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Birth Services Agreement

As a Birth Doula it is my role to accompany women in labor to help assist them with a safe and satisfying birthing experience as they define it. I will draw upon my knowledge and experience to provide emotional support, physical comfort and the information you need to make informed decisions as they arise prenatally and in labor. 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 will support you to my fullest in facilitating the kind of birth you have envisioned for yourself and your family. I am independently self-employed. As your doula, I work for you, not your caregiver or hospital.

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Scope of Practice

As a birth doula I am not trained or authorized to perform the following:

  • Perform clinical tasks such as blood pressure, fetal heart check, vaginal exams, or other medical procedures.

  • Provide dosages or advice concerning prescription or alternative medication, or give medical advice pertaining to you or your baby.

  • Make decisions for you. I will help you get the information necessary to make an informed decision. I can remind you if there is a departure from your birth preference list.

  • Speak to staff on your behalf. I will discuss your concerns with you and suggest options, but you or your partner will speak on your behalf to the clinical staff.

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Childbirth Education

Because I cannot adequately explain the entire scope of the physiology and process of labor and birth, hospital/birthing center/homebirth procedures, medical interventions, comfort measures, coping techniques, breastfeeding, newborn care, etc., in one appointment. I offer childbirth education classes as an additional service (either private or in a group setting) or package upgrade. Participation in this class is not mandatory but highly recommended.

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Before Labor

I am available for phone and email consultations immediately from the date that the signed contract is returned to me and receipt of payment of the retainer fee is confirmed. I encourage you to contact me with questions, concerns, and any updates. I will get back to you as soon as I can. If your question is of an urgent nature please call me.


I also ask that you inform me of and about your meetings with your Midwife/Doctor to discuss any appointments and if you have any concerns, so that I am up to date with all relevant details throughout the pregnancy. It is important that we keep in contact with one another and communicate in the best way we can by keeping the channel of communication open and constant.

You, your spouse, and I will meet for a prenatal meeting (around 36 weeks) to become acquainted with each other; discuss your priorities and any fears or concerns; discuss your birth plans; discuss signs or labor; discuss when to call your doula; and plan how we might best work together. We may also decide on other meetings and will remain in touch by telephone and/or e-mail communication. 

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During Labor

During our prenatal meeting I will give you specific instructions on what to look out for and when to call if you think you are in labor. In most cases I will initially offer virtual support (call / text / video support) where I can answer questions and make suggestions over the phone, and we can decide if I should come to you then, or wait for further change. I will make every attempt to make it to you within one hour of you requesting my presence. 

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Once you confirm that you are in labor, we will then plan to check in with one another every hour, or as often as you prefer, by phone. It is up to you to decide and make known at what point in your labor you want me to come and be with you. Please understand that the sooner you call me to come (if you are not in active labor), the higher chance you may start feeling pressured to perform and the more likely it is your labor could slow down. Like the old saying goes- a watched pot never boils. The closer to active labor you are, the less likely this is to happen. You are my client, and I will come when you need me; however, active labor is preferred to prevent this for you.

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Inductions
When induced, I will make every effort to join you as soon as you need me. However, depending on your medical team's induction methods, this process can take hours to days to start. I will be available via  phone/text for all the support you may need and to help calm down any butterflies you may have. Please remember, being induced means forcing your body to do something it is not ready to do. I will join you when you are in ACTIVE labor and when your body is making changes on its own.

  • Example

    •  If you get a foley bulb, the bulb will be inserted and typically comes out when you are 4cm dilated. What does this mean? This means that you are 4cm because the bulb made you 4cm. You can be there for several hours until your body catches up. If you were 4cm 70% effaced -2 station when the foley comes out, chances are you will still be there at your next check. I will recommend things for you and your partner to do to get things moving and to actually put you into labor. At the next check if are you 5cm, 80% effaced -1 station, that means your body is making changes an recognizes that you are in active labor, and I will head to join you.

  • I will make every effort to join you when you need me; however, being induced does not mean you are in labor just yet. We can discuss more at your prenatal meeting if this is decided.

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Length of Labor

You and I both hope for a birth that lasts a reasonable amount of time. If you are lucky enough to have a very short labor, everyone ‘wins’ and if you have a very long labor, rest assured you will be supported at no additional fee. Unlike some doulas- I do not charge an hourly fee for labors that are extra long.

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After 18 hours of in person care, or under needed circumstances, I do reserve the right to switch out with an available backup doula in order for me to rest, look after personal matters, and return to you fit to continue support when possible. This is at my discretion and dependent on a multitude of factors: estimated time left until birth; time of day, weather, how I am feeling physically, etc. There is no additional charge for this, I will pay the back-up doula from my original fee collected for supporting your birth.

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After the Birth 

After your birth I will remain with you for about 1-2 hours or until you are comfortable and your family is ready for quiet time together. During that time I will help initiate breastfeeding (if chosen) and encourage family bonding. I will be available for phone contact after the initial postpartum period to answer any questions concerning baby care and breastfeeding. When you are ready, you can schedule a follow up virtual visit 7-10 days after the birth, to discuss how you are doing and review the birth and answer any questions you may have.

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Refund Policy

The fee for doula services covers the prenatal visits, on call time, limiting the number of additional clients, labor hours, etc. I will make every effort to personally provide the services described here. In the event of my personal illness or an unexpected emergency, I will send a backup doula to cover my place. There will be no additional charge or refund in this situation. If there is a failure to attend your birth due to an error on your part (failing to call, sending text messages between 9:00pm-7:00am for example) no refund will be granted. 

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If you decide against having a doula up to 36 weeks, you will not be required to pay the remaining amount; however, the retainer fee will not be refunded. If your child is born before 36 weeks and for unforeseen reasons, I am unable to attend the birth, the remaining funds will not be owed; however, the retaining fee will not be refunded. 

 

Occasionally the are are situations that will require a scheduled cesarean (i.e. breech baby, etc.). Refunds are not granted when this occurs. Families requiring cesarean still greatly benefit from the support of a doula. Please read more under Cesarean Births Section. 

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Release of Liability

As the express condition of my performance of services under this agreement, you agree, on your own behalf and on behalf of all persons or entities you may bind under Maryland law, to waive and hereby do waive any rights, claims or causes of action that you may have against your doula now and in the future with respect to your pregnancy, birth, postpartum period or the services your doula may provide and/or fail to provide to you. You expressly understand that, as doulas, we are not medical professionals and therefore cannot and will not provide you with medical care or advice.

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Disclosure of Communicable Diseases:

You agree to disclose any communicable diseases that you have so that your doula can take appropriate precautions.

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© 2023 by Doula Justine

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