Contract Of Services For Doula Support printable pdf download

Contract of Services for Doula Support

As a birth doula, I provide emotional and physical support to a woman during her labor and delivery. I can also

facilitate communication with the staff to ensure that you have the information you need to make informed decisions

regarding your baby’s birth. I can provide reassurance and perspective to you and your partner, make suggestions for

labor progress, and help with relaxation, massage, positioning and other techniques for your comfort. I am independent

and self-employed, and as such, am working for YOU, not your caregiver or place of birth.

BEFORE LABOR

I will meet with you and your partner at least once (preferably twice) before labor to become acquainted with you;

explore and discuss your priorities and any fears or concerns; present evidence-based information on the risks and

benefits of common interventions and procedures used during childbirth; discuss your birth plans; and plan how we

might best work together.

I will also inform you of times when I am unavailable for labor support. To cover those times, I will arrange one or

more qualified back-up doulas whom you may also meet.

We may also decide on other meetings, and will remain in touch by telephone and/or e-mail communication.

DURING LABOR

I prefer that you call me when you think you are in labor, even if you do not yet need me. This gives me time to clear

my calendar for the next 24 hours and arrange for childcare. I can answer questions and make suggestions over the

phone, and we can decide if I should come to you then, or wait for further change. 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 (home or hospital). Except for

extraordinary circumstances, I will remain with you throughout your labor 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.

I am available to answer questions about the birth or your baby, and I will schedule a follow-up meeting within a few

weeks of the birth to visit you and the baby, review the birth, and get feedback from you about my role.

LIMITATION OF SERVICES

As a doula, I do not:

1. Perform clinical tasks, such as taking blood pressure, fetal heart checks or vaginal exams. I am there to provide only

physical comfort and emotional support and facilitate communication between you and the staff.

2. Make decisions for you. I will help you get the information you need to make an informed decision. I will also

remind you if there is a departure from your birth plan.

3. Speak to the staff on your behalf. I will discuss your concerns with you and suggest options, as well as encourage

you to voice your opinions, questions and concerns to the staff.

EXTENUATING CIRCUMSTANCES

As a doula, I can help you prepare for your birth, but I cannot guarantee that your birth will go as planned.

If you plan a vaginal delivery and a cesarean is performed after the onset of labor, I will continue to provide support

during the cesarean surgery (as allowed by hospital and/or doctor policies) as well as immediately after to help with

your comfort and breastfeeding. I will also follow-up with you after the birth, as I do with all my clients. In this

scenario, my full fee applies, and no refund will be given.

Contract of Services (June 2009) // Jackie Mysak, Birth Doula //

Contract Of Services For Doula Support