Scope of practice for labor assistants/birth doulas.

Training

The ALACE Labor Assistant/Birth Doula Training provides a comprehensive understanding of all aspects of labor support, with an emphasis on comfort measures during childbirth, providing emotional and physical support to the birthing mother and her family, and understanding the physiology of, and the dynamics affecting, a woman's labor and birth.

The ALACE training emphasizes the importance of experiential learning. This is reflected in the workshop by the inclusion of many experiential exercises, including role plays, position and breathing practice, and an introduction to palpation, fetal heart tones, and vaginal examination. The objective of these exercises is to help ALACE students understand the procedures that midwives, doctors, and nurses use to assess the health of mothers and babies during labor, in order to provide educated, comprehensive support to laboring women and their families.

The inclusion of these experiential exercises serves only as an introduction to these subjects. After attending the ALACE workshop, students are not qualified or trained to perform these skills without additional or prior training. Furthermore, ALACE certification does not cover clinical or assessment skills such as palpation, fetal heart tones, or vaginal examination.

Scope of Practice

Labor assistants/birth doulas provide emotional support, physical support, education, collaboration, and professionalism to the birthing mother and her family. Labor assistants/birth doulas provide support in all settings: home, birth center, and hospital. The labor assistant/birth doula is not the primary caregiver.

Labor assistants/birth doulas are expected to offer a minimum of one prenatal and postpartum visit, in addition to being present at the client's birth. Many labor assistants/birth doulas choose to offer additional services as postpartum doulas, lactation consultants, massage therapists, and other specialties which do not conflict with their ability to provide labor support.

ALACE labor assistants/birth doulas are encouraged to create their practices to best fit their own interests and the needs of their communities. ALACE supports the choice of labor assistants/birth doulas to perform assessments such as palpation, checking fetal heart tones, or vaginal exams if they are already a midwife, physician, or labor and delivery nurse or have received specific training qualifying them to perform these assessments. In order to maintain the integrity of the profession and of the ALACE organization, all ALACE trainees must sign an agreement stating they understand the ALACE training and certification program does not train them to perform physical assessments.

Certification

ALACE certified labor assistants/birth doulas have demonstrated substantial competency in their practice by completing all of the requirements for certification: participation in the three-day training workshop, completion of the required reading list, participation in a childbirth class, providing labor support at a minimum of six births, providing written evaluations from three clients and/or health care providers, and successful completion of a written examination.

ALACE certified labor assistants/birth doulas must complete recertification requirements every year. Recertification requires completing 8 hours of continuing education and submitting one self-evaluation of a birth the labor support provider has attended.