Doula work is rewarding.
Doula work can be difficult.
But doula work is non-clinical and non-invasive.
When I became a doula for military wives in the early 1980’s, the word doula was just a Greek word for the most favored woman in the ancient Greek household. It had not yet been linked to a trained (and often certified) woman who gives informational, educational and physical support to laboring women and their families. Today, after 24 years of practicing as a doula and seven years as a doula trainer for DONA, it disturbs me to hear stories of how my fellow colleagues have stretched…and in some cases stepped outside of the scope of practice of being a doula.
By mutual definition of “doula” of the major organizations now training and certifying doulas (such as ICEA and DONA), doulas perform no clinical tasks such as altering IV drips, rearranging electronic fetal monitors, or performing vaginal exams. Yet doulas in many communities contact us expressing fears of “doulas on the edge” performing such tasks in their communities. What are the implications of these actions and are there any safety nets for either the clients or medical professionals who experience the actions of such “doulas on the edge?”
The implications of such actions is that even though one doula in a community chooses to step outside the bounds of accepted practice, all doulas in that community will feel the repercussions for a long time…months, years. And this ripple affect is difficult to stop!
Women enter the doula profession for many reasons: they have a passion for birth; they have had wonderful birth experiences and would like to “give back” to others so that they may have equally as wonderful experiences; they desire to enter the nursing or midwifery field in the future but choose doula work now as a stepping stone; OR they have a conscious (or unconscious) agenda of saving women from the medical community.
Does this sound harsh or blunt? Probably so. However this last reason for choosing doula work is a stepping stone for becoming a doula on the edge. Armed with a little information/knowledge and a whole lot of attitude, these doulas on the edge chip away at the acceptance that others have worked so hard to attain. They strain relationships between physicians and doulas, nurses and doulas, the public and doulas and each other.
Doula organizations have a Scope of Practice and Code of Ethics that their certified members are expected to follow. It is vital that doulas be held accountable when they step outside of the Scope and Code. If a non-conflictive conversation with the “doula on the edge” does not produce positive responses, contacting that doula’s certifying organization is the next step. Many of the organizations have grievance committees that are activated when a situation arises. Having the committee examine the situation and make recommendations/sanctions to the doula relieves the local doula community of this potentially explosive responsibility and hopefully helps the doula in question to get back on the right track.
Dealing with people that are negative or passive are some of the most challenging relationships. It is not always possible to correctly identify the reason(s) for someone’s poor behavior and so speculation can often lead to additional conflict. In your doula community, try to develop potential solutions for resolving a problem BEFORE it happens. Try to maintain a positive attitude about the person or the situation and this will help you to manage conflict with confidence…resulting in a positive outcome for all!
Birth 