Birth Doula Support Contract
Submission of this form constitutes my agreement to the terms of this contract.
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Doulas are non-medical support people who accompany women and their families during their labor and birth to help ensure a safe and satisfying birth experience. As your doulas, we will draw on our knowledge and experience with birth to provide emotional support, physical comfort, and the information you need to make informed decisions as they arise in your labor. We can provide reassurance and perspective to you and your partner, make suggestions for labor progress, promote a peaceful environment, and help with relaxation, massage, positioning, and other comfort techniques. As independent and self-employed doulas, we work for you, not your caregiver or hospital, and are therefore an advocate only for you and your growing family.
On Call: We are on call between 38 and 42 weeks of your pregnancy. This range may change depending on other circumstances (multiples, prior birth history). During this time frame, at least one of us will be available and accessible 24 hours a day to be there to support you. If your baby comes before or after then, we will, of course, be there for you though it may take longer for us to join you.

Other Clients: When we are on call for you, we have a “line” on our calendar. When both of us are available for doula work, we will never go beyond five lines deep. If only one of us is available, we will never go beyond three lines deep. By limiting the number of clients we accept, we ensure that we will be there for you during your birth.

Windows of Unavailability: In the unusual circumstance that both Ellen and Melissa are unavailable during a period of time, we will communicate that with you in advance and make arrangements for you to have support in our absence.
Consultation: We meet with you and your partner for a free prenatal consultation to become acquainted, to explore and discuss your priorities and any concerns, and to plan how we all might best work together. This meeting does not obligate you to use our service.

Visits: We meet with you for at least one prenatal visit so that we may become familiar with your birth plan and your preferences regarding comfort measures and the use of medications. We want to know your own best ways of coping with discomfort and fatigue and how you and your partner foresee working together and with us. It is also important at this visit to review how you plan to make decisions during birth, especially if there is a deviation from your birth plan, and what your expectations are of us as a resource in your decision making process. We are happy to meet with you for a second prenatal visit if you feel this is beneficial to you; this is also a time to redeem a premium service (see below). One of these visits usually occurs in your home, the other in our office space at VAST Wellness Center; they typically last for one hour. It is your responsibility to schedule them. We make every effort to have both Ellen and Melissa attend these meetings though circumstances may only allow one of us.

Communication: We request communication via phone, text, or email after prenatal visits with your care provider to give us the opportunity to discuss anything that may impact your birth.
Classes: In our packages that include prenatal classes, our schedule is posted on our website ( If you cannot make it to a scheduled class and require a private class, an additional investment may be required.

Library: You are welcome to borrow from our extensive lending library. Books and videos are due back within 2 months of birth so that other clients may have access to them. It is your responsibility to replace lost materials.

Premium Services: Every package includes at least one premium service. These are to be included in prenatal or postpartum visits when possible. They are transferable. They expire one year after your estimated due date.
Birth Tools: We offer our clients use of an obstetric TENS unit, therapeutic grade essential oils, and Bach Flowers during your birth. If you would like to use any or all of these tools, we will provide you with a letter of intent to have your care provider sign prenatally. It is your responsibility to discuss these tools with your care provider before birth so that they are informed of your plans to use them. We also bring other specialized tools that will be available during your birth to help with comfort and progress.

The Start of Labor: Please call us anytime when you think you are in labor or when your waters break, even if you do not need us yet. We can decide at this time when and where one of us should join you. We can generally join you within two hours from the time you ask us to come (this time may increase if you live more than 25 miles from our home addresses or the drive occurs during rush hours). After your initial contact or while you are waiting for one of us to arrive, we are available by phone to offer support and answer any questions. Please review “When to Call Your Doulas” for more details.

Recording Your Birth: If you would like, we would be happy to provide you with a written birth story. This can be kept as a memory in your baby book or other album/scrapbook, or to use as a resource in writing your own birth story. If you desire, we would be happy to take pictures with your camera or ours as the situation allows.

Cesarean Births: In the case of a planned cesarean, one of us will join you at your home or the hospital, remain with you, and support you based on your preference as expressed in our prenatal visit(s). For any cesarean birth, it is up to the care provider and anesthesiologist to decide if a doula is allowed in the operating room with you along with your partner. If only one support person is permitted, sometimes the doula is allowed back when your partner leaves with your baby. It is up to you to discuss your needs and preferences with your medical support team.

Epidural Administration: Some anesthesiologists only allow one support person in the room while administering an epidural. If you chose to use this tool, we may be asked to leave the room.

Backup Doulas: One of the greatest advantages to working with a doula team is that back up doulas are very rarely called in. In the case of a long birth we will call on each other so that you will have a rested doula. In the unusual situation where neither Ellen nor Melissa can be with you, we will arrange care from another competent and compassionate doula. We have access to a network of local doulas we can draw from for backup in case of a planned or emergency unavailability.

Breaks: During your birth, we may take breaks to attend to personal needs. We will take these breaks when they will have minimal impact on your birth. Breaks are about twenty minutes every four to five hours as needed and as circumstances allow.

After Birth: We will remain with you after the birth until you are comfortable and your family is ready for some quiet time together. This is usually about two hours, but may be shorter or longer depending on the circumstances of your birth. During this time, we may get you food and drink, assist with breastfeeding, take pictures, answer any immediate questions, or fill other needs you might have.
Visits: We will come and visit you at your birth place within 48 hours after you birth and again in your home within the first three weeks. We will answer any questions about your birth, admire your baby, make sure you are doing well, and provide you with any information and resources to help you grow as a family. It is your responsibility to schedule the second postpartum visit which should take an hour. As with prenatal visits, we make every effort to have both Ellen and Melissa attend these meetings though circumstances may only allow one of us.

Distance Support: After your baby is born, we are still happy to provide information and resources via phone, text, or email to help you have a peaceful postpartum and parenting career.
Limitations of Service
As doulas we do not:
~ Perform clinical tasks, such as monitoring your blood pressure, checking fetal heart rate, performing vaginal exams, make diagnoses, etc. We are there to provide only physical comfort, emotional support, and information. Our role is strictly non-medical birth support. Therefore, professionally and personally we assume no responsibility for the outcome of your birth.
~ Make decisions for you. We will help you get the information necessary for you to make an informed decision that is best for your family. We will help to clarify your options and support the decisions you make in consultation with your care provider for your birth.
~ Speak to the staff instead of you regarding matters where decisions are being made. We will discuss your concerns with you and suggest options, we will ask you pertinent questions so that you do not have to remember all the “right questions” to ask, but you or your partner will speak on your own behalf to your care providers.
Investment Policy
Retainer: A retainer of 50% of the investment is due upon contract signing. This retainer is nonrefundable; it covers prenatal and postpartum visits, our costs, on call service, and the time on our calendar.

Remainder: The remainder of the investment is due by 37 weeks pregnancy.

Private Class: If your package includes prenatal classes and you are unable to attend a scheduled group class, an additional private class investment of $60 for 6 weeks or $100 for 10 weeks may be included.

Legal proceedings: If we become involved in any way in a legal proceeding as a result of this service, you agree to pay all our expenses, including but not limited to travel, attorney fees, and lost business.
Refund Policy
The remainder of the fee may be refunded to you if we or our back-up are unable to attend your birth due to circumstances within our control. Refunds are not provided under the following circumstances:
~ Client does not contact us in a timely manner.
~ Acts of God.
~ Precipitous birth (two hours or less) that does not allow us sufficient time to attend the birth.
~ Client chooses not to have us in attendance.
Client Signature
Package *
Client Name (Digital Signature) *
Date of Signature *
Estimated Due Date *
Email *
Additional Notes (Subject to Approval by Balanced Birth Services)
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