust, creating emotional bonds both between the people being accompanied and the accompanists, as well as among the accompanists themselves. Second-trimester abortions involve considerable physical processes: bodily changes, cramps, intense pain, and the expulsion of uterine contents, including blood and tissue, through the vagina. Andrea, an Argentine accompanist, describes these experiences as “intimate,” explaining that accompaniment “involves not only sharing and caring for bodies, but also a moment that is very intimate.” She is amazed by this intimacy and shares her appreciation and surprise “that they [the people having abortions] allow you to participate in such an intimate moment as an abortion.”

On-site accompaniment also involves intimacy in the sense of physical contact. In this sense, Sandra, an accompanier from Chile, describes a key moment during the accompaniment of a woman who had an abortion:

[She] was in a lot of pain, she couldn't even open her eyes. She was very tense, her body was very tight, and I started to stroke her head and she started to relax. Then she started thanking me. It was as if I had never had this kind of contact with women, so based on affection, on doing things with affection.

As Sandra's story points out, the intimacy of accompaniment occurs between strangers and between women.

The companions affirm that physical intimacy between women during accompaniment — in which the woman is the recipient of care and not responsible for providing care to others — is absent in most social spaces accessible to people who have abortions. Sofía, a Chilean companion, explains:

Humanity does not offer women a space of complicity like the one provided by accompaniment. It is a different life experience […] being with a stranger, looking into each other’s eyes, committing a crime — all in the same day. It is very intense and very profound and can also be a very extreme experience, which is why I believe those of us who accompany abortions do so.

As Sandra's story points out, the intimacy of accompaniment occurs between strangers and between women.

Humanity does not offer women a space of complicity like the one provided by accompaniment. It is a different life experience […] being with a stranger, looking into each other’s eyes, committing a crime — all in the same day. It is very intense and very profound and can also be a very extreme experience, which is why I believe those of us who accompany abortions do so.

In a cultural context in which the norm is lack of intimacy or care for many people who are also primary caregivers for others, going through these experiences together physically and emotionally - and being explicitly linked to each other's lives - generates deep feelings associated with having a purpose in the companions.

The accompanists described the close relationships forged through accompaniment as something unique within their social contexts. Indeed, instead of allowing space for these kinds of connections and physical intimacy, the accompanists pointed out that dominant social norms associate these experiences and activities with disgust and shame. During accompaniment, by being present with the person having the abortion while they experience these physical changes, the accompanists felt they were rejecting those social norms. Celeste, the Chilean accompanist mentioned above, describes accompaniment as “wanting to get rid of the disgust [associated with bodies], to stop feeling ashamed when seeing someone else’s vagina, you know?” Accompaniment, in other words, is about challenging not only the forced continuation of a pregnancy but also the expectations underlying a social system in which women’s bodies are not valued. In the same vein, Paula, an accompanist from Argentina, explains:

We always abort much more than a pregnancy. It’s also like being able to break free from this anguish and not be defeated, right? It’s, at least the feeling I have, a much greater sense of freedom because we also eliminate — abort — many prejudices in that moment.

For companions like Paula, the pleasure of accompanying an abortion goes beyond terminating a pregnancy and extends to how the emotional and physical accompaniment of the abortionist is practiced. Together, accompaniers and escorts oppose not only the legal prohibitions against terminating an unwanted pregnancy, but also a social system that does not value autonomy over their bodies and rejects physical intimacy between women.

To the extent that the accompaniers conceptualize the accompaniment they offer as a correction to the absence of mutual care spaces for women, they also marvel at the beauty of what they have created. Their motivation is not only to fill a gap in abortion access. They also found the process of filling that void through accompaniment and witnessing this intimacy and this kind of care to be emotionally rewarding. Paula, quoted in the previous paragraph, continues her story:

It amazes me how a person can trust someone who is a complete stranger. I mean, being able to cry, scream, curse, say anything to each other, kill each other with laughter or hug each other, you know what I mean? Or even walk around the house completely naked, and we're strangers, and yet this other person is sharing themselves and they trust each other. And that shocks me, yes, it shocks me, it shocks me, and it never ceases to amaze me.

As Paula's account points out, to the extent that accompaniment depends on, and at the same time produces, trust and intimacy - within the framework of an unequal society - it becomes a source of pleasure and admiration.

The joy of empowerment

Finally, the interviewees highlighted the satisfaction they experience when they see the people who need an abortion being able to go through with it, especially in cases where there had been doubts about their ability to do so. Describing this experience, Beatriz, an accompanist from Chile, comments: “because it’s like they realize at that moment, like it’s not—it’s something they discover right there, the power they have inside, what they are capable of doing.” By witnessing this, the accompanists feel positive emotions. Ailén, another accompanist from Chile, explains:

The most gratifying thing [is] the gratitude of the women when they manage to abort, when they manage to finish the process, when they realize that they have had enough internal and physical strength to be able to abort [for example] a 20-week fetus.

The accompanists experience positive emotions from being able to help people who often come to them feeling overwhelmed and desperate. As Marta, an accompanist from Ecuador, explains, she feels pleasure in being able to share her knowledge and assist those in need. Marta says, “Abortion has, in general, something very gratifying, and that is that it’s something you solve — these are life situations or problems that get resolved. I find it very beautiful to resolve it together, to resolve it accompanied.” However, Marta continues, there is a fundamental part of the accompaniment that is not collective but depends on the person having the abortion. “It is a concrete situation in a woman’s life; it is a situation where she can decide.” Marta also highlights that many of the women she has accompanied have little experience exercising power and making decisions:

Many times, it is the first decision that many women make in their lives for themselves. So I think it's a decision that can be empowering even if it doesn't change the woman's context, but it's the possibility to decide, concretely. I think that is gratifying. It is also gratifying to feel that it is resolved.

By referring both to the pleasure of being able to solve the problem of a pregnancy that the person did not want to continue and to witnessing the moment when someone with structurally restricted social power recognizes her own strength and takes ownership of this possibility, Marta describes the appeal of accompaniment rooted in a collective effort to reveal and shed light on the power and agency possessed by people who have abortions.

For many accompaniers, accompaniment is about sharing joy with the person having an abortion, which includes responding to and reflecting the expressions of emotion of those being accompanied. Victoria, an accompanier from Chile, describes the transformation of these people throughout accompaniment: from a place of anguish and fear to having "like another face, of absolute joy." The theme of joy at the end of the abortion resonates throughout the interviews. Paola, an accompanier from Ecuador, describes seeing people who had an abortion "cry but with relief, but also with joy, like that ambivalence that the abortion experience has." Sofia, from Chile, explains:

The happiness of a woman who has had an abortion is an indescribable feeling, how it rubs off on you. I mean, the feeling of relief that she feels, and when she passes it on to you, I think it's something that makes you happy and that's why we all do what we do. Sometimes I think we are - we don't even do it for the other person, but for ourselves, because it's a pleasure, it's really a feeling of freedom, autonomy, trust, complicity. It has a whole mixture of feelings that I think it is very difficult to find in other spaces that humanity -or in humanity- offers you.

This does not mean that accompaniment is easy or simple. In fact, the interviewees emphasize the physical and emotional repercussions of on-site accompaniment. However, it is these same repercussions-which the accompaniers accept voluntarily-that may make accompaniment so rewarding. When asked if the experience of accompaniment is tiring, Valentina, from Chile, says:

Yes. But every time an abortion ends, the joy the women feel, the relief-the women tell us that we gave them their life back, that they have their life back, that they are so happy. That's when [the fatigue] passes. It's reward enough.

Recognizing the arduous challenges faced by many of the people they accompany allows the companions to put their own physical and emotional efforts into perspective. Ailén, from Chile, explains: "There are girls who arrive with advanced pregnancies in the second trimester, who do not want to give birth. And since they don't want to give birth, some of them have suicidal attitudes, they want to kill themselves. So helping them solve the problem of an unwanted pregnancy is saving their lives." Recognizing their circumstances, Ailén continues, made her appreciate their expressions of gratitude for the accompaniment. "[When they say] 'thank you for existing.' That's the most gratifying thing." Indeed, Sofia, from Chile, describes this feeling of satisfaction and exhaustion that comes with accompaniment as almost addictive:

It's addictive... you say 'no, I don't want to do it anymore', and then it's the first thing you go and do. It is very addictive. Or you are super tired, you have a lot of things to do, but there is an accompaniment and it's your only day off and you prefer to do that [accompany].

The joy that accompaniment of abortions produces is not, therefore, totally separate from the marginalization of abortion in these same contexts.

In this sense, the companions also describe the joy of their own transformations, of their own empowerment that comes from participating in the accompaniments. Celeste, from Chile, tells about an experience of accompaniment: "I felt that we were like wolves, there were some wolves hidden in our bodies, and I had not realized that power, because of course every woman has the power to have an abortion. I hadn't noticed the most surprising thing, feeling capable myself." The joy of accompaniment, in other words, happens in a context of societal expectations that dictate that escorts and abortionists are incapable of empowerment and should not be empowered.

Discussion

In this analysis, we studied how the practice of in-person accompaniment of abortions after 17 weeks of gestation can be a source of positive emotions for the accompanists. The interviewees described fundamental aspects of the abortion accompaniment practice, including building a feminist community, sharing intimacy with other women, and witnessing the empowerment of the people having abortions, as causes of feelings of pleasure, joy, and other positive emotions. These findings reflect accounts from academic literature about the positive emotional experiences of people who have abortions and are accompanied during their abortions (Wollum et al. 2022; Vacarezza and Burton 2023), which demonstrates the existence of a variety of positive emotions related to accompaniment as a model of care.

It is important to emphasize that these positive emotional experiences related to abortion do not occur despite, or even outside of, the broader structural and cultural marginalization present in these contexts. On the contrary, the accompanists describe these positive emotional experiences as at least partially rooted in the marginality within which this work takes place. The pleasure of going through the experience alongside other women, for example, happens in contexts of heteronormativity and misogyny, where the intimacy, support, and physical aspect of accompaniment serve to reject the rules and expectations of a sexist culture. In this way, the described positive emotions are better understood when considering that emotions are social and cultural practices (Ahmed 2004). Throughout Latin America, accompaniment occurs in a context that marginalizes abortion, the people who have abortions, and the bodies that abort. When accompanists experience physical closeness, observe, and interact with each other and with the people who abort, emotions arise from these relationships. Therefore, emotions, even those that are positive, cannot be separated from the marginality of accompaniment itself.

Consistent with the origins of accompaniment as a feminist activist response to the cultural and health system failure to ensure access to reproductive autonomy (McReynolds-Perez et al. 2023; Braine 2020), our findings demonstrate the centrality of the feminist underpinnings of accompaniment in terms of producing these emotional effects. While other studies have identified the pleasure of abortion-related work when done with people with whom one has things in common and being present for abortionists at a physically and emotionally intense time (O'Donnell, Weitz, and Freedman 2011; Chiappetta-Swanson 2005), feminism and the feminist community have not surfaced as important issues in relation to positive emotional experiences in this research (conducted in the United States). However, for the chaperones who participated in this study, the pleasure of chaperoning is linked to feminist politics that critique misogynist culture. Their positive emotional experiences arise from understanding accompaniment as a practice that rejects normative gender restrictions and offers a feminist alternative.

Limitations

While these findings offer evidence about how escorting abortions can generate positive emotions, including pleasure and joy, our research has limitations. Accompanying abortions in restrictive contexts is a different experience than outpatient clinical treatment in contexts where abortion is legal. Also, within the experiences of accompaniment, our analysis focused on accompaniment of on-site abortions in pregnancies of more than 17 weeks gestation may limit the generalizability of our findings. As many of the interviewees mentioned, some of the positive emotions they experienced were generated by the emotional and physical labor involved in multi-day on-site accompaniment. First-trimester abortion escorts and/or by text message or telephone may not be associated with the same emotional effects.

Conclusions

Overall, our findings echo Shuster and Westbrook's (2022) conclusions regarding the importance, both theoretically and methodologically, of considering and investigating feelings of joy, especially in socially marginalized populations. By starting from the premise that participation in abortions can generate positive emotions, and by examining how research can show a more complete picture of the experience of being part of a socially marginalized activity, new insights and new research questions can emerge. Moreover, doing so serves as a corrective regarding the largely performative nature of academic studies of abortion, which (often unintentionally) produce and amplify a negative normative association regarding abortion (Baird and Millar 2019, 2020). Although focusing on pleasure and joy was not the initial goal of the research, the interview guide with open-ended questions about the positive aspects of participating in abortion accompaniments allowed evidence of these emotions to emerge. Future abortion research-about other types of abortion participation in addition to the experiences of individuals seeking abortions-should be designed with the possibility of capturing positive experiences and studying the mechanisms that generate them.

Acknowledgments

We thank Sofía Filippa for her contributions to the research design and data collection, Yasmin Reyes for her contributions to the research design, and Sofía Carbone for her contributions to the analysis. We thank members of the Colectiva Feminista La Revuelta, Con las Amigas y en la Casa, and Las Comadres, who contributed to the conceptualization, design and implementation of this research. We thank Laurel Westbrook for her enlightening comments on a draft of the article.

Declaration of conflict of interest

The authors report no potential conflicts of interest.

Additional information

Financing

This work was supported by grants from the National Center of Excellence in Women's Health at the University of California, San Francisco (UCSF) and the David and Lucile Packard Foundation (#135329). The sponsors had no role in the design, analysis, or decisions regarding publication.

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