By Sharon Muza, BS, CD(DONA), BDT(DONA), LCCE, FACCE, CLE
Doulas have insight and information about clients during both an exciting and vulnerable time in the family’s childbearing year. We are privileged to hold and keep information that is not generally public knowledge. We witness with our eyes, our ears, our hands and our hearts people at some of their most powerful and weakest moments. (Oddly enough, sometimes these occur simultaneously.)
Being a doula is a “lonely” vocation, in that we rarely, if ever, work with a colleague. While being part of the overall birth team, it is unusual to have the insight and support of a fellow doula while serving a client. Therefore, the desire to connect with and seek advice, feedback, and information from our colleagues is strong and often sought out through online social media forums consisting of other birth and postpartum professionals.
I certainly understand the need to gather information and resources from colleagues in order to provide suggestions and options that are complete and comprehensive to our clients. I can appreciate the desire to learn, expand our knowledge base and grow our skills so that we can become better birth and postpartum doulas.
The Code of Ethics is important
I also have a healthy respect for DONA International’s (my certifying organization) Scope of Practice and Code of Ethics (birth and postpartum). I believe that I, my clients, my colleagues and my community are best served when I practice according to these guidelines.
In regards to confidentiality and privacy, DONA’s Code of Ethics states: “The doula should respect the privacy of clients and hold in confidence all information obtained in the course of professional service.”
I am not going to go into great detail about the importance of practicing confidentiality and respecting and keeping private personal and situational information about the clients you work with. That is not what this blog post is about. The bottom line is that it is the right thing to do, our clients deserve this respect and it is in DONA’s Code of Ethics. That is enough for me and I feel strongly about protecting my client’s story in this way.
Seeking information on social media
Sometimes the need to seek out information and additional resources for a client runs up against DONA’s statement on confidentiality. It doesn’t have to be that way with some forethought and simple reframing before posting on social media sites.
There is a right way and a wrong way
I think the best way to share this clearly is with a couple of examples. In each pair, you will see a poor post choice and then the more appropriate and confidential post that results in receiving the same information without compromising client privacy.
I think it is clear in all five examples, that it is really quite simple to compose your post quickly and easily to get the exact info you need. When doing this, you are following DONA International’s Code of Ethics as it pertains to confidentiality and privacy while hopefully receiving helpful and accurate information that you can use if needed when supporting a particular client.
The world wide web is world wide!
Some professional groups online contain thousands and thousands of members. Other more local ones may have fewer members but there is a strong likelihood that your client’s information would be recognized by someone who knows them. Regardless of the size or location or purpose of your online forum, once something is posted on the internet there is simply no way to keep it from being copied and pasted anywhere on the world wide web.
The smartest and most ethical way to prevent any oversharing, while still receiving ideas, information, and support from your colleagues is to remove any and all identifying information. It is easy to do and your clients deserve this.
Some doulas may ask their clients’ permission to post and seek information. They may feel that requesting this permission allows them to share personal information. I would still like to encourage everyone to keep the personal information offline and speak in general terms when requesting help. This is the safest way to avoid any problems and can receive equally effective results.
The test of time
DONA International’s Scope of Practice and Code of Ethics has been carefully written, tested, and revised throughout the 25 years of our organization’s existence. We are required to follow these guidelines. I think that when a doula behaves professionally and in line with these policies, we protect our clients’ private information and find that we still receive the help and support that we need to better do our jobs as birth and postpartum doulas.
I would love to have you join me in sharing a fictional “wrong” post and then make it “right” and share that too. Type your suggestions and examples of good and bad posts in a comment below. I appreciate your contributions! Thank you for all you do to help families and respect their privacy at the same time.! You are making a difference in families’ lives every day.
This is such a great blog post. Can I use your examples in doula workshops? I may need to share this too 😉
Absolutely Yana! Let me know if I need to send you the jpegs. Also easy to make as well, I posted on my wall, but kept the privacy setting to “me only”.
“Wrong”:My current doula client is very fat! When I met with her, she ate 5 cookies in one sitting! Does anyone have any good resources I could offer her about healthy habits during pregnancy? “Right”: I am looking for resources on healthy habits during pregnancy. Any suggestions?
Excellent! As a woman of size, I can imagine my client posting someplace..”My current doula is very fat! When I met with her she ate five cookies in one sitting. Does anyone have any good resources I could offer her about healthy habits” I laughed because I read your reply quickly and thought you wrote that! Clearly though, you get the point! thanks for sharing.
I’m digging DONA’s policy regarding respecting the client’s privacy. Every time I see a post from a doula looking for information while attending a birth, my initial thought is twofold:
1.) why are you posting this PPI all over Al Gore’s internet, and
2.) why do you not have access to this (often basic) information? (JPE, Cohcrane Library, “Pregnancy, Childbirth, and the Newborn”, etc)
I fully understand that there are SMEs that follow online groups and stand ready to offer their expert opinions. But if the doula has internet access to post a question on social media then she probably has the time & means to do some research.
I know it sounds a little harsh but it was (sometimes literally but mostly figuratively) pounded into my head when I started out in my career field to look up answers to questions myself before asking my supervisor…for several reasons. First, when you have to find the information yourself then you are more likely to retain that information. Second, and most importantly, you’ve looked it up yourself so you know the answer is correct. Not relevant, but a fun by-product is you get to look smart should you choose to answer when someone else asks the question. But it’s satisfying to require your inquisitor to learn the information herself.
If a doula is online writing during a birth, she is not giving her total attention to the mother. I tell my trainees to put away and turn off the phone when they are in the laboring woman’s and her family’s presence.
Well, there are appropriate times that a doula could be texting and writing posts online. There are bathroom and food breaks that the doula can be posting questions or doing research while on. I know that is typically when I do mine, or I will excuse myself for a moment if my client is resting etc. I also cannot turn off my phone completely when I am in attendance at births as I do have a family at home with small children (17 months, 4, and 6) and I do also need to be available to them if an emergency arises, so I never turn off my phone. I turn off a ringer and will only text or check texts at appropriate times when permitted.
so many acronyms. Got most of them but what is PPI?
PII = personally identifiable information.
Ah, whoops, I just noticed Bud said PPI, not PII. That’s usually “private personal information.” Either that, or Bud is military and got halfway between PII and PPE (personal protective equipment). 😉
Yes, PII or PPI (was gonna use PII but figured civilians wouldn’t get it.)
Personal private identified information…or any combination thereof.
I just got home from a long birth at xyz hospital and treated myself to a donut on the way home. I doubt there’s any correct way to say this – it shouldn’t be mentioned at all. Maybe…I like to treat myself to ___ after a birth.
Yes, I agree Ann, maybe just “what do you need to eat after a birth, I like donuts for myself!” and posted in a general timeframe!