|
MY ROLE AND SERVICES AS YOUR BIRTH DOULA
I support women and their partners during, pregnancy, labor and the birth of their baby. I provide physical, emotional, and informational support to women and their partners.
Tasks within my scope of practice are, but not limited to: assisting with birth plans, refer parents to resources, support during labor (massage, counter pressure, position suggestions, water, breathing, imagery, etc.), providing nourishment and hydration for mom and the birth team during and immediately after birth, taking pictures or video, documenting events and milestones during labor and the birth, and providing breastfeeding support.
PRENATAL VISITS
My goal is to help you have a satisfying birth as you define it. During prenatal visits, we will review your preferences for labor and birth, and go through your options to develop a birth plan. We will go through your own personal ways of coping with pain, fatigue and difficult situations. We’ll go through what your expectations are of your partner, doula and anyone else who will be attending the birth. We will explore alternative methods of coping techniques used during labor. We will discuss any fears and concerns you have regarding labor and birth.
ON CALL
I am available by phone and e-mail consultations immediately after signing the contract. I encourage you to contact me with questions, concerns and updates. I will get back to you as soon as I can, usually immediately, but definitely within 24 hours. Once you are two weeks from your due date, I will consider myself on call for you and I will have my cell phone with me at all times, but you are free to call me any time before that if you think you are in labor also. The more information I have, the more prepared I will be when you actually are in labor.
DOULA RESOURCES
As a client you have access to all of the resources in my Doula Library. I can refer you to other resources such as websites, and videos that might help you. I bring laboring support tools with me when I come to support you during labor. These tools include a birth ball, massage tools and oil, soothing scents for aromatherapy, soothing music, a CD player, etc.
BACK-UP DOULA
I will provide you with a back up Doula if you are comfortable with this. You have the right to meet the back-up Doula and request another one prior to delivery if you decide you do not click. In the case that I am unavailable to attend your delivery you will have the option to go with, or forgo, Back-up Doula care. In the event that you decide to forgo back up care the non-refundable deposit will still be non-refundable and no further payment will be requested. I will still continue with postpartum visits if desired.
LABOR AND DELIVERY
You are responsible for calling me when you think labor has begun, I ask that you contact me as soon as possible even if you are not sure you are really in labor. The more notice I have, the better prepared I can be. Once we determine you are in labor, it is up to you to decide at what point in your labor you want me to come and be with you. I will be there within an hour (depending on distance) or meet you at the hospital and stay with you continuously, and remain with you until a few hours after the birth. In some cases of a prolonged labor, I may need to call for back up Doula care. I will arrive with my Labor Bag, nutritious snacks and drinks for you and your partner during labor and shortly after delivery. During this time I can take pictures of video of anything you request.
I will remain with you for 1-2 hours after birth, until you are relaxed and comfortable with nursing, and your newly born family is ready for quiet time together. Again, each situation is different and my duties will vary depending on your needs.
POSTPARTUM VISITS
My services include one or two postpartum visits, the first within a few days after the birth if you need and the second anywhere from 4 - 6 weeks. During the visits, I can provide breastfeeding support, baby care tips, referrals to community resources, and a chance to discuss your birth experience. At this time I will provide you with a framed copy of your birth story in my own words for you to enjoy and share with others.
WHAT I DO NOT DO:
· I do not make decisions for you. I will help you get the information you need to make your own informed decisions. I will inform you if there is a departure from your Birth Plan.
· I do not speak for you regarding matters where health care decisions are being made. I can discuss your concerns with you. I can introduce opportunity to discuss concerns if needed and support you as your advocate to make sure your wishes are made known.
FEES
The total fee for my services is $_______.
This covers, but may not be exclusive of: prenatal visit at your home, optional visits with your care provider and facility tours, phone and email availability, on call availability beginning 2 weeks before your estimated due date, continuous labor and birth support, immediate postpartum care and two postpartum visits. This also includes travel expenses for all visits, and fees for parking at hospital. You may choose not to take advantage of any services outlined throughout the contract. (If necessary, I am open to payment plans)
Upon signing of this contract, a non-refundable deposit in the amount of $_____ is due. The remaining amount is due in the form of a postdated check for your due date. If you decide to not continue with my services after signing the agreement, prior to 6 weeks before your due date, you will not incur any additional fees beyond the initial non-refundable deposit.
In the case of a scheduled C-Section, you have the option of canceling your Doula services where your deposit will not be refunded, and no further payment is required. Or you may keep me as your doula for the c-section delivery and the amount of $_____ will go towards Postpartum Doula support.
In the case of labor resulting in non scheduled c-section the fee remains $_____.
The total fee due is: $____________________
Less the deposit of $____________________ Paid on _________________________
Balance Remaining $____________________ Due by _________________________
I have read this letter describing our doula’s services and understand that it reflects
our agreement.
_____________________________________________________________
Client Date
______________________________________________________________
Client’s Partner Date
______________________________________________________________
Doula Date
Specific individual arrangements, agreements, or other - not already covered in
this agreement are listed on reverse side of this page
|
