CAPPA STATEMENT ON RESTRICTIVE BIRTH PLACE POLICY

Childbirth And Postpartum Professional Association (CAPPA) has been training and certifying perinatal professionals (labor doulas, postpartum doulas, childbirth educators, and lactation educators) for over 25 years (new parent educator training was added more recently). We pride ourselves on providing the highest standard of training and returning doulas to their communities equipped to provide the highest standard of service.

We also take pride in our efforts and commitment to building bridges among all members of the pregnancy and birth care team. From its inception, one of the four cornerstones of the CAPPA approach has been to build bridges between doulas and health care providers, hospitals, and birth centers.¹ We believe that families benefit tremendously when doulas, health care providers, and birth place staff work together, honoring, respecting, and valuing the contribution of each member of the team. To that end, and as an example of our commitment to this principle, CAPPA is proud to offer a training program specifically for sharing doula skills with health care professionals. We acknowledge that doulas are most effective as members of the team when they operate within a scope of practice that clearly defines their role as non-clinical.

Published data makes it clear that the work of labor doulas improves outcomes for mothers and babies.² The work of labor doulas saves lives in the United States where the maternal mortality rate is the highest of any industrialized nation and where black women die at a rate two to three times that of their white counterparts.³ Every family has the right to choose if they have a doula at their birth and to have the doula of their choice.

For all these reasons, CAPPA is vehemently opposed to any birth place policy that prohibits families from choosing their own doula. We see such policies as a threat to the right of autonomous decision making of birthing families. No family should be limited in any way from making a choice that has the potential to save themselves or their infants from harm.

CAPPA also opposes policy that restricts doulas from working with their clients in the birthing facility of the client’s choice. We see such policies as restraint of the doula trade, in addition to being a violation of patient rights.

There is much to be improved in the ways our system cares for mothers and babies. CAPPA remains committed to doing our part to improve birth outcomes by providing the best training available for perinatal professionals and building bridges with other members of the health care team. Such collaboration can only benefit the families we serve.

1. https://cappa.net/about-cappa/
2. Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for
   women during childbirth. Cochrane Database of Systematic Reviews 2017, Issue 7. Art.
   No.: CD003766. DOI: 10.1002/14651858.CD003766.pub6. Accessed 08 August 2024.
3. Munira Gunja et al., Insights into the U.S. Maternal Mortality Crisis: An International
   Comparison (Commonwealth Fund, June 2024). https://doi.org/10.26099/cthn-st75

Issued August 2024