What do I do as a Birth Doula?
As a birth doula, I help women in labor (and their partners) to have a safe and satisfying birth experience.   As of December 2006 I have supported almost 50 women in labor and birth.  I draw on my knowledge and experience to provide emotional support, physical comfort, education, and, as needed, communication with the staff to make sure that you have the information you need to make informed decisions in labor. I can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, massage, positioning and other techniques for comfort. I am independent and self-employed. As your birth doula, I am working directly for you, not your medical care-giver or birth place.

When You Are in Labor
I prefer that you call me when you think that you are in labor, even if you do not yet need me, and even if it is in the middle of the night. I can answer questions and make suggestions over the phone. We will decide together if I should come right then or wait for further change. (Please allow up to three hours for me to get to you from the time that you ask me to come, although it would most likely be under 2 hours). We will also decide at that time where to meet – at your home, the hospital, or the birth center. Except for extraordinary circumstances, I will remain with you throughout the labor and birth, and will stay for one to two hours after the delivery to help you with breastfeeding and any necessary mother-care. If your doctor/midwife determines that your labor needs to be induced, I will provide phone support until you determine that you need my support in person, although I am open to coming at the start of induction if that is your wish or if it’s appropriate under the circumstances. If your baby is born via cesarean, deemed necessary either before or during labor, it is still my role and intention to be with you and support you throughout your birth experience.

Labor Support Services Provided
As your birth doula, I offer:
~ One prenatal visit, which may be included our the original meeting, depending on the situation
~24-hour on-call support beginning one month before the baby is due and continuing for two weeks after birth
 ~Early and continuous labor support individualized to the mother and partner’s needs and desires (I can meet you at your home or at the hospital)
~Assistance in preparation of a birth wish list, including discussion of options and provision of information to help you make decisions about your preferences
~Suggestions and referrals for before and after the birth
~My best effort to maintain a calm, peaceful birth environment, as well as keep an awareness of the mom and partner’s spoken and unspoken needs and concerns
~Emotional, informational, and physical support during labor and birth, and postpartum (whether the birth be vaginal or cesarean)
~Massage, relaxation exercises, and suggestions of different positions during labor and birth
~Use of helpful tools in my “birth bag”
~Photos (you provide the camera, etc., although if I can bring mine I will) during labor, birth, and postpartum, as desired and as feasible
~To remain with you for some time after the birth, until you are comfortable and your family is ready for some quiet time together (usually one to two hours)
~Postpartum support by phone to answer any questions about the birth or your baby
~One visit to your home after the birth to see how you are doing, to make sure that feeding is going well, and to give you a chance to ask questions about and process your birth experience
~Access to purchasing (and delivery and personalized instruction for use) of birth balls, breastfeeding cushions, breastpumps, and slings for carrying your baby.
~Breastfeeding support, information, and referral
~Parenting and newborn care information
~Concern, respect, and confidentiality

What Doulas Do Not Do
As a birth doula, I do not:
~Perform clinical tasks. I am there to provide only information, physical comfort, emotional support, and advocate diplomatically for your wants and needs.
~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 deviation from your birth preferences.
~Speak to the staff on your behalf. I will discuss your concerns with you, suggest options, and ensure that you have had the opportunity to ask questions and obtain information. But you or your partner will speak on your behalf to the clinical staff.

Expectations of the Mom and Her Partner
• Open and honest communication on issues that could have an influence on your childbirth and postpartum experience, including being up-front if anything I say or do concerns you
• Discussion of whether you will have a written wish list for presentation to and discussion with your health provider
• Call me after each prenatal exam for an update
• Call immediately when there are physical changes that might indicate labor is starting
• Call when you have any questions at all—the only silly question is one that isn’t asked!
• Tell others about the services and benefits of professional labor assistants/birth doulas
• Call me when you think you are in labor, and if you do not reach me at home, try my cellphone, and if you still do not reach me immediately, call my pager. I expect to return a page after 10 minutes or so.

Fees for Services
My fee for the services described here is as follows:
~My fee is $1200.00 (for births in the Boston area) or $850.00 (for Worcester area births).   The fee includes those services outlined above. 
~Payment may be made via check or online via PayPal.  If you pay with a check, I require that about 35% of that fee be paid at the time we agree to work together as a retainer fee, and at the same time a check be given to me (dated for your 35th week of pregnancy) for the remaining amount.  
~I will let you know about any possible conflicts or possible unavailability at the time that we decide to work together or if something unforeseen comes up. I will provide you with a back-up birth doula for any times that I will be unavailable.
~If I am for some reason unavailable for your labor/birth and I need to call another birth doula for back-up, I will take care of working out payment with her, and she will most likely take care of your postpartum visit. Deciding not to use a back-up doula does not mean that you will receive a refund.
~If desired, additional fees may be discussed for private childbirth education classes. Your health insurance provider will reimburse you the same amount whether you take classes with me or with a hospital. A separate tour of your birth center or hospital is possible to arrange, and if you’d like me to join you I am happy to do so.

Failure to Provide Services
I will make every effort to provide the services describes here. Sometimes this is impossible; for example, a precipitous (rapid) labor, or unsafe weather conditions. My refund policy is as follows:
~ If my failure to attend your birth is due to my error, there will be a refund of $250.00.
~If my failure to attend your birth is due to circumstances beyond anyone’s control, there will be no refund.
~If I am unable to attend your birth because you fail to contact me via my home phone, cellphone and pager, there will be no refund. Contacting me by email or only leaving me a message on my voicemail that you are in labor may not elicit a timely response. You must make every effort to reach me via home phone, cellphone, AND pager. I expect to respond to a page within fifteen minutes—please feel free to call/page me again if you haven’t received a response as quickly as you were hoping you would.

Why I Do This Work
Pregnancy, birth, and the development of a relationship with a baby is an amazing phenomenon. Each birth experience is unique and each family’s needs are different. I want to provide information and support to mothers and partners so they can make the best informed choices for themselves and their babies and then participate as fully as they wish in the birth process. Because the needs of a family during childbirth can be more than one support person may wish to handle, I offer myself as an additional support person and resource who will help facilitate a healthy, educated pregnancy, a positive birth experience, and a satisfying postpartum period. I believe, and studies have shown, that the services of a birth doula can greatly influence the course of the childbearing year for the mutual benefit of the mother, child, and family as a whole. I feel absolutely honored and in awe when I am present at a labor and birth and I am energized by being allowed to contribute my skills to help in any way I can.