Standards of Practice
A. Services Rendered. The doula accompanies the woman in labor, provides emotional and physical support, suggests comfort measures, and provides support and suggestions for the partner. Whenever possible, the doula provides pre- and post-partum emotional support, including explanation and discussion of practices and procedures, and assistance in acquiring the knowledge necessary for the client to make informed decisions about their own care. Additionally, as doulas do not “prescribe” treatment, any suggestions or information provided within the role of the doula must be done with the proviso that the doula advises his/her client to check with the primary care provider before using any application.
B. Limits to Practice. Doulas of Eastern Idaho Standards of Practice apply to emotional, physical and informational support only. DOE Idaho member doulas do not perform clinical or medical tasks, such as taking blood pressure or temperature, fetal heart tone checks, vaginal examinations or postpartum clinical care. DOE Idaho member doulas will not diagnose or treat in any modality. i. If the doula has qualifications in alternative or complementary modalities (such as aromatherapy, childbirth education, massage therapy, placenta encapsulation, etc.), s/he must make it very clear to her/his clients and others that those modalities are an additional service, outside of the doula’s scope of practice. ii. A healthcare provider (such as a nurse, midwife, chiropractor, etc.) may not refer to her/himself as a doula while providing services outside of a doula’s scope of practice. iii. On the other hand, if a health care, alternative care or complementary care professional chooses to limit her/his services to those provided by doulas, it is acceptable according to DOE Idaho's Standards of Practice for her to describe herself as a doula.
C. Advocacy. The doula advocates for the client's wishes as expressed in her birth plan, in prenatal conversations, and intrapartum discussion, by encouraging his/her client to ask questions of her care provider and to express her preferences and concerns. The doula helps the mother incorporate changes in plans if and when the need arises, and enhances the communication between client and care provider. Clients and doulas must recognize that the advocacy role does not include the doula speaking instead of the client or making decisions for the client. The advocacy role is best described as support, information, and mediation or negotiation.
D. Referrals. For client needs beyond the scope of the doula’s training, referrals are made to appropriate resources.
II. Continuity of Care
A. The doula should make back-up arrangements with another doula to ensure services to the client if the doula is unable to attend the birth. Should any doula feel a need to discontinue service to an established client, it is the doula’s responsibility to notify the client in writing and arrange for a replacement, if the client so desires. This may be accomplished by:
• Introducing the client to the backup doula
• Suggesting that another member of Doulas of Eastern Idaho or other doula may be more appropriate for the situation.
• Contacting a DONA International regional representative or local doula organization for names of other doulas in the area • Following up with the client or backup doula to make sure the client’s needs are being accommodated
III. Training and Experience
A. Training. Members that are certified doulas have been though a professional doula training course by a professional training organization, verified proof of their training and that they are a member in good standing, and have completed their requirement of receiving at least 3 positive birth referrals from health care providers. All other doulas (uncertified and those in-training) need to provide proof of training through a professional doula training organization and have at least 3 positive birth referrals from health care providers.
Code of Ethics
I. Rules of Conduct
A. Propriety. The doula should maintain high standards of personal conduct in the capacity or identity as a birth doula.
B. Competence and Professional Development. The doula should strive to become and remain proficient in the professional practice and the performance of professional functions through continuing education, affiliation with related organizations, and associations with other birth doulas.
C. Integrity. The doula should act in accordance with the highest standards of professional integrity.
II. Ethical Responsibility to Clients
A. Primacy of Client’s Interests. The doula’s primary responsibility is to his/her clients.
B. Rights and Prerogatives of Clients. The doula should make every effort to foster maximum self determination on the part of his/her clients.
C. Confidentiality and Privacy. The doula should respect the privacy of clients and hold in confidence all information obtained in the course of professional service.
D. Obligation to Serve. The doula should assist each client seeking birth doula support either by providing services or making appropriate referrals.
E. Reliability. When the doula agrees to work with a particular client, his/her obligation is to do so reliably, without fail, for the term of the agreement.
F. Fees. When setting fees, the doula should ensure that they are fair, reasonable and commensurate with services performed. The doula must clearly state his/her fees to the client and describe the services provided, terms of payment and refund policies.
III. Ethical Responsibility to Colleagues
A. Respect, Fairness, and Courtesy. The doula should treat colleagues with respect, courtesy, fairness, and good faith.
B. Dealing with Colleagues’ Clients. The doula has the responsibility to relate to the clients of colleagues with full professional consideration.
IV. Ethical Responsibility to the Birth Doula Profession
A. Maintaining the Integrity of the Profession. The doula should uphold and advance the values, ethics, knowledge and mission of the profession.
B. Community Service: The doula is encouraged to assist the mantra of "every doula for every woman who desires one" by making reduced cost or no cost birth doula services available when possible.
V. Ethical Responsibility to Society
A. Promoting Maternal and Child Welfare. The doula should promote the general health of women and their babies, and whenever possible, that of their family and friends as well.
-Adapted from DONA International's Standard of Practice, www.dona.org