Hanover, MA 02339
Contract of services for doula support
As a birth doula, I provide emotional and physical support to a woman and her
family during her labor and birth. I can also facilitate communication with the staff
to ensure that you have the information to make informed decisions regarding
your baby’s birth.
I provide reassurance and perspective to you, make suggestions for labor
progress, and help with relaxation, massage, positioning and other techniques for
I am independent and self employed, and as such, am working for YOU, not your
caregiver or place of birth.
I will meet with you and your partner at least once (preferably twice) to become
acquainted with you, explore and discuss your priorities and any fears or
concerns you may have.
I will provide evidence based information on the risks and benefits of common
interventions and procedures used during childbirth. Discuss your birth plans,
and how we might best work together.
I will also inform you, if this is the case, of times when I am unavailable for labor
support. To cover those times, I will provide one or more qualified back-up doulas
whom you may also meet with.
We may also decide on other meetings, and will remain in touch by telephone,
text, or email communication.
I prefer that you contact me when you think you are in labor, even if
you do not yet need me. This gives me time to clear my calendar. I
can answer questions and make suggestions over the phone. We can
decide together whether I should come right away or wait for further
changes. I need at least one hour to get to you (usually quicker!) 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 1-2 hours after the birth, or until you are comfortable
and ready for quiet time as a new family. I can also assist with initial
breastfeeding, get food for you and make sure you have everything you need.
I am available to answer any questions you may have about your birth,
breastfeeding and new baby care.
I will schedule a follow up meeting within a few weeks of the birth to visit you and
the baby, to answer any questions you may have, and to discuss your birth
LIMITATION OF SERVICE
As a doula, I do not:
Perform medical tasks, such as checking blood pressure, cervical exams, or fetal
Make decisions for you, I will help you get the information that you need to make
informed decisions about your care. I will also remind you if there is a departure
form your previously discussed wishes.
Speak to medical staff for you, I will discuss concerns with you and suggest
options, as well as encourage you to voice your opinions, concerns and
questions to the staff.
Provide transportation, I am unable to drive you to the hospital or place of birth. If
there is no transportation available, we will call a taxi.
As a doula, I can help you prepare for your birth, but I cannot
guarantee that your birth will go as planned.
If you are planning for a vaginal birth, but a cesarian is performed, I
can support you before, during and after, as the hospital allows.
There will be no refund.
If you decide not to have me there, and do not call me, you are still responsible
for total fee.
If you change your mind before my on-call period (38 weeks) a refund will be
given minus the retainer fee.
I will make every effort to provide the services described here. If my failure to
attend your birth is my fault, a full refund will be given.
Circumstances out of my control will be addressed on a case by case basis.
For the services described here, to be paid as follows:
$300 as a retainer fee, due when you select me as your doula and sign this
$600 Due by your 37th week of pregnancy.
I/We have read this contract describing the doulas services, and agree to enter
into a client-doula relationship for the pregnancy and birth with the due date
Client name_________________ Client signature_________________ date:
Client name_________________ Client Signature_________________ date:
Doula name_________________ Doula signature_________________ date