Doulas and Cervical Exams?
Before we even try to connect them, let’s lay a couple things on the table. Let’s define cervical exams and doulas’ scope of practice.
A cervical exam is performed to check if your cervix has begun to dilate (open) or efface (soften) to prepare for birth. While they do not indicate when you will go into labor or how long until baby is here, it can give a good idea of your progress in that moment.
A doula’s scope of practice consists of guidelines that are laid out for them, to ensure they are only filling the roles they are qualified to. A doula is trained to provide physical, emotional, and informational support without judgment. Because they are not medical professionals, doulas are not trained to perform clinical tasks. They are also unqualified to diagnose, treat or prescribe anything. Prodoula explains it more in depth with their mission, promise, and philosophy.
Although the scope of practice is clear, there are conflicting opinions about doulas performing cervical exams. Some feel having a doula that performs them could be a useful tool for the moms and could really benefit those who want to labor at home as long as possible. While that may be true...
Having these feelings indicate that this exam is not significant enough for a medical provider to perform it. However, if this is the case, why does no doula training teach doulas how to do this? Because it is not a doula’s job. It may seem like a simple task and not hard to do but, the thing is, what is the point of a cervical exam? To diagnose and potentially treat. Are doulas qualified to diagnose and treat anything?
See where this becomes problematic? A doula performing cervical exams not only is acting out of scope, but they are stepping into the medical field. Nurses, midwives, and doctors are taught how to do them in their medical training. In order for doulas to adapt to such a responsibility, everything would change…
The certification process to becoming a doula would need to change to implement medical training. In order for them to be trained properly, doula trainers would need to learn first.
Seasoned doulas would need to be retrained.
This would make a doula responsible for the birth outcome and, in result, would completely change the relationship between the birthing family and their doula. Now, instead of only focusing on a healthy mom and healthy mind, their doula will also need to consider a healthy baby. If a doula is taking some responsibility for their clients’ experiences, they just aren’t able to provide the continuous support throughout labor that their job description suggests.
A doctor/midwife’s role is important.
A nurse’s role is important.
A doula’s role is important… They may be better left clear-cut.