SEM Contract-Stephanie Medina PDF

Letter of Agreement Describing Birth Doula Services, Limits, and Fees
Role of a Birth Doula

As birth doulas, we accompany women in labor to help them have satisfying and memorable birth experiences. We draw
on our knowledge and experience to support women and their families. As your doulas, we are working for you, not your
caregiver or hospital/birth center. Our goal is not to ensure any particular event or outcome, but to help you to have the
best experience possible.
As your doulas, we will not:

Perform medical tasks, such as blood pressure, fetal heart checks, vaginal exams, etc.

Make decisions for you or judge your choices.
This is your birth and we support you.
Speak with medical staff on your behalf. We will discuss options with you and help you to advocate for yourself, but you
or your partner will speak directly with the medical staff regarding procedures and interventions.
How Our Team Works

As a client of SEM Community Doulas, you have a whole team of doulas working for you. You will choose one of us to be
your primary doula the doula who will be your first contact for any questions you have during your pregnancy. You will
have the opportunity to get to know the rest of your doula team at your prenatals and during Community Meetings and
Office Hours, which you may attend as often as you like. It is your responsibility to meet and be comfortable with the
doulas who may be on call for your birth.
We all believe that the most important thing is that you have consistent and experienced support. We will schedule the
on-call period so that you will always have a doula who is well rested and prepared for your birth. Although there may be
last-minute changes, you will have access to our on-call schedule on our website. You will find contact information for all
of your doulas at the bottom of this contract.
Clients Responsibilities
As your doulas, we will do everything we can to help ensure you have a satisfying birth experience. To help us to do this,
you can do the following:
Meet your entire doula team, through prenatal meetings, Community Meetings, or Office Hours. It is your responsibility
to meet and be comfortable with the doulas who may be on call for your birth.
Update your primary doula regarding your prenatal health, including after meeting with your care provider and any
other unexpected visits to the hospital or non-routine testing.
If this is your first birth, we suggest you take a childbirth education class. We will assume that you already have an
understanding of your body and the normal labor and birth process. Wed be happy to make suggestions, if youd like.
Before Labor
Because of the incredibly intimate nature of birth, we like to meet and get to know you before your babys birth. The
number of prenatals included depends on which package you choose. Prenatals take place in your home and usually last
about 60-90 minutes. Youre also welcome to schedule additional 30-minute meetings after our Community Meetings and
come to any Office Hours. We will also be available to you by phone and email throughout your pregnancy and early labor.
We think its very important that your partner meet us before your babys birth.
We will be on call for you as soon as this contract is signed and your deposit is paid.
During Labor
We ask that you call your primary doula as soon as you think you are in labor, even if you do not yet need hands-on
support, so that we can make any necessary arrangements. If you text your primary doula and dont immediately get a
reply, it is your responsibility to call. If you do not get a return call within 15 minutes, please call one of your other doulas.
We can answer questions and make suggestions over the phone. We find it best to join you at the beginning of active labor,
but it will ultimately be your decision when you want a doula to join you and whether you want support at your home or at
the hospital/birth center. From the time you ask for hands-on support, we may need up to two hours to get to you,
depending on location, time of day, traffic, and the amount of notice you give us.
After Birth
We will remain with you for one to two hours after your babys birth, until you are comfortable and your family is ready for
quiet time together. Well be available by phone or email any time after your babys birth for questions or concerns. One of
your doulas will visit you (usually within the first week after birth) for a follow-up visit. One of our packages includes a
lactation visit from an IBCLC with In Home Lactation Specialists, LLC. If you are outside of IHLSs service area or if you
are not planning to breastfeed, we are happy to substitute an additional follow-up visit at no additional charge. We also
offer a monthly postpartum group to offer you continued support in the months after your birth. And we love updates on
how your baby is growing!
Depending on your location and the needs of your family, we can provide more postpartum support for an additional
hourly fee. Please let us know if youre interested in hearing more about these services.
Failure to Provide Service

We will always make every effort to provide the services described here. However, there may be unusual circumstances
when a doula outside of the SEM Community Doulas team attends your birth as a backup. If you do not have a doula at
your birth due to circumstances beyond anyones control, such as the weather, a fast labor, etc., or to your error or your
failure to call us, we will keep the full payment.
Confidentiality
Although doulas are not bound by HIPAA, we understand that you will be sharing intimate information and experiences
with us and will be sensitive to your privacy. SEM Community Doulas will share information regarding your history,
family, pregnancy, labor, birth, and postpartum amongst each other. Should the need arise to have a backup doula outside
the SEM Community Doulas team available, we will also share your information with her. We may also use your
information, anonymously, for statistical purposes and online for networking purposes.
Cesarean Birth
Although research shows that including a doula on your birth team decreases the occurrence of many interventions and
cesarean sections, we obviously cannot guarantee any specific outcomes. If you decide that a cesarean section is the best
option for you and your baby, our support of you will not change. Regardless of the path your birth takes, our fee is the
same.
Termination of Services
If either party chooses to terminate this contract for any reason before 37 weeks, we will keep the deposit and no further
payment will be owed. After 37 weeks, we will keep the full payment. If you choose to terminate this contract, you must
notify your primary doula by email.
Packages and Services

Both our packages include:
Support at your birth
Invitation to all our Community Meetings and Office Hours
Invitation to join our SEMCD Village facebook group
Invitation to our Postpartum Support gatherings
The Basic Package The Standard Package A La Carte Items
One 60-90 minute prenatal visit Two 60-90 minute prenatal visits Prenatal meeting $75
One 60-90 minute follow-up visit One 60-90 minute follow-up visit Follow-up visit $75
One lactation visit Postpartum doula support* $30/hr
Investment: $950 Prenatal/Postpartum massage Placenta encapsulation* $200+
Massage* $75+
Investment: $1,200 Belly binding* $100
Lactation visit w/IHLS* $150+
* Separate contract
Half of your investment is due when you select SEM Community Doulas as your doulas, sign this agreement, and we
reserve your EDD on our schedule. The balance is due three weeks before your EDD. Check, cash, PayPal, or credit are
accepted.
Basic Package
Package: ______________________________ 950
$__________
A La Carte Item: _________________________ $__________
A La Carte Item: _________________________ $__________
A La Carte Item: _________________________ $__________
Total: $__________
475
Deposit of __________ due __________
Balance of __________ due __________
I recognize that the doulas of SEM Community Doulas, LLC are trained to assist with labor and childbirth. They are not
medical professionals and, therefore, will not perform medical procedures; it is my responsibility to make informed and
educated decisions with input from my care provider. I recognize that childbirth is a natural and unpredictable process
and may not go as I plan; I understand that SEM Community Doulas will act with care for the mothers and babys well
being, but will not be able to alter and are not responsible for the course of labor or its outcomes. I have read this letter of
agreement describing the birth doula services and fees and agree that it reflects my understanding of them. In signing this
agreement, I agree to retain SEM Community Doulas as our doulas.
Stephanie Medina 9/18/2017 6/7/2017

__________________________________ _______________ _______________
Clients name Estimated due date Todays date
Stephanie Medina
__________________________________ 248-860-1691
__________________________________
Signature Phone number
__________________________________
Primary Doula
* SEM Community Doulas * www.SEMCommunityDoulas.com * [email protected] *

* Erin Barnes * [email protected] * 248 840 3269 *
* Jahmanna Selassie * [email protected] * 734 717 2709 *
* Diana Thornton * [email protected] * 989 858 0748 *
* Celeste Kraft * [email protected] * 734 772 4537 *
* Kaissa Moon * [email protected] * 734 478 2859 *

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Letter of Agreement Describing Birth Doula Services, Limits, and Fees

Role of a Birth Doula

As your doulas, we will not:

How Our Team Works

Failure to Provide Service

Packages and Services

A La Carte Item: _______________ $

A La Carte Item: _______________ $

A La Carte Item: _______________ $

Stephanie Medina 9/18/2017 6/7/2017

* SEM Community Doulas * www.SEMCommunityDoulas.com * [email protected] *

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