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Birth Journey Prep Doula Service Contract
I accompany women in labor to help facilitate a safe and satisfying birth experience. I use my classroom and practical experience to provide physical and emotional support. I am also equipped to provide detailed information before, during and after your labor and birth. I can support both you and your partner with encouragement, reassurance and practical suggestions for relaxation, pain coping, and comfort. I work only for you, not the hospital or caregiver.
If possible, I would like to meet with you at least once before labor. Our first meeting would involve us becoming acquainted and discussing preferences, priorities, fears, concerns, etc. This meeting does not obligate you to use my services. If you do decide to hire me, we would meet again for a prenatal interview so that I can become familiar with your birth plan and discuss the ways that I can be of the most help to you and your family.
Please be aware that as a doula I do not:
~ Perform clinical tasks, such as blood pressure checks, fetal heart checks, vaginal exams, or any other medical procedure.
~ Provide information, dosages, or advice concerning prescription or alternative medication for you or your baby
~ Make decisions for you. I will, however, help you get the information you need to make an informed decision.
~ Speak to the medical staff on your behalf.
Please call me as soon as you think you may be in labor or if your bag of water has broken, even if you don’t need me yet. I, or my back up, can usually get to you in 1 to 1 and ½ hours from the time you call me. I can come to your home or meet you at your birthplace. I, or my back up, will remain with you throughout your entire labor and birth, except in the case of extraordinary circumstances. I will inform you of the times that I am unavailable and will arrange for one or more back-up doulas. I will also always inform you when I travel.
I will usually remain for 1-2 hours after birth to make sure you are comfortable and ready for quiet, family time. I am also available to help with initial breastfeeding.
I would like to meet with you about 1-2 weeks after baby is born to review your birth experience, admire the baby and get an evaluation from you on my role as your doula.
To summarize, my services include:
~ 1-2 prenatal visits
~ Unlimited phone contact
~ Packet of information that you may find helpful
~ Continuous support throughout labor and birth
~ Digital photos of labor, birth and baby saved to disk
~ 1-2 hours of support after birth and assistance with breastfeeding, if desired
~ 1 postpartum visit
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. 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.
The full cost for the services described herein are $______, to be paid as follows:
$_________ Non refundable retainer fee
$_________ Balance due ____________
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.
Please print and sign below.
Date:
Client:
Partner:
Doula:
God Bless You,
Stephanie Nobles CD (DONA) |
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