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. DONA International Standards and Certification apply to emotional, physical and informational support only. The DONA certified or member doula does not perform clinical or medical tasks, such as taking blood pressure or temperature, fetal heart tone checks, vaginal examinations or postpartum clinical care. The DONA certified or member doula 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 DONA International’s Standards of Practice for her/him to describe her/himself 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.

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