Doula and c-section

schoolsoutbride

So both of my twins are currently breech (well, at last u/s 2 weeks ago, and I think I'm still at least baby A kicking my cervix, and he's the one who needs to be cervix to have a vaginal birth.)  I'm not interested in doing a vaginal breech birth with both because of how my delivery with my 1st son went.  So if Baby A doesn't get with the program here, I'm looking at a planned c-section around 38-39 weeks.  We had to do an external version with my son, but that's not an option with twins.

I'm interviewing a doula in a couple of weeks, and I'm wondering what common policy is on doulas and planned c-sections.  If I have to have a c-section, I don't really think I'll need the doula (yes, I know they do that too, but it's not something I'm interested in paying that much money for when my one of midwives will be there to do similar things.)

Do you think there will be a reduced fee, or can we just cancel her?

margeincharge2

My doula contract had a clause that she still got her fee if there was a c/s. I can't remember if it changes if there is a planned one or not but I don't think so. Basically, it would be too difficult to manage financially because by the time you'd know you'd need a planned c/s, it would be too late for her to get another client. My doula was a full time doula and one of the best in my area. Unfortunately, I had a c/s with no labor so the money wasn't really used. But, that was the risk I knew I was taking in hiring one.

It doesn't hurt to ask about a reduced fee or cancellation but I really don't think most professional doulas go for that because of the uncertain nature of births.

Nechie122

My doula's contract has a c-section clause; we still owe her fee, which covers the pre- and postnatal visits as well as being "on call" for us from 37 weeks on with unlimited phone and e-mail support. In addition, she will still attend the birth if we want, or at least help us check into the hospital.

schoolsoutbride

I wonder if I can just put off booking her...

SageBeginnings

Mine says that, if you have a planned cesarean and choose to not have me there, I still keep the retainer (covers prenatals, a postpartum visit (that I still do) and the gas used to come to your prenatals). Everything else is returned. If you have a trial of labor in which I am there for and then end up in a cesarean for any reason, my contract is considered fulfilled. Ask if she can do that for you.

schoolsoutbride

SageBeginnings:

Mine says that, if you have a planned cesarean and choose to not have me there, I still keep the retainer (covers prenatals, a postpartum visit (that I still do) and the gas used to come to your prenatals). Everything else is returned. If you have a trial of labor in which I am there for and then end up in a cesarean for any reason, my contract is considered fulfilled. Ask if she can do that for you.

That sounds reasonable, though I was going to ask to skip the postpartum visit anyway.

iris427

When will you know if you are having a planned c/s?  It wouldn't be fair to a doula to cancel on her at the last minute and expect her to refund all your money.  And it also wouldn't be fair to ask a doula to take you on as a client knowing that there's a good chance you are going to cancel on her, because she might lose out on booking another client.  Doulas can only take a couple clients a month so if you think there's a good chance you are going to cancel, I think you need to be upfront about that.

tracy41

Definitely negotiate the c-section clause.  I was so sure I wouldn't end up with a c-section that I didn't even worry about it.  There went $800!  My doula said she would have come to the hospital anyway, but another of her clients actually had her natural birth at the same time and needed her.  She felt bad and came by the house a couple times to give breastfeeding advice, but I didn't really need it and though she was a sweet woman I still felt like I wasted my money!

schoolsoutbride

iris427:

When will you know if you are having a planned c/s?  It wouldn't be fair to a doula to cancel on her at the last minute and expect her to refund all your money.  And it also wouldn't be fair to ask a doula to take you on as a client knowing that there's a good chance you are going to cancel on her, because she might lose out on booking another client.  Doulas can only take a couple clients a month so if you think there's a good chance you are going to cancel, I think you need to be upfront about that.

I don't know. Depends on when/ if baby A turns vertex.  I wouldn't expect her to refund all my money, but if I do have one, I won't really need her so don't expect to pay her full price either.  It's not something I'll keep from her.

I THINK the one I'm looking at isn't going to have her schedule screwed up because she's scheduling me as a March client (I'm due 3/15), but the chances of me going until March are slim to none.  So she'd still have time to book someone else.

Temp34783000004059

I would definitely explain upfront and make sure you are on the same page with what happens if you have a planned c/s. Some doulas will atill ask for full price, some will only ask for half, and some will do 'a la carte' so it's worth exploring.I doula and I've never had a client who had a planned c/s (well, I did have 1 who was attempting VBAC and ended up with a planned c/s at 41 wk, 6 days, but she was a friend and I was training, so I wasn't charging her anyhow), but I think it depends on how in depth your pregnancy relationship is as well, and how in demand the doula is. I might be willing to take a client on contingency if she let me know within X weeks of her EDD whether she wanted to keep me, and just charge for each piece of care individually.

 Hope both babies end up vertex!

bea0422

I would just talk to her up front about the possibility of you being required to get a planned c-section. She may be willing to put you on her calender for a fee and if you need to cancel just retain the fee.

SoxChamps

You would have to ask individually most likely. I have that if a CS is scheduled before my on call period, my fee will be less. But that is assuming that I would still be at the birth. If someone was in your situation, I would probably be ok with just canceling since I was aware of the situation in advance, but probably not if it prevented me from taking on another client. 

aug05dc

In your case, I would be upfront about the possibility of a c/s, and go from there.

Our doula's clause says if the decision is made 2 weeks before the due date, we can either 1) cancel services with no further payment beyond the deposit, or 2) she can come to the birth (surgery or waiting rm), assist with breastfeeding and other stuff for a few hours, and have an extra postpartum visit with no charge.

barine

Personally I really don't think you need a doula. If you don't have a support person/ husband not around then might get a doula. If your husband would be around, I owuld suggest  having a postpartum doula instead. 

  If you feel you still need a doula, be upfront with her about lowering charge due to scheduled c-section.