Code of Ethics (Download ~PDF)

I. Rules of Conduct

1. Propriety. The doula should maintain high standards of personal conduct in the capacity or identity as a labor support provider.
2. 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 Labor Support Providers
3. Integrity. The doula should act in accordance with the highest standards of professional integrity.

II. Ethical Responsibility to Clients

1. Primacy of Client's Interests. The doula's primary responsibility is to her clients.
2. Rights and Prerogatives of Clients. The doula should make every effort to foster maximum selfdetermination on the part of her clients.
3. Confidentiality and Privacy. The doula should respect the privacy of clients and hold in confidence all information obtained in the course of professional service.
4. Obligation to Serve. The doula should assist each client seeking labor support either by providing services or making appropriate referrals.
5. Reliability. When the doula agrees to work with a particular client, her obligation is to do so reliably, without fail, for the term of the agreement.
6. Fees. When setting fees, the doula should ensure that they are fair, reasonable, considerate, and commensurate with services performed and with due regard for the client's ability to pay. The doula must clearly state her fees to the client, and describe the services provided, terms of payment and refund policies.

III. Ethical Responsibility to Colleagues

1. Respect, Fairness, and Courtesy. The doula should treat colleagues with respect, courtesy, fairness, and good faith.
2. 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 Labor Support Profession

1. Maintaining the Integrity of the Profession. The doula should uphold and advance the values, ethics, knowledge and mission of the profession.
2. Community Service: The doula is encouraged to assist the DONA vision of .A Doula For Every Woman Who Wants One. by making reduced cost or no cost labor support services available when possible.

V. Ethical Responsibility to Society

1. 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.

Standards of Practice (Download ~PDF)

I. Scope

1. 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 to make informed decisions about her 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 advise her client to check with her primary care provider before using any application.
2. Limits to Practice. DONA Standards and Certification apply to emotional and physical support only. The DONA certified 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. If doulas who are also health care professionals choose to provide services for a client that are outside the doula.s scope of practice, they should not describe themselves as doulas to their client or to others. In such cases they should describe themselves by a name other than .doula. and provide services according to the scopes of practice and the standards of their health care profession. On the other hand, if a health care professional chooses to limit her services to those provided by doulas, it is acceptable according to DONA.s standards for her to describe herself as a doula.
3. Advocacy. The doula advocates for the client's wishes as expressed in her birth plan, in prenatal conversations, and intrapartum discussion, by encouraging her client to ask questions of her caregiver 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 caregiver. 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.
4. Referrals. For client needs beyond the scope of the doula.s training, referrals are made to appropriate resources.

II. Continuity of Care

1. 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 back-up doula.
   . Suggesting that another member of Doulas of North America (DONA) or other doula may be more appropriate for the situation.
   . Contacting a DONA Regional Representative or local doula organization for names of other doulas in the area.
   . Following up with client or back-up doula to make sure the client.s needs are being accommodated.
   

III. Training and Experience

1. Training. Doulas who are certified by DONA will have completed all the requirements as set forth in the DONA Requirements for Certification. This includes training in childbirth and a labor support course, which has been approved by the DONA Education Committee, reading four books from the DONA Reading List, and completion of an essay on the value and purpose of labor support. See the DONA Requirements for Certification for more detail on Training and Experience.
2. Experience. Doulas certified by DONA will have the experience as set forth in the DONA Requirements for Certification. This includes provision of support to at least three clients, good evaluations from clients and health care providers, and records of three births, including a summary, observation form, and account of each birth.
3. Maintenance of Certification. DONA-certified doulas will maintain certification as outlined in the DONA recertification packet. Recertification must be completed after each three-year period of practice.