I often get asked what the difference between a Doula and a Midwife are. When I announced I was going back to school to become a Doula my parents (and a few others) thought I was studying to be a midwife. Doula’s are like a trained birth partner. Midwifes are a medical professional. Doula’s help listen, comfort, assist and give credible sourced information during pregnancy, labour, birth and the first year of having a baby. Midwifes perform medical exams, give advice, prescribe medication during pregnancy, labour, and first 6 weeks of baby’s life, as well as delivery in hospitals and home births.
The information below is taken from Doula Canada. I do not own these words but I follow them. As a doula leaning through Doula Canada I follow this scope of practice laid out below.
A labour and birth doula provides non-medical, physical and emotional support as well as informational assistance before, during, and after childbirth.
Prenatal consultations with pregnant clients and partners in order to obtain a preliminary history and to determine their preferences for the birth, to discuss prenatal education, as well as pain-coping techniques.
Provides resources to assist the expectant parents with birth planning.
Provides telephone and/or email support as required Emotional support and comfort.
LABOUR & BIRTH
Suggests non-pharmacologic comfort measures
Assists with application of hot/cold packs for pain relief as needed
Provides a soothing massage for relaxation and pain relief
Suggests positions that may help progress labour, provide comfort and pain relief
Provides suggestions and applies methods to promote relaxation, including guidance in breathing techniques
Provides positive verbal encouragement, reassurance, praise, affirmation and validation.
A labour doula must have excellent listening skills
Setup and maintain an environment conducive to a positive birth experience
Provide support and suggestions to the partner or other support person
Facilitate communication between the family and the medical staff
Assistance with the baby’s early breastfeeding and/or alternative feeding
Referral to appropriate community resources, as needed
LIMITS TO PRACTICE
A labour and birth doula does not perform clinical or medical tasks (including, but not limited to, such things as taking blood pressure or temperature, checking fetal heart tones, performing vaginal exams, or postpartum clinical care). Where possible, all informational support rendered will be supported with evidence-based research and qualified resources. The labour and birth doula will provide information on benefits, risks and alternatives rather than their personal advice on all matters. The doula does not diagnose or prescribe treatments (as per definitions below) and are to refer to a qualified professional wherever possible.
The doula must also advise their client to inform their primary caregiver prior to using any alternative therapies.
Where the doula has additional training in areas outside of the doula’s scope of practice, they should refer to that profession and their scope of practice, and determine if it is appropriate to combine the roles. In any event, they are to clearly inform clients of such training, the limits of their ability to offer knowledge and/or practice in this area, and that any additional services offered is separate from their training as a doula. The Doula is also encouraged to clearly define this situation to any healthcare provider they encounter in order to avoid confusion regarding the labour doula’s role and scope of practice
Advice: An opinion recommended or offered, as worthy to be followed; counsel.
Counsel: To advise or recommend, as an act or course. Advice given especially as a result of consultation. A policy or plan of action or behaviour.
Evidence: To indicate clearly; exemplify or prove. Something that furnishes proof.
Opinion: A notion or conviction founded on probable evidence; belief stronger than impression, less strong than positive knowledge. A view, judgment, or appraisal formed in the mind about a particular matter.
Prescribe: To specify with authority. To direct, as in a remedy to be used by a patient; as, the doctor prescribed a medication. To write or to give medical directions; to indicate remedies.
Research: Scholarly or scientific investigation, inquiry. Careful or diligent search.
As a doula in my community working closely with families and businesses, I will not recommend business that are known to work outside of their own scope of practice. Other doulas that I work with also abide by these set of rules.