Celebrated BIRTH
Doula Service Description and Agreement
Mari Stutzman Smith-Celebrated BIRTH
44260 Navajo Drive
Ashburn, VA 20147
703.408.0911
Mari@celebratedbirth.com
Birth Doula Service Description
A Celebrated BIRTH Professional Birth Doula provides continuous care for the laboring woman
and partner, and helps them fully experience their birth by offering physical, emotional and
informational support. She is trained to understand the natural process of birth, respect its
spiritual, physical, and emotional aspects, and help facilitate the birth experience. A doula can
provide prospective, make suggestions for labor progression, coach in relaxation and positioning
techniques, and provide encouragement for the laboring woman. The support of your Celebrated
BIRTH doula contributes to the well being of the mother, baby and father-before, during, and
just after birth. We have your best interest in mind. We are self-employed which means we are
working for YOU, not your caregiver or hospital.
Doula Responsibilities
Once this contact is signed, Celebrated BIRTH is committed to offer two prenatal visits, one
postpartum visit, unlimited email and phone support, continuous labor support upon the
establishment of labor, birth and postpartum support lasting for up to two hours post delivery.
We are available on-call for your birth two weeks prior to your due date through two weeks post
delivery. We will provide you with email addresses and phone numbers so that we may be
reached 24 hours a day. We generally arrive within 2 hours of your request. During the prenatal
visits, we will provide on loan a Celebrated BIRTH binder with informational material about
pregnancy, birth, and infant care. Also, you may choose to borrow books from our lending
library. During your labor, we will encourage relaxation, position changes, pain management
techniques and comfort measures to aid in easing labor. We are also available to help you make
informed choices about your birth.
Service Limitations
Should labor support exceed a 24 hour period, Celebrated BIRTH is permitted to call a backup
doula, if available, otherwise support is limited to a 24 hour period. If we are on-call for you and
are attending another client’s birth (unlikely event), or another emergency situation occurs in
which attending your birth is impossible, Celebrated BIRTH will provide you with a backup
doula. If you happen to go into labor earlier than your on-call period, Celebrated BIRTH will
make EVERY attempt to attend or try to arrange a backup to attend your birth.
Birth doulas cannot:
• Perform clinical tasks such as vaginal exams, blood pressure monitoring, fetal heart
tones, or any other medical procedure. We are not health care professionals.
• Provide advice or recommend information concerning prescription drugs, alternative
medication, or medical advice pertaining to you or your child.
• Attend a birth without the attendance of a healthcare professional.
• Make decisions for you concerning your health, labor, or birth. We will help by
providing information necessary for you to make informed decisions.
• Speak to medical staff on your behalf. Though, we can discuss medical
recommendations with you and offer options. We will also support you in your choices
and act as an advocate for your decisions.
Responsibilities of the Client
Once you have committed to Celebrated BIRTH, we require that you inform your caregiver that
a doula will be present at your birth. It is your responsibility to inform Celebrated BIRTH of
any pregnancy or non-pregnancy related health complications or illnesses so that we can provide
you with the best care as well as take any extra precautions necessary. You are also responsible
for the cost to replace any items loaned to you, such as library books.
It is your responsibility to notify us as soon as you think you are in labor or if your water has
broken-even if you do not want immediate support. Failure to do so may result in arrival delays,
or even worse, we could miss your birth.
Failure to Provide Services
After the first prenatal visit, the retainer fee is non-refundable. If we fail to attend your birth due
to circumstances beyond anyone’s control (i.e., extremely rapid labor and birth, natural
catastrophic event, etc.), we will split the remaining balance. In the extreme unlikely event that
we cannot attend your birth and a backup doula cannot attend, the remaining balance is not due.
If you do not call Celebrated BIRTH for your birth, payment is still due.
Caesarean Section Clause
If a decision to schedule a C-Section is made before the 34th week of pregnancy, and you choose
to cancel Celebrated BIRTH doula services, the remaining balance is not due. The retainer fee is
not refundable. If you do not wish to cancel services, we will meet you at the hospital. We can
accompany you during your surgery or wait for you in the recovery room, assist you with
breastfeeding and infant care/adjustment. If this option is chosen, the remaining balance is due.
Photo Consent
Initial if agreeing to terms.
I do give Celebrated BIRTH permission to use a photograph of us or our minor child for
publication purposes, such as placement in the Celebrated BIRTH website.
_________ (mother’s initials) _________ (father’s initials)
Fees
The fee for a Celebrated BIRTH doula is $ 600 to be paid as follows,
$ 300 Retainer Fee- Due at contract signing. This is non-refundable and covers the cost of
prenatal visits, active on-call, and the possibly of declining potential clients to avoid
overbooking.
$ 300 Remaining Balance- Due at the postpartum visit.
Notes/Special Arrangements:
I have read the above Celebrated BIRTH- Birth Doula Description and Agreement and agree
to its terms and conditions. I fully understand the responsibilities of the Celebrated BIRTH
doula, as well as my own. I understand that Celebrated BIRTH and Mari Stutzman Smith may
provide alternative suggestions surrounding my birth options, but I, ultimately, take full
responsibility for my birth decisions. I do not hold Celebrated BIRTH or Mari Stutzman Smith
responsible or liable for unexpected clinical outcomes.
Print Name:__________________ Signature: ____________________ Date _________
Print Name:__________________ Signature: ____________________ Date _________
Doula Name:_________________ Signature: ____________________ Date _________