How can Doulas and Nurses work together? and is there a regulatory body for Doulas?

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Hi, I am a nursing student living in B.C., Canada. The idea of Doulas working here along side other health care professionals is still fairly new in our hospitals, therefore, there is still some confusion around what the role of the Doula is in the hospital and what happens if the ideas of the Doula come into conflict with other health providers. It has been my experience that Doulas can play a very special part in the birth process, providing much needed care for the mom. However, recent tension has developed on the perinatal care unit where I have been placed. A young mom who had given birth and was giving her child up for adoption was encouraged to breastfeed by her two attending Doulas. This advice that the Doulas were providing for this mom angered the nurses as they felt their role in caring for the mom in the hospital setting had been taken over by the Doulas. My questions are do you have any suggestions as to how Doulas and Nurses can work together in order to provide the best care possible for the patient? And who regulates the work of the Doulas? For example the Nurses here have the RNABC which outlines standards for nursing care.

-- Chrystal Brown (chrystalbrown@hotmail.com), October 12, 1999

Answers

Hi Chrystal! Good question. I am also concerned about the relation- ship between nurses and doulas. The last thing doulas want to do is cause tension in the labour and delivery unit. Most doulas are members of DSA (Doula Services Assoc.) and a few are also certified DONA (Doulas of North America) members. We all strive to follow a "Code of Ethics" and in it there is a section titled - Ethical Responsibility to Health Care Providers of the Client. A. The provider should treat her client's caregivers with respect, courtesy, fairness and good faith. B. The provider should recognize that responsibility for clinical management belongs to the Health Care Provider (nurse, midwife, physician) and the client. The provider should not interfere with clinical management beyond making suggestions to or asking questions of the Health Care Provider and client based on her knowledge of the client's birth plans and preferences. A good idea for doulas would be to submit our "Standards of Practice" and "Code of Ethics" to the nurses station upon our arrival and to try and keep the lines of communication open during the labour and birth.

-- Joy Boudreau (joy_doula@hotmail.com), November 23, 1999.

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