Birth Doula Contracts - The Good, The Bad and The Ugly
When you become a doula, even if you are doing pro-bono births to start, its important to have a well produced contract that will protect not only you but your family and your client. A contract is meant to specify what each individual is responsible for.
For the doula, your contract should include what your scope of practice is. Outlining that you are non-medical and will not preform medical procedures such as vaginal exams or check blood pressure. Being specific about what you do include in your services, such as emotional support, out lining different positions, massage, or use of massage tools or TENS units and informational support, however, you should highlight that you do not make decisions for your clients or discuss your case with a care provider to make decisions on your care.
And while this is obvious you will want to include your fees for those services you have listed that you provide.
You will also want to outline your back up policy, if you have a back up (you should have a back up), who that person will be, if the client can meet the back up prior to labour starting and how payment for the back up will work, namely that it is not the responsibility of the client to pay the back up should they attend the birth.
You will want a refund policy, laid out in detail with clear and specific language. Unfortunately there are still many out there who think having a doula is a novel concept and they don't appreciate what we do or what we give up to support them in labour. And as such they are often looking for ways to weasel out of paying for the service. Therefore having an ironclad refund policy protects you from spending energy on servicing a client and then actually getting paid for it.
And some extras you can include may be:
- a space for days you aren't available, such as a vacation or kids birth days and such, when a back up doula will be on call for you.
- Times to contact you for non-labour questions or resources, non-emergent communication. Such as only calling during the day to discuss visits with the care provider or something they read on a blog.
- How to contact you anytime they need to reach you. If there is more than one number to call, make sure you are listing them and when to use each one.
- What may happen if the labour is precipitous and you are unable to make it (included in your refund policy as well)
- What may happen if you are labouring at home with them and things go quickly (i.e. calling 9-1-1 and/or the midwife, having partner assist in the delivery)
For the client you will want to include the payment schedule. When to pay, how much to pay and how to pay, such as cash, cheque, email money transfer, Paypal or credit card. You can also include for the client if they must take any classes or read any books or do any homework while they wait for the end of their pregnancy and labour to begin. If you require them to contact you at certain times, such as after each care provider visit to update you on how they are doing.
Over the span of 14 years as a doula and signing hundreds of contracts with my clients I have seen quite a bit that has had me changing my contract, tightening up the language in it or reflecting on what others have gone through with their own clients and contracts. For example, I changed a contract one time for a repeat client that was due close to a new client I had just signed. They wanted the contract to reflect that if both of the clients were in labour that I would go to them and send the back up to the other client. After speaking with the other client they agreed and I changed the contract to reflect that discussion. As it was, they did not go into labour at the same time so it all worked out.
I have also changed some of the language to rephrase the "24/7 on-call status" wording. The way it was written a client assumed I was sitting at home waiting for their labour to start all day and an night from two weeks before their due date. Which, in their mind meant, I couldn't go out to get groceries, see other clients, take my kids to school, go to my teaching job, go for dinner with my family ect... So now the wording is such that "I will not be further than 1 hour away from the hospital they are birthing at from two weeks prior to their due date. And that I require 2 hours to get to the client from the time they ask for me." This way they tell me when labour has started in the very beginning so I can plan ahead and get my ducks in a row so I can support them without worrying about anything.
I added wording around when I could be contacted prior actually being in labour. That I would be available during business hours for general questions and concerns. (Unless of course there was some anxiety or prenatal depression happening) I changed this because I was fired by a client who I had begun working with who phoned and texted constantly after 6pm. The final straw came when I was driving my son to Scout Camp and I asked if I could talk to them tomorrow as I was just driving with my family and wouldn't be back until later. It was 7pm on a Friday night. This was unacceptable to the client and I received an email the next day day asking for their deposit back. Normally I would have fought that as it was a non-refundable deposit but I really had had all I could manage with them so I gave the money back.
I also have listed on the contract when I will leave them after the birth. I had a client once assume I was staying with them to look after the baby while they slept that night. When I said no, they then assumed the nurses would take the baby to the nursery to be looked after. Um no. I also now insist clients take a prenatal class to have a better idea of what birth and postpartum will be like.
Perhaps you will have a client who wants to alter and change the contract to their specifications. I would say no. This is your contract and ultimately it is designed to protect you and your family. If it works for you and they are asking for an unreasonable amount of changes or changes that would ultimately compromise you and prevent you from getting paid, the answer is no. No client is worth the risk of not getting paid. And odds are, if they are insistent on these changes then something is likely amiss with them and it is big red flag you can't ignore.
You can also consider having your contract looked at by a lawyer, perhaps a barter system. Some postpartum support for a look at the contract and close up any loop holes it might contain.
Ultimately the contract doesn't have to complicated and full of legal speak. But it does have to be clear, concise and cover the basics of what is expected on all sides.