Scope and Standards of New Beginnings Doulas


Professional New Beginnings Doula Scope and Standards of Practice

A doula certification organization has responsibility to its students, doulas, and the public it serves to develop the scope and standards of its profession’s practice. As a training and certifying company, New Beginnings Childbirth Services assumes responsibility for developing the scope and standards that apply to the practice of professional doulas trained through New Beginnings Doula Training. In order to do this, New Beginnings looked at previous work done to define doula practice. This includes various scope and standards of certifications and licenses in the area of health care and alternative therapies, as well as current initiatives underway that establish greater labor support for women and families. The current scope and standards for New Beginnings doulas were established based on research, as well as extensive discussion with other doulas, medical professionals, and practitioners of alternative therapies.

Scope of a New Beginnings Doula Practice

A doula provides non-medical, holistic care to the childbearing family. A birth doula provides information to help a family plan how they would like to be cared for during their birth. Whereas a postpartum doula provides information that helps a mother adjust to life after birth, including self-care, care of the newborn, and family adjustments. This includes providing current, accurate, and evidence-based information on labor and birth, in collaboration with other medical professionals if needed, but without providing medical advice. During the birthing process, birth doulas provide continuous labor support and help the laboring family work smoothly through the process of labor and birth. This involves non-clinical actions with a focus on support, facilitates normal physiologic labor, and minimizes emotional and physical stress during and after necessary procedures. The doula also helps facilitate communication between the laboring family and the medical staff by helping their client identify questions and intentions as well as helping the client communicate to care providers.

Referrals

If care is needed outside the New Beginnings Scope of practice, then the doula should provide appropriate referrals.

Characteristics of New Beginnings Doulas

1. A New Beginnings doula provides care that is holistic.

Holistic care is defined as care that pertains to the physical, emotional, spiritual, and social well being. New Beginnings doulas utilize Maslow’s Hierarchy of needs in order to assess and provide this care.

2. A New Beginnings doula provides information that is evidence-based.

The New Beginnings doula works with women, families, support systems, and other providers to provide evidence-based information to their clients as the need is identified.

3. A New Beginnings birth doula provides continuous labor support, and the postpartum doula provides supportive care in the postpartum period.

Continuous labor support is being present with the client from when labor starts — or the mother perceives the need of help during labor — to after the birth of the infant, breastfeeding is established, and the mother is settled. The doula also meets with the client before labor and assesses needs and establishes goals, then meets during the postpartum period afterward to process the impact of the birth and assess any needs that may still be unmet.

4. A New Beginnings doula acts as a patient advocate by facilitating communication and coordination between her client, the medical staff, and any other facilities involved in the mother’s care.

A New Beginnings doula helps empower women within the healthcare system. They ensure their clients understand their rights and provide them with information on what is happening so they can make an informed choice. Working collaboratively with doctors, nurses, midwives, hospitals and other institutions is essential to help their client express their wishes.

5. A New Beginnings birth doula supports normal physiologic labor through non-medical support measures.

New Beginnings defines normal physiologic labor as defined by a joint statement put out by MANA, NAPM, and ACNM. As discussed in the statement, a normal physiologic labor;

  • Is characterized by spontaneous onset and progression of labor.
  • includes biological and psychological conditions that promote effective labor.
  • Results in the vaginal birth of the infant and placenta.
  • Results in physiological blood loss.
  • Facilitates optimal newborn transition through skin-to-skin contact and keeping the mother and infant together during the postpartum period.
  • Supports early initiation of breastfeeding.

A New Beginnings birth doula provides labor support that helps encourage physiologic labor, as well as reduce any side effects should interventions be needed. They provide comfort care, which helps create an environment that supports these physiologic processes.

Standards of New Beginnings Doulas

Development and Function of New Beginnings Doula Standards

The Standards of New Beginnings Doula are statements of the duties that all our doulas are expected to perform. The standards published here serve as evidence of the standard of care within New Beginnings Childbirth Services, LLC, with the understanding that the use of the standards depends on the individual situation. The standards are subject to change as the profession develops and laws are instituted. The standards are subject to formal periodic review and revision.

The Function of Competencies in Standards

The competencies that accompany each standard may be evidence of compliance with the corresponding standard. The list of competencies is subject to change and may be added or eliminated.

Standard 1: Assessment of Non-Medical Needs

New Beginnings doulas collect information about the non-medical needs of their client.

Competencies

New Beginnings doulas:

  • Collect information utilizing Maslow’s Hierarchy of Needs as a way to address all aspects of their client’s health.
  • Continue to collect information throughout pregnancy, birth, and the postpartum period.
  • Involve their client, client’s families, and other healthcare providers in the collection of their data.
  • Follow the New Beginnings code of ethics, and state or federal legal guidelines, as it applies to their client’s personal information.

Standard 2: Identification of Needs

New Beginnings doulas identify non-medical needs based on information they gather.

Competencies

New Beginnings doulas:

  • Discuss the needs of their client with their client, their client’s family, care provider, and other members of her birth or postpartum team.
  • Use Maslow’s Hierarchy of Needs to assess and identify the non-medical needs of their client.
  • Reassess and evaluate needs as the status of their client changes throughout pregnancy, labor,  birth, and postpartum.
  • Use information they gathered to document their client’s needs, goals, and plans.

Standard 3: Planning

New Beginnings doulas develop a plan that describes goals and actions needed to achieve these goals.

Competencies

New Beginnings doulas:

  • Develop a plan that includes their client, their client’s family, care providers and other members of the birth or postpartum team.
  • Establish the plan priorities following the framework of Maslow’s Hierarchy of Needs.
  • Include their client’s goals, scientific research, and ways to address needs as a part of their plan.
  • Utilize the plan to inspire communication among members of the healthcare team.
  • Ensure the actions taken follow current rules and regulations pertaining to the work of a doula.
  • Modify the plan as situations change throughout pregnancy, labor, birth, and postpartum.

Standard 4: Implementation

New Beginnings doulas implement the identified plan.

Competencies

New Beginnings doulas:

  • Work with their client, family, and other members of their birth or postpartum team to implement the plan in a safe manner.
  • Utilize evidence-based skills as much as possible to help with the problems identified.
  • Apply knowledge of pregnancy, labor, birth, and postpartum in implementing the plan of care.
  • Identify and use community resources to implement the plan.
  • Collaborate with healthcare providers to implement the plan.
  • Understand and respect different styles of communication used by their clients, families, and care providers.
  • Promote the participation of their client in problem-solving and creating the plan.

Standard 4A: Coordination of Care

New Beginnings doulas help to coordinate the care of the client.

Competencies

New Beginnings doulas:

  • Write a plan based off the goals of their client and the non-medical needs identified.
  • Help their client write a plan for how they want to be cared for and make sure other care providers have a copy.
  • Help identify ways they can increase their client’s independence.
  • Assist their clients in making informed decisions.
  • Use evidence-based research to educate their clients about ways to address the needs identified.
  • Communicate with other members of the healthcare team.
  • Refer their client if the care needed is outside their scope of practice.

Standard 4B: Supports Physiologic Labor and Healthy Practices

New Beginnings doulas utilize their knowledge to educate their clients and support normal physiological birth; as described by the consensus statement on Physiologic birth by ACNM, MANA, and NACPM (included below).

Competencies

New Beginnings doulas:

  • Are educated in normal physiologic birth and mechanisms used to provide non-medical support during pregnancy, labor, and birth.
  • Educate their clients on normal physiology and health when these needs are identified, while collaborating with other health care providers.
  • Facilitate communication between their client and the care provider to ensure informed consent is given.

Standard 4C: Doula Skills

New Beginnings doulas provide care through doula skills that help to achieve the goals identified.

Competencies

New Beginnings doulas:

  • Use skills that will address the non-medical needs identified.
  • Provide education for their clients and other support persons on how to utilize skills that may be beneficial.
  • Communicate and coordinate their client’s desires to utilize specific doula actions with other health care providers.

Standard 5: Evaluation

New Beginnings doulas evaluate progress towards outcomes of the goals.

Competencies

New Beginnings doulas:

  • Evaluate the outcome of their care as detailed in their plan.
  • Collaborate with other members of the healthcare team when evaluating the plan of care.
  • Continue assessing their client’s needs during pregnancy, labor, birth, and postpartum and revise the plan as needed.

Standard 6: Ethics

New Beginnings doula practices ethically.

Competencies

The New Beginnings doulas:

  • Use the Code of Ethics for the New Beginnings Doula to guide practice (included below).
  • Maintain the confidentiality of their clients.
  • Maintain appropriate boundaries with their clients.

Standard 7: Education

The New Beginnings doula gains an education backed on knowledge, research, and experience in the field.

Competencies

New Beginnings doulas:

  • Participate in educational activities that increase their knowledge, skills, and abilities related to work as a doula.
  • Maintain a commitment to lifelong learning.
  • Share educational experiences and thoughts with peers and clients.

Standard 8: Evidence-Based Practice and Research

New Beginnings doulas integrate evidence and research findings into their practice.

Competencies

New Beginnings doulas:

  • Utilize current evidence-based knowledge to guide practice. If evidence is unavailable, practice should be based on knowledge of normal physiology.

Standard 9: Communication

New Beginnings doulas strive to communicate effectively with their clients and other members of the health care team.

Competencies

New Beginnings doulas:

  • Assess how they communicate with their clients and other members of the healthcare team.
  • Seek to improve their communication and conflict resolution skills.
  • Encourage and facilitate communication between their clients and other members of the healthcare team.
  • Make appropriate referrals when necessary.

Standard 10: Leadership

New Beginnings doulas demonstrate leadership in the profession and community.

Competencies

New Beginnings doulas:

  • Demonstrate a commitment to lifelong learning.
  • Mentor colleagues and student doulas if needed.
  • Treat others with respect.
  • Develop communication and conflict resolution skills.
  • Participate in community organizations aimed at furthering the education of the birthing community or doula profession.

Standard 11: Collaboration

New Beginnings doula collaborate with healthcare consumers, family and others.

Competencies

New Beginnings doulas:

  • Partner with others to produce positive outcomes.
  • Communicate with the birthing community, families, and healthcare providers regarding the doula’s role in the provision of that care.

Additional Links

Normal Physiologic Labor

Grievance Policy

Code of Ethics

References

Barrett, S. J., & Stark, M. A. (2010). Factors Associated With Labor Support Behaviors of Nurses. The Journal of Perinatal Education, 19(1), 12–18. http://doi.org/10.1624/105812410X481528   Gentry, Q.M. et al. (2010) “Going Beyond the Call of Doula” : A grounded theory analysis of the diverse roles community based doulas play in the lives of pregnant and parenting adolescent mothers. Journal of Perinatal Education, 19 (4): 24- 40.      

http://www.doulas.info/publi/pro/200605-JOGNNjournalmag.pdf

https://c.ymcdn.com/sites/www.awhonn.org/resource/resmgr/Downloadables/perinatalqualitymeasures_ref.pdf

http://www.jognn.org/article/S0884-2175(15)30584-0/pdf

https://course.trainingdoulas.com/wp-content/uploads/2016/01/physioloigical-birth-consensus-statement-final-may-18-2012-final.pdf