What is a Birth Doula?

As a birth doula, I help women in labor (and their partners) to have a safe and satisfying birth experience. I draw on my knowledge and experience to provide emotional support, physical comfort, education, and, as needed, communication with the staff to make sure that you have the information you need to make informed decisions in labor.  I can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, massage, positioning and other techniques for comfort.  Of course, I also use my own sense of humor to add a bit of fun to the experience (when appropriate)…this is an exciting time, after all!  I am independent and self-employed.  As your birth doula, I am working directly for you, not your medical care-giver or birth place.

Labor Support Services Provided

As your birth doula, I offer:

• One or two prenatal meetings to get to know each other better and discuss a plan for early and active labor at home (if we schedule one meeting, it is usually 3 hours long)
• 24-hour on-call support between 38 – 42 weeks of pregnancy and continuing for two weeks after your baby is born (of course this is flexible if you have your baby prematurely or need additional support postpartum)
• Unlimited phone/text/email support
• A packet of reading material (mostly provided electronically)…unless you took a childbirth class with me, in which case you already have the packet
• Access to my large selection of books and videos
• Continuous labor support individualized to the mother and partner’s needs and desires (I can meet you at your home or at the hospital)
• Assistance in preparation of a birth plan, including discussion of options and provision of information to help you make decisions about your preferences
• Suggestions and referrals for before and after the birth (medical providers, mental health practitioners, alternative and complementary medicine practitioners)
• My best effort to maintain a calm, peaceful birth environment, as well as keep an awareness of the mom and partner’s spoken and unspoken needs and concerns
• Emotional, informational, and physical support during labor and birth, and postpartum (whether the birth be vaginal or cesarean)
• Massage, relaxation exercises and suggestions of different positions during labor and birth
• Use of helpful tools in my “birth bag”
• Photos (you provide the camera, etc., although if I can bring mine I will) during labor, birth, and postpartum, as desired and as feasible
  • To remain with you for some time after the birth, until you are comfortable and your family is ready for some quiet time together (usually 1.5 – 2 hours)
  • Postpartum support by phone to answer any questions about the birth or your baby
  • One visit to your home after the birth to see how you are doing, to make sure that feeding is going well, and to give you a chance to ask questions about and process your birth experience (additional visits can be requested)
  • Breastfeeding support, information, and referral
  • Parenting and newborn care information
  • Of course, concern, respect, and confidentiality

What Doulas Do Not Do

As a birth doula, I do not:

• Perform clinical tasks.  I am there to provide only physical comfort, emotional support, and advocacy.  I will, however, provide you with names of care providers that can provide services that I cannot.
• Make decisions for you.  I will help you get the information necessary to make an informed decision.  I will also remind you if there is a deviation from your birth preferences.
• Speak to the staff on your behalf.  I will discuss your concerns with you, suggest options, and ensure that you have had the opportunity to ask questions and obtain information.  But you or your partner will speak on your behalf to the clinical staff.

My Epectations of the Mom and Her Partner

• Open and honest communication on issues that could have an influence on your childbirth and postpartum experience, including being up-front if anything I say or do concerns you
• Discussion of whether you will have a written a birth plan for presentation to and discussion with your health provider
• After 36 weeks of pregnancy, call me after each prenatal exam for an update (or before 36 weeks, if there are things you’d like to discuss)
• Call immediately when there are physical changes that might indicate labor may be starting
• Call when you have any questions at all—the only silly question is one that isn’t asked!
• Tell others about the services and benefits of professional labor assistants/birth doulas
• Call me when you think you are in labor, and if you do not reach me at home, try my cellphone, and if you still do not reach me immediately, send a text to my cellphone.

When You Are in Labor

I prefer that you call me when you think that you are in labor, even if you do not yet need me, and even if it is in the middle of the night.  I can answer questions and make suggestions over the phone.  We will decide together if I should come right then or wait for further change.  (Please allow up to three hours for me to get to you from the time that you ask me to come, although it would most likely be under 2 hours).  We will also decide at that time where to meet – at your home, the hospital, or the birth center.  Except for special circumstances (illness, emergency or co-doula plan), I will remain with you throughout the labor and birth, and will stay for one to two hours after the delivery to help you with breastfeeding and any necessary mother-care.  If your doctor/midwife determines that your labor needs to be induced, I will provide phone support until you determine that you need my support in person, although I am open to coming at the start of induction if that is your wish or if it’s appropriate under the circumstances. If your baby is born via cesarean, deemed necessary either before or during labor, it is still my role and intention to be with you and support you throughout your birth experience.

My Education and Current Activities Related to Pregnancy and Birth

Maternity Circle.  Boylston, MA. 2003-present.

• Birth Doula, Childbirth Educator, Breastfeeding Counselor, Parenting Coach.

Mothers and Company.  Boylston/West Boylston, MA.

• Owner, Executive Momma, Co-Founder, Childbirth Educator.  June 2006 – February 2012.

Massachusetts Midwives Alliance.

• Basic Midwifery Course.  August 2009 – May 2010.

Boston Association for Childbirth Education. Newton, MA. 

• Certified Childbirth Educator. June 2003.
• Training Committee, Childbirth Education Training Program.   June 2004 – present.
• Director, Childbirth Education Training Program.  June 2006-June 2010.

Association of Labor Assistants and Childbirth Educators.  Cambridge, MA.

• Certified Birth Doula.  February 2003.

Nursing Mothers’ Council.  Newton, MA.

• Breastfeeding Counselor.  December 2002.

Johns Hopkins School of Hygiene and Public Health.  Baltimore, MD.

• Master of Health Science.  January 1998.  Specialized in International Health, coursework concentrated on nutrition for pregnancy and lactation and maternal/child health program management and research.

Peace Corps. Côte d’Ivoire, West Africa.

• As Peace Corps Volunteer, worked for two years in large village with a nurse and a midwife as a rural health educator and community developer.  Training and work focused on prenatal care, lactation and weaning, infant growth monitoring, nutrition and hygiene education, community development and program management.
  

I have also been an active member of the Partners in Perinatal Health Conference Planning Committee from 2001-2011.  This committee is a group of representatives from several perinatal organizations in the state who plans an annual all-day conference (with 450-700 attendees) for childbirth educators, midwives, birth and postpartum doulas, nurses, social workers, and lactation specialists.  Additionally, I was an active member of the Boards of Directors of the Boston Association for Childbirth Education and the Health Mothers, Healthy Babies Coalition of Massachusetts for ten years.

Experience Related to Pregnancy and Birth

I also have two daughters, one born at a hospital and one born at home.  I have provided labor support for 85+ births at different hospitals in Massachusetts.  I have attended non-medicated and medicated vaginal births, cesarean births, and VBAC births (vaginal birth after cesarean).  I have attended extensive training workshops, conferences and continuing education programs through certifying organizations, and have read numerous books and research articles and seen hundreds of video births.

I am prepared to work in a variety of settings; I understand the benefits of social support systems; I have audited several childbirth classes taught by various instructors; I have been teaching childbirth classes with Mothers and Company since 2007 but also taught at Newton-Wellesley Hospital and St. Vincent Hospital for several years each.  I have also led breastfeeding and natural childbirth classes at Destination Maternity in Natick, and I also teach privately.  I am prepared to address a variety of needs for mothers and their families and I am prepared and happy to provide referrals and suggestions on birth and child-related topics.  My experience breastfeeding my own children as well as my education and experience as a breastfeeding counselor allow me to help families get started breastfeeding and help with any problems that may arise.  When more expert knowledge is needed, I can recognize that and make referrals to board-certified lactation consultants, physicians or alternative health care providers like chiropractors, acupuncturists or naturopathic/homeopathic practitioners.

Fees for Services

My fee for the services described here is as follows:

• My fee for doula services depends on the location of the birth:
  • For Boston area births, my fee is $1250.00
  • For Worcester area births, my fee is $950.00
•  I require that 50% of my fee be paid at the time we agree to work together and at the same time a check be given to me (dated for your 36th week of pregnancy) for the remaining amount.   PayPal/SquareUp payments are also possible ways to pay my fee (if you’d like to use a credit card) but the fee would then be 3% more to cover the fees associated with those online services ($1287.50 or $978.50)
• I will let you know about any possible conflicts or possible unavailability at the time that we decide to work together or if something unforeseen comes up. I will provide you with a back-up birth doula for any times that I will be unavailable.
• If I am for some reason unavailable for your labor/birth and I need to call another birth doula for back-up, I will take care of working out payment with her, and she will most likely take care of your postpartum visit. Deciding not to use a back-up doula does not mean that you will receive a refund.
• If desired, additional fees may be discussed for private childbirth education classes. Your health insurance provider will reimburse you the same amount whether you take classes with me or with a hospital. A separate tour of your birth center or hospital is possible to arrange, and if you’d like me to join you I am happy to do so.

Additional Services Available

There are other services I can provide for no additional fee:

• Birth plan coaching and editing
• Baby registry consultation (online and in stores).  What do you need?  What don’t you need?  What are some eco-friendly options?  What is healthier for you and your child?  I can help!
• Babywearing basics.  Whether you are interested in a wrap, ring sling, mei tai or more structured carrier, I can help!
• Cloth diapering basics and referrals to local and online cloth diaper resources

Failure to Provide Services

I will make every effort to provide the services described here, and get to you as quickly as possible after we agree on a mutual time to meet.  Sometimes this is impossible; for example, a very rapid labor, or unsafe weather conditions.  This is a very rare event for any doula, and this has never happened to me.  My refund policy is as follows:

• If my failure to attend your birth is due solely to my error, there will be a refund of 75% of the amount you paid, if you paid in full by the time of your birth.
• If my failure to attend your birth is due to circumstances beyond anyone’s control, there will be no refund, but I will make every effort to provide some additional postpartum support after you give birth.
• If I am unable to attend your birth because you fail to contact me via my home phone, cellphone and text, there will be no refund.  Contacting me by email or only leaving me a message on my voicemail that you are in labor may not elicit a timely response.   You must make every effort to reach me via home phone, cellphone, AND text.  I expect to respond to a call within fifteen minutes—please feel free to call/text me again if you haven’t received a response as quickly as you were hoping you would.

Why I Do This Work

Pregnancy, birth, and the development of a relationship with a baby is an amazing phenomenon.  You are growning a human—how fascinating is that!?  Each birth experience is unique and each family’s needs are different.  I want to provide information and support to mothers and partners so they can make the best informed choices for themselves and their babies and then participate as fully as they wish in the birth process.  Because the needs of a family during childbirth can be more than one support person may wish to handle, I offer myself as an additional support person and resource who will help facilitate a healthy, educated pregnancy, a positive birth experience, and a satisfying postpartum period.  I believe, and studies have shown, that the services of a birth doula can greatly influence the course of the childbearing year for the mutual benefit of the mother, child, and family as a whole.  I feel absolutely honored and in awe when I am present at a labor and birth and I am energized by being allowed to contribute my skills to help in any way I can.

Agreement/Contract for Services

I/We have read the above statements in this four-page document describing our birth doula’s services and agree that it reflects the discussions we have had with her.  In signing this letter we are agreeing to contract her services for our birth.

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Mother’s Signature                                Date

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Partner’s Signature, if applicable            Date

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Jeanette P. Mesite Frem                        Date   

If you’d like to set up an interview, contact me via email at jeanette@maternitycircle.com or call me at (617) 686-0052.  I love to talk about how birth can be a-mazing!