Experienced Doulas - What forms/handouts do you use, what do you discuss at prenatals - Mothering Forums

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#1 of 15 Old 10-31-2003, 12:24 AM - Thread Starter
 
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Hi,
Well, my two clients have turned into four - three due in December (I'm crossing my fingers - and I've arranged backup) and so I've got to get myself organized way quicker than I ever thought!

I've qot three specific questions - and I'm hoping that some of you lovely ladies can help. There seems to be such a wide variation in how things are done, and I really thought I'd have a little longer to think and research before making my own decisions. I've got at least two prenatals in the next two weeks - so I really, really, really appreciate your feedback.

Forms/Handouts:
Aside from the contract/agreement - what forms do you use? I've talked to the few doula's around here that I know, and they each seem to have a different list of things they have clients fill out (one does little more than the contract, the other has a stack of paperwork). In your experience, what information do you find most useful or important?

Also, do you give handouts to your clients? Do you go over the topics, or just leave them to read on their own time?

Prenatals:
Do you have a specific list of topics to cover at each of your prental visits, or does it vary from client to client. What are the major things you like to be sure you have covered with the client before the birth.

Payment:
I have seen a great variation in this area - some people requiring payment in full at first visit, others requiring a downpament, with full payment before the birth, and others not requiring full payment till the month after the birth.

What do you find works well for you?

What do you NOT include in your base fee? If you have extra services that carry extra charges, what do you charge - and is this covered clearly in your main contract - or do you cover that elsewhere?

Thanks so much
Jeanette
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#2 of 15 Old 11-06-2003, 04:59 PM
 
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I am also a new doula and here are a few things that I am doing, hopefully it will help you a little.

I have a contract the specifically states what services I am going to provide and at what cost. My base price includes : 2 prenatal, labor, and 1 postpartum. I have seperate charges for more prenatal or postpartem visits

I also have a question form that I will go over with my client. I will ask the questions and they will provide the answer. These things would include basic info about them and thier family. Who will be at the birth, where is the birth, have they had any problems in the past conderning labor, what are thier fears, what do they think about labor, what is their ideal setting for a labor, where do they hold stress, what do they do to relax etc. I don't want to hand them a form and have them fill it out, that seems too impersonal. The only thing that they will fill out is the medical history and that is only for their privacy if they dont want to talk about it.

I am going to collevt my fee after the birth.

I haven't thought about handouts, one think I might do is a nutrition hand out and a what to do if....handout.

Hope that helps a little.
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#3 of 15 Old 11-10-2003, 01:26 AM
 
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I do at least 4 prenatals before the due date (hopefully before baby comes).

The first visit I go through my contact which includes what my scope of practice is, my fees, how to reach me when in labor, etc. My payment schedule is that I require at least half of the total amount paid by the due date and then I have to have the total paid in full by the last time that I see them 2-3 weeks after the birth. I also go through health history w/this pregnancy and previous pregnancies, any allergies, goals for this birth, what they imagine labor to bel like, do they smoke, are they planning on breastfeeding, etc. We go through what to expect during the last weeks, what providers may suggest during this time, early labor stuff, the rest of first stage, and second stage. I always go through normal progress of labor and at the same time include what interventions may be suggested/used including induction stuff. I keep a folder with all of the info written down in it so that I make sure that I don't forget anything. I have every intervention that I can think of in it with pros and cons so that I give a comprehensive list. We also talked about alternatives, etc. I also give a folder at this time that has a variety of different articles in it about things like drugs during labor, placenta prints, herbs, exercises, nutrition, Cytotec, interventions in general, beta strep, etc. I usually lend out videos at this time. I also give out any samples that I've been given by companies like Lamaze, Luna, etc. at this time.

The second visit is dedicated to what they're thinking about w/pain. We talk the options and go into all kinds of different techniques if they are desiring drug-free. I talk about "tricks" that support people can do to distract the mom (water, walking, positions, birth ball, etc.) at that time. We also go through what comfort measures they're interested in or not interested in of course keeping in mind that they may change their minds. We talk about 3rd stage.

The third visit we work on birth plan. We talk a lot about hospital policy and where that's flexible, what to expect from staff and providers. We talk about c-section stuff also and what their stay at the hospital will be like. We finish the rough draft of the birth plan and then I take that home and type it up onto one page for easy reading.

The fourth visit we go over the finished birth plan adding anything that they want. I give them 2 copies one for their bag and one for their providers. We talk about postpartum depression and breastfeeding at this appointment also.

I choose to spend a lot of time w/the families because I personally feel that the childbirth prep classes are so biased towards patient compliance that I want them to hear from a person not employed by the hospital.

I keep a chart including:
1. A timeline check off list for each visit to make sure that I cover everything that I need to
2. A "progress notes" page w/notes on anything new in the pregnancy, how they're feeling, etc.
3. Our contact
4. The registration form and health history
5. Comfort measures intake form w/info on what they'd like
6. A form to help break down fears to see where they stem from
7. A copy of the birth plan
8. Penny Simkin's "Pain Medication Preference Scale"
9. Labor flow sheet
10. Labor summary sheet
11. Follow-up sheet to include all postpartum contact

Handouts that I give (other than in the folder):
1. Info for the partner on support, how the doula works w/them, what to expect
2. Immediate postpartum breastfeeding info on commonly asked stuff like sore nipples, engorgement, and storage

Can't remember what else.

I also have a pretty extensive lending library availible to them which includes videos also.

I also keep a huge file w/all kinds of different info to use in specific situations like breech, c-section recovery, waterbirth, herbs, VBAC, hypertension, etc.

Whew, all done
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#4 of 15 Old 11-16-2003, 12:53 AM - Thread Starter
 
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Wow! I don't even know where to begin to thank you for all your information - or where to start with all the questions that you brought to mind!

First off, would you even consider sharing any of your forms/handouts, etc? I understand if you would rather not, but I would be incredibly grateful - you mentioned information I had not even really thought of going over.

I love how you have structured your prenatal visits, and how committed you are to your clients - it is truly an inspiration to someone who is just beginning this journey.

I have been thinking of purchasing some videos for my growing lending library - which ones would you recommend?

Also, you mentioned giving out samples - how do you go about obtaining samples to distribute to your clients?

Thanks so much, I am sure I could come up with more questions if I gave myself more time!

Jeanette
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#5 of 15 Old 11-16-2003, 03:52 AM
 
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I think that sharing my forms would hinder rather than help you. When I was making out my forms I put in questions that I felt were important information to me but to other doulas they don't feel as important. I didn't really have any forms to go off of so I developed my own. I just really feel like everyone has their own comfort level on what questions they should be asking/not asking. Trust me, you'll appreciate it much more doing your own!

Hard to say on videos for the lending library. I used to use a copy of "Introducing the Doula" from DONA but it is the most boring video EVER! I did like it though because it showed a couple of births on it with a doula present so I felt that was helpful for the couple to kind of see what it's like. It's a cheap video also, I think it's like $15 or something. The other video that I used was a video of a waterbirth that I filmed because the mom was so vocal. I used that especially with couples planning a drug free birth so that they got a real feel for what labor song sounds like and that those noises are OK. It was also a great video for couples to see what a hospital room looked like, first breastfeeding, etc. The other video I actually got from a Goodwill and was just a basic baby care video. I especially liked giving that out to new parents so they could see what meconium looks like, see what the umbilical cord will start to look like, etc.

There are a few lists online for samples. Try searching under "doula freebies" or "childbirth educator freebies". I used to get them from Lamaze, LUNA, Lasinoh, Motherwear, our health dept prints out our state laws that protect breastfeeding on little cards also. I screened stuff pretty heavily though and wouldn't hand out magazines or packets of stuff w/o looking through and reading all the articles first. I used to get Baby Talk but stopped handing that out because of the excessive coupons and advertisements for formula. I ended up getting so much stuff that I couldn't hand it out fast enough!
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#6 of 15 Old 11-16-2003, 07:36 PM - Thread Starter
 
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Thank you so much for all the tips - you have been an invaluable resource! :-) I did find a list of freebies, and will start making calls on Monday.

Thanks again so very much,
Jeanette
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#7 of 15 Old 01-29-2006, 06:06 AM
 
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I wanted to revive this thread because it is exactly what I was looking for and I had to search and search until I found it. So, here it is again, in case others were looking for this advice also.

Mother to one wild and crazy boy 12/29/2002.
Midwife, Homeschool Educator and Crafter.
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#8 of 15 Old 01-29-2006, 12:11 PM
 
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Forms/Handouts:
I have my clients sign a HIPPA consent form letting them know I'll be taking notes on them. I have a client info sheet that I fill out in the initial meeting. I ask them about previous births, BF, allergies, contact info, goals in birth, etc. I give them a sample birth plan if they need birth plan guidance. I give them a BF info handout, labor positions handout, interventions handout. Most of these handouts have come from my CAPPA doula book. I also offer a lending library. I have several books on labor, preg, BF, and parenting.

Prenatals:
I have at least two prenatal meetings. I try to get as much info as possible. My client info sheet has everything on it that I NEED to know, anything else that the client brings up is also discussed.

Payment:
I am still volunteering and not taking payment. When I do charge I plan on asking for 1/2 up front, this will be a non-refundable deposit. The other 1/2 will be due by 37 weeks preg. I was going to ask for payment after the birth but most doulas in this area ask for full pymt by 37 weeks. It makes sense to me because things can get really hectic after having a baby and I don't want to have to keep contacting someone to get payment. Payment will be refunded if I miss a birth because of my own problems, errors. If the client does not contact me then payment is still due. If a labor is very fast (one hour or less) and I don't make it then 1/2 payment is refunded. I let my clients know that it will take me about and hour to arrive at the birth.

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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#9 of 15 Old 02-05-2006, 11:56 AM
 
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I have found all the previous suggestions and tips helpful and incorporate most of these types of things into my services. However, I just wanted to add that something I have found incredibly useful and invaluable for new parents is a list of local contacts in the community that might be helpful after the baby is born (eg. breastfeeding and new mother groups, people who offer different post partum services, licensed infant and mother carers, infant massage, mother-and-me classes for various activities etc).
It really depends on how much research you want to commit to. The gathering of all the information can be time consuming if you live in a large city with lots of resources, but once it is initially compiled all you need to do is keep it updated.
Good luck to all aspiring doulas!
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#10 of 15 Old 02-05-2006, 12:19 PM
 
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Forms/Handouts:
My doula partner and I give three forms- the first is a contract agreement, the second is a prenatal history packet (parents fill out basic responses in terms of where they are birthing, who their practitioner is, if any; any relevant history that they want to share with us, what they use typically to relax and what doesn't work, and religious/cultural preferences during their labor and birth) and the third is a handy little info sheet on our phone numbers and some basic reminders (ie, don't worry about phoning, blah blah blah...)

Also, do you give handouts to your clients? During our interviews, if we get a feeling that they will be hiring us (or usually they come right out and say, "When can we sign and start?") we discuss topics of interest to them, and broach things that may also tie into what they are saying. I always ask if they want more info- a lot of my mommas are pretty well read.

This may be slightly controversial, but as my partner and I no longer take people who willingly are induced with Cytotec (we still work with Cervadill inductions) due to a traumatic experience with a near-rupture in October (we need some time and space from that incident, and we may revisit it again. We got some slack from doulas we converse with for not taking them, but it's just what we need to do right now) and so we do include that in the contract, and when necessary have the FDA warnings and Searle insert letter copies to show them.

Prenatals:
Varies from client to cliet; we're pretty client-led, and before each next prenatal, we ask what they would like to do. As a general rule of thumb, we use the first prenatal to get a birth-plan onto paper for them to take to their practitioner, and the second one we go over just a bit of wrap-up on it, if their OB (if using an OB) was reluctant on issues. The first one is also a good time to do the B'LIEFS form if it seems the birth mother and practitioner are not on a similar page.

Payment:
We're flexible, and have agreed to extended payment plans, but in general have a non-refundable "holder" amount (that "holds" our time within two weeks before and after their EDD as theirs) upon signing the contract, and the other two payments are due ont he second prenatal (or whichever is the final one before the birth) and after the birth. So far it's worked for us.

What do you NOT include in your base fee?
Well... it sort of depends. LOL, I'm looking at these questions, and questioning myself as to whether or not we're too laid back! After one client in particular took a mile when we gave her an inch (to a major extreme) we have two one-hour prenatals and a one-hour postpartum visit included in our fee, with additional hours for $50 as needed. We're not totally draconian about times, our last prenatal went over by about 20 min, and it was no biggie.

We have a basic business plan, but we also are very flexible, and reflect often on what each individual client adds to our perspective. It works beautifully for us!

Best birthy-vibes to your clients, and strength to you!

Clara

Mama to a beautiful little girl, born July 18, 2007
Eager for a VBAC some time around April 10, 2010!
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#11 of 15 Old 02-07-2006, 10:40 AM
 
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: Just registered w/ALACE for my Labor Assistant course. This stuff is great, thanks for sharing!

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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#12 of 15 Old 02-20-2006, 04:07 PM
 
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: Any more, ladies? I have impending meetings this week, and I want to be sure that I've thought of everything without overwhelming them, you know?

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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#13 of 15 Old 02-25-2006, 06:45 PM
 
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I AM CONSIDERING A DOULA CAREER AND WAS WONDERING WHAT KIND OF MONEY THEY MAKE? THANKS FOR ANY INPUT--MRSMLH4051--PROUD MOM OF 5
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#14 of 15 Old 02-25-2006, 06:49 PM
 
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HI! LADIES---HAS ANYONE PARTICIPATED IN A DISTANCE DOULA TRAINING AND IF SO WHICH ONE?--I'M LOOKING FOR THE BEST ONE FOR THE MONEY--THANK YOU!! MRSMLH4051--PROUD MOM OF 5
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#15 of 15 Old 02-25-2006, 08:04 PM
 
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Hi mama!
I'm with DONA. I like it. However...I am thinking of not being certified.
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