Birth Doula Services Contract
We, the undersigned, state that we have discussed and reviewed our birth plan with our Doula, India Posner. We understand that planning for a baby’s birth is an important process and responsibility for us as parents, but does not guarantee how the birth will proceed or what the outcome will be; it may not go as we imagine.
General definition of a doula
We understand that:
A doula accompanies a women in labor to help ensure a satisfying birth experience.
A doula works for us, not our care provider or hospital.
A doula does not perform clinical tasks such as vaginal/cervical exams, blood pressure or fetal heart rate monitoring, or temperature checks. She does provide physical, emotional and informational support.
A doula does not speak to the medical staff instead of us regarding matters where decisions are being made. A doula will not discuss concerns with, offer information, facilitate discussion. We will speak on our own behalf to the clinical staff.
General Information about our doula
We understand that India:
Is a trained labor support specialist. She is working towards her doula certification through DONA International.
Draws on her knowledge and experience to provide emotional support, physical comfort and facilitate communication with medical staff to make sure we have the information we need to make informed decisions during labor.
Can provide reassurance to us, make suggestions to help labor progress, and make suggestions to help labor progress and help with relaxation, massage, positioning and other techniques for comfort.
Is independent and self-employed.
Obligations of our doula
We understand that:
India will be on call for us 24 hours a day beginning two (2) weeks before our due date of and ending two (2) weeks after our due date or with the birth of our baby. This means that India will carry her phone with her at all times. Of course India will provide doula services beyond the 4-week window of time, but she may have other commitments that take her further away from the Seattle area. Known times India will be unavailable during your 4 week window are: .
Unforeseen circumstances may prevent India from attending our birth. She will have a backup doula available to us, whom we will also meet. Of course, we have as much choice over our backup doula as our primary doula. India will communicate with the backup doula as to our care and progress, yet she must waive all responsibility of the backup doula’s services.
Services provided by our doula
We understand that India:
Will meet us two-three times (depending on our package) before birth to discuss your plans
Will help us create a birth plan if wanted.
Will answer questions and provide information via phone/text/email any time support is needed.
Will provide early labor support as requested.
Will remain with us onc active labor has begun until one to two hours after the baby is born.
Will use non-medical support and comfort techniques for labor and birth.
Will help us gather information to make informed decisions before, during, and after birth.
We strive to maintain a calm and peaceful birth environment.
Will photograph labor, birth or recovery if desired, as time and circumstances permit.
Will meet us two-three times (depending on chosen package) after the birth at your home to answer questions, help with breastfeeding if desired, give referrals for any further concerns, visit with baby, and discuss the birth.
Our Obligations as clients
We Understand that:
We have hired India as an independent professional for a fee of .
We will complete an intake form and pay a non-refundable retaining fee of $500 upon hire.
We will keep India updated after visits with our care provider.
We will call India when we think we are in labor,even if we are not sure, so that India can make arrangements to attend your birth.
We will allow India approximately one hour to arrive to our birth.
If we decide not to use India as our doula less than three weeks prior to our due date, we will forfeit the $500 retaining fee. If we decide not to use India as our doula more than four weeks prior to our due date, we will be refunded the $500 retaining fee minus $30 per hour for any time we have already spent together.
We will pay the balance of the total fee at the first visit after the birth unless other arrangements are made in advance.
In the event of a scheduled (non-emergency) labor induction or cesarean birth, we will take India’s schedule into consideration.
Failure of our doula to provide service
We understand that:
India will make an effort to provide the services described here.
In the case of rapid birth or medical emergency, it may be impossible for India to provide these services.
If India or her backup does not attend our birth due to error on her part, there will be no charges beyond the retaining fee.
If we fail to call India for any reason, she will keep the retaining fee and the remaining balance will be due within two weeks of our birth.
Signed,
__________________________________ Client Date __________________________________
__________________________________ Partner Date __________________________________
___________________________________ Client Date __________________________________
