Make your birth doula contract

You have to make a contract. It’s intimidating. Nobody wants to share theirs. We’re probably all self-conscious about how ours compares to other doulas. What do you put in it? Where do you start? How do you word it? Let’s talk about it.
 
A contract protects the doula. It clarifies what they do and don’t do. Any client signing it is stating they understand this. They’re also agreeing to pay your fees. Don’t procrastinate. Get it over with. You’ll feel better after it’s done.
 
Let’s set it up. This is how I have mine. It is not done by a lawyer. You should get an attorney to review yours. Throughout this blog, I’ve copied pieces of my contract, italicized, and in green font.   
 
At the very top you may want to add a title to the document such as
“contract of hire for birth doula services.”
 
Next you want your information.

• Company
• Name of doula
• Website
• Email
• Phone number

I put a box around that section.  
 

SERVICES
I break these down into sections with titles so the contract is easy for them to read. 

• General description – Give a few sentences about the basics of birth doula services. I also mention I am an independent contractor and not employed by any hospital, birthing center, medical practice, or doula agency.
• What services include – You may want to say how you offer support (in-person and over the phone or video chat), locations you support, and what types of births you support.
• Birth doula services do not include – I also list a few bullet points of what is not included in this such as medical care, transportation, cleaning, child care, attendance of intentionally unassisted births, etc.
• Time frame of services – How early can they hire you? When do your services end?
• On-call availability – When does your on-call period start? For most of us, we go on call at 36 weeks.
• Time of arrival – This section clarifies expectations for how quickly you can get to them once called. I recommend using language such as “Please allow a minimum of two hours to arrive” instead of saying something like “Will arrive within two hours”. You may get there sooner, but don’t break your contract over it. Mine also says to please consider drive time from New Carlisle, Ohio. This gives them an idea of how far I’m driving.
• Duration of shift – How many hours in a row can you or will you work? Do you want to mention allowing small breaks for food? Is there a time limit for max amount of hours you’ll support a birth? Mine says that after 12 hours of work, I may take a break. I do not put a limit on the overall time I provide services.
• Inability to provide services – What happens if the hospital won’t let you in? Will you offer virtual support or refund? Mention your sick policy here.
• Back-up doulas – Do you work with a back up doula? Be straightforward about this. If you do, mention when you would call them in. Do you cover the cost or does the client? Do you guarantee back-up support?

 

CONFIDENTIALITY
Make a statement about confidentiality. Mine says,
 
All medical and personal information shared is confidential. I do not disclose when someone is in labor, if they have given birth, details about their birth, or information about their baby. It is also confidential when a person is a client.
 
After that I have a social media section where I mention that I do not talk about my clients on social media without permission. I may ask permission for reasons such as reviews, promotion, a welcome baby post, or educational opportunities.  
 

RELEASE OF INFORMATION TO THE HEALTHCARE TEAM
In this section, I ask permission to share relevant information with the healthcare team. There is a space for them to sign and date if they give this permission. Mine says,
 
The doula is asking permission to release relevant information to the healthcare team as necessary for the health, safety, and well-being of the client or by client preference for the doula to communicate. Please sign and date below if you grant permission for this release.
 

FEES
Here is where you want to clarify what your fees are and when they are due. Here is mine as an example.
 
The standard package included 3 prenatal appointments and 1 in-person postpartum appointment.
Fee: $2200
 
Fees are non-negotiable. All clients have the same fee. This is for all types of birth (vaginal or cesarean, medicated or non-medicated) with any outcome.
 
50% of the total fee is due at time of hire.
The remaining balance is due by 36 weeks.
Birth support will not be provided without full payment.
 
If you do a sliding scale, talk about it here and mention the requirements and the price.
 
Scholarship amount or discount applied

• None
• $______
• _______ % for a total of $______

 

REFUND POLICY
You need to have a refund policy decided. Many doulas decide the birth itself is a certain percentage of the fee. They may also decide to have a non-refundable retainer fee. Mine is in green here. It is okay to have a cut off for refunds such as 36 weeks because they have taken that slot for the month and it may be difficult to fill that slot last minute (and pay your bills on that income). You may also want to clarify refund policy in case of perinatal or newborn loss.

The retainer fee is 40% of the overall fee. That is $880 of the $2200. This secures the client’s due date and the doula’s availability for that month. That is non-refundable.
 
If the client wishes to end services before 36 weeks (according to the due date given at time of hire), all but the retainer fee will be refunded. That would be a refund of $1320 of the $2200.

After 36 weeks, there is no refund if/when a client cancels services.
 
If the doula misses the birth through no fault of her own (i.e. the client did not notify in a timely manner), no refund is given.
 
If the doula misses the birth through her own circumstances (such as illness) and no back-up doula serves as a substitute, 50% of the total package fee is returned. That would be a return of $1100 after prenatal appointments and support. Postpartum follow-up will still be offered.
 
In case of loss (miscarriage, stillbirth, or neonatal death), doula support is still provided. The above policies are followed. If the doula provides bereavement support, that is birth support. If the doula misses the birth, 50% of the package fee is returned.
 
If a different amount was paid due to discount or scholarship, the refund amount will be adjusted. The percentages stay the same.
 
If the client’s insurance company has provided reimbursement or funding has come from HSA or a similar account, no refund will be given.
 
If the doula chooses to terminate services, a full refund is given.

Remember your time doing appointments and providing support prenatally is still worth charging for even if you miss a birth. Don't give a 100% refund when you have done work for this family.


TERMINATION OF SERVICES POLICY
After you share your refund policy, you should clarify that the client can terminate services and there are situations the doula can as well. Mine says,
 
The client is able to end services at any point for any reason. 
 
The doula may end services for reasons including the following: violence, unsafe environment (including presence of drugs), unhygienic environment (including excessive smoke or allergens), threats, harassment, mistreatment, change in planned birth location, or incompatibility with expectation of care.

If the doula has a medical need or personal reasons to take a leave of absence from work, services will be terminated with a full refund and with referral to other doula support options in your service area.
 
Note: I am unable to provide care in a home with a cat. I’m highly allergic. While I discuss this matter before scheduling a consultation, please note that if a client gets a cat after hire, I will have to terminate services unless we can arrange appointments to be done in another home.
 
Notice that I mentioned in my contract about an allergy of mine. I am sadly very allergic to cats. Some breeds actually make my eyes swell shut. I cannot be in a house with cats. I actually ask about pets in the home before I schedule a consultation.

When I was a newer doula, I didn't have a termination section. I think it's a good idea to have a formal exit opportunity if safety becomes an issue.
 
What are some situations you want to be able to end a contract with someone?


LIABILITY
You may want to mention some things about not being liable for outcomes that aren't what the client wanted. Here is what mine says.

• The doula does not make medical decisions or give medical advice. Therefore, the doula is not responsible for the outcomes of medical choices made by the patient.
• The doula cannot guarantee preferred outcomes or birth preferences. Therefore, the doula is not liable when preferences are not met.
• The doula is not responsible for the outcomes of the pregnant client, fetus, birthing mother, or infant.
• The doula is not liable for injury using equipment provided by the doula.
• The doula is not liable for injury caused by the client choosing or agreeing to positions or recommended techniques.

CLIENT RESPONSIBILITIES
Be clear about what responsibilities they have. How soon do they need to notify you? Some examples in my contract,

• It is the client’s responsibility to understand a doula’s role and scope of practice before hiring.
  
• It is the client’s responsibility to notify the doula as soon as labor is suspected. Proper notification of labor is a voice call. Text messages are not sufficient notification.
  
• It is the client’s responsibility to notify the doula when the client is ready for in-person doula support to begin.
• In the event of an emergency, preterm labor, or an unexpected outcome during pregnancy, notify the doula as soon as you are able.
• If the client switches to a different care provider and/or planned birth location, please inform the doula of this change.
  

 
COMMUNICATION EXPECTATIONS
It may not be necessary to mention this in the contract, but I think it's helpful to clarify how they need to contact you and when they can expect a response if you happen to have office hours. Here is what mine says.

• When labor is suspected, a voice call is necessary.
• If/when an emergency is suspected, please voice call.
• Voice call to notify the doula of when you would like her to come. Text messages and emails can easily be slept through or unheard; therefore, are insufficient notification.
• During pregnancy and the postpartum period, feel welcome to email or text at any time.
  
• Messages that are not urgent will be answered during office hours. Those hours are Monday through Saturday 11am to 7pm.
• Communication during pregnancy and postpartum is client-led. Please keep the doula informed of updates by your own initiative.
• The client must communicate medical decisions and requests directly with the staff. While the doula can speak to staff on your behalf with non-medical matters, the patient has to speak for herself on matters regarding medical care.

CLIENT INFORMATION

• Birthing woman’s name
• Phone number
• Email *the invoice will be sent to this email
• Home address
• County of residence
• Estimated due date
• Intended location of delivery
• Name of provider for maternity care
• Name of practice

 
AGREEMENT TO HIRE SERVICES
This is where the action comes in. Will they say I do? Is it a match?
 
I, (type a line long enough to handwrite the client's name), hereby agree to hire (your name) of (your LLC) for birth doula services as agreed upon in this contract.
 
I understand this agreement becomes active upon payment and that without payment this contract will be null.
 
I understand the doula’s role of support.
 
I understand medical care is not included in doula services.

I understand services will not be provided for labor and delivery without payment in full.
 
I understand the fees, refund policy, and termination policy of this business.
 
(line)
Print your name
 
(line)
Sign your name
 
(line)
Date
 
Symbols “doula portion” symbols
 
(line)
Doula signature
 
(line)
Date
 
 
 
 
 
 
Ta-da
You did it. You made your very first contract. See, that wasn’t so scary. Open a document. Do your outline. You are welcome to use the outline I have here. Draft. It doesn’t need to be perfect today. Get it drafted. Go from there. And remember you are always allowed to update your paperwork. You can tweak things as you go. You’ve come this far. Don’t let the intimidation of a contract hold you back.