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Scope of Practice: A Doula Thing?

Recently, in a Doula group I watch online, someone brought up a question of whether a certain practice was within our Scope of Practice. Now, as far as my certifying body (DONA) is concerned, the practice in question would certainly not be ok for a Doula to perform. (Honestly, I'm not sure that any of the certifying bodies would be alright with it.)

That said, this is more about something that someone else brought up in the comments. They were speaking as a Doula in the USA, which I can't really relate to, but they were very passionately protesting the idea that any Doula must conform to a Scope of Practice because, legally speaking, it simply does not exist. Because there is no one governing body for Doulas, like there would be for a health care professional, they say that there is no Scope of Practice at all. Therefore, in their opinion, each Doula is open to decide what practices they choose to use with their clients, even if those practices border on (or are specifically) those of a Midwife or Doctor. They also believe that nobody has the right to tell a Doula what they should or shouldn't do.

I disagree with this, just as passionately as they believe it.

If Scope of Practice does not exist for Doulas formally, it does not mean that we should overstep our bounds into areas that are medical and belong to other professionals (where things are regulated and overseen). I might think it would be great to offer pelvic exams and provide c-sections to my clients, but those are not services that Doulas provide. I have no education, licenses, or experience that would make those ok to do. Even if I did, if I were providing those services, I would not be doing so as a Doula. I would be taking off my Doula hat and putting on that of a Doctor or Midwife.

It is also a matter of protecting the health and well being of your clients AND the well being of the Doula profession as a whole. If a Doula, or group of Doulas, begin providing medical services that they don't have permission or education for and something goes horribly wrong because of them, it reflects on other Doulas and the profession as a whole. We are accountable. We are accountable to our clients and to other Doulas.

Perhaps there is no formal Scope of Practice, but it shouldn't be hard to imagine what that scope would entail. I also doubt that it will be terribly long before a formal scope exists and I will be glad and relieved when it does.

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