Letter of Agreement Describing Labor Support Services Limits, and Fees

What is my role as a doula?

I accompany women and their partners during their birthing time to help provide a memorable birth experience. I help provide physical, emotional, and informational support to women and partners. I am independent and self-employed. As your doula, I am working for you, not for your caregiver or the hospital. 

My availability.

From the moment we agree that we will work together, I consider myself "on-call" to provide support for you and your partner. I will notify you of any times when I am not available and will provide the name and contact information for the back-up doula.

Prenatal Conference.

We will have a prenatal meeting to review your Birth Plan and do a Birth Rehearsal.  This will give us a chance to talk in detail about your preferences regarding your birth.  I will invite you to share how you and your partner foresee working together, and the roles of others who may be attending the birth. We can discuss together what concerns you have regarding the birth.

My role is to help you have a satisfying birth as you define it. The more we explore this in advance, the better I will be able to fulfill this role.

When you are in your birthing time.

I prefer you that you call me when you think your birthing time has begun, even if you do not yet need me.  I can answer questions and make suggestions over the phone.  Together we will decide if I should come right then or wait for further changes.  (I usually need approximately 1 hour to get to you from the time you ask me to come)  We will also decide where to meet – at your home or at the hospital.  Except for extraordinary circumstances, I or my back-up will remain with you thorughout your birthing time. 

I can offer help and advice with relaxation, movement, positioning, and massage and of course your hypnosis cues. I can assist with gathering information about the progress of your birthing time to make sure you have the information you need to make informed decisions about your birth. I can also serve as an advocate for your needs with the medical staff. My most critical role is providing continuous emotional reassurance and comfort.

I will also be recording information for your birth story and take picture of events you have requested and clarified before labour, if the situation allows.

•       In some cases, labor progresses more quickly than anticipated. If you call me to advise me that your labor has progressed very quickly and delivery is imminent or your baby has been born unexpectedly at home, I will call an ambulance from the hospital you were planning to deliver at and arrange for you t o be transferred to that hospital.

•       If your baby arrives unexpectedly at home with me present, I will request that you or your partner catch your baby.  After ensuring you are both safe, we will arrange for an ambulance to the hospital.  I am not responsible for delivering your baby or any clinical skills related to the delivery of your baby.

•       If you are planning a hospital birth, you agree to give me permission to call 911 in case of an imminent delivery at home.  If you are planning a homebirth,  you agree to allow me to call your midwife directly and inform her of the situation

After Birth.

I expect to remain with a client for 1-2 hours after birth, until you are comfortable, and the family is ready for quiet time together. I can help with initial breastfeeding, if desired.

I am available for phone contact to answer questions about the birth of your baby. My services include one postpartum visit, usually within two weeks of the birth. During this visit, I can provide breastfeeding support, baby care tips, referrals to community resources, and a chance to discuss the birth experience. If you are in need of further support, additional visits are always an option.

Failure of a doula to provide service.

I will make every effort to provide the services described here. Sometimes this is impossible for a variety of reasons. If failure to attend the birth is due to my error, there will be no charge for my services, and I will refund your deposit. If it is due to circumstances beyond anyone's control (e.g. an extremely rapid labour and birth), or your failure to call me, I will keep the deposit, but there will be no further charge.

Fees.

My fee is $______. I ask for a deposit of $_____, which is typically paid during or shortly after the prenatal conference. The balance of the fee $______ is due at the Postpartum appointment.

Doula's Signature ____________________________ Date_______________________

I / We have read this letter describing the doula services and agree that it reflects the discussion we have had with her. I do not hold my doula responsible for unexpected clinical outcomes.

Mother’s Signature ____________________________ Date_______________________