You wanted to be helpful because the midwife was stuck in traffic, so you put on gloves and checked the client’s dilation. Now, after a complication that had nothing to do with that check, the parents’ lawyer is framing you as a “rogue doula” who was playing doctor. You are looking at a lawsuit for practicing medicine without a license, and your insurance agent just told you that your policy might be void from the moment you put those gloves on.
Key Takeaways
- The “Criminal Acts” Exclusion: Most policies exclude coverage for criminal acts. In many states, practicing medicine without a license is a crime. If you are charged, your insurance walks away.
- One Check Voids the Policy: It doesn’t matter if the check caused the injury. The moment you stepped out of your scope, you breached the contract with your insurer.
- Text Messages are Evidence: “I think you’re at 8cm” sent via text is admissible proof that you were diagnosing.
- Doulas vs. Monitrices: If you are a Doula but also a retired nurse, the court holds you to the Nursing standard of care, but your Doula policy won’t cover Nursing liability.
The “Why” (The Trap): The “Services Excluded” Clause
Every Doula liability policy has a section called “Exclusions.” In 2026, this section almost always contains a “Medical Procedures” clause. It states that coverage does not apply to bodily injury arising out of the performance of medical services, including but not limited to: vaginal exams, fetal heart monitoring, or clinical diagnosis.
The trap is the “Scope Creep.” You think, “I’m just checking for progress.” The insurance adjuster sees, “Unlicensed Medical Procedure.” If the lawsuit alleges you acted as a midwife, the Doula insurer says, “We don’t insure midwives,” and denies the claim. You are then personally liable for the settlement.
[IMAGE: Screenshot of a Doula contract highlighting the ‘Scope of Practice’ limitations clause]
The Investigation: I Called Them
I contacted three liability providers commonly used by birth workers to see how they handle “Scope Creep” allegations.
CM&F Group (Doula Policy)
- The Verdict: Very strict. I asked, “If I accidentally do one clinical task, am I covered?” The underwriter said no. Their policy is specific to non-medical support.
- The nuance: They do cover “Monitrices” but only if you buy the specific Monitrice upgrade and have a valid nursing license. You cannot mix and match.
Hiscox (General Business Liability)
- The Verdict: Dangerous. I spoke to an agent who tried to sell me a general consultant policy.
- The Risk: This policy covers slips and falls. It contains a “Professional Services” exclusion. If you are sued for how you supported the birth (medical or not), this policy pays $0.
Lloyd’s of London (Surplus Lines via Broker)
- The Verdict: Flexible but expensive.
- The Upside: They can write custom policies for “Birth Assistants” that cover clinical tasks under supervision. If you work for a midwife, you need this, not a generic Doula policy.
Comparison Table
Risks for a Doula performing any clinical task.
| Carrier | Policy Type | Cost (2026) | Clinical Tasks Covered? | Risk Level |
| CM&F | Doula Liability | ~$600 | NO. Zero tolerance. | High if you touch the client clinically. |
| NSO | Nurse Policy | ~$1,200 | Yes, if working as a Nurse. | Medium. Risk is “Role Confusion.” |
| General Liability | Business Owner | ~$350 | NO. Covers property/injury only. | Extreme. No malpractice coverage. |
Step-by-Step Action Plan
- Retract Medical Advice: If you have sent texts interpreting medical data (“That sounds like a deceleration”), stop. Send a follow-up: “Please verify that with your provider, as I cannot give medical advice.”
- Review Your Website/Socials: Delete any post that says “I monitor the baby” or “I check progress.” Use phrases like “I support your labor” or “I help with comfort measures.”
- If You Are Sued: Do not speak to the family. Call your insurer immediately. If the insurer denies you because of the “Criminal Acts/License” exclusion, you need to hire a private defense attorney who specializes in administrative law immediately.
- Check Your “Birth Assistant” Status: If you occasionally assist a midwife, do not rely on your Doula insurance. You need a “Birth Assistant” endorsement.
FAQ
Q: I am a nurse, but I work as a doula. Am I safe?
A: You are at the highest risk. The law expects you to act like a nurse (high standard), but your Doula insurance only pays for non-medical support. You need a policy that acknowledges your nursing license, or you need to strictly separate your roles.
Q: Can I catch the baby if the midwife isn’t there?
A: Good Samaritan laws might protect you in a true, unpreventable emergency. But if you have a history of “catching” because you hesitate to call 911, insurance will label that as “practicing midwifery” and deny coverage.
Q: Does my certification organization defend me?
A: No. Organizations like DONA or CAPPA can revoke your certification if you violate scope, effectively aiding the prosecution against you.