I can't attend the birth - what to do about fees?

[Pixie T]

Hi Ladies-
I think I've settled this, but was curious if anyone has had a similar experience:

I have a mom due at the end of the month - she has placenta previa and will be having a scheduled c/s (ugh! she's bummed and so am I). She was told that if her husband is present for surgery, I won't be permitted to attend in surgery or recovery. She's okay with this, and so is dad - we're doing lots of prenatal prep about the surgery etc. I'm feeling like I should be offering to take what she's paid me so far, and waive the rest. I can't my usual pp bf support as she's had a reduction and is seeing an LC in our area who has experience with this - normally I would just make up for the birth with extra pp, but she's not really interested.

Any suggestions?
Thanks and hope you are all well!
Trish

[teachinmamaof4]

My contract for that type of situation states that if they don't want any further services they must nullify my contract, in writing by both parties. I will refund anything paid above the non-refundable deposit or no more will be owed above the non-refundable deposit.

[UtahDoula]

It would depend on the amount she's already paid you. Do you feel that what you've already received is adequate compensation for the work you've done? If so, then do that. If not, figure out what WOULD be appropriate and then bill for that.
I've never actually faced that situation, but my contract says that full payment is still due, because I really *am* turning away clients. (I probably turn away 2 people for every person who hires me right now) So if they take a slot, I get paid. However, in this situation, I might say something like "If I'm able to fill the slot, I'll just bill you for time spent"

[tlcdoula]

I think it depends on what your contract says.

I have to admit I am always torn on stuff like this because a) when a doula takes on a client she blocks her time and schedules for that clients and she may turn away clients so if the client cancels the doula loses income and b) typically a mom knows she has previa prior to this point in the pregnancy and c) any other business person is not going to expect the rest of their payment if the client pulls out. For example, if you decide that you no longer want your house and you decide to sell it for way less then you owe on it you will still be expected to pay the rest of the fee that is owed on the bill. If you buy a new car and are making payments on it and you get in an accident and total it you can't say "well, I don't have it anymore and can't use it so I am not going to pay."

I know that some will argue that our services are different and yes they are, but this is a business transaction just like all others.

It really is a hard call, and one that only you can decide on how to handle. In my case thankfully I have not had to refund any money yet because I truthfully don't know what I would do. There is part of me that say no way, they owe because I booked that time for them, but then there is part of me that says they aren't really getting the full service. Perhaps you could expect payment in full and do some postpartum doula work for them - I am sure she will need the help after a cesarean birth.

[Jilian]

My contract says that in the case of scheduled cesarean I keep the deposit for services up until that point. I can either stop being their Doula and nothing else will be due, or I can continue preparing them for the birth and throw in an extra post partum visit and the entire fee is still due. I think you should absolutely keep the deposit because you've been her Doula for a while now, and you continue helping educate her. I think a nice option would be to do an extra post partum visit in lieu of the birth and still charge full price. Either way - you should get some payment for the time and effort you've invested up until this point.

[AmandaB]

Why cant you be with them in recovery? I would think that having someone there, to help her find a calm place before surgery and to see a happy face after may be wonderful. Certainly an advocate to get baby skin to skin would be as beneficial as immediate breastfeeding. You could stay with them so that dad is able to look after himself and that there would be someone to help her with baby. Just a thought.

[DiscoDoula]

I agree with Amandoula. The only section I have attended involved the uterus clamping down on the head and a precarious resuscitation. Dad followed the baby out very quickly thereafter and if I hadn't been there, Mom wouldn't have had anyone. I'd probably request to be there and scrubbed up in the rare instance that Dad has to leave Mom and she has no one with her for the suturing, or even recovery, if Dad remains in a different place with baby.

[UtahDoula]

Hey folks, she already said she would NOT be permitted to attend the surgery OR recovery, so let's not tell her to do that in our responses, OK? Sure it would be wonderful, sure she could be a help, but her client has already explored that option and been rebuffed.
I know as a doula, I'd feel badly enough about the situation without my fellow doulas advising me to do what I've already looked into and found is not an option. The question was about fees.

[1stimestar]

Yes, I go in with them to help them prepare. Sometimes it is pretty scary for them. Then I go into surgery when the dad leaves with the baby and then I stay with mom through recovery.

[AmandaB]

Utah, Trish is in my city and Doula group. I am then surprized to hear that a local hosp will not let her into recovery as I have never been refused. Yes, it is true that we may not be able to go into the surgery but there is plenty we can do beforehand.

I would not return the fee as you have done prenatal and a low lying placenta would have been detected early on and monitored. You can offer to go to the hospital and in case somethng happens and they need an extra pair of hands at least you are there. Think about it, talk to them and I am sure a solution will come to you. And hey if you need to talk, just give me a call.

[Pixie T]

Thanks ladies -
I have offered to be at the hospital in case they do need me, though I have been told I will not be admitted to scrub in "just in case". This mom wasn't aware of her previa earlier on, and if she did I wasn't told about it - I think in this case she wasn't really aware of the implications of a low-lying placenta if she was informed (she also didn't let me know about her breast reduc. surgery until this week either, which cramps our plans for lact. support too).

And I have asked to wait through the surgery and be with her in recovery and been denied. This was surprising, as it's never happened before (it's at WCH too, Amanda...I have a feeling this doc has had a pushy/aggressive doula at some point, cause she is just not down with doulas...).

I'm keeping the deposit, and waiving the rest - her mom and sister are here for pp help, and it's been made clear I won't be needed - welcome to come see the baby, but nothing more. Kind of odd, but she's got her boundaries around this for a reason I've got to respect, even if I'm not sure what it is. I'll keep my phone line clear, and hope for the best for her. I'll be six months preggo by the time she gives birth, and though the $$ would be nice, it's not like I've turned away clients by the dozen, as she was one of my last before mat. leave.

Thanks for the input - it's great that you ladies are out there! T.

[Doula Network of LI]

I know at this point the conversation is complete, but I agree with your decision. If the c-section happens before my 'support' time I dont charge the extra money. Obviously, if I am with her in labor and it turns into a c-section then that is different.
What I have done, however, was increase my non refundable deposit to half of my fee. This way, if I do turn down other clients and this client doesnt need me, I will have at least been compensated for what I have done.
Hope this helps.
Debbie

[brilliant]

trish i think your decision is the right one. i also can't believe that women's college is placing these restrictions on you. that's depressing...