Crystal Minnick
Birth & Postpartum Doula
Placenta Encapsulator
Prenatal Yoga Instructor
Lactation Educator
Cell: (808)673-8717
Email: crystal.minnick@gmail.com
Website:
www.lovinglotusbirth.com
Birth Doula Services Agreement
What is my role as a doula?
As a doula service provider, I help women stay strong and calm during birth. I offer comfort measures,
coping techniques, and constant presence to help you create a satisfying birth experience. I get to know
you and your birth companion(s) prenatally and continuously support you and your loved ones during
the birth. I will provide comfort and perspective to you and your partner, make suggestions as issues
arise, and assist with massaging, positioning and relaxation techniques during birth as required. As your
doula, I work for you directly, not for your caregiver or hospital.
My goal as your doula is to be completely present for your birth experience-physically, emotionally and
energetically. Through using active listening techniques, I adjust my role according to your needs and
seek to promote communication among all members of your birthing team.
Prenatal visits
After our initial meeting, I will meet with you and your birth companion(s) for two prenatal visits. This
gives us a chance to get to know each other before the birth. During these prenatal visits, we will review
your Birth Plan, and give us a chance to talk in detail about your preferences regarding your birth. I will
ask about your knowledge of the birth process, and can provide information and education as needed. I
will want to know your own personal ways of coping with pain and fatigue and difficult situations, and
what internal resources we can draw upon to assist you with the birthing experience. I will want to know
how you and your partner foresee working together, and the roles of others who may be attending the
birth. We can discuss together what fears and concerns you have regarding the birth. We can review
your preferences regarding the use of pain medications.
My role is to help you have a satisfying birth as you define it. The more we explore this in advance, the
better I will be able to fulfill this role. I can support your preparations for birth and parenthood by
Page 1 of 4
offering exercises, activities, role-plays, and referrals to other resources as necessary. We will remain in
touch by telephone and/or email in the weeks leading up to your birth.
On-call period
I consider my on-call period for a birth to be from two weeks before a due date to two weeks after the
due date. I generally will only take a client if I plan to be in town and available for this “on-call” period.
Limits of availability near your due date: I would list specific dates and times here when I would not be
available and my back up doula would attend….
I do have a cell phone, and in general I can be reached at any time. In the rare instance where I need to
turn it off for some reason during an on-call period, I try to check it at least every two hours for voice
mail.
Late Pregnancy
I am available for phone consultations and email questions in late pregnancy, and encourage clients to
call with questions or updates. Once we enter the on-call period, I encourage clients to check in with me
every few days to let me know how they’re doing.
When you are in Labor. Please call me when you think you are in labor, even if you do not need me at
that time. If I am unable to answer the phone, please leave a message and I will call you back as soon as
possible. I will decide if I should come then or wait for further change. In the case of a long early labor,
or an induction, I can check in periodically and come when you are moving into active labor. I need
approximately 60 minutes to get to you from the time you ask me to come. We will also decide together
where to meet--at your home, the birth center, or the hospital. Except for extraordinary circumstances, I
will remain with you throughout labor and birth. In the rare circumstance that I cannot attend your
birth, I will call a back-up doula to attend. If you go into labor before 37 weeks, I will make my best effort
to join you as soon as possible, or make back-up arrangements as necessary.
Comfort techniques: I can offer help and advice with comfort measures such as guiding your breathing,
enhancing relaxation, encouraging movement, suggesting effective positions for labor, and doing
massage. Advocacy: I can assist with gathering information about the progress of labor to make sure you
have the information you need to make informed decisions about your birth. I can also serve as an
advocate for your needs with the medical staff. Emotional support: My most critical role is providing
continuous emotional reassurance and comfort.
After Birth
I will remain with you for an hour or two after birth, until you are comfortable and ready for quiet time
with loved ones. I can also help with initial breastfeeding, as desired, and help you create the
environment you want for those first few critical hours of bonding with your new family.
I am available for phone contact to answer questions about the birth of your baby. I will schedule your
postpartum visit in the week following your birth to see how you and your family are adjusting, assist
with early breastfeeding, and listen to your birth story. Taking the time to process joyful or difficult
moments from the birth with your birth team and your doula can influence how you remember your
baby’s birthday for years to come.
Page 2 of 4
What Doulas do not do:
- Perform clinical tasks. This includes tasks like taking blood pressure, fetal heart monitoring, and
vaginal exams.
- Make decisions for you. We will help you get the information necessary to make an informed
decision. We will also remind you if there is a departure from your birth plan. Our role is to observe,
listen and reiterate rather than to give opinions.
- Speak to the staff on your behalf. I will discuss your concerns with you and suggest options, but
you or your loved ones will speak directly to the clinical staff. I am there to encourage communication
with your care provider.
Explanation of Fees
I will make every effort to provide the services described here. If I show any symptoms of
contagious illness, I will call on my back-up doula to attend your birth. If my back-up doula attends your
birth for this or any other reason, my fee is due in full.
_____ / _____
If your medical care provider or the policies at your birthing location prevent me from providing
services, my fee is still due in full. If hospital policy prevents me from being with you during a
Cesarean birth, I will still provide immediate postpartum support, and my fee is due in full. I
recommend you discuss your plans for doula support with your provider before the birth.
_____ / _____
If you have a cesarean birth that is planned before you go into labor, I will be available to support you
before, during and after the birth. I will also offer an additional four-hour session of
postpartum support in conjunction with our postpartum visit, and my fee will remain the same.
_____ / _____
If you call me when you are in labor, and I am unable to attend your birth, and you were not
attended by a back-up doula, I will refund everything but the non-refundable deposit. If you do not call
me to attend your birth or I am not given adequate time to attend your birth, I will not issue a refund. In
any of the aforementioned circumstances, I will always be available for two postpartum visits.
_____ / _____
Fees
I ask for a non-refundable deposit of $300, which is paid during or shortly after the consultation, which
is applied to the fee. I will not consider myself obligated to the birth, or “on-call” until I have received
this deposit. The remaining balance is due at the second prenatal visit, payment plans can be discussed
if necessary. If a parking fee is charged at hospital during your birth, I will provide you with a receipt and
request reimbursement at postpartum visit.
• Birth Doula Services
Deposit: $300
Balance: $600
Total:
$900
Page 3 of 4
Additional Services:
• Additional prenatal or
• 20 hours PP support: $550
postpartum visit: $100
• 40 hours PP support: $1100
• Birth Sealing Ceremony: $50
• Private prenatal yoga sessions: $60
(One hour private session in my home)
• Placenta Encapsulation: $250-$400
(Options and pricing can be discussed at prenatal)
Checks should be made payable to Crystal Minnick and sent with the signed contract to:
1065 Keolu Drive
Kailua, HI 96734
The fee you will be paying is: ________
I / We have read this letter describing the doula services and agree that it reflects the discussion we
have had with her.
Print Name(s):_____________________________________________
_____________________________________________
Signature(s): ______________________________________________
__________
Date
______________________________________________
__________
Date
______________________________________________
Loving Lotus Doula – Crystal Minnick
__________
Date
Page 4 of 4