Association of Ontario Doulas – Practice Guidelines (previously Scope of Practice)

Association of Ontario Doulas
Guidelines for Professional Practice

The Association of Ontario Doulas (AOD) represents professional and traditionally trained doulas in the province of Ontario.

In order to become and maintain membership with the AOD, the doula must be certified or working towards certification by a professional training organization who aligns with the Ethical Conduct Guidelines, Equity and Inclusion Policy, and Strategic Priorities of the AOD and meets the outlined educational expectations.  
* Self-trained doulas are not accepted at this point in time.  No person or training organization with a current insurance claim or filed grievance related to professional conduct may apply or maintain membership with the AOD.  

Services & Support Guidelines:  An AOD doula provides client-directed support through the values of inclusivity, equanimity, autonomy, ethics, and advocacy.  Their support may take the form of emotional, physical, or evidence-based informational support, however it is not limited to those experiences.   

Such support may include, but is not limited to:

  • All periods of client-directed support:
    • Offering assistance in obtaining up-to-date, evidence-based information to encourage self advocacy and informed decision making;
    • Offering referrals when a situation arises that requires additional attention and support that falls outside support practices as listed in the Regulated Health Professions Act (1991) or health professions acts (i.e., Medicine Act, 1991);
    • Modelling and encouraging effective communication strategies with the clients direction and other invited participants involved in their care;
    • Advocating on the behalf of the client or their immediate support community at the request of the client;
    • Assistance in formulating realistic preferences that match the client’s values and needs; 
    • Nonpharmacologic pain management suggestions, referring client to a medical provider when a client feels a diagnosis or prescription may be required;
    • Supporting initial chestfeeding support and encouragement of skin to skin
  • Offering continuity of care.  A specific backup should be found for all clients so the labouring or postpartum person and/or their immediate support community are never left unsupported.  This includes paid, pro bono and charitable work.  

AOD Limits to Practice:

    • Perform restricted medical procedures, diagnose, or prescribe anything under the Regulated Health Professions Act (1991) or health professions acts (i.e., Medicine Act, 1991).  Such actions include, but are not limited to: performing vaginal exams, reading and interpreting medical tests and diagnosis, performing clinically defined manoeuvres, diagnosing disease, prescribing medications, performing surgeries or other surgically related tasks, dressing or caring for surgical or vaginal wounds.  If you are outside the Province of Ontario please refer to your provincial or territorial Health Act for guidance; 
    • Act on behalf of medical care when a client has chosen the direction of a licensed medical practitioner; 
    • Make decisions and/or speak for their clients;
    • Use personal opinion or conjecture to influence clients choices or experiences 

Where the doula has additional training in other modalities or practices they should refer to that profession and their practicing guidelines, and determine if it is appropriate to combine the roles. Members should clearly inform clients of such training, the limits of their ability to offer knowledge and/or practice in this area, and that any additional services offered is separate from their services as a doula. The doula is encouraged to clearly define this situation to any healthcare provider they encounter in order to avoid confusion regarding the doula’s role and the client-directed support they have been invited to attend.