Doula Services Agreement

Doula Services Agreement

This agreement is made on {date} between {Client Name}, hereafter “Client,” and {Doula}, hereafter “Doula”:

The Doula represents {Doula Service}, a company which provides non-medical support to birthing people during pregnancy and delivery.

The Doula will provide:

• {Number} of prenatal meetings {in-home/at facility}, lasting roughly {amount of time}. These meetings will cover contact plans, laboring and delivery preferences, comfort and care, rituals and coping mechanisms, location, and Client questions.
• Help with crafting a birth plan/birth preferences.
• Availability via {phone/text/email} between the hours of {hour} and {hour} between the signing of this contract and {pregnancy week} for answering questions or giving advice.
• Availability via phone, text, or email at any time of day from {pregnancy week} onward should labor begin or the Client have any questions or concerns.
• Emotional and informational support, guidance, massage, positioning help, ambiance creation, birth photography, and non-medical advice during labor at home, a birthing center or hospital, or both.
• Advocacy for the Client to medical staff if required or requested by the Client.
• Transportation to a medical facility, if needed.
• An emergency replacement in the highly unlikely circumstances that the Doula is unable to provide these services as requested.
• One postpartum meeting {in-home/at facility} within {number of weeks} of delivery for follow-up emotional and informational support, lasting roughly {amount of time}.
• The Doula {does/does not} offer newborn doula services (night care for baby, light cleaning/cooking, etc.) for additional fees.
• The Doula {does/does not} offer cord banking or placentophagy for additional fees.

The Doula will NOT provide:

• Medical advice.
• Medical services such as vaginal exams, fetal heart rate checks, blood pressure checks, etc.
• Medical decisions. The Doula will make no decisions for the Client but will advocate for the Client’s choices.
• Delivery. In the event of rapid labor or emergency delivery, the Doula will provide transportation or call emergency services as needed but will not deliver the baby. They will make every effort to make the Client comfortable and safe as outlined by the Good Samaritan Law.

The Client Agrees to the following:

• The Client will provide the Doula with any necessary information about the Client’s health, risks, allergies, and the important details of the pregnancy.
• The Client will provide the Doula with contact information for the Client’s doctor/midwife, clinic, hospital, birth center, and home.
• The Client will not ask the Doula to perform any tasks outside of the scope of this contract.
• The Client will treat the Doula with respect and not subject them to verbal or physical abuse.

The Client will pay {amount} for the Doula services outlined in this contract in {one lump sum, installments of $} by {date(s)}.

The Doula will provide a discount or refund for {planned caesarean/emergency caesarean/rapid labor, pregnancy loss, failure to contact the Doula, hospital restrictions that exclude the Doula, emergency outside of anyone’s control, family interference, the Client chooses not to continue services, the Client moves out of the area, the Doula fails to provide the services outlined in this contract}.

The Doula will NOT provide a discount or refund for {planned caesarean/emergency caesarean/rapid labor, pregnancy loss, failure to contact the Doula, hospital restrictions that exclude the Doula, emergency outside of anyone’s control, family interference, the Client chooses not to continue services, the Client moves out of the area, the Doula fails to provide the services outlined in this contract}.

Client agrees to indemnify and hold harmless the Doula from and against any and all liabilities arising out of or resulting from the Client’s gross negligence or willful misconduct.

____________________________________

Client, signature & date

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Doula, signature & date

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