This working agreement is between the client, named and signed below, and Samantha Garcia Gagnon.
As your Birth Doula:
- I accompany birthing persons/families in labour to facilitate a safe and satisfying birth experience.
- I provide emotional support, physical comfort, and communication with your health care provider to ensure you have the information needed to make informed decisions in birth. - I can provide reassurance and perspective to you and your partner, make suggestions for labour progress, and help with relaxation, massage, positioning and other techniques for comfort.
- I can be a constant for a birthing family in a time of ever changing hospital shifts and/or alternating provider schedules.
- I work for you, not your health care provider or hospital.
As your Birth Doula, I will not:
- Perform clinical tasks, such as blood pressures, fetal assessments, vaginal exams, etc.
- Make decisions for you. Instead, I will help you get the information necessary to make an informed decision.
- Speak to the staff on your behalf regarding matters where health care decisions are being made. I will, however, discuss your concerns with you and suggest options, but you or your partner will speak directly to the clinical staff.
- Transport clients, in my vehicle, no matter the circumstance.
- Replace your spouse/birth partner, rather I work with them. A doula knows pregnancy, labour and birth, and the partner knows the birther — it's a perfect team.
While I am a home birth doula, in the event that you risk out of home birth or have to transfer to the hospital, I will continue my support in hospital. Changing from home birth to hospital birth does not null this agreement and no refund will be given.
From the moment of hire, I will do monthly zoom connection call for you to have an opportunity to ask your questions, share your concerns and for us to build a strong connected relationship.
I will meet with you and your birth partner sometime between 30-32 weeks gestation and at approximately 35-37 weeks into your pregnancy. These meetings will be approximately 1.5-2 hours and will cover such topics as:
Discussion of, or assistance in creating, your birth plan
Pain management techniques
Understanding informed choice
Getting a deep understanding of your unique needs in birth
Breastfeeding and Baby Care
If you are pregnant at 41 weeks, then a third prenatal meeting may be included. During this prenatal, I will review the information available about going past your estimated due date so that you can make a fully informed choice on how you would like to proceed postdates.
Birth doula clients are required to take my My Powerful Birth Prenatal class which is included in this package.
Once I enter the on-call period (38 weeks onwards), I encourage clients to check in after every appointment with your care giver (at a minimum) to advise me how you are doing either via phone, text or email.
When you think you are in Labour:
Please let me know as soon as you THINK you are in labour, even if you do not feel like you need support at that time, your doula can answer questions or make suggestions over the phone.
I usually takes somewhere between 30 minutes to an hour to join you however I have up to 2 hours to join you at your birth from the time you request my presence.
You will receive continuous labour support until 1-2 hours after the birth of your baby.
During your Labour and Delivery:
I will provide continuous physical, emotional, & informational support during labour and birth.
I will be with you from the onset of active labour until 1-2 hours after the birth. I will require short, infrequent breaks if the labour is longer than 4 hours, but at no time will I leave you alone without at least one member of your support team.
If I have been with you for 14 hours, I have the option to call a backup doula to take my place.
I reserve the right to be relieved by a backup doula in the event that I am ill or for any reason am unable to properly support you during your birth.
After the Birth:
I will remain with you for one to two hours after birth, until you are comfortable and ready for quiet time with your family. If the birth happens at home, I will tidy up your space after the birth.
Included in the package is two postpartum visits, up to 3 hours each. See how you are physically recovering
Provide feeding support, if needed
Review the birth
Admire your baby(s)
Scheduling a caesarean birth does not nullify this agreement and no refunds will be granted.
In the case of a scheduled caesarean birth, I will accompany you at the hospital as you prep for surgery. If I am granted access to the OR, I will join you for the birth. I will also remain for up to 2 hours after the birth to assist with baby and breastfeeding if required. For emergency/unscheduled caesarean births, there will be no refunds.
Birth Pool Use for Home Births:
For home birth clients, the cost of rental of a La Bassine Birth Pool is included in the birth doula package, as well as the disposable equiptment.
BY SIGNING BELOW YOU AKNOWLEDGE THAT YOU ARE AWARE OF THE RISKS OF USING, LABOURING, AND BIRTHING IN A BIRTH POOL. YOU ARE VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER AND/OR PROPERTY DAMAGE THAT MAY OCCUR AND ACCEPT ALL RESPONSIBILITY OF OUTCOMES, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN.
Samantha Garcia Gagnon is not liable for any and all actions, claims, or demands that the client now has, or may have in the future, for injury, death, or property damage related to using the birth pool, fill hose, tap adapter, air pump and/or sump pump.
The client agrees to replace any part of the rental that they may damage or have used improperly (La Bassine Pool, Air Pump, Sump Pump) and this replacement will be by the discretion of Samantha Garcia Gagnon.
Failure to Provide Services:
Full fees will apply if you fail to call me to attend your birth. If this is the case, please inform me of the birth so I may provide appropriate postpartum care.
If I miss your birth due to circumstances beyond anyone’s control (for example, an extremely rapid labour or weather), the full payment for doula services will be required.
If I am unable to attend, a back up doula will be sent in my place. If the back up doula is declined by the client, there is no refund.
During your on call period, I am also entitled to 3 days OFF CALL. These three days may happen with little notice, they may happen consecutively, or be split up, or I may not take the 3 days off at all. Having these three days available allows me to commit to lifes needs as they come up. When I choose to take an off call day, you will always have a back up doula ready to be with you in case you go into labour.
A 50% retainer fee is due at the time of hire, along with this signed working agreement and a completed client intake form (in your welcome package).
The balance of 50% is due at your first prenatal appointment.
Payments are preferred to be received via E-Transfer to firstname.lastname@example.org. If you prefer to pay via credit card, please indicate so below and you will be sent an invoice where you have the option to pay via our secure online credit card processing system.
---- COVID 19 ----
Due to the Covid 19 Pandemic, prenatal appointments may need to happen digitally depending on current health guidelines at the time. If digital prenatals will happen, they will change to shorter 1 hour meetings across 4-5 meetings instead of 2-3 in person 1.5 hour meetings. We will decide closer to the prenatals how to proceed depending on Health Canada guidelines.
Currently, Fraser Health accepts doulas in all of their hospitals. In the event that this policy should change and you are no longer able to birth at home and must/or choose to birth in the hospital, and I am no longer able to attend your birth, the following will happen:
1. If this happens before your on call period (38 weeks) then you have the option to cancel you service. 50% retainer fee will be kept and the balance of 50% will be refunded.
2 If this happens after your on call period (38 weeks) or you choose not to cancel you services as per #1, then I will provide 8 postpartum hours in replacement.