Scope of Practice

Scope of Practice Statement for toLabor Professional Birth Doulas

toLabor Birth Doulas provide emotional support, physical support, education, collaboration, and professionalism to the birthing mother and her family. Birth Doulas may provide support to a woman in childbirth at home when a primary care provider is present or up until the time to leave for the birth site (hospital or birth center). The  Birth Doula is not the primary care provider nor should she misrepresent herself as one.

toLabor 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 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.

toLabor Birth Doulas are encouraged to create their practice to best fit their own interests and the need of their communities. toLabor supports the choice of an individual 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. These professionals shall not call themselves Doula when including these assessments in their practice. In order to maintain the integrity of the profession and of the toLabor organization, all toLabor trainees must sign an agreement stating they understand the toLabor training and certification program does not train them to perform physical assessments.

toLabor Certified Professional Birth Doulas have demonstrated substantial competency  in their practice by completing all of the requirements such as 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 a successful completion of a written examination.

toLabor Certified Professional Birth Doulas must complete recertification requirements every year. Recertification requires continuing education, submitting one self-evaluation of a birth the Birth Doula has attended and current membership. These requirements must be submitted for the title of Certified to be maintained and recognized, failure to do so will result in the removal of the certified status.


The toLabor 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 toLabor training emphasizes the importance of experiential learning. This is reflected in the workshop 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 toLabor 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 toLabor workshop, students are not qualified or trained to perform these skills without additional or prior training. Furthermore, toLabor certification does not cover clinical or assessment skills such as palpation, fetal heart tones, or vaginal examination.

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