DSA Standards of Practice

I. Scope of Practice

A. Services Rendered. The Labour Support Provider, hereafter called the Provider, accompanies the woman in labour, provides emotional and physical support, suggests comfort measures and provides support and suggestions for the partner. Whenever possible, the Provider provides prenatal and postpartum emotional support, including education and advocacy throughout the course of service.

B. Limits to Practice. The Provider does not perform clinical or medical tasks such as taking blood pressure or temperature, fetal heart tone checks, vaginal examinations or postpartum clinical care. DSA Standards apply to emotional and physical support only. Providers who are also health care professionals may provide these services within the scope and standards of their professions.

C. Advocacy. The Provider advocates for the client's wishes as expressed in her birth plan, in prenatal conversations and intrapartum discussion. She helps the mother incorporate changes in plans if and when the need arises and enhances communication between client and caregiver. Clients and Providers must recognize that the advocacy role does not include the Provider speaking on behalf of the client or making decisions for the client. The advocacy role is best described as support, information and mediation or negotiation.

D. Referrals. For client needs beyond the scope of the doula's training, referrals are made to appropriate resources.

II. Continuity of Care

A. Back-up Arrangements. The Provider should make back-up arrangements with another Provider to ensure services to the client if the Provider is sick or unable to be reached. Should any Provider feel the need to discontinue service to an established client, it is the Provider'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 Provider's back-up associate. 
• Suggesting that another member of Doula Services Association or other Provider may be more appropriate for the client's needs. 
• Contacting the Referral Coordinator for names of other Providers in the area or suggesting the client do so. 
• Following up with client or back-up Provider to make sure the client's needs are being accommodated. 

Ill. Training and Experience

A. Training. Providers who have successfully completed the DSA Application for Referral Volunteer and Experienced Lists will have completed the following minimum training requirements: completion of an approved training course with a minimum of 16 hours of training from an approved trainer, documentation of continuing education in maternal-child health, completion of a narrative statement on the value and purpose of labour support and observation or instruction of a childbirth education series. Our Experienced List doulas also have had a criminal record check done prior to being added to our list. 

B. Experience. Providers who have successfully completed the DSA Application for Referral Experienced List will have the following minimum experience: observation of or support for, at least three births (other than their own), including written reflections and observations of each.