Terms of agreement document for Doulas
Below is the wording for a terms of agreement document that you may wish to use with the couples you support.
It is not compulsory at all but gives you the starting point for something in writing to agree upon with your couples regarding the scope of your relationship with them. The Doula relationship is such an intimate one and it seems weird to have a formal, legal-style document between you but this does provide a written agreement so that all expectations between you are clear. It’s important to be very straight forward about the fact that you have no medical role in the birth and that your paid relationship with them has a starting and a finishing point.
Many thanks to Chris Vose from Optimum Birth and the Doula Register who’s legal team approved this wording. Just copy and paste it into Word and include all your contact details at the bottom. This is provided as general information only and you should seek your own advice before using this form.
Letter of agreement describing labour support services
Limitations and fees
What is a Doula?
A Doula is not a doctor or midwife and has no clinical responsibility or role in your birth. However, your Doula can improve the birth experience for the mother and baby in many ways. As a Doula, I support women before, during and after labour by providing personal assistance. I draw on my experience and knowledge to give you emotional support and physical comfort throughout the birth. I also provide you with as much information as I have on topics surrounding childbirth so that you can base your decisions and your birthing plan on a variety of information. The information I have comes from published books, articles and DVDs, which I can loan to you or direct you to find. Throughout your pregnancy, birth and the postnatal period I am employed by you, not the hospital and I dedicate myself only to your needs. I make myself available to provide reassurance to you and your partner, to discuss all options available to you, and to help you relax and find your most comfortable positions during labour. I am also available on the phone or by email before and after the birth should you wish to talk about anything related to the birth.
Choosing a Doula.
I prefer to meet you and your partner at least once before the birth to become acquainted with you, to discuss your wishes and concerns and to explore the ways in which I can support you. Our initial meeting does not obligate you in any way. There is no charge, although we may discuss fees should you wish to appoint me as your doula.
If you choose me as your Doula.
I will visit you, two or three weeks prior to the due date, to familiarise myself with your wishes and plans for the labour, birth and postpartum. I will also want to know how you prefer to cope with pain and fatigue and how you and your partner wish to relate and work together. I do not perform any clinical tasks, such as monitoring blood pressure or physical examinations. I will provide for your physical comfort and emotional support. I will not give you advice or make decisions for you, but I will endeavour to get unbiased information to you so that you can make your own, informed decisions.
Unavailability.
In the case of unforeseeable circumstances preventing me attending your birth, one of my doula colleagues will substitute.
The labour.
When you go into labour you will need to phone the hospital to find out when they want you to be admitted. I usually need between 30 minutes to 1 hour to get to you so it is important that you phone me when you leave your home to go to the hospital. I will meet you at the hospital as soon as I can after you phone and will remain with you for the labour and birth unless extraordinary circumstances intervene.
After the birth.
I usually stay with you for one or two hours, unless you are comfortable and you wish to be alone with your family. I would like to meet with you within two weeks after the birth to see you and your baby and to review the birth.
Fees for my services.
My fee is $XX including the retainer fee of $XX due when you select me as your doula. The balance is payable as soon as possible after the birth of your baby, unless full payment has been made in advance. The final payment will be refunded if I or one of my colleagues are unable to attend the birth (eg. a very rapid labour and birth) the retainer fee will be kept to cover the other services and support provided.
I/we have read this letter of agreement describing [insert doula’s name] services as a doula and agree it reflects the discussion between us.
Mother’s name, signature, date
Father’s name, signature, date
Doula’s name, signature, date
