Statement of Professionalism of Doula Education and Care
Among doulas, the need to define their work as a profession is a growing trend. Our birthing communities need this in order for doulas to be autonomous. Professional doulas create a more effective collaboration among the entire birth team, including doctors, nurses, and midwives. In an article defining professionals, Helen Hurd discusses the importance of working interdependently instead of independently and in isolation. (Hurd, 1967) Working as a collaborative team helps to offer the greatest support for a birthing woman. “Collaborative practice happens when multiple health workers from different professional backgrounds work together with patients, families, careers and communities to deliver the highest quality of care. It allows health workers to engage any individual whose skills can help achieve local health goals.” (World Health Organization, 2010) By working together, we can pool our resources and help each other develop to our best potential, thus better serving our clients and communities.
In the past, professionals earned money for their services, as opposed to a hobbyist who worked for free. Today though, many scholars describe a professional as someone who pursues a moral or ethical code instead of someone who just earns a living. (Professional Standards Council) Thus, these standards for doulas do not define a professional doula by paid services, but by whether they contribute value to their profession as a doula (Bogue, 2014). We can define that value by the quality of work or dedication to the profession instead of how much pay they receive.
The Professional Standards Council further defines professionals as those who are “Governed by codes of ethics, and profess commitment to competence, integrity and morality, altruism, and the promotion of the public good within their expert domain. Professionals are accountable to those served and to society”. Both the Professional Standards Council and Professions Australia (two groups that work to promote the role of the professional), break this down into three concepts. A professional is someone who:
- Holds ethical standards.
- Holds a specialized knowledge that comes from research and a high level of education and training.
- Applies these skills in the interest of others.
The work of a professional doula can be involved in many experiences that include ethical responsibility. Ethical issues are a part of the work. These can range from how we react when we disagree with other doulas or healthcare professionals to how we view the role of a doula. When ethical standards have been defined, it decreases some of the problems inherent in these dilemmas because it provides guidance on what actions should be taken. Thus, it is important for the professional doula to adhere to a set of ethical standards either set by a certification organization or ones that they have set for themselves. At minimum, a professional doula should adhere to these values: honesty, respect for colleagues (including medical professionals) and clients, accountability, and equal treatment for clients and other members of the birth team. (Elsayed, 2009)
The body of knowledge of the doula is what constitutes the specialized knowledge held within the doula profession. Because the role of a doula is not legally defined, the definition from the oxford dictionary and the most recent research into the benefits of labor support have been used in these standards in order to define the unique body of knowledge that the professional doula has. Thus, the professional doula is “A woman who gives [non-medical] support, help, and advice to another woman during pregnancy and during and after the birth”. (Oxford Living Dictionaries) The body of knowledge of a doula includes labor and postpartum support involving “emotional support, comfort measures, information and advocacy” (Cochrane Collaboration, 2013) This body of knowledge is unique from nursing, family support, and midwives as the literature has shown that it is through those trained within the doula framework as defined above, that the best benefits are seen in laboring women. (Cochrane Collaboration, 2013) Research studies have also shown that the work provided by doulas is unique to the doula profession. (Gruber et al, 2013,. Gilliland, 2011, Gillilan, 2002) More research will be needed to define how doula support is different from other professions, and doula professionals should be involved in looking for ways to extend their knowledge base through many different avenues. It is important to note that different certifying agencies may add to this definition and it is advised that policy makers within healthcare institutions look at individual organizations or doula practices when incorporating doula care into their institutions.
Ultimately it is through the trust of our communities that a profession is recognized. Thus, a professional doula has an obligation to their clients and communities they serve. This obligation includes acting and responding to challenges with their clients and other birth professionals with good will and integrity. It also involves maintaining the confidentiality of their clients and other birth professionals. A professional doula will put their clients and community’s needs before their own as an ultimate expression of their commitment to their profession.
Given the above statements, as a professional doula:
I commit to providing care to my clients and community with “integrity and morality, altruism, and the promotion of the public good”.
I commit to do my best to work in a framework of collaboration with other doula businesses or organizations, as this is what will best serve birth women and our communities.
I commit to living by a set of ethical standards. At minimum these include honesty, respect for colleagues (including medical professionals) and clients, accountability, and equal treatment for clients and other members of the birth team. Other standards may either be established by an organization, or ones that an individual adheres to themselves. In living by ethical standards I am able to take action on issues that may need more guidance.
I commit to provide quality work and dedicate myself to the profession of a doula.
I commit to adding to the doula professions current body of knowledge by gaining an education in my profession through certification, mentorships, or field experience, and by furthering my education of the role of the doula by staying current on literature as it is published. I will also complete continuing education units, according to the rules of my certifying organization.
Bogue, Robert. (2004). What’s the difference between a hobbyist and a professional? Quinstreet Enterprise. Retrieved online: December 14, 2016, http://www.developer.com/mgmt/article.php/3443461/Whats-the-Difference-Between-a-Hobbyist-and-a-Professional.htm
Elsayed, Dya E. M., Ahmed, Rabaa E. M. (2009). Medical Ethics: What is it? Why is it important? Sudanese Journal of Public Health. Vol. 4 No. 2.
Gilbert JH, Yan J, Hoffman SJ. A WHO report: framework for action on interprofessional education and collaborative practice. J Allied Health. 2010;39:196-197.
Hodnett ED, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.
Poh, H.L., Koh, S.S.L. and He, H.-G. (2014), An integrative review of fathers’ experiences during pregnancy and childbirth. International Nursing Review, 61: 543–554. doi: 10.1111/inr.12137
Oxford Living Dictionaries. Retrieved online: December 14, 2016. https://en.oxforddictionaries.com/definition/doula
Professional Standards Councils. What is a profession. Retrieved online at: December, 2016 http://www.psc.gov.au/what-is-a-profession
Schottenfeld L, Petersen D, Peikes D, Ricciardi R, Burak H, McNellis R, Genevro J. Creating Patient-Centered Team-Based Primary Care. AHRQ Pub. No. 16-0002-EF. Rockville, MD: Agency for Healthcare Research and Quality. March 2016.
Statement of Professionalism in Doula Education and Care by New Beginnings Doula Training is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.