Birth Doula Contract

Doula's role and obligations:

I am independently employed; I work for you, not your doctor, midwife, or hospital.

I will meet with you four times prenatally, at mutually agreeable times. During these visits, we can discuss any questions you might have, and review your birth plan which will help organize your thoughts about what is important to you and help communicate your wishes to your medical caregivers. It would be helpful if both you and your partner or other birth companion can be present at these meetings. Additional visits can be arranged at an additional hourly charge.  I understand you may be taking a childbirth education class; please think of our meetings as a refresher and time to discuss anything you may have more questions about.

 

The meetings will go as follow:

1. At 28 weeks First Childbirth Preparation meeting: 

we will discuss birth plans, post-birth plans, baby plans, and postpartum planning. I can provide information on options for your birth plan. However, you will be responsible for deciding on a birth plan that is best suited to your individual needs and preferences and for discussing the terms with your doctor.

 

2. At 32 weeks Second Childbirth Preparation Meeting.

 

3. At 34 weeks we will discuss Labor techniques and Breastfeeding At this meeting will go over different laboring positions, and comfort measures and do a walk of your home if you are deciding to labor at home. This helps me to become familiar with the surrounding. We will also discuss breastfeeding, different positions, common issues, and troubleshooting. Again this may be a repeat of any childbirth education classes you may be taking. 

ON-Call Time

Beginning at 38 weeks of pregnancy, I will be on call for you 24 hours a day up until labor begins.

I will remain with you as long as possible from the time you request me to be with you once labor has begun, until one to two hours after your baby is born, apart from short breaks for meals and rest as time allows. Longer breaks, for instance, if you first call me in early labor, may be taken at mutually agreed upon times.

 

I can help you to utilize non-medical support techniques for labor and birth, such as breathing techniques, massage, heat packs, bath or shower, positioning, et cetera.

 

I will maintain a birth log, as circumstances allow, of the events that occur during labor and birth. I will strive to be as accurate as possible in recording the entries, but I can provide no guarantees in this respect. If you request them. I will provide a written record of your birth based on these notes within two weeks of the birth of your baby. All records remain confidential. I will not share these records with any person, except where disclosure is required by law.

 

I will help you initiate breastfeeding if that is what you choose to do. I am not a certified lactation consultant, but I can provide the names of local lactation consultants if the need arises. If you wish to bottle-feed your baby, I can help with the first feeding if required.

 

Postpartum Expectations:

After the birth, I will make _2 postpartum visits The first will be 3 days after the birth unless you prefer to wait. The second will be 7-10 days after the first meeting, again depending on your desires. I will strive to answer any questions or connect you with another professional where appropriate. Additional postnatal visits can be arranged for an additional hourly charge of _$30.00_

 

My role is limited to providing your physical, emotional, and educational support. The following are outside my scope of practice:

• I will not make decisions for you. I will provide information that may be helpful for you and/or your partner to make an informed choice. I will verbally remind you of your choices to encourage you to advocate for yourself. 
• I will not perform clinical tasks such as assessing blood pressure, checking the dilation of the cervix, monitoring the fetal heart rate, making any medical diagnosis, administering or prescribing medication, or any other procedure that qualifies as practicing medicine.
• I will not provide medical advice or advice concerning any alternative therapies. Any information I provide should not be construed as medical advice and is not a substitute for medical advice, which only a licensed medical practitioner can provide. It is your responsibility to seek the advice of an appropriately qualified practitioner in case of doubt.
• I will not speak to your medical caregivers on your behalf. I can discuss your concerns with you and provide information on options that may be available to help you with composing questions for you to ask your caregivers, but you or your partner will be responsible for communicating your needs to the medical staff.
• I am not licensed or permitted to deliver your baby or to perform any clinical skills related to the delivery of your baby. In the event that the baby arrives unexpectedly at home without a licensed medical practitioner in attendance, you or your partner, or another attendant will be responsible for catching the baby as they are born. However, should your partner or attendant not be available to catch the baby as they are born, and if you are unable to do so yourself, then with your consent I may take on this role.

Client Obligations:

• You will complete a written birth plan and discuss it in detail with the medical practitioner scheduled to attend your birth. You will make the necessary arrangements to tour your proposed birth facility and will do so before the birth.
• You will call me when you think you may be in labor, even if you are not sure, or as soon as your waters break so that I may make arrangements to attend your birth. I will provide support over the phone until you decide you would like me to be with you in person. If for any reason you are unable to contact me once labor has begun, you will leave a message for me and then contact your backup doula.
• You will allow me approximately 2 hours to reach you from the time you have informed me that you require my presence. Please ensure you have either spoken with me verbally or received confirmation from me that I am aware that you are in labor. It is up to you and your partner to determine when you will leave for the hospital.
• It is your responsibility to ensure that the necessary arrangements are made to have a medical practitioner present at the birth whether the birth is to be in the hospital or at your home.

A deposit of $_900.00_ is due within seven days of submitting your registration form for booking a doula. The remaining balance is due at your 34th week of pregnancy. I will collect it at our 4th prenatal appointment.

Services must be paid in full by 36 weeks at which time I am able to be available on call for your birth.

If you decide to cancel this contract the following will apply:

• Cancellation more than four weeks before your due date: 75% refund, less costs of any prenatal visits made. The cost of each prenatal visit for this purpose is $_30.00_
• Cancellation between four weeks and two weeks before your due date: 50% refund, less the costs of any prenatal visits made. The cost of each prenatal visit for this purpose is $ 30.00_
• Cancellation less than 2 weeks before your due date: no refund.

 

Failure to provide service

I will make every effort to provide the services described herein. In the case of circumstances beyond anyone's control, including but not limited to a rapid birth or medical emergency, it may be impossible for me to provide these services. No refund will apply.

 

If you call in good time and advise that you are in labor, but neither I nor your backup doula attend your birth due to an error on our part (such as losing or inadvertently turning off our cell phones, or missing your call) I will refund the total amount paid minus the cost of any prenatal care already provided and any postpartum care desired. If you are unable to contact me you are required to leave me a message on my cellphone, and then to contact your backup doula both at home and on her cellphone, leaving a message on her cellphone as well.

 

If you fail to call me and/or your backup doula to advise us that you are in labor, for whatever reason, you will not be due a refund of the amounts paid. If there is a remaining balance outstanding, this will be due.

 

Limitations of Liability

To the fullest extent permitted by applicable laws, my liability for any and all claims, losses, expenses, injuries, or damages related to the performance of services under this contract of whatsoever nature and howsoever arising whether in tort or in contract or otherwise shall be limited to the amount paid by the pursuant of this contract.

I will not be liable for any direct, indirect, incidental, special, or consequential damages, resulting from the provider's non-provision of services under this contract, even if the possibility of such damages has been specifically advised.

In signing this contract, you agree that you understand and agree with all the points herein. You further agree that you have been given the opportunity to raise any questions that you might have concerning my services and that these questions have been answered to your satisfaction.

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