Childbirth International views the role of the doula as an integral part of the birth support team. A doula is a professional practitioner, working with women (hereinafter referred to as the "client") and their families during pregnancy, labor and birth, and the early postpartum period. This document outlines the scope of practice for Childbirth International doulas, including both students and certified practitioners.

Support Role

A Childbirth International doula:

• recognizes that her role is defined by her client, not by herself; she will actively identify the needs, values, and expectations of each client, including her client's individual definition of the doula's role

• supports the client's choices, regardless of the doula's personal views (limits to this are discussed under Ethics and Values)

• recognizes she works within an integrated support system, including the client�s family and medical care providers, and encourages her clients to consult medical caregivers on any areas of medical concern

• works to avoid an adversarial stance with other supporters, including medical staff and family and to promote open and respectful dealings with all persons she comes into contact with in the course of her work

• provides physical and practical support, emotional support, and information and perspective; she does not provide prescriptions, advice, or recommendations, including regarding use of "natural" remedies or complementary ("alternative") therapies such as homeopathy or herbal medicine

• recognizes that it is always the client who makes decisions, and that it is not the doula's responsibility to advocate with caregivers on behalf of the client; the doula may discuss options, or remind a client of her previously stated wishes, but it is the client's responsibility to state her preferences and intentions, and to determine whether to accept medical interventions

• does not provide clinical care, medical assessment, diagnosis, or advice, and is not expected to assist the client in any clinical manner in the actual birth of the baby

Evidence

A Childbirth International doula:

• promotes evidence-based care as the standard for all women and babies

• has a duty to provide clients with information on the medical evidence for or against any practice, to the extent desired by the client; where the doula may provide information that is not in line with current best-available evidence, or where evidence does not exist, this must be clearly stated to the client

• recognizes that clients may choose care that is not evidence-based, and supports them in that informed choice

Skills-Based Service

• a Childbirth International doula emphasizes teaching of tools and skills, including those in research, evaluation, assertiveness, communication, and decision-making, not just providing passive information, so that clients have the practical means to achieve their goals and further reinforcing the responsibility of clients to make their own decisions

General

A Childbirth International doula:

• maintains the highest standards of honesty, integrity, respect, courtesy, and professionalism when dealing with any other persons in her professional capacity, including clients' family members and medical caregivers

• is punctual for client appointments

Fulfillment of Responsibility

A Childbirth International doula:

• agrees with her clients terms of service, availability, back-up arrangements, limitations of service, fees, refunds, cancellation policy, and other relevant details - we recommend that this is a written agreement signed by both the client and the doula

• makes herself available continuously during the agreed on-call period; if a situation arises that prevents her from being available, she will make every effort to communicate this orally (in person or in a live telephone call, not solely by voicemail, email, or text message), and to ensure a back-up doula is available

• makes every effort to disclose as soon as is practicable, including on first meeting, any circumstance in which she is unable to provide service including because of ethical or personal conflicts; she will make every effort to provide a referral to another doula especially if she has already undertaken to provide support for the client

Confidentiality

A Childbirth International doula:

• maintains client confidentiality and will not discuss any personal details of a client except with a back-up doula, and only such information as is necessary for the back-up to provide appropriate care; the doula may discuss details with others if expressly permitted by the client, or as required by law

• keeps all records confidential, except where disclosure may be required by law

Intellectual Property

A Childbirth International doula will respect copyright and intellectual property at all times, including as set out below.

Copyright
All written work is protected by copyright, including books, articles, study guides, online articles, websites, business forms, personal emails, posts to an internet discussion forum, and any other written work, regardless of how formal it is, or whether it has been "published" in a recognized book or journal.

Distributing or reposting copyrighted material on paper or online without the express permission of the author or copyright holder is illegal and unethical. This includes acts such as posting an article from a medical journal on an internet discussion forum, photocopying an article to include in a set of handouts for clients, or using another doula's page on "what is a doula" or another doula's registration form on one's own website without express permission.

Plagiarism
Plagiarism is the use of the written work of another without giving credit. Plagiarism is not acceptable in student assignments, handouts or other materials created for clients, websites and promotional materials, discussion in personal communications such as email or posting to discussion forums, or any other written work. Plagiarism includes such acts as quoting any material from another source without credit, or passing off someone else's idea as one's own where the original idea is identifiable and the originator known.

Adaptation
No written work is 100% original; all work builds on ideas from elsewhere. It is permissible to build on the ideas of others so long as the original work is credited where those ideas are still identifiable. Changing a few words to make a work or an idea appear slightly different from the original is not adequate. Work must be completely rewritten with significant transformation or new elements added, or else credit must be given, even if direct quotes are not used.

Training materials
Childbirth International students and certified doulas may use CBI materials when working with clients. They may not train other doulas with CBI materials, provide workshops using CBI materials, or distribute the material to persons other than clients without the express written permission from Childbirth International.

Competition

If a student or graduate subsequently establishes a Doula training program that is deemed by Childbirth International to be in direct competition to Childbirth International, membership with Childbirth International will be terminated and graduates will not be eligible for recertification. If the Childbirth International training program has not been completed at the time the student establishes such a training program, the student will be terminated from the Childbirth International training program and will not be eligible for certification. In such cases, Childbirth International will not be liable for a refund of any training or membership fees.
 

A Childbirth International doula:

• uses reflective practice in her daily professional practice

• pursues continuing education as part of her professional development

• once a certified Doula (CD), if identifying herself as a certified Doula, she will acknowledge Childbirth International as the certifying body by using the initials CD(CBI)
   

Grievance Policy

Childbirth International maintains a grievance procedure with the following aims:

• to systematically address specific instances of misconduct by Childbirth International doulas

• to remedy misconduct where possible

• to support accountability of individual doulas as well as Childbirth International as a certifying body and professional association

• to support professional standards in the doula profession

• to ensure fairness in the grievance procedure.

Complaints.   If a member of the public, another doula, a health professional, or a member of Childbirth International, has a complaint against the conduct of a Childbirth International doula, this must be put in writing within 12 months of the event taking place, addressed to the Director of Childbirth International (hereinafter referred to as "Director"). Childbirth International employees and officers may also institute a grievance proceeding internally, without a complaint filed by an outside party.

Investigation.   The complaint will be investigated by the grievance committee, during which time the grievance committee may request supporting documentation and evidence of the complaint. The student or certified doula will be contacted for their perspective. The student or certified doula will have four weeks to respond to the Director.

Action.   Following the investigation, the grievance committee may take one of the following actions:

• no action taken

• written warning sent to the doula

• temporary withdrawal of Childbirth International certification, pending actions that must be carried out in order for certification to be reinstated, including but not limited to, making appropriate amends to the aggrieved party

• permanent withdrawal of certification and/or membership status