15. Substance Use and Impairment

Substance Use and Impairment

Doulas shall be fully present, alert, and unimpaired at all times while providing services to Raya Health patients. This includes all in-person and virtual visits, labor and delivery support, and any time a doula is on-call or actively coordinating a patient's care. Impairment compromises patient safety, professional judgment, and the trust that is central to the doula relationship. Doulas shall not:

• Use, consume, or be under the influence of alcohol, cannabis, or any legal or illegal non-prescribed controlled substance while serving a patient or while on-call for a labor and delivery.
• Report to any visit, birth, or patient interaction while impaired by any substance, including the misuse of prescription or over-the-counter medication.
• Possess, distribute, or offer alcohol, cannabis, or any controlled substance to a patient, a patient's family member, or any other person during the course of Raya Health services.
• Use any substance that would impair alertness, reaction time, or judgment during periods when they may be called to attend a labor and delivery.

Doulas who take prescription medication that may cause drowsiness or impairment are responsible for managing their schedule and availability so that patient care is not affected. If a prescribed medication may interfere with a doula's ability to serve safely, the doula shall arrange backup coverage and notify the Raya Health team rather than attend a visit while impaired.

If a doula is unable to provide safe, unimpaired care for any reason, the doula shall not attend the visit. The doula shall contact the Raya Health team at 415-295-2759 or email support@findraya.com as soon as possible to arrange backup coverage. Prioritizing patient safety in this way is expected and supported.

Violations of this policy are considered serious breaches of the Code of Conduct and may result in review, suspension, or removal from the Raya Health network.