BirthWise in Birmingham, as a group of doulas serving mothers in Birmingham, Anniston and Tuscaloosa, have decided to stop providing labor support at UAB hospital. We would like to explain why:
BirthWise doulas pledge to uphold the DONA Code of Ethics and Standards of Practice governing a doula’s behavior, ethics and scope of practice. DONA is the oldest and most recognized doula certifying organization nationally, and has developed this code and these standards to assure doulas behave in a professional manner and provide the best services possible. If a client, OB, nurse or hospital should have a complaint about a doula’s actions, DONA has a grievance procedure in place.
As doulas, we believe a woman has the right and competence to choose the members of her labor support team. This includes the right to hire the doula of her choice, based on her personal priorities and preferences. It also includes the right to bring her doula with her to the hospital to provide continuous labor support.
Furthermore, BirthWise doulas enter into a contractual agreement (here's our contract) with our clients. We are not employed by a hospital or particular provider. Research has shown that the benefits of doula support on maternal/fetal outcomes and satisfaction are greatest when doulas work independently of hospitals (Continuous Support for Women During Childbirth and see more research about doulas here). We believe that we are able to establish trust and provide the best support for our clients when we work independently.
UAB has recently instituted a policy requiring doulas and doula clients to sign UAB documents that were drafted without doula input. All patients are now being asked to sign “Information for Patients and Families Regarding Doulas”, and all doulas must sign a “Doula Partnership Agreement". The “Doula Partnership Agreement” is essentially a contract between the doula and the hospital that was created without the input of doulas or doula clients. Being required to sign this agreement conflicts with our doula-client contract, infringes on our ability to practice our profession according to the full scope of our practice, and therefore prevents us from providing the best care possible for our clients.
We believe these documents come between ourselves and our doula clients. They create an environment of distrust, rather than one of mutual respect and collaboration between doulas and hospital staff.
Therefore, regretfully, as long as UAB’s regulatory policy remains in place, we cannot, in good conscience, provide labor support at UAB hospital.
Birmingham is fortunate to have many options for pregnancy and birth. Among these there are many who recognize the positive emotional and clinical impact a doula can have before, during, and after birth. We would be happy to point you to a provider or facility that recognizes the patient's right to choose her own birth team without interfering in the contractual relationship with the doula she chooses.