The following agreement is hereby entered into between hOMe holistic doulas, referred to as “I” or “we” and the client enter above referred to as “you,” with the following conditions understood and accepted by both parties.

As your birth doulas, hOMe holistic is a doula collective and although we are all on call for you, one of us will be assigned to birth with you and one doula from our team will attend your birth. Doulas provide emotional and physical support to mothers and their partner and/or family during pregnancy, labor, birth and postpartum. We can also facilitate communication with your care provider to ensure that you have the information you need to make informed decisions regarding your birth. We can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, massage, acupressure, positioning and other techniques for your comfort.

Before Birth:

We will meet with you and your partner before labor to become acquainted with you; discuss your priorities and any fears or concerns; present evidence-based information on the risks and benefits of common interventions and procedures used during childbirth; discuss your birth plans; and plan how we might best work together. We offer a “Meet the Doulas” twice monthly and you and your partner are welcome to come more than once, we offer a bi-monthly Date Night with your Doulas for current doula clients and their partners, and we will always have a final meeting around 36 weeks…. We are on call 24/7 for your birth and 9 am-8pm for pregnancy questions and support. Please reserve the overnight texts and calls for labor only.

During Labor:

We ask that you group text us when you think you are in labor, even if you do not yet need our support. We can answer questions and make suggestions over the phone, and we can decide if we should come to you then or wait for further change. We can meet you at your home or your planned place of birth or at the studio if needed. We usually need approximately 30 minutes to get to you from the time you ask us to come. Once you call/text us and let us know you’d like us to begin supporting you, we will make every effort to be there immediately. Except for extraordinary circumstances, we will remain with you throughout your labor and birth.

Belly Births/Cesarean Section Births. Your doula regularly attends c-sections and will provide support during that process as long as hospital/provider allows us to attend. When we are not “allowed” in the operating room for your birth, we will either stay in the recovery room and provide pictures and postpartum support when you return or come upon your request later.

Long or short labor: The fee for doula services covers the prenatal visits, on call time, limiting the number of clients we take monthly. You and your doula are both hoping for a birth that lasts a reasonable amount of time. If you are lucky enough to have a very short labor, everyone ‘wins’ and if you have a very long labor, your doula will be there for as long as you need her to be and not charge you any more money.

After Birth:

Circumstances permitting, we will remain with you for one to two hours after the birth and longer if needed. We are available to answer questions about the birth and/or your baby, (we will schedule a postpartum meeting within a few days of the birth to visit you and the baby, this is optional and the doula attending your birth is who will do a postpartum visit) additional postpartum visits can be scheduled for an additional fee.

As doulas, we do not:

1. Perform clinical tasks, such as taking blood pressure, fetal heart checks or vaginal exams. We are there to provide only physical comfort and emotional support and facilitate communication between you, medical staff, and care providers.

2. Make decisions for you. We will help you get the information you need to make an informed decision.

3. Speak to medical staff or providers on your behalf. We will discuss your concerns with you and suggest options, as well as encourage you and your partner to voice your opinions, questions and concerns to the staff.

4. Provide medical advice. We can direct you to resources that might help you answer your questions and make informed decisions on your own. If you have questions or want advice about your care or that of your baby, you should contact your care provider.

Extenuating Circumstances:

While it is always smart and helpful to have a plan, births do not always go according to plan. If you plan a vaginal delivery and a cesarean is performed after labor has already started, We will continue to provide support during the cesarean surgery (as allowed by hospital and/or doctor policies) as well as immediately after to help with your comfort and breastfeeding. We will also follow-up with you after the birth. Our full fee would apply. If you and your doctor decide that a planned cesarean is necessary (that is, a cesarean done before your due date and/or before the onset of labor), We will provide support during the cesarean (as allowed by hospital and/or doctor policies) and immediately after, as well as the additional follow up for the full fee. If you are having a birth center or home birth and need a transfer to the hospital, we will accompany you and continue to provide doula support there, if wanted. We cannot under any circumstances attend a planned home birth without a midwife or other care provider present. In the event of a precipitous birth in a location other than your planned birth place (such as home or a vehicle) when a care provider is not present, we will provide emotional and physical support as outlined above.

Failure to Provide Services:

We will make every effort to provide the services described here. If failure to attend your birth is due to our error, we will offer additional postpartum services or yoga classes in lieu of monetary reimbursement. If failure to attend your birth is due to an error on your part (failing to call us, for example) we will retain the full amount paid and continue services to completion. If we are not allowed to attend your birth due to hospital/provider policies, we will offer additional yoga classes. If failure to attend your birth is due to a rapid labor (baby is born less than one hour after you text/call and ask us to come), we will offer an additional postpartum visit for support at no additional cost once you leave the hospital or birth center. This can include assistance with breastfeeding, laundry, cleaning, baby care, etc. Our full fee applies. I reserve the right to call in a backup doula (somebody from our team) if your labor should last over 24 hours, or if extremely exhausted, but will make every effort to remain with you through the entire duration. Any other circumstances out of our control (weather, act of god, hospital policy, etc) that result in our absence at your birth or your voluntary termination of this contract will not be refunded.

Back-up Doula:

In the event that we cannot attend your birth, you will have a backup doula (someone from our team) scheduled for our agreed upon fee. Their payment will come from the original payment at no extra charge to you.

Additional Services:

We are happy to create a custom doula package for you that includes any and all combinations of the services we provide, including prenatal doula services, birth doula services, postpartum doula services, photography, videography, lactation education, additional prenatal or postpartum visits, massage therapy, counseling, health coaching extra yoga classes or any other combination of services that is mutually agreeable to both you and us. All packages must be agreed upon in writing by all parties.

Release and Confidentiality:

You hereby give us permission to take notes about you and your birth, including personal information about yourself and your child(ren). This information may be shared with our doula team. Signing this contract also gives us permission to discuss your pregnancy and birth with other birth professionals in both formal and informal settings. We will never use your name, your child’s name, the date you gave birth or any other identifying information. A separate release of information, participation agreement, and photographic release are included in this package.

Responsibility of Client:

I ask that you inform me of any pregnancy-related or other health complications or conditions you may have, as well as any other special circumstances you might have or require. We also ask that you keep us abreast of what happens at your prenatal appointments from 36 weeks forward (if your cervix is dilated, any tests or procedures you might experience, anything your care provider seems concerned about, etc). Group text is the preferred form of communication. We also request that you inform your care provider that you have hired a doula. If for any reason you decide not to have us at your birth after you have signed this contract, we ask that you let us know as soon as possible.

Fees:

Fees are agreed to based on selected package, additional visits, and extra services. The total amount due is owed at 36 weeks or final appointment. Initial deposit is a minimum of $500 to secure our services unless otherwise agreed upon in writing. We accept cash, check (made out to hOMe holistic), or payments through your account at homeholistic.com. If alternative means of payment, such as barter, sliding scale, or a payment plan are being used, they must be agreed upon in writing by you and Ashley Walburn prior to the signing of this contract. The final payment is required before we attend your birth. If you are set up on a payment plan, please know the final payment is still due BY 36 weeks.

Liability:

In entering a contract for Doula Services with hOMe holistic doulas, I/We hereby acknowledge that during the performance period of this contract, services may be provided to me/us in my/our home, traveling to a medical facility, and/or hospital. I/We understand that we have a limited role pursuant to the description of tasks outlined in the above-referenced contract wherever services are provided to me/us.

hOMe holistic doulas have not represented to me/us that contracting for services guarantees in any way a risk-free or emergency-free labor and birth experience. I/We understand that my/our doula(s) does not make medical decisions on my/our behalf, to include the decision when to seek medical care at a hospital when labor support services are provided in my/our home. When services are performed in a medical facility, I/we acknowledge that hOMe holistic and/or the doula attending your birth is not responsible for the performance of clinical tasks to include medical decisions regarding the inclusion or exclusion of treatments available to me/us and my/our baby.

Now, therefore, in consideration of the above acknowledgements, I/we (both jointly and separately) on behalf of myself, ourselves, my/our heirs, administrators, personal representatives, executors, and assigns to RELEASE AND FOREVER DISCHARGE hOMe holistic and/or the doula attending your birth from all damages or causes of actions, either at law or in equity, which I/we may have or acquire or which may accrue to me/us, my/our heirs, administrators, personal representatives, executors or assigns as a result of using the doula services of hOMe holistic doulas.  I/We intend this to be a COMPLETE RELEASE AND DISCHARGE them from all liability whatsoever.

I/We have read all statements contained herein and I/we fully realize that I/we are signing a COMPLETE RELEASE AND BAR to any claims which I/we have or believe I/we have resulted from our contract for doula services.

If we have previously agreed upon any changes or addendums to this contract, including but not limited to additional services or changes to the services outlined above, please copy and paste the terms of the agreement below: