To register for our Postpartum Doula Program, please complete the following questions:

Where do you plan to deliver?

Who is your OB/GYN or CNM?

What is your due date?/When was your baby born?

Consent

Services to Be Provided by the Postpartum Doula
Postpartum doulas provide physical and emotional support as well as evidenced-based information to mothers and families.

Physical Support

  • Set up changing stations around your house
  • Make sure you have food and drink at your side
  • Care for your baby while you take a break
  • Light housekeeping, laundry, meal preparation
  • Care for other siblings and pets
Informational Support
  • Teach you basic newborn care, including bathing, changing, swaddling, and soothing your baby
  • Bottle-feeding and breastfeeding information and support
  • Locate resources or postpartum support groups
Emotional Support
  • Assist with your emotional and physical recovery
  • Support for mother-baby bonding
  • Discuss your fears and concerns
  • Answer questions or concerns regarding newborn care or care for yourself
Fees

  • The initial fee for our Postpartum Doula Program is 120 dollars for a three-hour minimum package.
  • Additional customized hours are available for 40 dollars per hour.
  • If you purchase additional hours, the fee will be charged to your card on file.
Confidentiality
By joining the program, you agree to give permission to the postpartum doula to take notes about you, including personal information you choose to disclose regarding your pregnancy, labor, birth, postpartum period, and child/ren. This information will be charted in a system shared with the doulas providing services through the Birth Center Program.
By stating “yes” I indicate that I have read and understand the above information, I want to hire a postpartum doula to perform the services described herein, and I will comply with the terms and conditions set forth in this agreement.