Virtual Doula Agreement

I don’t provide medical diagnosis. Instead I will refer you to the appropriate professional and possibly suggest questions that you may want to ask in order to facilitate a good discussion with your provider.

I provide emotional and educational support. I do not perform clinical tasks such as checking blood pressure, fetal heart tones, vaginal exams or any other medical procedure that falls under the legal definition of practicing medicine.

I don’t make decisions for you. I will point you toward accurate, evidence based information in order to ensure an informed decision, discuss appropriate ways to convey decisions or preferences to your care providers and remind you of previously stated decisions. The responsibility of all decision making lies with you and your care provider.

I don’t speak to medical staff on your behalf. I can discuss concerns and options with you, as well as support you in voicing your concerns, ensuring that you have the opportunity to discuss choices with your care provider. It is your responsibility to convey your thoughts to the medical staff.

I will be available as able by phone, text, or email from the start of this contract with responses within 24 hours.

During labour I will be available by phone, text, or Facetime.

We will choose a care provider and birth facility to reflect our birth vision.

We will keep our doula updated after visits with our care provider, by phone, text or email.

We will contact our doula when we think we might be in labour, even if we are not sure so that she may provide support during labour and birth.

Hold Harmless Agreement

We will indemnify and hold the Doula harmless from and against any and all liabilities, including personal injury, death or property damage, which any of them may incur as a result of any action or failure to act by the Doula or arising out of this agreement or the subject matter thereof. The Doula shall only be liable to us for her gross negligence or intentional misconduct. We assume all other liabilities relating to or arising from this agreement or the subject matter hereof, including without limitation any investigation or failure to investigate the Doula and her qualifications and limitations of services provided.

Release of Confidential Information

We give our permission, for the Doula to keep records about us, including personal information we choose to disclose to her and information regarding our pregnancy, birth and postpartum, as well as any information regarding our child/ren. This information will be shared with her backup doula(s) as a means to insure continuity of care should she be unable to attend our birth. We understand that this information may be used for the purpose of certification as a doula. We also understand that this information may be used anonymously for statistical purposes.

Failure to Provide Services

The Retainer is non-refundable under any circumstances. If the Doula fails to provide support during the birth through her own actions and does not provide a backup doula as a replacement, the Birth Fee will be refunded. If the Doula misses our birth due to unforeseen circumstances such as severe weather conditions or a precipitous birth (less than 2 hours of labor, total), the Birth Fee will be refunded. The Retainer is non-refundable.

Unforeseen Circumstances

Failure to contact the Doula during labor, refusal of services, refusal of her backup doula, or cesarean section are not grounds for a refund of the Retainer. In these situations, refunds of the Birth Fee will be negotiated on a case by case basis. The Doula reserves the right to retain the birth fee and provide additional services equal to a portion of the fee not used.

Cancellation

The Retainer is non-refundable under any circumstances. This fee is earned when paid and covers time spent prenatally, materials, administrative costs, holding our space on the Doula’s calendar, etc. The Birth Fee whether paid in full or part is refundable if a written cancellation is received prior to 37 weeks gestation. If we choose to cancel doula services, the Doula’s contract to provide any labor support, phone support, email support or any other services is considered null and void at the time a refund is issued.

Photographic Waiver

Delia Muhammad retains the copyright use of all images she takes at a birth for professional use. Images may be used with discretion and in accordance with general decency and anonymity. In general verbal permission will always be obtained in addition to this paragraph that constitutes written permission in lieu of further signed waiver.

All Doula services begin with the Basic Birth Doula Package. Features of this package include:

• One prenatal appointment over FaceTime to solidify your birth plan and make sure you feel confident and relaxed as you await your baby.

• Access to my library and curriculum and the opportunity to pick my brain by phone as needed.

• 24/7 on call availability beginning at 38 weeks.
• Experienced birth support during your labor, birth, and immediate postpartum for both you and your partner by phone, text, email, or FaceTime.
• One postnatal appointment virtually to check on your general well being and make sure that you are off to a solid start with breastfeeding.

$100.00 of your total Fee is due at signing to reserve your space in my calendar. The remainder of your fee is due at 38 weeks (two weeks prior to the above due date). Payments can be made up to 38 weeks via cash, check, or Paypal {links provided if needed}.