doula client payment question

[happyartmama]

Here's the scoop: client hired me as their doula, paid deposit to reserve their spot in their due date month (a little over third of total fee), with remainder due at postpartum visit wrap-up.

Baby is now in breech position, with caregivers--not very natural birth freindly; tried to discuss this with her prenatally... pushing for c-section. I went over numerous turning techniques, and her attitude was that she was "assuming none of them will work." ECV was tried yesterday without success.

When the c-section was scheduled four days ago (if the ECV failed), she asked me to come to the hospital on that date. I of course agreed and said I could lend emotioanl support, help with breastfeeding, answer questions, etc. Today she calls and says her doctors told her she probably didn't need a doula, the hospital nurses are great, yada, yada, and she then suggested that I come after the birth to do postpartum doula tasks (I guess to fulfill the fee?....) rather than attend the c-section. I'm not a postpartum doula.

So I've never experienced this before with a scheduled c-section. Do we just part ways and that's it? Does she pay the remainder of the fee even if she doesn't want/need me there and I'm not a postpartum doula? HOw do other doulas handle this? :

[SublimeBirthGirl]

IMO she owes you the fee. It's not your fault she didn't want you to fulfill the duties; you set aside time for her, possibly turned away other clients for her. Your call; I don't know what I would do. I think you are ethically on solid ground collecting it though.

[MidwifeErika]

I have in my contract that if a c-section is scheduled prior to 38 weeks (so that I don't go oncall for the couple) and they do not wish to have my support for the c-section, then I keep the deposit (50%) as my payment for the prenatal work that I have done with them. If they wish to keep me for c-section support, the fee is a full fee and I will go through the c-section with them or hang out and wait for the mom in her room (if the docs won't let me in the OR) to go over breastfeeding help. I do not change over and do postpartum work in order to earn the money just as I wouldn't do that if suddenly a client had a superfast birth. If the c-section is scheduled after I have already gone on-call or happens during labor, they owe me the full fee. It is their choice then if they want to use me for the c-section support or not.

You have to figure that in this country, 1/3 of hospital births go to c-section. So, if you refunded every c-section mama.... well, that could be very bad on a business end.

[memiles]

Originally Posted by happyartmama

Here's the scoop: client hired me as their doula, paid deposit to reserve their spot in their due date month (a little over third of total fee), with remainder due at postpartum visit wrap-up.

Baby is now in breech position, with caregivers--not very natural birth freindly; tried to discuss this with her prenatally... pushing for c-section. I went over numerous turning techniques, and her attitude was that she was "assuming none of them will work." ECV was tried yesterday without success.

When the c-section was scheduled four days ago (if the ECV failed), she asked me to come to the hospital on that date. I of course agreed and said I could lend emotioanl support, help with breastfeeding, answer questions, etc. Today she calls and says her doctors told her she probably didn't need a doula, the hospital nurses are great, yada, yada, and she then suggested that I come after the birth to do postpartum doula tasks (I guess to fulfill the fee?....) rather than attend the c-section. I'm not a postpartum doula.

So I've never experienced this before with a scheduled c-section. Do we just part ways and that's it? Does she pay the remainder of the fee even if she doesn't want/need me there and I'm not a postpartum doula? HOw do other doulas handle this? :

Are you not trained as a postpartum doula but willing, or would you rather not do postpartum work?

I actually started doing pp work for a client who was having a planned cesarian. Her husband was going to be able to be home for the birth and 2 days following, but then she was going to be totally alone for a month. I had never done postpartum before, but I couldn't say no, and she had already paid me.

This is the reason that I ask for payment in full by 37 weeks. I'm happy to attend planned surgical birth or to come spend time with them the first day in the hospital to help establish breastfeeding, or to do postpartum care in their home, but once they hire me, they are committed to the payment unless I miss a birth due to an error on my part.

[tlcdoula]

What does your contract say concerning this? In my contract, in the event of a cesarean all fees remain the same and I make myself available to the family. If their healthcare provider does not allow me in for the surgery my fees still remains the same, and I stay at the hospital during the procedure and get together with them as soon as I can.

The way I see it the family contracts for my time, and once they sign on with me I make myself available to them. I also limit the number of clients I take so potentially I could have a loss of income, and all of my clients know right up front what my fees are and how they will need to pay me regardless of the type of birth. If I take on a client and then they back out on me they still owe me my fee, but I think you need to determine what your contract states.

If you are not comfortable doing pp work then I would not do it.

If you do not have a contract that addresses cesarean births then I suggest that you change your contract or create one. A contract helps to protect both the doula and the family by making expectations very clear.

[happyartmama]

Thanks for your thoughts. Well, one thing I know for sure is that I will be amending my contract. I don't specify this situation clearly at all, which is on me. However, my clients know that I only take on 2-3 clients per month, so "canceling" a wish/need for services does affect me financially.

I guess it seems different since it's planned, versus supporting mom through labor that ends in a c-sec. As to other question, I'm not able/willing to do postpartum care as I have two children under 4 and would have to pay for childcare for any hours I work (I do for labor support as well, but I know postpartum doulas who schedule their work time during school hours, for example). Plus, this client has been rather difficult/high drama/very intense/poor boundaries from the get-go so postpartum work is not very palatable even if it were possible.

As for time frames, this client is currently 37 weeks, but then again, I don't specify in my contract a limited on-call period. Taking on so few clients, I've never felt it necessary to specify on-call two weeks before/after due date. More to consider....

Anyone else want to weigh in? Also, how do other doulas collect payment in general? Entire fee prior to birth? Some before and some at postpartum?

[Justmee]

I am not a doula, but as a client I would pay you. I have a good friend who is a doula and she told me she would be happy to come to my births for free, but if I wanted to book her, I would have to pay her. I risked it and thankfully she was free for both my births . When you took her it meant you didn't take someone else, so you are entitled to be paid.

As a side note 37 weeks is way to early for her to be scheduling a section : Rivka was breech at 38 weeks, and she turned by 39 weeks on her own.

Good luck getting paid, you deserve it

[MidwifeErika]

I collect my whole fee before I go on-call for the family. I want 50% to retain my services at the time they sign the contract and the other 50% prior to 38 weeks. I have heard from many that if you don't get the money before the birth, you are likely to not get the money at all..... and I believe it.

[tlcdoula]

I collect half the fee at the contract signing and then the secon half of the fee is due by 38 weeks.

As for the pp care I would simply tell this woman you are not a pp doula and do not do pp care. I would let her know that you are fulfilling your end of the contract and that she needs to as well. Let her know that you will be there for the birth if she wants, but that in either event she still owes you as your contract states.

[tlcdoula]

Originally Posted by hotwings640

I collect my whole fee before I go on-call for the family. I want 50% to retain my services at the time they sign the contract and the other 50% prior to 38 weeks. I have heard from many that if you don't get the money before the birth, you are likely to not get the money at all..... and I believe it.

I have heard the same thing and that is why I also collect the money before for the birth.