As doulas, one of our most important responsibilities is to remain clear about our role and scope of practice. If you’ve looked anywhere in the media, on social media, etc., you’ve likely seen discussions about Tylenol and Autism.
Families turn to us for support, information, and guidance during pregnancy, birth, and postpartum. However, it is essential to remember doulas never provide direct medical advice.
Instead, doulas can share general educational information and guide families back to their midwife or doctor for individualized medical recommendations. This boundary not only protects clients but also preserves the integrity and professionalism of doula care.
Like all topics related to pregnancy, Tylenol and autism must be approach within our scope of practice and in an evidence-based way.
What Does Evidence-Based Information Mean for Doulas?
Evidence-based information refers to knowledge supported by reputable research, peer-reviewed studies, and recommendations that have influenced clinical practice guidelines.
Clinical practice guidelines are formal recommendations issued by respected professional organizations, such as:
- ACOG – American College of Obstetricians and Gynecologists
- ACNM – American College of Nurse-Midwives
- WHO – World Health Organization
These guidelines are developed after reviewing large bodies of research and represent the highest standards of safety and effectiveness. For doulas outside the US, you would also follow WHO information as well as your country’s equivalent overseeing body for obstetrical professionals.
Here is an example of an evidence-based article related to Tylenol and autism:
https://jamanetwork.com/journals/jama/fullarticle/2817406
What About Small Studies, Opinions, or Case Reports?
Not all information outside major guidelines should be dismissed. Practitioner opinions, case studies, and small-scale research can offer insights. However, to remain within scope as doulas, it is vital to present these findings honestly and clearly.
For example, you might say:
“The WHO recommends X. Another practitioner suggests Y, based on smaller studies or their clinical experience. If you’d like to know how this applies to your care, I encourage you to discuss it with your midwife or OB.”
This approach keeps you in scope, provides clients with context, and reinforces the importance of medical decision-making with their care providers.
Example: Acetaminophen Use in Pregnancy
Clients may ask, “Is acetaminophen safe to take during pregnancy?”
Here’s how a doula can respond while staying within scope:
“That’s a great question. According to ACOG and ACNM, acetaminophen (a brand name is Tylenol) is still considered a first-line safe option for treating fever and pain when used as directed. While a few small studies raised concerns, further research adjusting for genetics and sibling factors did not show the same correlation. If you have pain, fever, or other concerns, your midwife or doctor can help you make the best decision for your care.”
Notice that you do not say:
- “I think Tylenol is safe.”
- “I think Tylenol is dangerous.”
- “You should (or should not) take Tylenol.”
Instead, doulas share reputable evidence and direct clients to their provider for personalized medical advice.
Building Your Skills as an Educator
At IDI, our childbirth educator (CBE) students read How to Read a Paper—a foundational resource for understanding medical research. While not required for doulas, developing research literacy is a valuable skill if you want to deepen your knowledge.
Understanding research also means being aware of study types. For instance, the “gold standard” is the double-blind randomized control trial, but such studies are rarely conducted during pregnancy due to ethical considerations. Instead, most pregnancy research relies on retrospective studies, with large meta-analyses offering the most reliable conclusions.
Even if you don’t fully grasp every detail of research methodology, you can still confidently say:
“That’s outside my scope, but your midwife or doctor can give you personalized guidance.”
Key Takeaways for Doulas
- Never provide medical advice. Always redirect clients to their provider.
- Use evidence-based resources. Share information grounded in peer-reviewed research and clinical guidelines.
- Be transparent. Differentiate between authoritative recommendations (ACOG, WHO, ACNM) and practitioner opinions or small studies.
- Support with honesty. If you’re unsure, it’s okay to say so—your role is to guide, not prescribe.
By practicing within your scope and relying on evidence-based information, you ensure families receive safe, trustworthy support while reinforcing the professionalism of doulas everywhere.
Interested in a real-world example of how doulas can share information? Be sure to check out the work of one of IDI’s doulas below:
Author: Maria Silver Pyanov, CPD, CCE
Maria Silver Pyanov, CPD, CCE has been serving prenatal and postpartum families since 2007.