Contract for Doula Services

My Philosophy of Birth:  As a birth doula, I accompany you in labor to help develop a safe and satisfying birth experience.  I believe that birth is an empowering, profound, marvelous, sacred, life-changing experience.  I offer a complete understanding of the birth process but more importantly I offer sensitivity, stamina, patience and reverence to your birth process. I will provide information to enable you to make informed choices.  I will maintain complete confidentiality of all details relating to your pregnancy and birth.  As I am independent and self-employed, I will be working for you, not your care provider or hospital.  I am there to provide on-going, nurturing, emotional and spiritual care and provide physical comfort measures to you during your birth experience.  I can provide reassurance and perspective to you, make suggestions to help, and help with relaxation, massage, distraction, position and other techniques for comfort.

Your Partner:  The presence of a doula lifts the sole responsibility of the labor off the shoulders of your partner, allowing him/her to enjoy the whole birth process.  I can help your partner to feel calm and informed, giving him/her ideas to continue support from beginning to end.  At no time will I “take over” or deliberately exclude your partner.  I am there to provide support to both of you at all times.  Sometimes a partner likes to stay by the mother’s side during the whole of labor, while others prefer to take a break.  This is your birth experience and it is important that you feel free to decide on what you want at the time. 

The Initial Meeting:  I am available for as many email/telephone consultations as you’d like and I can meet with you and your partner for an initial meeting to explore and discuss your priorities, discuss any fears or concerns and plan how we might work best together.  This meeting typically lasts one to two hours and the fee is 10% of the doula fee.  This initial meeting fee is applied to my doula fee should you decide to hire me.  This meeting does not obligate either you or I to go forward in utilizing my doula services.

Prenatal Meeting(s):  If you select me as your doula, I will want to meet with you again before labor to become familiar with your Birth Plan and your preferences regarding labor.  I also will want to know your own best ways of coping with stress and fatigue and how you and your partner foresee us working together.  I will also inform you of times when I am unavailable for labor support.  To cover those times, I will arrange for a backup doula whom you can also meet. We may also decide on other meetings and we will remain in touch by phone or email.  I’ll ask you to call or email me after each of your appointments with your doctor or midwife to keep me informed about your pregnancy and baby.

The Backup Doula:  I work with several wonderful doulas and we back each other up in the unlikely event that I am unable to attend your delivery or if I am at another birth.  This situation is very rare.  I always select a backup doula for you, depending upon location, personality and availably, to be the backup for your birth.   On rare occasions I may have another doula cover a weekend or a day for me and I would let you know ahead of time that I would be having another doula cover for me for a certain day or weekend.

When you are in labor:  I prefer that you call me when you think you are in labor, even if you do not yet need me.  I can answer questions and make suggestions over the phone.  Regardless of the time, day or night, call my home phone first at 508-757-4964.  If there is no answer, leave a message and call my cell phone at 508-728-6588.  If there is no answer, please leave a message.  If I do not respond within 15 minutes, please call both numbers again.  If I do not respond within 15 minutes, please contact my backup. 

When we speak, we will decide if I should come to you right then or wait for further change.  I will come to you when you are in active labor.  I need anywhere from one to three hours 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/birth center.  Except in extraordinary circumstances, I or my backup will remain with you throughout your labor and birth.

Clinical Tasks:  At the times where you request that I perform a clinical task prenatally or in labor such as a blood pressure reading, fetal heart rate check with a Doppler, cervical exam or postpartum such as weighing the baby, doing a PKU, administration of oral vitamin K, etc., I am working outside of my scope as a DONA certified doula and assisting you in your birth and/or postpartum as a midwife.  I am unable to perform clinical tasks at the hospital.  There is no additional charge for me completing these tasks.  However if you have a surprise home birth, additional fees will apply. 

Option to Give Birth at Home:  As your doula, I support your right to give birth in any location that you choose.  It is important to know, however, that a planned home birth is much safer and relaxing than an unexpected homebirth.  Though I am a midwife, you are hiring me as a doula.  However, there have been occasions when some of my birthing mothers decide in labor that they would rather birth at home than leave for the hospital.  For some mothers, they are enjoying the familiarity of comfortable surrounding, or the closeness of older siblings or the intimacy, safety and privacy that only home can offer.  And sometimes, there is simply not enough time to travel due to travel distances, weather, or quick progression of labor.

If you have not selected a planned homebirth and birth progresses more quickly than anticipated, I will contact a second midwife to assist me in stabilizing you and the baby, assess you and the baby’s vitals, complete a newborn exam, assist in suturing if necessary and clean up after the birth.  My midwife assistant is vital to the safety and ease of transitioning to a home birth when a hospital birth was planned.  If I attend your delivery at home, planned or not, there is an additional cost for this service and payment should be made prior to my departure.  If my birth assistant supports you and me for your delivery and/or immediate postpartum, a $500 payment must be made to them on the day of the birth.  The remaining $2200 due for my midwifery services, less any doula fee already paid, can be paid in full that day of birth or spread over payments.  I am also happy to perform your postpartum care, under normal circumstances, through 3 weeks postpartum.  There is an additional cost of $100 for each postpartum visit.  Please ask me if you have any additional questions regarding homebirth.  

After birth:  I usually remain with you for an hour or two after birth, until you are comfortable and your family is ready for quiet time together.  I can also help with initial breastfeeding, if necessary.  During the postpartum period, I am available by phone to answer questions about the birth or your baby or how you are feeling.  Within a week or two after birth, we will meet to see how you are doing, to review the birth, to admire your baby and to get feedback from you about my role.  If you are interested in additional postpartum services, please see my postpartum doula contract.

In summary, my doula services include the following:

• Assistance with completion of a written birth plan.
• An initial meeting to discuss your birth wishes and one or two prenatal visit(s) to finalize your birth vision/plan. 
• Twenty-four hour on-call availability from two weeks before the due date until labor begins.
• A back-up doula in the event I am unavailable.
• Labor support during active labor, delivery and immediate postpartum, including in your home labor support during early active labor. 
• Continuity of care once active labor has begun including assistance and support during labor and birth and for at least one hour after the baby is born.  I may take short breaks for meals and/or rest if time allows – this will be discussed with you at the time and I will not leave you if it is inappropriate.
• Assistance in managing unexpected circumstances with compassion and knowledge.
• Photography at labor and birth, if desired.  Film and developing at your expense.
• Twenty-four hour on call postpartum and breastfeeding support for one week after the baby is born.  I can assist in providing information and supplying emotional support by telephone on postpartum care, breastfeeding, and newborn care after the birth, as requested.  Please contact me if you have any concerns.  If I cannot help, I will be able to find the appropriate person who can. 
• Sibling support during the birth, if necessary.
• An hour and ½ postpartum visit to process, talk or help in any way you need.

Fees:

• Fee for doula services as outlined above: $1,350 in Worcester County, $1,600 in all other counties.
• $500.00 is due as a retainer fee due at the time you select me as your doula and return the signed contract.  This is non-refundable. 
• The remaining doula fee balance is due by the 36^th week of pregnancy.
• Additional prenatal and postpartum visits are available at the rate of $40.00 per hour including travel time.
• If my backup or I do not attend your birth is due to circumstances beyond anyone’s control, such as rapid labor or you don’t call me, no portion of the fee will be refunded.  However, postpartum support will be provided, as well as the postpartum visit.
• If your baby is delivered by c-section, no portion of the fee will be refunded.  If you have a planned cesarean birth (due to breech, baby size or other), no portion of the fee will be refunded.  I would still provide prenatal care, help you prepare a cesarean birth plan, help you and your partner prepare emotionally and mentally for the surgery and attend the cesarean birth with you and your partner.  Immediate postpartum services will still be provided as well as the postpartum visit.
• If my backup or I do not attend your birth due to my error (i.e. car accident), half of the doula fee will be refunded.  However, postpartum support will be provided, including the postpartum visit.

As a doula I do not:

• Make decisions for you.  I will help you get the information necessary to make an informed decision. 
• Argue with the staff on your behalf.  I will discuss your concerns with you and suggest options, but you or your partner should speak, on your behalf, to the clinical staff.
• Provide transportation to or from the hospital/birth center for the mom.  I usually do not ride as a passenger in the mom’s vehicle.  When providing support at home, I will follow you in my car and meet you at the hospital/birth center.

The client understands and agrees that Joyce Kimball, as a doula, does not give or provide medical diagnosis, advice or treatment.  The client further understands it is her/their responsibility to seek and obtain medical advice from an appropriate medical practitioner.  The care services to be provided consist solely of labor support.  By signing this contract the client agrees to all provisions contained in this contract.