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                       Letter of Agreement Describing Doula

              (Labor Support) Services, Limits & Fees 


What is a Doula?


          As a birth doula, I accompany women in labor to help ensure a safe and satisfying birth experience. I have completed training approved by DONA International and have the following experience: I have 10 years bedside nursing experience as an LPN, I have birthed 5 children (1 hospital birth with an epidural experience, 1 birth center waterbirth with a midwife and 3 homebirths with a midwife. I completed my DONA International birth doula workshop in October 2015 and am looking forward to a lifelong career in this field, as it is an area that I am very passionate about. I have breastfed all my children into their toddler years and I have assisted others with successful breastfeeding. I draw on my professional training, knowledge and experience to provide emotional support, physical comfort and communication to make sure that you have the information you need to make informed decisions as they arise in labor and birth. I can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, positioning and other techniques for comfort. I will not make final decisions for you; those are for you to feel empowered to make yourself or as a couple. I am independent and self-employed. As your doula, I am working for you, not your caregiver or hospital.


As a Doula, I do not 



          1. Perform clinical tasks, such as blood pressure, fetal heart checks, vaginal exams, and others. I am there to provide only physical comfort and emotional support.

          2. Make decisions for you. I will help you get the information necessary to make an informed decision. I will also remind you if there is a departure from your birth plan.

          3. Speak to the staff on your behalf. I will discuss your concerns with you and suggest options, but you or your partner will speak directly to the clinical staff.


Free consultation


          It is very important that you and your partner are comfortable with me and with my role in the birth. Thus, I do expect to initially meet with clients to become acquainted and to plan how we might best work together. This initial meeting is free and does not obligate you to use my services. If you choose to select me as your doula, I will want to become more familiar with your plans for labor, birth, and postpartum.


Prenatal meetings



          I prefer we arrange for at least 2 prenatal meeting (1-2 hours) before labor begins, preferably before 37 weeks in your pregnancy. Additional meetings may be arranged if necessary. These meetings gives us a chance to talk in detail about your preferences regarding your birth. If you have a Birth Plan, we will review it carefully. If you do not have a Birth Plan and would like to create one, I can assist with this. I will want to know your own personal ways of coping with pain and fatigue and difficult situations, and what internal resources we can draw upon to assist you with the birthing experience. I will want to know how you and your partner foresee working together, and the roles of others who may be attending the birth. We can discuss any concerns you may have regarding your birth. We can review your preferences regarding the use of pain medications. My role is to help you have a satisfying birth as you define it. The more we explore this in advance, the better I will be able to fulfill this role. My clients are welcome to borrow books from my lending library for a 2 week at a time borrow period, depending on availability. Failure to return any books you borrow will result in a fee of the cover price plus $10 to cover shipping costs for reorder. 



Late Pregnancy



          I am available by phone, text or email around the clock, and encourage clients to call with questions or updates . Once we enter the on-call period, I encourage clients to check in with me every few days to let me know how they’re doing. I consider my on-call period for a birth to be from 38-42 weeks of your pregnancy. During the on-call period, I am committing myself to be within 90 miles of Edmonton at all times, unless previously discussed with you and covered by a back-up doula. 



When Labor Begins 



          I prefer that you call me when you think you are in labor, even if you do not yet need me. I can answer questions and make suggestions over the phone. We will decide if I should come right then or wait for further change. I may need 1-2 hours to get to you from the time you ask me to come, so please call earlier than later. We will also decide where to meet—at your home, or the hospital or birthing center. During your labor I may need to take breaks to eat and/or rest. I may need to call for back up doula care if your labor is very prolonged. Except for unforseen circumstances, I will remain with you throughout your labor and birth. If you do not hire a photographer for your birth, I can snap pictures for you with your camera. I am not a professional photographer but am happy to take some photos of your experience.


After your birth




          I can remain with you for 1 or 2 hours after birth, until you are comfortable and your family is ready for a quiet time together. I can also help with initial breastfeeding, if you desire. I am available to answer questions about the birth or your baby and would like to get together with you within 1-2 weeks after you deliver to see how you and baby are doing, to review the birth, and to get feedback from you about my role.





          The total fee for my services is $             . I ask for a deposit of $               which is due as soon as you choose me as your doula. This secures your birth in my calendar. The remainder of the fee is due within 1 week of your birth. You can pay in cash or cheque written to Sharon Jong. This fee is not just for being at your birth. This covers prenatal visit at your home, optional visits with your care provider and facility tours, phone and email availability, on call availability beginning 2 weeks before your estimated due date, continuous labour and birth support, immediate postpartum care and 1 postpartum visit. If you choose not to take advantage of any or all services outlined throughout the contract, by signing this agreement you understand the fee stays the same. Upon signing of this contract, a non-refundable deposit, in the amount of $        is due. The remainder of the fee is due within 1 week after your birth. If you decide not to continue with my services after signing the agreement, you will not incur any additional fees beyond the initial non-refundable deposit.



Failure of a doula to provide service



          I will make every effort to provide the services described here. Sometimes this is impossible for unforeseen reasons. My refund policy is as follows:

- If my failure to attend your birth is due to my error and my back-up doula is not available, there will be no charge for my services and I will refund the $              deposit.

- If my backup doula attends your birth because I was unavailable (whether pre-arranged or unexpectedly), full payment to me is still required. I compensate the back-up doula directly. 

- If I miss your birth due to circumstances beyond anyone’s control (for example, extremely rapid labor), I will keep $          but there will be no further charges. I can still attend a postpartum meeting with you.

- If you fail to call me to attend your labor, there is no refund of the $            deposit, but there will be no further charges.


Additional Options


          I offer belly casting & decorating and facilitation of transforming your pregnant journey into creative art. These options are not included in your HeartRoots Doula package and are set as extra services. The descriptions and costs are in detail on my website ( I am happy to answer any questions you may have regarding these. Payment is due at the time of each service. Payment cn be made as cash or cheque written to Sharon Jong. As for placenta encapsulation, I do not currently do this but I have several sources I am happy to share with you.



Specific individual arrangements, agreements, or other - not already covered in this contract:







I  have read this letter describing the doula services and agree that it reflects the discussion we have had with her.


Client's name                                             Client's signature                                        Date


Doula's name                                             Doula's signature                                        Date  




                                                         Sharon Jong, 






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