BIRTH DOULA CONTRACT

What is my role as a doula? As a birth doula, I accompany women in labor to help ensure a safe and satisfying birth experience. I have completed training approved by DONA International. I draw on my professional training, knowledge and experiences to provide physical, emotional, and information support to women and partners. 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 comfort. I am independent and self-employed. As your doula, I am working for you, not your caregiver or the facility where you birth.

As a doula, I do not:

Perform clinical tasks, such as blood pressure, fetal heart checks, vaginal exams, etc. I am there to provide only physical comfort and emotional support.

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 your Birth Plan.

Speak to the staff on your behalf regarding matters where health care decisions are being made. I will discuss your concerns with you and suggest options, but you or your partner will speak directly to the clinical staff.

Free consultation. It is very important that you and your partner are comfortable with me and with my role in the birth. Thus, I do expect to meet with clients at least once before labor to become acquainted, to explore and discuss your priorities and any fears or concerns, and to plan how we might best work together. At that time, we can discuss fees. This initial meeting is free and does not obligate you to use my services. If you choose to select me as your doula, I will want to become more familiar with your plans for labor, birth, and postpartum.

Prenatal meetings. I prefer we arrange for 1 prenatal meeting (1-2 hours) before labor begins, preferably before 37 weeks in your pregnancy. Additional meetings may be arranged if necessary. This meeting gives us a chance to talk in detail about your preferences regarding your birth. If you have a Birth Plan, we will review it carefully. If you do not have a Birth Plan and would like to create one, I can assist with this. I will want to know your own personal ways of coping with pain and fatigue and difficult situations, and what internal resources we can draw upon to assist you with the birthing experience. I will want to know how you and your partner foresee working together, and the roles of others who may be attending the birth. We can discuss together what fears and concerns you have regarding the birth. We can review your preferences regarding the use of pain medications. My role is to help you have a satisfying birth as you define it. The more we explore this in advance, the better I will be able to fulfill this role. This contract will be signed at or before the first prenatal meeting. 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. I generally accept only 2 clients per month, so the likelihood of your birth overlapping with another client’s birth is extremely small.

Late Pregnancy . I am available for phone consultations and email questions in pregnancy, and encourage clients to call with questions or updates. Once we enter the on-call period, I encourage clients to check in with me every few days to let me know how they’re doing. I consider my on-call period for a birth to be from 38-42 weeks of your pregnancy. During the on-call period, I am committing myself to be within 90 miles of Greensboro at all times unless previously discussed with you and covered by a back-up doula. In general, I am almost always in town anyway.

When Labor Begins : 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. We will decide if I should come right then or wait for further change. I usually need approximately 1 hour to get to you from the time you ask me to come, so think ahead. We will also decide where to meet—at your home, or the hospital or birthing center.

After Birth. I usually remain with you for 1-2 hours after birth, until you are comfortable and the family is ready for quiet time together. I can also help with initial breastfeeding, if necessary. I am available by phone or email to answer questions about the birth of your baby. My services include 1 postpartum visits – usually 2-5 days after the birth. During this visit, I can provide breastfeeding support, baby care tips, referrals to community resources, and a chance to discuss the birth experience.

Fees . The total fee for these services is $450. I ask for a deposit of $200 (applied towards the total fee) as soon as you have chosen me as your doula. This secures your birth on my calendar. The remainder of the fee is due at the post-partum visit. You may pay in cash or checks written to Jacqueline Messick.

Payments can be mailed to…

3607 Plympton Pl

Greensboro, NC 27410

The fee you will be paying is: _____________________________

Deposit received: _____________________________________

Final payment due: ___________________________________

Failure of a doula to provide service. I will make every effort to provide the services described here. Sometimes this is impossible for unforeseen reasons. My refund policy is as follows:

If my failure to attend your birth is due to my error and my back-up doula is not available, there will be no charge for my services and I will refund the $200 deposit.

If my back-up doula attends your birth because I was unavailable (whether pre-arranged or unexpectedly), full payment to me is still required. I compensate the back-up doula directly. The back-up doula will then also attend postpartum meetings.

If I miss your birth due to circumstances beyond anyone’s control (for example, extremely rapid labor), I will keep $100 but there will be no further charges. I will still attend a post-partum meeting with you.

If you fail to call me to attend your labor, there is no refund of the $200 deposit, but there will be no further charges.

I / We have read this letter describing the doula services and agree that it reflects the discussion we have had with her.

___________________________________ ___________________________________

Client Client’s Partner

___________________________________ ___________________________________

Jacqueline Messick, CD(DONA) Date

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