Does HIPAA apply to doulas?

As doulas become more popular, it's important to know if cornerstone healthcare laws apply, even if the mother has already seen an obstetrician. Doulas are often not covered under HIPAA due to the strict definitions of covered and business entities.

Doulas' role in healthcare

Based on a Journal of Obstetrics, Gynaecological and Neonatal Nursing study on the joint roles of nurses and doulas in maternal care, “Today, this woman is often called a doula; what is different now is how the doula fits into the medical environment. Her role has evolved along with the institutionalization of childbirth and perhaps even because of it.”

Doulas are defined as non-medical professionals who provide emotional, physical, and educational support to women during childbirth and postpartum. Unlike doctors or nurses, doulas do not perform clinical tasks. Instead, their primary responsibilities revolve around offering comfort, encouragement, and assistance in understanding and navigating the birthing process. They advocate for the mother's wishes, assist in creating birth plans, and provide continuous labor support, including techniques for pain management and relaxation. 

HIPAA's applicability to doulas

HIPAA's scope

HIPAA, a federal law in the United States, sets standards for protecting and securing health information. It primarily applies to three types of entities:

1. Healthcare providers: This includes doctors, nurses, hospitals, and other entities that provide medical services and engage in certain electronic transactions, like billing and medical records transfer.
2. Health plans: Insurance companies, employer-sponsored health plans, and government programs like Medicare and Medicaid.
3. Healthcare clearinghouses: Entities that process health information from one format to another.

See also: What is the HIPAA Privacy Rule?

Reasons for non-inclusion under HIPAA

• Nature of services: Since doulas provide non-medical support and do not engage in the handling or transmission of protected health information (PHI) in electronic form for transactions HIPAA covers, they fall outside the scope of the entities regulated by HIPAA.
• Lack of electronic transactions: HIPAA's privacy rules are particularly focused on entities that handle PHI electronically in connection with specific transactions like billing through methods that include HIPAA compliant email. Doulas typically do not conduct these types of transactions.
• Professional classification: Doulas are not classified as healthcare providers in the traditional sense. They don't fit into the categories of entities (like doctors or hospitals) that HIPAA specifically regulates.
  
  

Despite this lack of coverage under HIPAA, it does not free doulas from the responsibility of maintaining confidentiality and privacy regarding their clients' information. Many doulas adhere to ethical standards set by their certifying organizations, often including preserving client privacy. 

See also: What is protected health information (PHI)?

FAQs

What is PHI?

PHI refers to any information about health status, provision of health care, or payment for health care that can be linked to an individual.

Who is subject to HIPAA regulations?

HIPAA regulations apply to covered entities such as healthcare providers, health plans, and healthcare clearinghouses, as well as to business associates who handle PHI on their behalf.

Are doulas considered covered entities under HIPAA?

Doulas are typically not considered covered entities under HIPAA because they usually do not engage in activities that involve the use or disclosure of PHI in electronic forms covered by HIPAA.