§ I will support you during your pregnancy, labor and in the postpartum period, in whatever choices you make.
§ I will provide information to enable you to make informed choices.
§ I will remain up to date on current research into birth related issues.
§ I believe that birth is a normal physiological process and an important journey in a mother and father’s life.
§ I will maintain complete confidentiality of all details relating to your pregnancy and birth.
§ I will strive to support you during labor to ensure a positive birth experience and to help you to achieve the type of birth you would like.
§ As I am independent and self-employed, I will be working for you, not your care provider or hospital.
§ I do not perform clinical tasks such as blood pressure or fetal heart rate monitoring. I do provide physical, emotional and educational support.
§ I will draw on my knowledge and experience to provide emotional support, physical comfort, and communicate with the medical staff to make sure you have the information you need to make informed decisions during labor.
§ I can provide reassurance and perspective to you, make suggestions to help labor progress, and help with relaxation, massage, positioning, and other techniques for comfort.
§ I will be on call for you 24 hours a day beginning two (2) weeks before your estimated due date (EDD) up until labor begins. This means that I will carry my handphone/pager with me at all times, and will not leave town without advising you unless it is an emergency or an event not known about at the time of this contract signing.
§ Once you have requested me to act as your doula, I will arrange an antenatal visit. During this visit I can discuss any questions you might have, sign our contract, and go over exactly what you want from me as your doula. I will discuss birth plan options, your personal information, when you will call me in labor, etc. Additional visits to cover childbirth education including physiology of labor, further breathing & relaxation, breastfeeding and are available.
§ The presence of a doula lifts the sole responsibility of the labor off the shoulders of your partner, allowing him to enjoy the whole birth process. I can help your partner to feel calm and informed, giving him 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.
§ I will provide birth plan information and consultation.
§ I will answer questions and make suggestions over the phone any time before labor begins.
§ I will provide early labor support as requested, including in your home.
§ I will remain with you once active labor has begun until one to two hours after your baby is born. I may take short beaks for meals and rest if time allows – this will be discussed with you at the time and I will not leave you if it is inappropriate.
§ I may utilise non-medical support techniques for labor and birth.
§ I will strive to maintain a calm and peaceful birth environment.
§ I will maintain a birth log as circumstances allow. This will then be given to you within 2 weeks of the birth of your baby.
§ I will 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. I will help to initiate the breastfeeding process, if that is what you choose to do. Please note, I am not a breastfeeding consultant, but will refer you to one if you would like. If you wish to bottle feed your baby, I will help you with the first feeding.
§ Within the first 5 days after the birth of your baby I will visit you at home or in the hospital. I will answer any questions or give you a referral to the appropriate professional that can meet your needs. Follow-up visits can then be arranged if desired.
§ All records are personal and confidential. I will not share these records with any other person without your express permission.
Your Obligations
§ You will complete a birth plan and discuss this with your caregiver.
§ You will tour your birth facility.
§ You will call me when you think you may be in labor, even if you are not sure, so that I may make arrangements to attend your birth.
§ You will allow me approximately one hour to reach you.
§ A deposit of $150 will be due at our second prenatal appointment. The remaining balance will be due two weeks before your estimated due date. Total cost of professional doula services is $550.00.
§ If you decide not to employ me as your doula after signing this contract, the following will apply:
ù Cancellation more than 4 weeks before your due date – 50% refund
ù Cancellation between 4 weeks and 2 weeks before your due date – 25% refund
ù Cancellation less than 2 weeks before your due date – nil refund
ù Cancellation of antenatal classes only – nil refund
§ If, after signing this contract, you plan to have an elective caesarean and do not require me to be with you immediately before and after the birth of your baby, an amended service is available. I will still provide full prenatal care and one postpartum visit. If you choose this amended package, a $400 refund will be given to you. You must advise me of your decision to have a planned caesarean at least 2 days before your estimated due date for this amended package to apply.
§ If you would like additional antenatal or postnatal visits, these are available as required. The cost for these is $85 per hour for visits made between 9am and 6pm on weekdays. For visits outside of these times, or on weekends or public holidays, the cost is $100 per hour. These visits are invoiced separately.
§ I will make every effort to provide the services described here.
§ In the case of a rapid birth or medical emergency, it may be impossible for me to provide these services.
§ If you contact me to advise that you are in labor in good time, but I do not attend your birth due to an error on my part, I will refund the total amount paid less the cost of any prenatal care already provided. If you are unable to contact me you are required to attempt to contact your backup doula, and leave a message for the primary doula.
§ If you fail to call me to advise that you are in labor, for whatever reason, you will not be due a refund of amounts paid. If there is a remaining balance outstanding, this will be due.
IMPORTANT - Emergency Delivery
§ In some circumstances, labor progresses more quickly than anticipated. If you call me to advise that your labor has progressed very quickly and delivery is imminent or your baby has been born unexpectedly at home, I will call an ambulance from the hospital you were planning to deliver at and arrange for you to be transferred to that hospital.
§ If your baby arrives unexpectedly at home with me present, you or your partner will be responsible for the delivery of your baby. After the birth, I can help you arrange transport by ambulance to the hospital. I am not responsible for delivering your baby or performing any clinical skills related to the delivery of your baby.
In signing this contract, you agree that I have discussed all the points herein and you understand and agree with them.
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Client's name
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Client's signature Date
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Doulas name
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¨ Deposit Received $
¨ Balance Received $
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