At their August meeting, the Board of Directors for DONA International approved revisions to the Standards of Practice for both birth and postpartum doulas. These documents, which all DONA International certified and member doulas agree to abide by, include the important definitions of our scope of practice. The primary changes to the Standards of Practice were made to section I.B. Limits to Practice.

Board of Directors President Sunday Tortelli, explains:

“The Standards of Practice were updated to clarify the scope of practice for doulas who are also trained in other modalities, such as lactation or aromatherapy. Many doulas are expanding their skills and offerings by receiving training and certification in complementary services. While this is wonderful in terms of the additional options available to families and the expansion of one’s services, it can create confusion on what is within the scope of practice for a doula. Our hope is that the revised documents help provide clarity for doulas, our clients and the community as a whole.” — Sunday Tortelli, President, Board of Directors, DONA International

The new Limits to Practice section of the Standards of Practice are as follows:

Birth Doulas

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.

  1. If the doula has qualifications in alternative or complementary modalities (such as an aromatherapist, childbirth educator, massage therapist, placenta encapsulator, 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.
  2. 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.
  3. 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.

Postpartum Doulas

Limits to Practice. DONA International Standards and Certification apply to emotional, physical and educational support only. The DONA certified doula does not perform clinical or medical tasks, such as examining the mother or baby, or taking temperatures, blood pressure checks or any other type of postpartum clinical care. The DONA certified or member doula will not diagnose or treat in any modality.

  1. If the doula has qualifications in alternative or complementary modalities (such as aromatherapy, lactation, infant sleep, child development, 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.
  2. A healthcare provider (such as a nurse, mental health professional, pediatric provider, etc.) may not refer to her/himself as a doula while providing services outside of a doula’s scope of practice.
  3. 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.

Other changes were made to the documents as well to refer to requirements for certification rather than state them explicitly. This will help the Standards of Practice remain current should any requirements change.

The Standards of Practice documents are available on the DONA International website:

Birth doulas: http://www.dona.org/PDF/Standards%20of%20Practice_Birth.pdf

Postpartum doulas: http://www.dona.org/PDF/Standards+of+Practice_PP_08-15.pdf

All DONA International member and certified doulas are also bound by our Code of Ethics, which was last updated in March 2015:

Code of Ethics for birth doulas: http://www.dona.org/PDF/Code%20of%20Ethics_Birth.pdf

Code of Ethics for postpartum doulas: http://www.dona.org/PDF/Code%20of%20Ethics_PP.pdf

— Adrianne Gordon, CD(DONA), MBA