By continuing, you are accepting and acknowledging your agreement to the additional terms below and confirm that it is your intent that your electronic acceptance be given the same authority as a hand-written signature. This agreement does not expire unless the patient or a legal representative cancels it in writing.
Care Services Agreement
Effective date: 1/16/2025 Last updated: 1/16/2025
Doula Care Services Agreement
The Benefits of the Services
There are benefits to the use of the Services, including:
- Decreasing anxiety associated with labor and delivery; increasing confidence
- Improving communication with healthcare providers
- Advocating for your wishes and supporting communication around your birth preferences
- Providing continuous emotional support and reassurance during labor and postpartum
- Helping you make informed decisions based on evidence
- Reducing risks of serious health complications
- Supporting improved birth outcomes, including lower likelihood of cesarean birth, shorter average labor duration, and decreased use of pain medication.
- When in-person labor/birth support is possible: offering hands-on comfort measures such as massage, positioning techniques and breathing exercises, which can reduce pain and stress
- During infant feeding: identifying and avoiding potential breastfeeding challenges, and assisting with weaning and return to work or school
The Risks of the Services
The Services are generally low risk; however, there is risk that clients may misunderstand the nature of the Services and improperly rely on the Services. Doulas are not licensed healthcare providers, so they cannot give you medical advice, provide medical treatment or intervene in an emergency.
While the use of Doula Services can provide benefits for you, there are also risks associated with the use of doula services during labor and birth. These risks include but are not limited to the following:
- Despite best efforts, there may be a mismatch in communication styles, preferences or approaches, which could lead to dissatisfaction and stress.
- Comfort measures may carry a risk of discomfort or minimal injury if not performed with proper technique.
- In-person support carries a potential risk of transmission of illnesses, including COVID-19, particularly if precautions are not adequately followed.
- The intensity of birth and postpartum experiences can make some individuals more emotionally vulnerable, and there’s a small risk of misunderstanding or feeling overwhelmed by the doula’s presence.
- In rare cases, a doula may be delayed or unable to attend the birth due to unforeseen circumstances, leaving the client without the anticipated support.
Alternatives
There are other alternatives for support during pregnancy, birthing and postpartum. Talk to your healthcare provider about these alternatives.
Scope of Services
Pacify doulas will:
- Offer help and advice on physical, mental, and emotional comfort measures and non-medical techniques.
- Adhere to patient confidentiality and privacy.
- Aid the Client and their family in the understanding of medical procedures and treatments by encouraging and supporting communication between the family and care provider.
- Find resources necessary to make informed decisions, and remind the Client if there is a departure from the Client’s plan.
Pacify doulas will not:
- Perform clinical tasks, such as, but not limited to, blood pressure or fetal heart rate checks, vaginal exams, etc.
- Administer medications, including both pharmaceutical and homeopathic, to the Client or the Client’s family.
- Make decisions for the Client, or project personal values and goals onto the Client.
- Interfere with medical treatment, especially in the event of an emergency situation.
- Provide transportation for the Client, the Client’s child(ren), or any family member.
Availability and Communication
- Virtual doula appointments: Doulas are available for virtual appointments to address Client questions and concerns.
- Operating Hours: Doula services are available Monday through Friday, from 9:00 AM to 5:00 PM (Eastern Time).
- Chat Response Time: Doulas will respond to Client messages within 48 hours Monday through Friday from 9:00 AM to 5:00 PM (Eastern Time).
Emergency and Non-emergency Situations
- In case of an emergency, Clients or support person should:
- Call 9-1-1 or contact their obstetrician (OB), midwife or pediatrician.
- For non-emergency situations:
- Clients should contact their assigned doula through the text chat function.
- Limitations: The chat function is not designed for emergency situations. Doulas will respond to Client messages within 48 hours Monday through Friday from 9:00 AM to 5:00 PM (Eastern Time).
During Labor
Pacify recommends regular communication with the doula, so that the doula can help the Client navigate the Client’s early and active labor. A good benchmark is to call the doula during or immediately after each contact with the Client’s medical provider (midwife or OB), to keep the doula up-to-date on evolving circumstances. Following initial contact, the doula can answer questions and offer support via the Application, and decide with you whether you need immediate support or wish to await further change.
In labor, Pacify suggests that you call your doula when you think you are in labor, even if you do not yet need the doula's support at that exact moment. Text-based communication can be unreliable, and Pacify cannot be held accountable or liable for any harm resulting from missed text-based communication.
- Clients are required to maintain close communication with their assigned doula about when their due date is, with any updates, and upon the onset of labor.
- Clients must inform their doula when preparing to depart for the hospital or birthing center.
- Your failure to maintain adequate communication may impact the doula’s ability to provide timely support.
- Contact [email protected] if additional assistance is required.
Communication Requirements
- The Client must notify their assigned doula to attend the delivery. For the purposes of these terms and conditions, “delivery” includes but is not limited to:
- Vaginal birth
- Vaginal birth after Cesarean section (C-section)
- Cesarean section (planned or emergency)
- Induced labor (elective or medically necessary)
- Failure of Client to Notify Doula
- If the Client fails to notify their assigned doula within two hours of the beginning of perceived labor, the doula may be unable to attend the birth.
- In such cases, the Client forfeits their right to in-person labor support.
- Unable to Reach Doula
- If the Client is unable to reach their assigned doula via text or phone call when labor begins:
- The Client should attempt to contact the backup doula (if one has been assigned) or the Pacify Care Coordinator.
- In the event that a doula is unreachable, and services cannot be provided as scheduled, Pacify may, at its sole discretion, offer a partial refund or credit of the unused portion of the services. Note: Partial refund or credit is subject to limited subscribers.
- If the Client is unable to reach their assigned doula via text or phone call when labor begins:
- Doula Unable to Attend Birth
- If the doula cannot attend the birth, the doula will activate backup doula support, subject to availability.
- If no backup doula is available, the Client may need to proceed without in-person doula support.
- If doula support is not provided due to limitations on the part of Pacify or the assigned doula, Pacify will, at its sole discretion, offer a partial refund for the unused services.
In-Person Labor & Delivery Doula Care
In-person labor and delivery doula care is limited to specific subscribers and is only available for labor and delivery. In order to receive in-person Services, you must purchase services directly, or participate with a healthcare plan or employer-based plan that covers in-person birth support.
In addition to the Doula Services Terms and Conditions above, Clients receiving In-person Labor and Delivery Doula Services agree to be bound by the following terms:
- Your doula usually needs approximately one to two hours to get to you from the time you ask them to come; this one- to two-hour window begins when the Client explicitly requests that the doula join them in labor.
- Due to the unpredictable nature of travel in certain regions, Pacify cannot guarantee to the Client that the doula will arrive by a set time. The doula will make every reasonable effort to get to the Client within two hours.
- The doula may provide virtual support while you remain at home, but can only provide in-person support once you have arrived at your planned birth place: either a hospital or birth center. Pacify Doulas do not provide support at home births.
- From the first time you contact your birth doula by phone to inform the doula that they may be in labor, the doula will provide continuous support* throughout the Client’s labor and birth. This support may take several forms: the doula may coach the Client via the Application (normally in early labor), may be physically present (normally in active labor), or may provide hybrid support to best meet your needs.
- The Doula cannot come to you in labor until you explicitly ask the Doula to join you. Please be sure to inform the doula — by telephone — when you are ready for the doula to physically accompany you. When in active labor, Pacify recommends that the Client call the doula when the Client is ready for immediate support, as text messages are too easily missed.
* A note on continuous support: Pacify recognizes and respects the Client’s right to privacy. With the Client’s agreement, the doula may step out at appropriate times while the Client is in labor, or while supporting the Client during the postpartum period. Breaks are understood to be a necessary part of the doula’s work hours. As such, “continuous” does not equate to immediate or constant. Even if not physically present, the doula remains available via phone or text. If the doula has been physically present with the Client, at any location(s), for more than 15 hours, Pacify may rely on a backup doula to provide ongoing support (if needed) while the primary doula takes a break. At no time will the primary doula leave the Client without prior discussion with the Client.
In-Person Postpartum Doula Care
In-person postpartum doula care is limited to specific subscribers. In order to receive in-person Services, you must purchase services directly or participate with specific employer-based plans. Healthcare plans generally do not cover in-person postpartum doula services.
In addition to the Doula Services terms and conditions above, Clients receiving In-person Postpartum Doula Services agree to be bound by the following terms:
- In the postpartum period, Pacify relies on the Client to manage your own scheduling needs and preferences through the Application, and Pacify requires 24 hours’ notice of any schedule changes to avoid charges for a late cancellation. Pacify will accommodate only two schedule changes per appointment per Client.
- Your failure to maintain adequate communication may impact the doula’s ability to provide timely in-person support.
- Contact [email protected] if additional assistance is required.
In-Person Care Health Provisions
Because Pacify has an obligation to protect the health and well being of all its clients and to avoid the spread of contagious illnesses, Pacify retains the right to deny or reschedule services if the Client or a member of the Client’s family is ill. Pacify Providers cannot be physically present with the Client until the Client and their family member(s) have been well for 24 hours. Pacify Providers may transition to virtual doula services and refer the Client to nursing services for more appropriate in-person care in the interim.
Doula Mentorship Program
As part of Pacify’s quality control efforts, and to ensure consistency in your experiences with Pacify providers, senior doulas regularly encourage junior doulas to “shadow” them at births and sometimes at regularly scheduled client appointments. Sometimes, senior doulas may also shadow junior doulas to provide helpful oversight and feedback. This mentorship program allows junior doulas to gain experience and knowledge, and provides support to our senior doulas (especially significant at longer births). Client feedback has been very positive; former clients have enjoyed the helpful presence and support of an additional doula. There is no additional cost to the client for the presence of a mentee doula, and not all circumstances will permit the presence of a mentee doula. You are free to opt out of the presence of a mentee doula, and may communicate your preference directly to your Pacify doula.
Lactation Consultant Care Services Agreement
Availability and Communication
- Appointments: Lactation Consultants are available for virtual on-demand support, scheduled visits and chat to address Client questions and concerns.
- These options depend on certain contracts. Not all options are available to every Client.
- ON-DEMAND: Available 24/7
- SCHEDULED APPOINTMENTS: Schedule up to 60 minutes with a lactation consultant.
- CHAT: Lactation Consultants will respond to Client messages within 48 hours Monday through Friday from 9:00 AM to 5:00 PM (Eastern Time).
Emergency and Non-emergency Situations
- In case of an emergency, Clients or support persons should:
- Call 9-1-1 or contact their obstetrician (OB), midwife, internal medicine/family medicine physician or pediatrician.
- For non-emergency situations related to lactation:
- Clients should contact a lactation consultant through the virtual on-demand network, schedule an appointment depending on what is available or initiate a chat for assistance.
Consent to Bill/Financial Responsibility
By continuing with use of this application and the Pacify website, you acknowledge that you are responsible for providing accurate and current insurance information, and understand that failing to do so may result in your financial responsibility for services, including any associated costs and fees.
Consent to Bill
You authorize Pacify to submit claims to your Medicaid plan, insurance company, or other third-party payors on my behalf and to receive payment of medical benefits for services rendered now or in the future. You also authorize the release of necessary health information for billing purposes.
Authorized Payment to Pacify
You authorize your Medicaid plan, insurance company or third-party payor to make direct payments to Pacify for services rendered now or in the future. You understand and acknowledge that, if applicable, you will be financially responsible for co-payments, deductibles and coinsurances, and for services not covered by your insurance plan.
Financial Responsibility
You acknowledge that not all services may be covered by your insurance plan for one or more reasons, including but not limited to exclusions from your insurance plan. You understand and acknowledge that, if applicable, you will be financially responsible for any collection fees, court costs and reasonable attorney’s fees incurred by Pacify if required to collect on your unpaid debt owed. Collections policy can be provided per request.
Disclaimers Related to Services
USE OF THE SERVICES IS NOT FOR EMERGENCIES. IF YOU THINK YOU HAVE A MEDICAL EMERGENCY, OR IF AT ANY TIME YOU ARE CONCERNED ABOUT YOUR HEALTH OR THE HEALTH OF YOUR CHILD, CALL 9-1-1 OR GO TO THE NEAREST EMERGENCY ROOM.
THE CONTENT ON THE PACIFY APPLICATION AND PACIFY WEBSITE IS NOT AND SHOULD NOT BE CONSIDERED MEDICAL ADVICE OR A SUBSTITUTE FOR INDIVIDUAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT WITH A PHYSICIAN OR OTHER LICENSED PRIMARY HEALTHCARE PROVIDER. PACIFY PROVIDERS CANNOT AND DO NOT GIVE MEDICAL ADVICE AND ARE LIMITED TO MAKING HEALTH RECOMMENDATIONS BASED ON THEIR SCOPE OF PRACTICE. YOU SHOULD ALWAYS TALK TO YOUR MEDICAL PROFESSIONALS FOR DIAGNOSIS AND TREATMENT, INCLUDING INFORMATION REGARDING WHICH TREATMENT MAY BE APPROPRIATE FOR YOU AND/OR YOUR CHILD. PACIFY MAKES NO REPRESENTATION OR WARRANTY REGARDING ANY OF THE INFORMATION ON THE APPLICATION OR PACIFY WEBSITE NOR WHETHER ANY PARTICULAR TREATMENT IS SAFE, APPROPRIATE, OR EFFECTIVE FOR YOU AND/OR YOUR CHILD.
Pacify Providers
Depending on the service you subscribe to, Pacify arranges for Providers to be available on the Application and/or in-person, and to make their services available to you on both a scheduled basis and on-demand. Pacify provides other types of administrative services and information to you and the Providers.
Pacify Providers are solely responsible for maintaining any required licenses, certifications and/or authorizations, as applicable, in the respective state(s) in which they provide their services. Some Providers are independent contractors and are not employees of Pacify. All Providers are responsible for their independent professional judgment and recommendations. Each Provider’s scope of service is limited by his/her applicable licensure/certification and any service restrictions established by Pacify. Pacify Providers are in no way intended to replace your primary care physician, ob-gyn, midwife, pediatrician or any other clinical relationship you maintain or may need. Pacify does not recommend or endorse any specific treatment, services, tests or advice provided by Pacify Providers.
Content on Application and Website
The information that Pacify provides on the Application or its Website(s) is intended for general informational purposes only. It is not intended as professional medical advice, diagnosis or treatment. Reliance on any information provided by Pacify Providers or appearing on the Application or Website is solely at your own risk.
Your Use of the Application and Website and Access to Pacify Providers
Access to certain portions of the Application as well as access to our in-person doula services is restricted to registered users of our Services. Direct subscribers (as defined below) must be 18 years old to access the Application and the Services. As part of our registration process, you must provide us with information regarding but not limited to personal identification information, personal health information, a current, valid email address and phone number. Billing information is required for direct subscribers. A direct subscriber is a user who is responsible for paying any subscription fees, as opposed to an individual who has access paid for by their employer, health plan, or other organization.
We need this information so that we can communicate with you, verify your identity, initiate billing charges, and make the full scope of Member benefits available to you through the Website and the Pacify Application and other HIPAA-compliant applications Pacify may utilize for services. Additionally, you must provide us with personal identification information and personal health information about your child. This information will only be used by us and the Pacify Providers as permitted by these Terms and our Privacy Policy.
Direct Subscribers
- Individuals who register directly in the Application for either one (1) month, three (3) month or twelve (12) month subscriptions will have access to Pacify lactation consultants and nurses. Subscriptions run from the date of valid payment for enrollment and full payment is due upon enrollment. Upon your subscription period’s expiration, you will be charged the applicable subscription fee if you elect to re-enroll. You have 30 days from purchase to cancel your subscription and receive a full refund.
- Individuals who register for the Doula Program will have access to virtual prenatal and postpartum doula visits plus in-person labor and delivery support (where available). The program runs from the date of valid payment for enrollment and full payment is due upon enrollment. Full payment is due upfront.
Refund Policy
It is never in the doula’s scope of practice to make any decisions for the Client or the Client’s family regarding the outcome of the Client’s labor, birth, or any medical situation that may arise. Pacify Providers can help to facilitate communication between the Client and the Client’s primary medical care provider, but any such decisions are ultimately up to the Client and that care provider. Along those same lines, doulas cannot guarantee a particular outcome for the pregnancy, labor and birth, and postpartum period. The Client is hiring a doula to provide physical, mental, and emotional support. Pacify Providers offer such support no matter what choices the Client and their partner make for themselves and their experience and health, and no matter what medical or other circumstances may arise along the way. Once the Client has hired the doula and paid the fee, the doula provides unconditional support, and the payment for that service is not refundable.
Pacify Providers will make every reasonable effort to provide the services described within the Client’s selected package, or to have a suitable backup doula attend to the Client in place of the primary doula if the primary doula is unavailable. Pacify is not responsible for precipitous labors, shifting/restrictive hospital policies, public health crises, weather events, emergency situations, or acts of God. If a missed appointment, shift, or birth attendance is due to circumstances beyond a reasonable person’s control, no refund will be issued. The Client’s failure to communicate with the doula in a timely manner, and by telephone in urgent circumstances, will not result in a refund. The Client’s failure to follow safety guidelines and precautions may result in immediate termination of services without a refund.
If the Client determines prior to the 36-week mark of their pregnancy that the doula’s services are no longer needed, the Client may cancel the subscription at that time. Pacify will cease providing any services to the Client upon receipt of the Client’s cancellation request. In the event of a cancellation, Pacify will keep the retainer (50% of the package fee), but no further payment is required by the Client. If the Client cancels their subscription or any services therein after the 36-week mark or after services have begun (whichever is later), the package balance is due in full to Pacify and no refund will be given, regardless of whether Pacify provides the Client with those services or products.
If the Client fails to pay for the Services when due, Pacify may treat such a failure as a material breach of this Agreement and may cancel this Agreement, and retains the right to seek legal remedies. In the event of a failure to pay after services have been rendered, the Client will be responsible to pay all costs of collection, including, without limitation, attorneys’ fees.
All cancellation or refund requests will be processed within 3-5 business days from when the request was received. Any refund issued, for any reason, will be subject to a 3.3% + $0.30 payment processing fee.