if doula misses birth...follow-up question posts 42 & 55 - Mothering Forums

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#1 of 78 Old 06-06-2008, 03:12 AM - Thread Starter
 
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and you've already paid, what should you expect? Labor was super quick, so it just happened this way...

Mom to 11 y.o. lawyer, 9 y.o. actor, and 4 y.o. pilot. I believe 'em on those, too!

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#2 of 78 Old 06-06-2008, 04:04 AM
 
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I'd like to see what other doulas have to say on this. I missed a birth once, but it was unpaid anyway.

Heather Mike Married 8/1/99 Mom to Charlotte Aug 04, Nov 06, and Katherine Oct 07
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#3 of 78 Old 06-06-2008, 04:37 AM
 
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not the doula's fault she missed it if it was quick- she has spent time , has a cell phone or pager and organized her business to include this birth- I would say no refund- now if her kid was sick and she didn't come that would be a different situation...
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#4 of 78 Old 06-06-2008, 05:02 AM
 
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not the doula's fault she missed it if it was quick- she has spent time , has a cell phone or pager and organized her business to include this birth- I would say no refund- now if her kid was sick and she didn't come that would be a different situation...
My contract states that if I miss the birth due to no fault of my own, ie rapid labor, that the final payment is still due.

What I actually do depends on the situation really.

If I had a lot of hours into the relationship I'd likely collect the full fee, offer some extra postpartum/breastfeeding support and not charge for that.

If we'd recently met and it was a late hire, I might keep half the remaining balance and would like to see them put the other half towards a postpartum doula or breastfeeding support if needed.

It's entirely situational.

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#5 of 78 Old 06-06-2008, 07:39 AM
 
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I'm not a doula, but have done a lot of freelance work - in those situations while it would be great to paid for the time spent on the phone and the prep time I would NEVER expect to be paid for the main event if I wasn't there!
In my opinion the doula should charge you half (reasonable!) or not at all depending on the time she spent with you prior to birth. I know doulas have to make a living too, she probably has only a handful of openings per month, in a way you should pay her just for keeping the "appointment" open. But since she wasn't there for the 10-36hours of birth you expected paying her the full amount would be ridiculous.
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#6 of 78 Old 06-06-2008, 10:26 AM
 
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Congratulations on a precipitous birth!

You had a contract.
Being a doula is her livelihood and she deserves her full fee.

Her entire life has been on call for your birth 24/7 and she did not take other clients because of her commitment to your birth. That is why she deserves to be paid. Her time is valuable.

Most seasoned labor doulas have contracts where full payment is expected even when the birth is missed and it was not their fault.
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#7 of 78 Old 06-06-2008, 10:31 AM
 
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I'm not a doula, but have done a lot of freelance work - in those situations while it would be great to paid for the time spent on the phone and the prep time I would NEVER expect to be paid for the main event if I wasn't there!
In my opinion the doula should charge you half (reasonable!) or not at all depending on the time she spent with you prior to birth. I know doulas have to make a living too, she probably has only a handful of openings per month, in a way you should pay her just for keeping the "appointment" open. But since she wasn't there for the 10-36hours of birth you expected paying her the full amount would be ridiculous.
Your assumption is incorrect.
As you said You're not a doula, so there is no comparison to any other work you do. You can only compare other work where you're on call 24/7 for weeks tethered to a beeper all the time. That is built into the payment. That has a value when a doula provides that level of commitment to a client.
Doulas go over that part of the contract and how payment works!

The labor doula puts her life on hold to attend a clients birth, and she does NOT take other clients if she has booked that client.
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#8 of 78 Old 06-06-2008, 10:31 AM
 
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If the doula misses the birth because she doesn't answer her phone, because she's with another woman in labor, because her dog died and she's at the funeral...you shouldn't have to pay.

If you don't call her, or the birth is very fast, or something else that's not her fault, you should pay. A doula is like insurance. She held aside that space for your due date. She was on call for you 24/7. You had a fast labor and didn't need her. Yay for you! You could've had a 50-hour back labor and she was with you the whole time. If that had happened, she would not have expected you to pay double even though she'd probably have deserved it.

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#9 of 78 Old 06-06-2008, 10:55 AM
 
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She was on-call. Firemen get paid for being on-call even if there is no fire. I agree that she deserves to be paid for her time.

Another thing to think about...she may have missed the birth, but did she come as soon as possible? Was she there right after the baby was born? A rapid birth is not her fault, and if she tried to get there as soon as she could, she did her job.

Congratulations on the birth of your baby!

Sprat , Certified Professional Midwife, loved very much by Sprig , the most open-minded, loving, gentle man in the world, little Sprout and now someone new! on begins with .
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#10 of 78 Old 06-06-2008, 11:25 AM
 
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I'm a doula, and in my contract it states that the full fee is still to be paid in the event of a precipitous birth or a planned or unplanned cesarean. As pp have explained, this work, while fulfilling and something I love doing, is also a job, and my family counts on the income it provides.

If a client asks, I explain that I can't control the outcome of their birth any more than they can, and that by agreeing to work with them, I'm often then saying no to other clients (if I'm booked for the month).

It really is situational though; there are times I offer a "quick labor discount" if I met the couple late (twice it was just a week before the birth), therefore did no second prenatal meeting, and the birth was fast. In BOTH those instances, the couple refused the discount and paid me anyway, saying they valued the support and that they were aware not all births are so fast! It all evens out....there are some births where I provide over 30 hours of labor support!

Bottom line, I think the full amount should be paid unless the doula herself offers a discount.
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#11 of 78 Old 06-06-2008, 11:50 AM
 
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In my contract:

If I miss the birth due to something that is my fault (didn't answer my phone, etc) I refund the second half of their fee.

If I miss the birth due to a precipitous labor or their failure to call me in time, I offer 10 hours of postpartum care. I wouldn't include the time spent the day of birth in these hours, so basically they would get 10 hours of postpartum doula care to be used as they wish.

I've never had to use these, but I make them very clear to clients before they hire me.

Megan- mama to 3, midwifery student , doula, , runner , knitter .
Violet Lane Birth Services Doula care and placenta encapsulation serving Seattle to Mount Vernon
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#12 of 78 Old 06-06-2008, 01:21 PM
 
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I agree with everything that has already beeen said. For non-doulas, it is hard to understand what it means to be a doula. My husband is also a freelancer and it is totally different work. He has a schedule, people tell him when they need him. He can go hiking for a day or accidently leave his phone at home or turn his phone off for a few hours or expect to sleep through the night and schedule child care for when he needs it instead of having crazy contingency plans!

I love being a doula and so I am fine with what that means about my life and what I can and can not do. I go to sleep with my phone everynight. I missed Mother's Day this year because of a birth that started on Saturday and ended on Monday. I live on-call. I never make real plans because everyone knows I might cancel at the last minute. I sleep whenever I can to make up for missing whole nights of sleep. I don't travel even to upper Manhattan when I have a client who is likely to give birth soon. This means I don't take my kids to events with their friends uptown because I am on-call. It would be too much time to get back to them if a client needed me.

My last birth, yesterday, was super quick. Started with a SROM at 1 am. She called and told me contractions might be starting. At 2 am she said they were happening but nothing like a typically labor pattern. I decided to go anyways. I got there and got us in a cab to the hospital within minutes. She was pushing before the cab made it uptown (and this was in the middle of the night, had it been day time it could have been a cab birth). If I had not gone over, even though she was not sure she needed me yet, I might have missed it. Thankfully she called me right away when she knew something was starting.

I will always try to work out something that feels fair with my clients and anyone who knows me (and most doulas), knows that we all give above and beyond what we ever get paid for. My last super long labor was actually a low-fee client and she had complications afterwards and I have been working with her for free for weeks because I care about her and want to help, not because of the payment. Doulas do this work because we care, not because we are getting rich off of it.

I would pay my doula if she did not make it due to a quick birth or me not calling. As a doula, my policy is a full refund for a missed birth that is my fault (unless my back-up goes for me, then I pay her with your fee). I would talk to her about your feelings and what happened.

Congrats on your birth.

Megan Davidson, Labor & Postpartum Doula, Breastfeeding Counselor, Anthropologist, Mom to August (9) and Clay (4), Partner to Shawn.

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#13 of 78 Old 06-06-2008, 01:29 PM
 
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In my contract:

If I miss the birth due to something that is my fault (didn't answer my phone, etc) I refund the second half of their fee.

If I miss the birth due to a precipitous labor or their failure to call me in time, I offer 10 hours of postpartum care. I wouldn't include the time spent the day of birth in these hours, so basically they would get 10 hours of postpartum doula care to be used as they wish.

I've never had to use these, but I make them very clear to clients before they hire me.
I do something very similar to Megan, I offer some additional postpartum hours on top of the two postpartum meetings that are part of my package. Two four hour shifts or one overnight. I of course go to the birth location to offer support with initial breastfeeding and recovery. I feel that so much of my fee is the "on call" subsidy, and we all know that being on call is draining emotionally and physically for a doula and her family!

I would also like to mention, that if the labor went very long, I don't collect additional money from those clients! It truly goes both ways!

My two cents!
Sharon

Birth doula, doula trainer, ican leader, lamaze childbirth educator, and most importantly, mom of 2 great girls!
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#14 of 78 Old 06-06-2008, 01:38 PM
 
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I agree with everything that has already beeen said. For non-doulas, it is hard to understand what it means to be a doula. My husband is also a freelancer and it is totally different work. He has a schedule, people tell him when they need him. He can go hiking for a day or accidently leave his phone at home or turn his phone off for a few hours or expect to sleep through the night and schedule child care for when he needs it instead of having crazy contingency plans!
I agree! I am also a freelance writer, in addition to my doula work. I'd never expect to be paid for a freelance job I didn't complete, but I do expect to be paid in the event of a precipitous labor, for all the reasons that the other doulas have mentioned.

My contract states that if I miss the birth due to my own fault (I'm sick, missed the call, family emergency) and do not send a back-up, I will keep the deposit and refund the balance they paid at 38 weeks.

If I miss the birth because they didn't call me soon enough, precipitous labor, etc., there is no refund. This has never happened to me, but I think as others have suggested I would offer some extra post-partum support. If a c-section happens before 38 weeks they have the option to cancel our contract and just pay the deposit, but if after 38 weeks the fee stands and I'll be available for support before and after the surgery (and during, if the anesthesiologist allows).

I had an unexpected UC with my second child. My doula was there for less than an hour, and the midwife missed it by 9 minutes. I cheerfully paid the midwife her full fee (even though the labor wasn't THAT fast -- 5.5 hours -- and they really should have been there). I would have done the same for my doula, had she missed it.

So no, I wouldn't expect a refund.

Congratulations on your little one! I hope that it was a beautiful birth and you're settling in well.
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#15 of 78 Old 06-06-2008, 04:44 PM
 
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normally, it is written into the contract that the doula gets paid regardless of whether or not she makes the birth. I would absolutely not expect a refund.

CPST
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#16 of 78 Old 06-06-2008, 05:21 PM
 
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Originally Posted by memiles View Post
In my contract:

If I miss the birth due to something that is my fault (didn't answer my phone, etc) I refund the second half of their fee.

If I miss the birth due to a precipitous labor or their failure to call me in time, I offer 10 hours of postpartum care. I wouldn't include the time spent the day of birth in these hours, so basically they would get 10 hours of postpartum doula care to be used as they wish.

I've never had to use these, but I make them very clear to clients before they hire me.
agreed.

Carrie, The Birthteacher CCE and Doula, real mom to five; and womb-mom to G. born at 23w by emergency C. 12/09
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#17 of 78 Old 06-06-2008, 05:36 PM
 
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Originally Posted by BrooklynDoula View Post
I agree with everything that has already beeen said. For non-doulas, it is hard to understand what it means to be a doula. My husband is also a freelancer and it is totally different work. He has a schedule, people tell him when they need him. He can go hiking for a day or accidently leave his phone at home or turn his phone off for a few hours or expect to sleep through the night and schedule child care for when he needs it instead of having crazy contingency plans!

I love being a doula and so I am fine with what that means about my life and what I can and can not do. I go to sleep with my phone everynight. I missed Mother's Day this year because of a birth that started on Saturday and ended on Monday. I live on-call. I never make real plans because everyone knows I might cancel at the last minute. I sleep whenever I can to make up for missing whole nights of sleep. I don't travel even to upper Manhattan when I have a client who is likely to give birth soon. This means I don't take my kids to events with their friends uptown because I am on-call. It would be too much time to get back to them if a client needed me.

My last birth, yesterday, was super quick. Started with a SROM at 1 am. She called and told me contractions might be starting. At 2 am she said they were happening but nothing like a typically labor pattern. I decided to go anyways. I got there and got us in a cab to the hospital within minutes. She was pushing before the cab made it uptown (and this was in the middle of the night, had it been day time it could have been a cab birth). If I had not gone over, even though she was not sure she needed me yet, I might have missed it. Thankfully she called me right away when she knew something was starting.

I will always try to work out something that feels fair with my clients and anyone who knows me (and most doulas), knows that we all give above and beyond what we ever get paid for. My last super long labor was actually a low-fee client and she had complications afterwards and I have been working with her for free for weeks because I care about her and want to help, not because of the payment. Doulas do this work because we care, not because we are getting rich off of it.

I would pay my doula if she did not make it due to a quick birth or me not calling. As a doula, my policy is a full refund for a missed birth that is my fault (unless my back-up goes for me, then I pay her with your fee). I would talk to her about your feelings and what happened.

Congrats on your birth.
This put it in respective for me. Originally i was going to say i wouldn't pay for a Doula who wasn't there for the birth. But i think its only fair since they put aside everything (not booking clients around the time your due or planning family stuff) just so they can be there for you. And labor can go either way its very unpredictable. I think the Doula still deserves to be paid. I think if i was a Doula (which i plan on doing) and i wasn't able to make a birth because it was fast i would try to be of some help during postpartum care.
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#18 of 78 Old 06-06-2008, 06:29 PM
 
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I think the doula still deserves payment if missing the birth is due to precipitous labor and delivery. I almost missed a birth this morning and came in when the mom was pushing. (baby was born 10 minutes later) She was still so glad I got there to see the birth of her child. I helped her to breastfeed for the first time and make sure her wishes immediately after the birth were carried out. I believe if every attempt was made to get to the birth, then compensation should still be given.

Wife, Mother and Doula.
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#19 of 78 Old 06-06-2008, 06:54 PM
 
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Congratulations on a precipitous birth!

You had a contract.
Being a doula is her livelihood and she deserves her full fee.

Her entire life has been on call for your birth 24/7 and she did not take other clients because of her commitment to your birth. That is why she deserves to be paid. Her time is valuable.

Most seasoned labor doulas have contracts where full payment is expected even when the birth is missed and it was not their fault.
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#20 of 78 Old 06-06-2008, 07:23 PM
 
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what is the baby flips in the 40th week into a breech position or if there is no baby movement for hours and a NST shows major problems right before the due dates and the mom who is devastated on not having a natural birth has to decide on a c-section . What would be done in such circumstances?
Would that be fully charged as well? some doulas i have shortlisted charge almost $ 1000, and it would be totally out of pocket expense. Please consider the above info only for a healthy discussion, to weigh out both sides of the story! Go Doula!

Pari, Student, Job Seeker and mom to K (2006) and A(2011)
 

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#21 of 78 Old 06-06-2008, 07:47 PM
 
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what is the baby flips in the 40th week into a breech position or if there is no baby movement for hours and a NST shows major problems right before the due dates and the mom who is devastated on not having a natural birth has to decide on a c-section . What would be done in such circumstances?
Would that be fully charged as well? some doulas i have shortlisted charge almost $ 1000, and it would be totally out of pocket expense. Please consider the above info only for a healthy discussion, to weigh out both sides of the story! Go Doula!
a mama needs as much (if not more) support for those circumstances then anything else, and I'd vote that the doula deserves whatever she chooses to charge.

Having a doula is not a gurantee for a certian kind of birth.

(ps a surgical birth for breech is a choice, too)

Carrie, The Birthteacher CCE and Doula, real mom to five; and womb-mom to G. born at 23w by emergency C. 12/09
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#22 of 78 Old 06-06-2008, 07:57 PM
 
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I don't know how to post with a quote, but what was described just above recently happened to a client of mine. VBAC mom, very much wanting a natural birth, went a few days postdates, AFI showed extremely low fluid level, non-reassuring NST led to deciding on a c-section immediately following those tests. While I offered to come, client (I think) was thinking in terms of the contract and money out of pocket) opted to not have me come and instead call when she got home and settled for a postpartum visit.

I didn't hold her to the full fee (even though my contract states it would still be expected) because she was devastated enough losing her wish for a vaginal birth; didn't want her to then be thinking about her checking account on top of all that. I'm not in a position with my kids to be able to offer postpartum care or I would do that. I think each case needs to be handled independently.
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#23 of 78 Old 06-06-2008, 08:09 PM
 
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(ps a surgical birth for breech is a choice, too)
mini-hijack...this is not necessarily true. it depends on the state. many states do not have any midwives or docs willing to attend a known breech delivery. even if there are one or two who will do this the chance that they happen to be your provider is quite slim. this is a crappy situation because many women who could birth their breech babies vaginally are essentially forced to have surgery.

main topic - this should have been covered clearly in the contract. if it wasn't, you have room to negotiate IMO and this will be a learning experience for the doula and she will most likely change her contract after this! if she had this clearly stated in the contract then you absolutely owe the full fee. like others have said - her time was reserved for you and she is owed payment. some birth doulas i know will offer some postpartum hours instead if they miss a birth due to fast labor. congrats on babe!

Still a sleepy mama to my fabulous 2 year old girl
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#24 of 78 Old 06-06-2008, 09:18 PM
 
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what is the baby flips in the 40th week into a breech position or if there is no baby movement for hours and a NST shows major problems right before the due dates and the mom who is devastated on not having a natural birth has to decide on a c-section . What would be done in such circumstances?
Would that be fully charged as well? some doulas i have shortlisted charge almost $ 1000, and it would be totally out of pocket expense. Please consider the above info only for a healthy discussion, to weigh out both sides of the story! Go Doula!
Most often, these would be situations where I did more work, not less. I would be helping mom find a doc who would do a vaginal breech or preparing her for a section.

In the other case, I would be at the NST with her when the movement was not felt. We would likely be together beforehand also trying techniques to stimulate the baby and get a kick count going.

I have sat in the lobby during a section and then while dad follows the baby to the NICU I go in with mom so she is not all alone in recovery. I still work just as much, sometimes more.

And, I would also be willing to do some postpartum services, but I still need to pay my rent and in NYC, that's $2000 every month plus all the expenses.

Megan Davidson, Labor & Postpartum Doula, Breastfeeding Counselor, Anthropologist, Mom to August (9) and Clay (4), Partner to Shawn.

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#25 of 78 Old 06-06-2008, 09:26 PM
 
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A full fee would still be something that needed to be paid I think. What the doula chose to do would be up to her - on-call time, not taking other clients, family, etc. all comes into play majorly.

I agree re: the "we can never know how your birth will be" because I'm there if it's 38 hours +, and don't expect to be paid more, just as if I'm there for 5 min. I don't expect to be paid less. My own doula was here last time for only 5 min. If that happens again, we will still pay her full fee.

Good topic/question.

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#26 of 78 Old 06-06-2008, 09:39 PM
 
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A full fee would still be something that needed to be paid I think. I agree re: the "we can never know how your birth will be" because I'm there if it's 38 hours +, and don't expect to be paid more, just as if I'm there for 5 min. I don't expect to be paid less.

I agree with this. In terms of the section, I take $200 off... but still expect payment per my contract. I am still on call, prenatal visits, and postpartum visits as well as lactation support....
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#27 of 78 Old 06-06-2008, 10:13 PM
 
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i dont get keeping a deposit if you fail to attend and it is your own fault??? i would think this would be a serious breach of contract, to fail to attend, no? nevermind feeling entitled to keep the deposit...
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#28 of 78 Old 06-06-2008, 10:17 PM
 
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Originally Posted by naturals View Post
what is the baby flips in the 40th week into a breech position or if there is no baby movement for hours and a NST shows major problems right before the due dates and the mom who is devastated on not having a natural birth has to decide on a c-section . What would be done in such circumstances?
Would that be fully charged as well? some doulas i have shortlisted charge almost $ 1000, and it would be totally out of pocket expense. Please consider the above info only for a healthy discussion, to weigh out both sides of the story! Go Doula!
I've had situations turn high risk at the last minute and my work DOUBLES with them in our prenatal discussions, research, etc.

I wouldn't refund because of that. We'd proceed, I'd be by her side every step of the way.

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#29 of 78 Old 06-06-2008, 10:20 PM
 
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Originally Posted by DoulaMary View Post
mini-hijack...this is not necessarily true. it depends on the state. many states do not have any midwives or docs willing to attend a known breech delivery. even if there are one or two who will do this the chance that they happen to be your provider is quite slim. this is a crappy situation because many women who could birth their breech babies vaginally are essentially forced to have surgery.

!

Actually it's always a choice. Mom can refuse a cesarean and show up in labor and the DR on call for the hospital has to do their best.

Now, the flip side is that mom may not choose to take that route once she researches all the risks of having a breech delivered by an unskilled attendant.

But it is always a choice to refuse a cesarean for breech, no matter the state. If the physicians disagree, they can attempt to get a court order to force a cesarean, absent that, it's mom's choice.

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#30 of 78 Old 06-06-2008, 10:24 PM
 
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I agree with thismama about not keeping a deposit if the doula fails to attend because of some personal issue or lack of response. I feel like from a customer service standpoint a total refund is called for. Assuming, of course, that you couldn't send a backup.

My contract specifies that I might send a backup if I can't make it. I offer people the opportunity to change their minds about doula care between the time they hire me and 37 weeks. After that point I'm on call for them and there are no refunds. The few times I have had clients have scheduled c-sections I usually just offer to be there pre and post-op, and to provide extra postpartum care to make up for a perceived lack of work at the birth. That is not spelled out in my contract, though, just something I try to do to keep everyone happy.

Stacia -- intrepid mama, midwife, and doula. Changing the world one 'zine at a time.
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