Letter of Agreement Describing Services

What is a Birth Doula?

A doula accompanies women in labour to help ensure a safe and satisfying birth experience. As a doula, I draw on my knowledge and experience to provide emotional support, physical comfort and, as needed, communication with the staff to make sure that you have the information you need to make informed decisions as they arise in labour. 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 am independent and self-employed. For references and information on my personal experience, please don't hesitate to ask.

Choosing a Doula

I prefer to meet with you and your partner first before you make any final decision about retaining my services. This meeting does not obligate you in any way. If you do select me, then I will want to meet with you a further two or three times to discuss your preferences regarding management options. I also want to know your own best ways of coping with pain and fatigue and how you and your partner foresee working together. In our meetings I also provide you with information to complement your prenatal classes. Or, if you wish, I can provide private prenatal classes in your home. As well as the home visits, I am available at all times for telephone consultations.

I will also inform you of the rare times when I may be unavailable for labour support. To cover those times, I can arrange one or more back-up doulas whom you can also meet. Of course, you have as much choice over your back-up as your primary doula.

When you are in Labour

I prefer that you call me when you think you are in labour, 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 one hour to get to you from the time you ask me to come). We will also decide where to meet - at your home or the hospital. Except for extraordinary circumstances, I or my back-up will remain with you throughout the labour and birth.

After the Birth

I usually remain with you for one or two hours after the birth, until you are comfortable and your family is ready for quiet time together. I can also help with initial breastfeeding if you wish. I am available for phone contact to answer questions about the birth or your baby and would like to get together with you within two to three weeks to see how you are doing, to review your birth, and to get feedback from you about my role.

Limitations of Doula Practice

As a Doula, I do not make decisions for you. I will help you get the information necessary to make an informed decision. I will also remind you if there is a departure from the "plans" you had prior to the labour.

As a Doula, I do not perform clinical tasks such as blood pressure readings, fetal heart checks, vaginal exams, and others. I am there to provide only physical comfort, emotional support, and advocacy.

As a Doula, I do not speak to the staff on your behalf. I will discuss your concerns with you and suggest options, but you or your partner will speak on your behalf to the clinical staff.

I will make every effort to provide the services described herein. Sometimes this is impossible (for example, with a rapid labour). If my failure to attend your birth is due to my error or due to circumstances beyond anyone’s control, there will be no charge for my services beyond the $100 retaining fee, which covers the cost of prenatal visit(s), handouts and my availability. If it is due to your failure to call me, I will keep, or you will owe me, the agreed upon full cost of service.

Fees

My fee for the services described above is $______. The fee is to be paid as follows:

$ ______ as a retainer fee, due when you select me as your doula +

$ ______ due within two weeks of the birth

(If the payment schedule should pose a problem, I am happy to discuss other options)

Copyright Mother Care 1998

 

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