Doula Contract

What is a Doula?
A doula is a Greek word meaning "woman's servant."
A doula's role is to provide physical, emotional, and informational
support to women and their partners during pregnancy, labor and
delivery. The doula offers help and advice on comfort measures such
as breathing, relaxation, movement and positioning. She also
assists families to gather information about the course of their labor
and their options. Perhaps the most crucial role of the doula is
providing continuous emotional reassurance and comfort. Imagine if
you could take your childbirth educator with you to your birth - that
is what is like to have a birth doula! When you hire me, I work for
you independently, and am there to assist you in your own personal
birth vision. As a doula, I assist birthing parents in finding the
information they feel they need to make their own informed
decisions and I am supportive of those. A birth doula does not press
her views onto her client, but helps to assist the woman and her
partner to birth in the way they chose. Doulas and partners work
together to support the laboring woman. Many fathers say that
having a doula allowed them to help their partner in a more
confident hands-on manner, as well as being able to better
experience the birth themselves.
AS A DOULA, I DO NOT:

Perform clinical tasks, such as blood pressure checks,

monitoring fetal heart tones, vaginal exams and others
medical procedures. I am there to provide physical comfort and
emotional support, not as a medical professional.
Make decisions for you.
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.
As a Doula I will not prescribe, diagnose or treat any medical
problems that may arise and will not be liable for interpreting
diagnostic procedures. This is the role of your provider.
Attend an unassisted birth. I attend homebirths attended by
CNMs in NC or CNM and CPM in VA.

Client's printed name___________________________________________________

Client's signature
_______________________________________________________

After you have decided that my services are right for you I will
provide comprehensive services including the following:

One - two prenatal visits to discuss your history and

expectations of birth as well as options in childbirth and go
through (depending on the time in your pregnancy I am hired,
depending on our collective schedules)
Birth plan assistance - We will discuss the risks and benefits of
many routine interventions and help you create a birth plan
that's right for you and your family (I ask you research every
option even if it is not favorable so you are informed and have
no regrets!)
Articles and handouts related to pregnancy, birth, and beyond
Unlimited email, phone and text availability
24/7 on call availability for your labor and birth, from two
weeks before through two weeks after your "guess" date
Continuous labor support from the time that active labor is
established until your baby is born - This may include but are
not limited to - suggestions for coping with pain and
recommending positions that aide labor progress.
After the birth I will stay until breastfeeding has been
established and your family has started to bond
1- 2 postpartum visit to review our experiences of the birth,
provide breastfeeding support, and answer questions (if you
are having a hard time do NOT hesitate to give me a call)
The cost for the above services is $400; I require $150 to secure my
services, with the
balance due two weeks before your due date.
There is no charge for the initial interview.
Your insurance company may cover the cost of a doula; please
contact them directly.
If you live outside my home area there is a $50 travel fee added.
I offer discounts to teen moms, single moms, military and more.
Additional services (upon request):

Childbirth Class attendance - If you are attending an out of

hospital childbirth class (which I do highly recommend) or in

hospital, I am available to attend those classes with you and

your partner if you so choose. I feel it helps in our bonding
process and really helps put us on the same page for the day
to come. also should your partner be unable to attend a class
with you, I may be able to fill in for him/her
One or more doctor appointment visits, so I can get to know
your care provider
Birth Videography/Photography - I will take pictures of your
labor and birth, either with your camera or my digital camera
and/or video camera. After the birth you will be able to access
the photos via a password protected page on this website.
Birth Announcement - As soon as possible after the birth I can
send an email to your friends and family with a picture of the
new baby and family and any information that you would like
to include
Birth story - A written account of your labor and baby's birth
which I will present to you during a postpartum visit
Access to my lending library from my own collection of birth
videos and pregnancy, birth, breastfeeding, and parenting
books - (Deposit may be required)
Labor Coach Training for Father to be
Private Birth Classes
Please let me know if there is anything I may help you with that is
not offered here. Payment plans, bartering, and discounts are
available. I would rather work something out with you than have
you go without a doula.
Cesarean Section may not be a surgery that we anticipate happening at
the time of hire.
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 in the recovery area or in your
postpartum room to provide emotional and breastfeeding support after the
birth.

Important - Emergency Delivery

In some circumstances, labor progresses more quickly than anticipated.
Please call me if your labor has progressed very quickly and delivery is
imminent or your baby has been born unexpectedly at home, if you want I
will call an ambulance from the hospital you were planning to deliver at and
arrange for you to be transferred to that hospital. I will call 911 if you request

that also. 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. This does NOT mean that I would
not gladly help you should the need arrive (I will be on the phone with 911
the whole time).
***In the event of a marathon labor (12+ hours), I may leave for a short while to refresh
myself (grab a bite to eat, a shower, or a short nap) so that I may provide you with the best
care possible, but I will have my cell phone with me at all times.***

Client's printed name___________________________________________________

Client's signature
_______________________________________________________

Refunds: $400.00 will only be refunded if I am unable to make it to

your delivery due to a fault of my own and an unable to provide you care
prenatally and postpartum. However, you must allow me at least one hour
of travel time (more if you live more than an hour away from me) so please
alert me immediately if you believe that you are in labor. If I am unable to
make it to your birth through a fault of my own but have provided care
prenatally and postpartum I will refund you $200.00 for missing the birth.
This refund will not be given if I have arranged to have a backup doula to
attend your birth, as I will be paying the backup doula $200.00 for her time
with you at your birth or for putting her on call. Refunds will not be given
in the event of a c-section, if you refuse my backup doula, or if you did not
contact me in time to alert me of your impending birth.I do not stack
discount or add discounts to bartering. For reduced fees, only money paid
above my $250.00 deposit will be returned. If I am attending your birth free,
please consider (if possible) offering reimbursement for gas or coming closer
to my location for our meetings.
Please Note: I work for the women in labor. Not the husband, partner,
parents (or step parents) of the women in labor, dad of child, or person who
pays me. I work for the MOM (woman in labor). Her wishes come before all!
In cases of discount, client hardship or financial difficulty, I Caitlyn V. Eubank,
do hereby agree to provide the aforementioned services to the above client

for a reduced fee of: $

without sacrificing any quality of services to my client.
Client's printed name
Client's signature
Partner's printed name
Partner's signature
Address
Phone Numbers
E-mail
Estimated Due Date(S)
ultra sound?
Doula signature
Phone

by LMP dates or