Do you have a different VBAC contract?

Stacie · 07-12-2008, 12:49 PM

I have done a handful of VBACs and things have worked well -- I am just wondering, does anyone use a different contract than their normal one when it comes to VBACs? Like changing fee amounts according to whether VBAC was achieved or not, etc.?

earthgirl · 07-12-2008, 01:36 PM

MothertheMother · 07-12-2008, 02:14 PM

I can't imagine a reason to do this. I feel like charging more for a successful VBAC than a CBAC would give the impression that I'm somehow delivering this to them. I can see how the information I give a women might be different if she was having a VBAC but the support would be the same.

Nicole E · 07-12-2008, 02:23 PM

I wouldn't. A woman who has a "failed" (I hate that word) VBAC and ends up with another c-section, may not need our physical support through pushing etc. but definitely needs more emotional support. It was devastating for me to end up with another c-section (after labouring to 9.5cm and feeling pushy) and I needed so much reassurance and support afterwards. I am so glad my doula was there.

1stimestar · 07-12-2008, 03:03 PM

Simple answer, heck no.

Stacie · 07-12-2008, 03:54 PM

The reason I asked this is, I have known doulas who have taken VBAC clients who ended up with a cesarean again, then the client feels the doula shouldn't receive the remainder of the fee, and things get muddled. Like I said, this hasn't happened to me before, but with more VBACs coming up, I could see protecting myself from it.

And regarding differing amounts if a repeat is needed and the client calls before and says the doula won't be necessary anymore. What about in that situation?

I wasn't meaning I would charge more for a VBAC than a normal birth; I was just looking at alternate endings and fee adjustments.

Stacie · 07-12-2008, 03:56 PM

I don't see an edit option. I meant to say, I don't mean charging more for a VBAC mum versus what my normal fee is.

earthgirl · 07-12-2008, 04:38 PM

I guess one could put a disclaimer in the contract saying that there are no guarantees on outcome, if the birth ends in c/s your full fee still stands.

JackieM · 07-12-2008, 05:39 PM

Same contract. I have a statement along the lines of "I cannot guarantee the outcome of your birth," and then in my "Extenuating Circumstances" section, I have a clause that if the client's labor ends in a C-section, my full fee applies. I offer my support during and immediately after the C-section, but I offer no refunds ...

dorothyh · 07-12-2008, 05:43 PM

Quote:

The reason I asked this is, I have known doulas who have taken VBAC clients who ended up with a cesarean again, then the client feels the doula shouldn't receive the remainder of the fee, and things get muddled. Like I said, this hasn't happened to me before, but with more VBACs coming up, I could see protecting myself from it.

Any client could wind up with a scheduled cesarean, whether she is a VBAC mom or not.

As far as what I do, I do return half of the fee if mom has a scheduled cesarean and lets me know in advance that doesn't want me to be there. I am comfortable with that, and feel like I am compensated for my time prenatally and for holding the spot for her, but at the same time, it is fair to the client as well.

Other doulas do not offer a refund for a planned cesarean. It is really up to the individual doula what she wants to do. I think whatever you decide, just make sure it is spelled out in your contract. I use the same contract whether mom is a VBAC client or not.

If I am with mom for her labor and it ends in a cesarean, I do keep the full fee.

1stimestar · 07-12-2008, 06:52 PM

I get my full fee paid by week 38, when I go on call for client. Even if a client goes for a scheduled c-section, I am still there, still supporting. I am allowed in surgery so that helps.

Stacie · 07-12-2008, 07:52 PM

I work my fees differently. I request half before the birth, half after. This ensures if I miss a birth, or a family fails to call me, I don't have to hound anyone about being owed more money -- and I don't have to refund money if I didn't make it. Now, this has never happened to me, knock on wood, but I realize it does happen out there in the doula world. Plus, I like, during the birth, feeling like I am working towards that final payment, kwim? It gives me something to look forward to.

DL · 07-12-2008, 11:06 PM

Quote:

Originally Posted by MothertheMother

I can't imagine a reason to do this. I feel like charging more for a successful VBAC than a CBAC would give the impression that I'm somehow delivering this to them. I can see how the information I give a women might be different if she was having a VBAC but the support would be the same.

Yes

Quote:

Originally Posted by Stacie

The reason I asked this is, I have known doulas who have taken VBAC clients who ended up with a cesarean again, then the client feels the doula shouldn't receive the remainder of the fee, and things get muddled. Like I said, this hasn't happened to me before, but with more VBACs coming up, I could see protecting myself from it.

And regarding differing amounts if a repeat is needed and the client calls before and says the doula won't be necessary anymore. What about in that situation?

I wasn't meaning I would charge more for a VBAC than a normal birth; I was just looking at alternate endings and fee adjustments.

Quote:

Originally Posted by earthgirl

I guess one could put a disclaimer in the contract saying that there are no guarantees on outcome, if the birth ends in c/s your full fee still stands.

Mine says this with different wording, but the meaning is the same.

Quote:

Originally Posted by Stacie

I work my fees differently. I request half before the birth, half after. This ensures if I miss a birth, or a family fails to call me, I don't have to hound anyone about being owed more money -- and I don't have to refund money if I didn't make it. Now, this has never happened to me, knock on wood, but I realize it does happen out there in the doula world. Plus, I like, during the birth, feeling like I am working towards that final payment, kwim? It gives me something to look forward to.

I get half at contract signing and half at the postpartum visit. I really like doing it this way for some of the reasons that you stated, Stacie. I also acquire many of my clients past their 36th week, and paying the full fee at once is often financially next to impossible for many of my clients. I like to give them that extra time to come up with the remaining balance. Even so, no matter how I would choose to work out the payment schedule, I do not and will not make any differences in fees between whether she births vaginally or via Cesarean (planned or unexpected). I really see no reason why VBACs should be charged any differently at all nor that the contract should be worded any differently. I have had a VBAC end up Cesarean after she pushed for several hours. I wouldn't have dreamed of getting anything but my full fee.

Clients are paying for my support and they are getting it no matter how she births.

DoulaCBE · 07-13-2008, 01:42 AM

Quote:

Originally Posted by Stacie

I work my fees differently. I request half before the birth, half after. This ensures if I miss a birth, or a family fails to call me, I don't have to hound anyone about being owed more money -- and I don't have to refund money if I didn't make it. Now, this has never happened to me, knock on wood, but I realize it does happen out there in the doula world. Plus, I like, during the birth, feeling like I am working towards that final payment, kwim? It gives me something to look forward to.

It never ceases to amaze me how alike we practice!

I have the same contract, but different payment terms for VBAC clients.
If they labor and deliver or we labor and have a cesarean, I'm owed the full fee. (at that time it would be the 1/2 of the total balance due)

If they schedule a cesarean and feel they don't need me there, there is no balance due (I'd rather see them invest that money into postpartum doula care with a PP Doula)

If they schedule a cesarean and want me there, I charge 1/2 the balance due (so 1/4 of the total fee) to cover the 4-5 hours I'm there.

Stacie · 07-13-2008, 02:03 AM

Angie that is helpful to see how you do it. I think I will incorporate that. I do something similar, in that I have it written, if I miss a birth (too fast) and they still wish for me to come to the hospital, I will require a final payment of $100, but not the whole half of the fee. I change things as situations arise and I learn from them, or from what happens with other local doulas, kwim?