Doula liability insurance (malpractice insurance) is not currently mandated by any state or national laws. But does that mean you should not have it?
Statistics for doulas being sued are not available through online searches, most likely because the instance is extremely rare. Although rare, the fact is that doulas can be, and have been, sued. If something goes wrong in labor, malpractice lawyers typically name everyone who was present in the labor room in the lawsuit. Even if the doula did nothing wrong, doula liability insurance could cover lawyer fees. Simply because obstetrics is one of the highest litigated areas of medical malpractice, having liability/malpractice insurance may make sense.
Ways to Limit Your Need for Doula Liability Insurance
The Association of Labor Assistants and Childbirth Educators (ALACE) recommends several simple steps doulas can take before and after a birth to help limit the chance of being sued in their role as a doula. These include:
• Communication: Before the birth, spend time with your doula clients so you know what they want from you, and they know what you can and cannot do for them. After the birth, communication may be even more important, especially if the labor and delivery did not go as well as the client had planned and hoped. One or two postpartum visits to discuss the birth experience gives your client an opportunity to ask questions and process the momentous experience you shared.
• Liability Release Agreement: While a release of liability form does not protect you if you are negligent, by having your client sign a liability release form, particularly one that covers various potential complications, it shows informed consent to the comfort measures you will provide. The Institute of Somatic Therapy provides a sample template for a doula contract and release as part of the Massage Doula Support training program. You might also consider adding a mediation clause to avoid being named in a lawsuit.
• Operate only within your scope of training: By becoming certified, you have demonstrable proof of knowing the standards in the doula profession. Doulas are not medical providers, and should not be performing any clinical tasks, such as dilation or heart rate monitoring, etc. You should also not give medical advice, especially anything that contradicts what the doctor or midwife gives. Your role is secondary to the primary care provider, and your client should know that by your words and actions. Provided that you only operate within established standards, you are less likely to be found responsible for adverse circumstances that arose during the labor.
• Don’t take risks: Massage doulas are discouraged from going to their clients’ home prior to hospitalization so as to not get in a situation where labor progressed faster than anticipated and getting to the hospital in time is not possible. Driving your client to the hospital exposes you to additional risks. You also have to use precautions based on intervention the client might receive. For example, if she is confined to the hospital bed, don’t take risks by trying unusual positions, or if she has an epidural, don’t use heat or ice to areas where she has no feeling.
Sources for Doula Liability Insurance
Massage doulas, as long as they are working within the legal scope of massage therapy, should be covered under their massage malpractice policy. Such policies are offered by a variety of professional massage therapy associations, such as ABMP and AMTA, as well as through private insurers. For doulas who are not massage therapists, or massage doulas who specifically want doula liability insurance, one insurance group popular among birth doulas is Cotterell, Mitchell & Fifer. Other sources can also be found through any internet search engine.
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Institute of Somatic Therapy offers online continuing education for massage therapists. Our courses include prenatal massage and massage doula support.