My Contract

(This contract is an identical copy of the one you will be asked to sign when you decide to use me as your doula, feel free to print it, but when we meet I will have a copy for each of us.)

Your Cherished Birth Contract for Doula Services

Serving Doula: Samantha Mehaffey                 Back-up Doula:

Before Labor.       I will meet with you and your partner at least one, preferably three times to get to know you, your hopes, fears and concerns regarding the birth of your child, and to assist you in the preparation of your birth plan.  We will discover together the ways that you hope I can assist in your birthing experience, and what role your partner hopes to play in the birth of your baby.  We will also strive to discover the methods you already have in coping with pain and fatigue.  I will inform you of times I am unavailible, and who my back-up will be at those times, you are free to meet with my back-up doula at your convience. Phone or e-mail contact for emotional or informational support will be provided to you as needed or desired.  You will be given a reliable way of reaching me and a few back-up phone numbers if for any reason you can not reach me by my primary number, this is just a precausion and you should feel comfortable in being able to reach me at any time once I am on-call for you.  I consider myself “on-call”  two weeks before your estimated due date and will continue to be on-call for two weeks after your estimated due date.

During Labor.       It is your responsibility to call me as soon as you believe labor is starting, this will enable me to be sure that when you are in need of my assistance I can get to you as quickly as possible.  By establishing early phone contact I am also availible to answer any questions you may have about your labor, and discuss where and when we should meet.  You are free to change this destination if needed, but you must give me appropriate warning of those changes, I will need at least one hour from the time that you call to arrive at your labor.

Once I have arrived at your birth center, home, or hospital I will remain with you, using my resources, and training to provide you with comfort measures during labor.  I will help your partner by offering breaks, reassurances, suggestions and information that we discussed in previous meetings.  I will help the communication between your care provider and yourself by reminding both of you of the prepared birth plan and explaining medical proceedures when and if needed, and encourage you to ask the ‘right’ questions when more information is needed before making decisions.

If for any reason I am unable to attend your birth I will inform you of this and arrange for my back-up doula to meet you at our agreed upon location, and pass along any helpful information that she may need, including how the two of you can contact each other.

After Birth.           I will attend to your needs for approximately 1-2 hours after the birth of your baby.  During this time I will take pictures of your new family (if requested), answer questions about what is happening with you or your baby (as you are delivering the placenta, and if baby is not in your arms), help you to establish breastfeeding if you feel it would be helpful, and quietly pack up my things once everyone is ready to settle in and have some quiet time together.

I will contact you by phone approximately 3 days after the birth of your baby to arrange a time to meet for your first post-partum visit.  During this time I am of course availible to answer questions that you may have in regards to how you are feeling, or the care of your baby.  I will meet you at least once, but I’m availible for two post partum visits, during which we will review your birth experience, clarify any events or areas of your birth that you are unsure of.  I will also at this time answer any questions regarding your baby, and ask for your feedback on my preformance as your doula.

As a Doula I do not:             Perform any clinical tasks (including but not limited to, blood pressure checks, vaginal exams, fetal heart rate).  I am there to provide elements of physical comfort, and emotional support.

I will not make decisions for you regarding your care.  I can and will help you to get the information you need to make an informed decision and will remind you if there is a departure from your birthplan.

I will not speak to staff on your behalf, I will discuss concerns with you, but you or your partner will be the ones to discuss the options with your care provider, not me.

Fees.      The total fees for the services listed above amount to $500.00.  From the moment that you sign this contract I will limit my acceptance of other clients near your due date so as to give you my full and undivided attention and assure you that there will be minimal chance of my need of calling a back-up doula to attend your birth.  Therefore the following fee schedule must be followed if not paid in full at the time of your signing this contract.

Fee Schedule        $275.00 is non-refundable and due at the signing of this contract

$275.00 is due at your 3rd prenatal visit or two weeks before your due date (which ever comes first)

I will make every effort to attend your birth, and provide the services listed above.  Unfortunately sometimes it is impossible (for example with rapid labor).  If my failure to attend your birth (or send a back-up in my place) is due to my own error the second payment of $275.00 will be returned to you, however if it is due to circumstances beyond anyone’s control, or your failure to call me, then I will keep the full amount and no refund will be given.

I/we understand that Samantha Mehaffey is a labor support specialist trained to assist with the physical and emotional demands of labor and childbirth.  I/We also recognize that childbirth is a natural unpredictable process and may not go as I/we hope or plan: in this arena I/we understand that a doula will act with resonable care for the mother and baby’s well being, but will not be able to alter the course of labor or its outcomes.  I have read and fully understand this form describing the services of Your Cherished Birth and agree that it reflects the discussion we have had with our doula.  In signing this contract we agree to retain her as our doula and pay the fees required.

_____________________________________             ____________________________

Client                                                                                                                                  Date

____________________________________                ____________________________

Client’s Partner                                                                                                            Date

____________________________________                 ____________________________

Doula                                                                                                                              Date


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