A Doula’s Scope Of Practice – The Scope of Practice describes the procedures, actions, methods, and processes that a Doula is permitted to undertake in keeping with the terms, values, and vision of Doula work as a whole. A Scope of Practice is typically commanded by a professional licensing structure or regulatory body. As Doula work does not operate within a professional licensing structure or regulatory body, our scope of practice is agreed on, initiated, and self-monitored by the Doula as an individual, and by collectives of Doulas around the world. As a Doula with Angela Gallo, you can expect to operate within two realms: scope of practice and code of conduct.
Scope of Practice – Doulas training with Angela Gallo provide emotional, spiritual, and physical support during periods of TTC (trying to conceive), conception, pregnancy, labour and childbirth, and the postpartum period. This includes accompanying the woman, person, and/or partner during said times, educating on a myriad of topics relevant to each of these phases of childbearing and child rearing; providing explanations of procedures, protocol, and policy relevant to the client & their journey; creating space for discussion in order for the client to make empowered and informed decisions about their own care; providing resources and information; suggesting comfort measures and coping techniques in labour; inspiring the client to recognize their unique strengths; guiding them to assert their desires and communicate their concerns to their care provider in order to improve odds at achieving an excellent outcome & experience.
Doulas do not prescribe treatment or perform clinical/medical tasks such as taking blood pressure, drawing blood, taking temperatures, checking for fetal heart tones, vaginal examinations or similar. Doulas trained and certified with Angela Gallo will not diagnose or treat under any modality.
Any information or suggestions coming from within the role of a Doula must be done with the proviso that the Doula advises his/her client to check with the primary care provider before applying any recommendation.
Should the Doula have additional skills or qualifications in alternative or complementary modalities (massage therapy, placenta encapsulation, reiki practitioner, herbalist, aromatherapy, hypnotherapy, etc.), the Doula must make it very clear to their clients in writing, that these modalities are an additional service or diversification of their offerings, separate and in operation of outside of the Doula Scope of Practice.
Nurses, Midwives, General Practitioners, Chiropractors, etc., cannot call themselves a Doula if they are providing services that fall outside of a Doula’s Scope of Practice. However, if a health or alternative care professional chooses to limit his/her/their services to those provided by Doulas, they are allowed to refer to themselves as Doulas because they are operating within the Doula Scope of Practice.
The Doula advocates for their client’s wishes, desires and preferences, as explained in their birth and postpartum plans, and conversation in the perinatal period; by encouraging 1) their client to communicate confidently and clearly to their care provider, 2) their client to ask their care provider the necessary questions, 3) their client to do research to help them make decisions that suit their individual needs, 4) their client to assert their individual wishes, desires, and preferences in and out of the birth space. Advocacy as a Doula can be best described as bringing unconditional support, education, information, awareness, inspiration, and mediation to client and care provider interactions, by helping streamline clear communication between the client and their care provider, and by helping the client to create and/or change plans when the need presents itself. Doula advocacy does not include speaking on behalf of their client, speaking instead of their client, making decisions for their client, and imposing bias to influence decisions their clients may have to make.
Operating your business as a professional Doula outside of the Scope of Practice risks:
- Jeopardizing the physical, mental, and emotional health of your clients,
- Putting the professionals and people you work with in danger due to breaches of conduct;
- Sabotaging the relationships Doulas have worked tirelessly to cultivate with professionals in the perinatal worlds,
- Compromising the reputation and professional integrity of Doula work as a whole,
- Stifling the vast social impact of visionary, activist and advocacy work acted out by professional Doulas,
- Having a formal grievance filed against you by your clients or colleagues;
- Possibly having your certification with Angela Gallo’s Dynamo Doula Training Program, as well as access to the Facebook Group and any association with Angela’s branding, revoked without notice.
If you are unsure whether you are operating as a professional Doula outside of the Scope of Practice set out in Angela Gallo’s SOP, we recommend reading our Code of Conduct for more detailed information and reference. Should you still be unclear, contact Angela or someone on team DDT directly.
Code of Conduct
Definition of a Doula and Role:
A Doula is a trained person who provides practical and emotional support for women, people, couples, and families throughout pregnancy, labour, birth, and the immediate postnatal period.
The Doulas of Angela Gallo’s Dynamo Doula Training are committed to:
- Working with and supporting women, birthing people, and families to be prepared for the birth of their baby/ies.
- Helping women, birthing people, and families feel supported throughout their pregnancy, labour, birth, and postnatal period.
- Helping women, birthing people, and families be empowered through sharing information and resources to make educated decisions that best suit the individual around their pregnancy, birth, and parenting preferences and/or needs.
- Working to address injustice and inequality in the perinatal period.
- Working to achieve social change, social justice, and advocacy in the area of Doula work and birth rights.
- Working to raise the standard of Doulas and businesses operated by maternal & perinatal professionals, by understanding how business and birthwork marry together- including charging a living wage as a minimum requirement to sustainable business that serves the Doula, client and community.
Graduates and students must at all times:
- Comply with the Code of Conduct and Scope of Practice.
- Respect all others, their uniqueness, and believe in their equal worth as human beings; as well as value diversity and difference.
- Practice compassion, respect, equity, fairness, and justice.
- Believe in collaboration as a foundation for community centric values and sustainable business.
- Believe in charging a living wage to support one’s individual sustainability but also as a responsibility to raise the standards of the profession as a whole.
- Value the importance of family and community as a foundation of wellbeing for both individual and society.
- Respect individual choice and personal responsibility.
- Promote human rights in the birth space and beyond.
- Use respectful, inclusive, and culturally respectful language.
- Respect privacy and confidentiality.
- Practice with professionalism and uphold integrity at all time.
This Code of Conduct contains a set of principles outlined by Angela Gallo. Upon signing up and becoming a Dynamo Doula Graduate, you make a commitment, and are required, to abide by this Code of Conduct.
Dynamo Doula members, both graduates and students, are called upon to account for their practice. In the event of non-compliance, an investigation regarding unethical conduct will take place, and escalated with the appropriate people and/or board of directors.
Failure to comply with the Code of Conduct may result in immediate removal from the program and/or certification revoked, as well as rights to be associated with Angela Gallo’s Dynamo Doula Training Program.
This code may be reviewed and altered at any time. Any alterations will be communicated to students and graduates for confirmation of further compliance.
The Code of Conduct is a core document that underpins the professional, ethical practice of all Graduates and Students in the Dynamo Doula Training.
This Code of Conduct expresses the integral values and responsibilities of the Doula profession. It is intended to assist all Dynamo Doula Graduates, collectively and individually, to at all times, act ethically and be accountable for their actions in the pursuit of the profession’s aims.
Ethical Responsibility to Clients:
- Doulas work at the interface between women, their families, their care providers and the outer social, cultural and physical environments.
- In all contexts, the Doula’s primary focus and attention is on that of the needs and requests of their client. The client’s needs and interests are the primary responsibility of the Doula at all times. Doulas are not bound by the agenda, policies, or protocols of the client’s care provider, but still, practice with integrity, as well as approach and communicate in a caring & respectful manner to the client’s core care providers.
- Doulas should ensure clear communication at all times with their clients, as well as clearly outline responsibilities, rights, inclusions, and exclusions in the form of a professional document binding both Doula and client.
Where a dispute arises between the parties to the agreement between Doula and client(s), the parties will in good faith and acting reasonably, use best efforts to resolve such dispute. If a dispute cannot be resolved by the parties using their best efforts, the parties may appoint a mediator to mediate a resolution of the dispute. Nothing in this clause shall prevent a party from seeking urgent equitable relief before an appropriate court.
As part of Angela Gallo Education and Training, the process of seeking advice on disputes and grievances are:
As a student seeking advice on disputes and grievances, you are asked to firstly contact your assigned Master Doula Educator to explain your individual circumstance and be instructed on the next point of escalation on the matter.
If a client approaches the school with a dispute or grievance against a student Doula or graduate Doula, a case will be opened and attended to as by Angela Gallo and the Board of Directors. Once assessed, further instruction will be provided to find resolution to said dispute or grievance.
The Doula students and graduates of Angela Gallo’s Dynamo Doula Training must….
- Respect all people as a collective and as individuals. We believe that everyone has equal inherent worth, and have a right to wellbeing, dignity, autonomy, and equal human rights.
- Practice with professional integrity, humane service, and with a duty of care to do no harm.
- Have respect for and recognise the role of care providers as being equal professionals; use respectful language and manners when supporting a mutual client.
- Promote empowerment, justice, and social fairness by acting with compassion to reduce barriers and to expand choice, information, and education.
- Be mindful of those who are disadvantaged, vulnerable, oppressed, or have unique needs.
- Advocate change to social systems and structures that preserve inequalities and injustice.
- Maintain a high quality of professional conduct and behave with dignity and responsibility.
- Demonstrate respect for clients at all times and endeavor to preserve and promote their dignity, individuality, and human rights.
- Respect others’ beliefs, religious or spiritual worldviews, values, culture, goals, needs, and desires.
- Provide the necessary and relevant information and resources for clients to make informed decisions. Doulas will provide information and resources that are unbiased and promote the use of current/up to date and/or evidence based information. It is the duty of the Doula to provide these without having personal input or say or benefit on the outcome of the decision being made.
- Never make a decision for their clients or speak on behalf of their client/s unless legally stipulated in a legal document in the case of convoluted circumstance (i.e client becomes involuntary and there is no family or estate to involve in the best interest of the client/s).
- Be aware of and reflect on their own personal beliefs, history, values, views, prejudice, and preferences and refrain from imposing these on clients.
- Respect the autonomy of clients to make the informed decisions that are right for them.
- Ensure ongoing professional development and life-long learning, education, training to maintain the standard of which they are taught.
- Participate in regular debriefing and supervision.
- Ensure unbiased, non-judgemental practice when faced with making decisions by being aware of their own worldview, moral, cultural, historical, political, religious, spiritual, societal, and professional values and biases, and the possible influence of these on their professional judgements.
- Seek guidance from a professional Dynamo Doula team member or if in doubt about a situation that may become outside of this agreement. Ie: If the law or Client requests conflict with perceived moral obligations, or Code of Conduct.
- Advise clients regarding their right to complain, the appropriate avenues to take and the procedures to follow in making a complaint.
Quality of Services
The Doula must perform the agreed services with integrity and professionalism; in keeping with their personal training, experience and achievements, and pursuant to this Code of Conduct.
If the Client or any other person gives written notice to the Doula of any deficiency in the performance of the services, the Doula should use their best efforts to correct any such deficiency immediately. In the event of a dispute or grievance, Doulas must speak to their Angela or someone on team DDT, or see the Angela Gallo Dynamo Doula Grievance Policy.
The Doula must at all times behave and perform the services in a professional, timely, and competent manner using reasonable care, skill and diligence including without limitation, in accordance with a high standard of honesty and integrity.
The Doula must do all things possible to attend the client’s birth in accordance with their contracted agreement.
A Doula must always have prearranged and offer the option of a back-up (replacement) Doula with the consent of the client in the event that the Doula is unable to attend the birth. The back-up (replacement) Doula will provide the services in accordance with both the contracted agreement, and in accordance with the Code of Conduct.
“What if back-ups aren’t available?”
A graduate or student of the Dynamo Doula Training will always, to the best of their ability, arrange a back-up (replacement) for their contracted services. In the event that there are absolutely no options for another Doula in the area, or another Doula who practices with the same professionalism, integrity, and Code of Conduct as Dynamo Doulas; the primary Doula must have, in writing, their inability to practice with a back-up (replacement) Doula.
A separate written agreement must be made with the client prior to the signing of the initial contract, about the Doula’s inability to practice with a back-up (replacement Doula). This written agreement must outline alternative arrangements regarding payment, refunds, cancellations, minimum/maximum hourly attendance, and other considerations.
Any financial agreements need to be agreed on. For example, should the Doula not be able to attend the birth at the last minute, with no access to a back-up (replacement) Doula, the Doula may be likely to offer increased hours of care in the postnatal period as consolation.
The Doula must not act in any manner which could disrupt or adversely affect the client’s birth processes or procedures. This might involve obvious use of cellular phone for text messaging or making calls, opening or closing doors and lights without appropriate notice, playing music without request or permission of your client/s, etc.
Provided the Doula took all reasonable steps to prevent it, the Doula cannot be held liable for non-attendance at the client’s birth in the following circumstances;
(a) The client failed to provide reasonable and sufficient notice at the first instance of labour and in accordance with the Doula’s instructions;
(b) The client has an extremely swift birth which falls outside the general standards of expected labour times;
(c) In the event of a force majeure, or unforeseen circumstances out of the Doula’s control.
Compliance with Agreement and Laws
The Doula must observe and comply with the provisions of this Code of Conduct and all applicable laws of their state and country in the performance of the contracted services.
Limitation of Services
Medical, Clinical and Health Care
It is important to note that Doulas have the Scope of Practice they do for a reason – and this is because our profession relies much more on emotional and spiritual skill than the ability to perform medical or clinical tasks. Doula work is a craft, an art – a beautiful dance between skill, experience, instinct, and intuition. It is important not to feel limited by what you cannot do but instead feel fulfilled freedom as you serve your clients in your unique capacity.
- a) The Doula does not perform any services of a Medical Professional or a Healthcare Practitioner. The Doula does not perform any clinical tasks including, but not limited to: measuring blood pressure, internal and external examinations, fetal assessments, general health assessments, vaginal exams, ultrasounds, injections, procedures associated with delivery or provide advice in the capacity of a Medical Professional or Healthcare Practitioner.
- b) In the event the client chooses not to contract the services of a Medical Professional or Healthcare Practitioner for any part of the birth process, including pre-labour, post labour and during labour, the client does so at their own risk. The Doula cannot and will not substitute the services, or assume the liability of a Medical Professional or Healthcare Practitioner, regardless of which premises the birth takes place at and who is present at the birth. The Doula’s own professional boundaries regarding attending a birth where a care provider is not present will be in writing in their contract for the client to be aware of prior to the birth.
- c ) A contravention of the above clauses (a) and (b) is unlawful. The client acknowledges that placing, or attempting to place the Doula in circumstances where the Doula is expected to breach this clause or any part of their contractual agreement, will be considered a material breach of the agreement and result in termination.
The Doula acknowledges that during the term of this agreement, the Doula may be furnished with or may otherwise receive or have access to confidential Information, including but not limited to medical records or information which relates to the client’s health or family, or other information which may be considered sensitive or private.
Obligations Regarding Confidential Information
- (a) use the confidential Information, only for the purpose of performing the contracted services within the scope of this Code of Conduct;
- (b) maintain the confidentiality of the confidential information and ensure that, without the prior written consent of the client (which the client may withhold in its absolute discretion), the confidential information is not disclosed to or used for the benefit of the Doula or any third party;
- (c) take all steps and do all things as may be necessary, prudent or desirable in order to safeguard the confidentiality of the confidential information;
- (d) not make or allow to be made copies or extracts of all or any part of the confidential Information except with the prior written permission of the client; and
- (e) upon the expiration or termination of contracted services, the Doula must hand over immediately to the client and not retain any record, representation, or reproduction (written, electronic, photographic or otherwise) of the confidential information other than as required for the purpose of maintaining its business records, that the client has expressly consented to, or as required by law.
Procedures, Standards, Directions
The Doula must comply at all times, including while on-site at any premise, with all relevant policies, rules and standards of conduct which apply from time to time (including those relating to health, safety, security, business ethics or methodology, or contact with Healthcare Professionals, Healthcare Practitioner or staff).
If the client is aware of any such policies and procedures, the client will endeavour to provide the Doula with reasonable prior notice.
The Doula must comply with the reasonable directions (consistent with the scope of the services and the terms and conditions of this agreement) of the client and provide reasonable cooperation with the client’s Medical Professionals, Healthcare Practitioners, guardians, agents, contractors.
In the event the policies and standards of an onsite premise are unsafe and may contradict this code of ethics, the Doula has the right to remove themselves from the premises. Doulas have the right to feel safe at all times and can terminate their services if they do not feel physically or emotionally safe. This includes being given directions to comply with staff, policies, rules and standards of conduct that make the Doula feel complicit, or physically and emotionally unsafe.
Degree of Skill, Care and Diligence
The Doula represents and warrants that Doulas will honestly represent their training, skills, experience and achievement.
No Other Understanding or Agreement
The Doula represents and warrants that they are able to perform the services and does not have any understanding or agreement with any other person which restricts their ability to perform or may be in competition with the client or the business.
No Conflict of Interest
The Doula represents and warrants to the client that, to the best of their knowledge, at the commencement date, no conflict of interest exists or is likely to arise in the performance of the obligations by the Doula and under this agreement.
Undertakings by Doula
The Doula undertakes that:
(a) subject to the remaining parts of this subclause, a Doula will not enter into any arrangements, schemes or contracts, however described, which may cause a conflict of interest concerning the Doula’s performance of the services; and
(b) should it become aware of the existence or the possibility of a conflict of interest, they will immediately notify the client, provide details of the conflict of interest or potential conflict of interest, and provide details of the steps that they proposes to take to resolve or deal with the conflict.
Rights of Doulas
Doulas have the right to redirect or refuse service on justifiable grounds, provided clients are redirected to a professional in the appropriate practice.
Doulas have the right to a break, at a minimum, of every 3 hours; including to eat, hydrate, nap, and use the restroom.
Doulas have the right to protect themselves from the effects of fatigue and adrenal fatigue, including calling in a back-up (replacement) Doula in labours and births that exceed 12 hour’s length.
Doulas have the right to feel safe at all times and can terminate their services if they do not feel physically or emotionally safe.
Doulas have the right to debrief and access support for professional issues that have risen through services rendered to clients in pregnancy, childbirth, and the postpartum period; safely and without negative consequences.
Doulas have the right to decline anything that makes them feel uncomfortable, or which asks them to act outside of this Code of Conduct, or outside of the local or state laws. For example, a Doula can decline to take on a client that is no longer under the care of a registered care provider. A doula can decline to clean up anywhere that has blood or bodily fluids present, etc.
The Doula’s private life will not impact their ability to perform the agreed duty. In the event that a Doula cannot fulfill their agreement, a back-up (replacement) Doula will have been arranged, unless otherwise previously arranged.
Doulas will not engage in any form of inappropriate sexualised conduct with a person with whom they are currently in a professional relationship, professionals they are working with, or similar. This includes sexually harassing or assaulting anyone, in any circumstance.
Doulas, not their clients or former clients, are responsible for setting and maintaining clear and appropriate professional boundaries in all forms of communication, including face to face contact, written communication, telephone and online communications (including social networking, email, blogging and instant messaging).
Ethical Responsibility to the Profession and Training Body (Angela Gallo’s Dynamo Doula Training)
Doulas must recognise their responsibility to contribute to and support the local, national and international Doula community.
Doulas will promote the integrity and standards of the profession when undertaking all forms of the work, and when interactive with all others (clients, potential clients, and other professionals).
Doulas will refrain from any behaviour which contravenes professional values and standards or which damages the profession’s integrity and good standing.
Doulas will represent the profession and Angela Gallo and her Dynamo Doula Training by carrying out contracted services with integrity, refraining from any behaviour which contravenes professional values and standards or which damages the training’s integrity and good standing.
Doulas are responsible for the standard of services they provide and how this may impact the profession as a whole.
Termination of Services
Clients and Doulas have the right to terminate services at anytime, with respect to the contract signed and the agreed terms for payment and services due.
Doulas have the right to terminate services if they feel unsafe, or are asked to perform in anyway outside of their scope of practice, outside of this code, or outside of their local laws.
If a Doula must terminate their agreement, they must do so in a respectful manner and if appropriate, offer a referral to another Doula or service provider, or seek guidance from their trainer.