Letter of Agreement Describing Labor Support Services, Limitations, and Fees

As a Doula, I accompany women in labor to help ensure a safe and satisfying birth experience. I draw upon my knowledge and experience to provide emotional support, physical comfort and communication with your health care provider to ensure you have the information needed to make informed decisions 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 am independently self-employed. As your doula, I am working for you, not your care giver or hospital/birth center.

Choosing a Doula I prefer to meet with you and your partner at least once before labor to become acquainted, to explore and discuss your priorities or concerns, and to plan how we might best work together. At that time, we can discuss fees. This initial meeting does not obligate you to use my services.

If you choose to select me as your doula, I will want to become familiar with your plans for labor, birth and postpartum. I will also want to know your own best ways of coping with pain and fatigue and how you and your partner foresee working together. I will also inform you of times that I am not available for labor support and will do my best to ensure my availability for your labor and birth. We may also decide on other meetings and will certainly want to remain in touch by telephone.

As a doula, I do not perform clinical tasks, such as blood pressures, fetal assessments, vaginal exams, etc. I am present to provide for your physical comfort, emotional support and advocacy. I won’t make decisions for you. I will help you get the information necessary to make an informed decision.

When you are in labor, I prefer that you call me when you think you are in labor, even if you do not yet need me. I can answer questions and make suggestions over the phone. We will decide at this time whether I should come to your home right then or wait for further change. I usually need at least thirty minutes to an hour to get to you from the time you request my presence. Except for extraordinary circumstances, I will remain with you throughout your labor and birth.

After birth, I usually remain with you for one to two hours, unless you are comfortable and your family is ready for private time together. I can also assist you with breastfeeding, if necessary. I am available for phone contact to answer any questions you may have. I would like to meet one last time within one two weeks following your birth to see how you are doing, to review the birth, to admire your baby, and to get feedback from you about my role.

If I am unable to attend your birth, there will be no charge for my services and I will refund the retaining fee. I will make every effort to provide the services described here. Sometimes, this is impossible (ie, a rapid labor and birth). If I am not called, the retaining fee will be kept but there will be no further charges.

My fees for these services as described is $______ is due within two weeks of your estimated due date, unless special arrangements are made in advance.

I/we have read this letter of agreement describing the doula’s services and agree it reflects the discussion we had with her.

Mother______________    Partner________________

Doula_______________    Date_________________