Birth Doula Agreement
As a birth doula I attend women during labor to help them achieve a safe and satisfying birth experience. I am currently training through DONA and am able to use my training and knowledge to help you become informed and prepared for birth so that you are able to make informed decisions, before, during and after labor. My job is to assist you and your support person(s) throughout the duration of your pregnancy, labor and immediately postpartum. I will offer you reassurance and perspective throughout your labor, along with suggestions for labor progress and emotional and physical support through relaxation, massage, counterpressure, positioning and other coping and comfort techniques. I am independent and self-employed. As your doula, I am working for you, not your caregiver or chosen birthing location.
Prior to Birth:
I will meet you and your support person(s) for 1-2 prenatal visits, during which we can become better acquainted with each other; discuss your views, fears and wishes for birth; and go over the relaxation, coping and comfort techniques you are most interested in. During these meetings I will also help you write or refine your birth plan so that it is the most realistic and effective plan possible. In addition, during our second appointment you will be able to meet my back up doula, so that you are for familiar with her prior to the birth in the event that she would need to take my place.
I am accessible to you by phone and e-mail from this point forward in your pregnancy to answer your questions and refer you to appropriate assistance if you have a question beyond my scope of training. We will remain in contact by phone (509.994.1972) and/or e-mail (chic_kenz@yahoo.com), and I appreciate for you to keep me informed following any prenatal visits you may have with your provider.
During Labor:
I will be on-call 24 hours a day, 7 days a week in the last two weeks leading up to your due date. I ask that you or your support person(s) call me as soon as you think you may be in labor or your water has broken, even if you do not yet need me. I can offer you over the phone support until the time you would like me to meet with you, whether that be at your home, or the hospital or birth center. I, or my back up doula, I will remain with you throughout the duration of your labor, unless extraordinary circumstances arise (such as an abnormally long labor, in which I will call my back up doula).
Postpartum:
Directly after birth I will remain with you for the first 1-2 hours to help with your initial breastfeeding experience and be able to offer advice for other comfort measures you may need. I will come to your home for a postpartum visit to review the birth with you, answer any questions you may have and help with breastfeeding within the first week after birth.
As a Doula, I do NOT:
Perform any clinical tasks such as (but not limited to) blood pressure, vaginal exams, or fetal heart checks. I do not make decisions for you, but rather help you find the information you need to make informed decisions yourself. I will help remind you during labor if your birth plan is being unnecessarily departed from and offer you and your support person suggestions for how to deal with the situation so that you or your partner may address your caregivers yourself. I will not speak to caregivers for you, on your behalf.
In the case of a missed birth:
I will make every effort to provide the above services. If I fail to provide these services due to my error and am unable to provide a back-up doula, there will be no charge for my services beyond the retainer fee, which covers the cost of handouts, prenatal visits and my “on call” availability. This same policy applies if I miss your labor due to a very rapid labor or other extraordinary circumstances. If I miss your birth due to your failure to contact me, I will keep (or you will owe me) the agreed upon full fee for the service. This policy ensures your spot on my calendar and as few conflicts as possible. I do not consider my self hired until I have received from you, a signed copy of this contract and the agreed upon retainer fee.
To summarize, my services include:
1-2 prenatal visits
Unlimited phone & e-mail contact
Packet of information that you may find helpful
Continuous support throughout labor and birth
Digital photos of labor, birth and baby if you so wish
1-2 hours of support after birth and assistance with breastfeeding, if desired
1 postpartum visit
Fees:
The full cost for the services described herein are $_________, to be paid as follows:
$____________ Retainer Fee (due at time of contract signing)
$____________ due at postpartum visit
Payments can be made by check (to Chic & Savvy Mamas), cash, credit or debit card, or Paypal. In the event that you prefer to pay by credit or debit card, or Paypal, I will e-mail you a “request for money” invoice via Paypal for the retainer fee, directly following the signing of this contract. A second invoice will be e-mailed to you within a week of your birth. Payment will be expected within 2 days of sending online invoices. Please remember that you have not reserved my services until I have received the retainer fee.
I/we have read and understood this letter describing the doula’s services and agree to its terms. I consent to the release of this and all other information pertaining to me to the person(s) designated as backup for my birth.
Date:_______________________
Client______________________________ Partner________________________________
Doula________________________________