Letter of Agreement

Below is my letter of agreement for my doula services. I will bring two of these with me when we first meet, and if you decide to hire me as your doula, the agreement is signed by you and your partner (if you have one), and returned to me through the mail.

_____

Letter of Agreement Describing Zipadee Doula Services, Limits, and Fees

What is a Doula?

As a doula, I support women in labor to help them achieve their goal of a safe and satisfying birth experience. I am a non-clinical care provider trained in providing emotional support, physical comfort and information throughout pregnancy, labor and delivery, as well as postpartum. I am independent and self-employed. I work for you, not your caregiver or hospital. As I do not make decisions for you, I will help you get the information necessary to make an informed decision. I will support you to my fullest in facilitating the kind of birth you have envisioned for yourself and your family.

Services Provided by the Doula

During your pregnancy

  • One or two prenatal visits*
  • Unlimited phone and/or email consultation
  • Educational information, lending library, resources, & referrals
  • On-call availability from your 38th week until the baby is born

During your labor & birth

  • Early labor support in your home
  • Help managing labor pain with such methods as: massage, relaxation, breathing, & voice
  • Suggestions on how to help labor progress
  • Continuous physical & emotional support, as allowed, once active labor has begun until one or two hours after the birth
  • Providing relief for your partner
  • Ensuring that everyone is comfortable
  • Keeping the space safe”
  • Photography (if requested)

After Birth

  • Early lactation help, if needed
  • Any help needed getting comfortable after the birth
  • Phone and/or email support as needed during the immediate postpartum period for postpartum care, breastfeeding support and newborn care
  • One visit at home within two weeks of your birth**
  • Referrals, if requested

Breastmilk soap and placenta services are available at an additional charge.

*During our prenatal visits, we will go over how your pregnancy is going, your thoughts about the birth, any questions or concerns you or your partner are having, as well as discussing how we can best work together. Our number of prenatals depends on how much time is left before your due date when you hire me.

**At our post partum visit, I would love to hear how you are doing, listen to your birth story, give any breastfeeding support, bring your birth pictures to you, as well as get any feedback from you about my role as your doula.

Limitations of Practice

  • I do not perform medical tasks such as blood pressure readings, fetal heart checks and vaginal exams, among others.
  • I do not take responsibility for the clinical or medical well being of you or your baby.
  • I do not make decisions for you or contradict medical advice from your care provider.
  • I do not speak to the staff or care provider instead of you regarding health care decisions. I will discuss concerns with you, and suggest options, but you or your partner will speak on your behalf.
  • I do not take the place of the woman’s partner (if there is one attending the birth). I am there to support them, as well as the mother.

Initials _______

Responsibilities of the Client

  • To inform her care provider that a doula will be present at her birth.
  • Discuss plans for the arrival of the doula prior to labor (where to meet, what phase of labor).
  • Inform me of any pregnancy or non-pregnancy related health complications, so that I may support you as needed.
  • Inform me if I need to take extra precautions when exposed to bodily fluids, etc.
  • Keep close contact with me (call or email every 2-3 days) once you reach 38 weeks to tell me how you are doing.
  • Inform me as soon as you believe you are in labor, even if you are unsure, so that I can make arrangements to attend your birth.
  • Allow me one to two hours to reach you from the time you request my support.
  • To call me. If you fail to call, or choose to not have me attend the birth, I will keep (or you will owe) the entire fee agreed upon.
  • Pay replacement costs for any lost of damaged library items.

Initials _______

Fees

My fee is $400, which includes a non-refundable retaining deposit of $200 due no later than 2 weeks after our initial consultation. This retaining fee holds your position on my on-call schedule. The balance of $200 is due at the second prenatal or 4 weeks prior to the estimated due date, whichever comes first. Payment schedules or special circumstances may be arranged with the individual doula, but must be agreed upon by all parties for this contract to be valid.

Placenta encapsulation services are $120, and due once the placenta capsules have been received by the client.

Failure to Provide Service

I will make every effort to provide the services described here. Sometimes this is impossible (rapid labor or natural disasters, for example). If a failure to attend your birth is due to my own error, I will keep the retaining deposit, and refund (or you will not owe) the remaining balance. If failure to attend your birth is beyond anyone’s control (rapid labor, etc.), our contract stands as is. If you choose not to call me to attend your labor, the fees will not be refunded, as I may have turned away other clients for your space to be reserved. If the client chooses to cancel service before 38 weeks, half of the fee will be refunded ($200). After 38 weeks, there is no refund for cancellation.

Early Labor

Should you go into labor, or your water breaks, before I am on-call (before 38 weeks of pregnancy) and are admitted to the hospital, please still call me. I will make every effort to attend your birth however it is possible I may not be available.

In the event of premature delivery, payment is due 10 days after delivery.

Cesarean Section

In the event you have a cesarean section, planned or emergency, all fees remain the same. I will stay and offer as much support as the medical staff will allow. It is up to you to secure my place in the operating room. If scheduled, I will meet you at the hospital at your scheduled time. I will accompany you in the operating room if allowed by medical staff, and offer emotional support and breastfeeding support after the birth. If for some reason I am not allowed to be present in the operating room (emergency, policy, etc.), I will join you after the birth so that your partner may accompany the baby without leaving you alone for the rest of the surgery.

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