Birth Doula Contract

Birth Doula Contract

Birth Doula Contract for BEST Certified Doulas Form Preview
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I am excited to work with you and honored to be a part of your birth day. 
I am excited to work with you and honored to be a part of your birth day. 
Please fill out and sign this contract and I will be in touch to schedule your prenatal visits. .
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    We understand that the experiences of survivors may impact their pregnancy and birth experiences.  We are here to support you.
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    • I am registered for class.
    • I do not plan to attend a childbirth course.
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    My Obligations to You


    As a certified BEST Doula, I provide relational and non-judgemental support to families through pregnancy, birth and early postpartum with relational and non-judgemental support. My goal is for you to feel supported and cared for throughout our time together and for you to have a positive birth experience. At all times I will abide my Code of Ethics and Standards of Practice. As your doula I will:

    * maintain a network of community resources so I can provide referrals as needed

    * remain up to date on birth related research and issues

    * respect your privacy in all aspects of your pregnancy, birth and the postpartum period

    * support and involve your partner

    * meet with you prenatally to learn how to best support you through your birth

    * be available to you for support throughout your pregnancy via phone and email

    * help you form a birth plan to encourage communication between you and your care provider

    * be on call 24/7 from 38-42 weeks of your pregnancy

    * provide early labor support via phone

    * join you during labor at a mutually agreed upon time, or within two hours of your request

    * provide continuous labor support, with the exception of short breaks to meet personal needs

    * strive to maintain a calm and peaceful birth environment

    * remain with you after delivery for up to two hours and help with the initiation of breastfeeding


    Should either a scheduled cesarean birth, or cesarean birth following labor, be necessary I will come to the hospital to provide support before, during and after delivery. I am prepared and trained to accompany you in the OR, should your birth place and health care providers permit.

    I will visit you at an agreed upon time approximately two weeks after the birth of your baby. Further postpartum visits may be scheduled for an additional fee. At the postpartum visit I will:


    * review and help process the joyful and/or difficult moments from your birth

    * assist with breastfeeding

    * make referrals and address any postpartum concerns


    Your Obligations


    In order to help you have the best birth experience, I ask that you and your partner do the following:


    * Complete a childbirth education course and discuss your birth plan with me.

    * Be responsible for your personal health for a healthier pregnancy and better birth experience.

    * Tour your chosen birth place.

    * Call me when you are in labor and allow me approximately two hours to reach you.

    * Disclose any communicable illnesses you may have so that I may take precautions.

    As a doula, I do not:

    1. Perform clinical tasks including vaginal exams, or assessment of maternal or fetal wellbeing.


    2. Make decisions for you. I will help you gather information necessary to make an informed decision, and I will offer myself as a sounding board rather than give opinions.


    3. Speak to the staff on your behalf. I will discuss your concerns with you and suggest options, but you and your partner will speak directly to the clinical staff about your care.


    4. Assist in the delivery of a baby, with or without a health care provider present. If your baby arrives unexpectedly at home with me present, you or your partner will be responsible for the delivery of your baby. Neither I nor BEST Doula Training will be held liable for not providing clinical services.


    Limitation of Liability.

    Client agrees to indemnify, defend and hold ________________________ harmless from all claims, losses, judgments, damages, expenses and costs (including, without limitation, attorneys’ fees and court costs), whether fixed or contingent, and whether or not adjudicated, arising from or in any way related to: (a) the breach of any of its obligations hereunder; (b) damage to real or tangible personal property of client or any third party as a result of the fault of the client and not due to the fault of ________________________ (c) bodily injury to any party caused by client and not caused by ________________________; (d) any breach of representations or warranties regarding services of ________________________ made by clients or any other third party; (e) payment of services owed to birthing facility (f) any unauthorized act or omission of the doulas; and (g) the negligence, recklessness or willful misconduct of ________________________ (h) the aforementioned exceptions of services, including but not limited to, medical monitoring, medical decisions, medical opinion, treatment options, physical services, and medical services.

    Fees


    A non-refundable deposit of half my fee of _______ will be due upon the signing of this contract. The remaining balance will be due by the 37 week point in your pregnancy.

    If circumstances are such that I cannot attend your birth, I will provide a qualified backup and I will be responsible for payment of her services. She will provide the services outlined in this contract. In the event of extraordinary circumstance or I have been with you for 18+ hours, I may request a backup doula to relieve me.


    My fee reserves your place in my calendar. Fees are non-refundable. In the event you fail to call me to advise you are in labor, if you have a rapid birth that I am not in attendance for, or if I am unable to attend your birth due to the policies of your birth place, I will provide a postpartum visit per our contract. Fees are not adjusted for length of time in labor or birth.

    Should fees not be paid in full as directed above, it is solely at my discretion to provide labor and birth support, unless other arrangements have been made.

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