*Monitrice and Doula Services*

As a Monitrice, I offer two options, as outlined below.  For both options, I accompany women in labor to help monitor the health of the mother and baby to ensure a satisfying birth experience. I draw on my knowledge and experience to provide physical, emotional, and informational support to women and partners. In addition, within the home environment, I offer clinical monitoring, under my Arizona Midwifery License.

This clinical monitoring is LIMITED to: 

*Monitoring the mother’s blood pressure every two to four hours

*Monitoring the mother’s temperature every two to four hours

*Utilizing urinalysis to monitor for dehydration or exhaustion in the mother every two to four hours

*Monitoring the mother’s pulse every two to four hours

*Osculating baby’s heart tones with a hand-held doppler every 30 minutes in active labor

*Ascertaining the mother’s cervical dilation, by digital examination, when/if requested.

As a Monitrice, I provide clinical data to the client. I am NOT the client’s primary care provider, and I do not diagnose. Clients choose when they will depart for their place of birth, though there are situations outlined below which would necessitate termination of monitoring within the home environment.

Prohibited Practice for a Monitrice includes but is not limited to the following:

*Multiples

*Any illness which the client’s primary care provider has communicated to the client is prohibitive for at-home labor

*Insulin-dependent diabetes

*Hypertension

*42 weeks gestation or greater

Situations that may arise, which would be an indication for immediate departure to the hospital, and would necessitate termination of monitoring within the home environment include but are not limited to:

*Cervical dilation of 7-10cm

*Maternal temperature of 100.4F or greater

*Blood pressure of 140/90 or higher

*Persistent fetal heart tones of less than 120 or greater than 160 beats per minute, or other non reassuring heart tones

*Waters having been released for greater than 18 hours

*Maternal exhaustion as evidenced by urinalysis and not responding to hydration by mouth, nutrition, and rest

*Bleeding heavier than normal bloody show

*Presence of meconium with waters released

As a Monitrice, I am independent and self-employed. As your Monitrice, I am employed by you, not the caregiver or the hospital. I do not perform any clinical tasks within the hospital environment.



Option #1:

I provide hourly monitoring services within the home environment. This service does not include any prenatal visits, postpartum visits, or accompaniment to the hospital.  Clients may choose a-la-carte add-ons, as listed under Option #2.

Hourly Monitrice Fees: 

With Deposit: For clients who already have a doula, and/or are interested only in clinical monitoring within the home environment, and who schedule an initial consultation and provide a deposit, the Monitrice rate is $250 for the first two hours of clinical monitoring, and $50 per hour, after that.  Example:  The Monitrice is used at home for 6 hours, before the couple departs for the hospital. The fee would consists of $250 (for first two hours) + $50 + $50 + $50 + $50 (for last four hours), for a total of $450. If the Monitrice is sent home and called out to the home a second time, during labor, a second fee of $250 for the first two hours of the second visit will be applied. A-la-carte services are identified in parenthesis, above and below. A retainer fee of $250 is due by 36 weeks gestation, and any applicable accrued $50 per hour rate (after two labor hours) is due within one week of the birth, payable by cash, check to Moxie Midwifery, LLC 8400 S. Kyrene Rd. Ste. 120 Tempe, AZ 85284 or by Square Invoice. A-la-carte services are due the day services are rendered. There are no refunds for the hourly Monitrice Fees option.

Without Deposit: For clients who contact the Monitrice in labor, and have not provided a deposit, the hourly Monitrice rate is $300 for the first two hours of clinical monitoring, and $75 per hour, after that.  Example:  The Monitrice is used at home for 6 hours, before the couple departs for the hospital. The fee would consists of $300 (for first two hours) + $75 + $75 + $75 + $75 (for last four hours), for a total of $600. If the Monitrice is sent home and called out to the home a second time, during labor, a second fee of $300 for the first two hours of the second visit will be applied.  Payment is due the day services are rendered, and can be paid via Square Invoice, cash or check. There are no refunds for the hourly Monitrice option.

Option #2:

I serve in the role of doula/monitrice, offering several prenatal visits, accompaniment to the birth, both at home, and at the hospital, as well as two postpartum visits.

On-call period. I consider my on-call period for a birth to be from three weeks before the “due date” to two weeks after the due date. If circumstances arise, in which I become unavailable during this period, even for an hour or less, I will communicate that to the client and provide a backup Monitrice to be on call.

Prenatal Conferences. We will have five prenatal meetings during the course of your pregnancy. All, save the provider visit, will be performed in the office.

The first will be a general information session, free of charge, where we discuss the role of the Monitrice, the interest and anticipated participation level of the Dad in the natural childbirth, as well as your general preferences for your birth.

We will then have a second meeting specifically set aside to co-create your Birth Plan, where I will provide a checklist of all available options, and we can discuss any at length.  I will put together a list of the preferences you identify and email you with a finalized Birth Plan for you to review and approve. ($100 a-la-carte)

Our third visit together will be a visit to your care provider, in which I accompany you, meet them, and am present as a support when presenting the Birth Plan.  ($100 a-la-carte)


Our fourth visit together will be a two-hour Blessingway, at the office, where you can invite friends and family.  We create collages for the mom, as well as do some pampering, with hand and feet massages (if desired).  This is also an opportunity for friends and family to hear the baby’s heartbeat.  There are light snacks and music, and it is an enjoyable and relaxed experience.  ($150 a-la-carte)

The final visit before the birth is a two-hour hypnotherapy session where the client can go on an empowering journey through her birth experience, in her mind, before actually embarking on it in “real life.”  This session assists clients with gathering their resources and releasing any lingering fears. It is well known that Olympian athletes use this technique many times over, when preparing themselves for their big performance. Clients come away feeling refreshed, rejuvenated, and excited for their birth. ($150 a-la-carte)

When Labor Begins:

When you think labor has begun, please let me know.  We will then plan to check in every few hours by phone, so I can provide information, ideas for comfort techniques, and reassurance. It is up to you to decide at what point in your labor you want me to come and be with you. Once you make that choice, I will generally be there within one hour, and will remain with you until after the birth.

When you are in Labor.  Comfort techniques: I can offer help and advice with comfort measures such as guiding your breathing, enhancing relaxation, encouraging movement, suggesting effective positions for labor, and doing massage. Advocacy: I can assist you with gathering information about the progress of labor to make sure you have the information you need to make informed decisions about your birth. I can also serve as an advocate for your needs with the medical staff. Emotional support: My most critical role is providing continuous emotional reassurance and comfort. In the rare instance that labor support exceeds 18 hours, there will be an additional fee of $25 per hour. In addition, the Monitrice may substitute another qualified Monitrice or doula (depending on whether we are at home or the hospital or birth center at that point) at the 18 hour mark, for a maximum of 18 hours. It is essential that the Monitrice be well-rested and thinking clearly, in order to provide the excellent support the client deserves. Jennifer will always return for the birth of the baby and to provide immediate postpartum support.

After Birth.  I will remain with you for 1-2 hours after birth, until you are comfortable, and the family is ready for quiet time together. I can also help with initial breastfeeding.

My services include two postpartum visits, one at one week (home visit) ($150 a-la-carte), and one at three weeks (office visit) ($100 a-la-carte).  This fills in the gap of standard maternity care in the US, where typically, moms only receive one postpartum visit with their care provider, at 6 weeks. During these visits, I can weigh the baby, provide breastfeeding support, baby care tips, referrals to community resources, and a chance to discuss the birth experience.


What Monitrices do not do:

  • They do not make decisions for you. They will help you get the information you need to make your own informed decisions. They will also remind you if there is a departure from your Birth Plan, and will verify if this is, in fact, your informed decision.
  • They will not speak to medical staff regarding matters where health care decisions are being made. They can discuss your concerns with you and suggest options. They can support you in discussions with staff as your advocate, but you or your partner will speak on your behalf to the medical staff.
  • They do not perform any clinical tasks within the hospital environment.

Doula/Monitrice Package Fees. The total fee for all services listed above is $1,600.  An initial payment of $300 is due at the first visit, a payment of $500 at the 36-week visit, and the remaining $800 is due within three weeks of the birth.

Failure of a Monitrice to provide service, as outlined above. I will make every effort to provide the services described herein.  If I am not able to attend your birth, nor able to provide a backup Monitrice or doula, the amount due after the birth would be waived. I will still perform the postpartum visits, as outlined in this agreement.

Our selection is the following:

__ Monitrice Package (ALL A-La-Carte included) $1,600

__ Hourly Monitrice With Deposit, $250 for first two labor hours, $50 per hour thereafter

__ Hourly Monitrice Without Deposit, $300 for first two labor hours, $75 per hour thereafter

A-La-Carte Services selections:

__ Birth Plan Meeting, where I will provide a checklist of all available options, and we can discuss any at length.  I will put together a list of the preferences you identify and email you with a finalized Birth Plan for you to review and approve. $100

__ Care Provider Visit, in which I accompany you, meet your doctor or midwife, and am present as a support when presenting the Birth Plan.  $100

__  Blessingway, at the office, (2 hours) where you can invite friends and family.  We create collages for the mom, as well as do some pampering, with hand and feet massages (if desired).  This is also an opportunity for friends and family to hear the baby’s heartbeat.  There are light snacks and music, and it is an enjoyable and relaxed experience.  $150

__  Childbirth Preparation Hypnotherapy Session, (2 hours) where the client can go on an empowering journey through her birth experience, in her mind, before actually embarking on it in “real life.”  This session assists clients with gathering their resources and releasing any lingering fears. It is well known that Olympian athletes use this technique many times over, when preparing themselves for their big performance. Clients come away feeling refreshed, rejuvenated, and excited for their birth. $150

__ 1-Week Postpartum Visit, in your home. This fills in the gap of standard maternity care in the US, where typically, moms only receive one postpartum visit with their care provider, at 6 weeks. During these visits, I provide baseline vitals monitoring, including blood pressure, assessing bleeding, assessing for postpartum depression, breastfeeding support, baby care tips, referrals to community resources, and a chance to discuss the birth experience. $150

__ 3-Week Postpartum Visit, at my office. This fills in the gap of standard maternity care in the US, where typically, moms only receive one postpartum visit with their care provider, at 6 weeks. During these visits, I provide baseline vitals monitoring, including blood pressure, assessing bleeding, assessing for postpartum depression, breastfeeding support, baby care tips, referrals to community resources, and a chance to discuss the birth experience. $100

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I / We have read this letter describing the Monitrice services and agree to all specifications outlined herein.  I understand that my Monitrice holds no responsibility for clinical outcomes.

Client: ________________________________________________________

Signature:_____________________________    Date:__________________

Monitrice:_____________________________________________________

Signature:_____________________________    Date:__________________

*Photos of Jen Courtesy of Cherry Blossom Doula Services

More About Doulas

Doulas support women emotionally, physically and intellectually during pregnancy, birth and postpartum.  Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.

I began my calling to walk alongside women during the journey of pregnancy, birth and postpartum, as a doula, and attended over 200 births in the doula role from 2005 through 2011.  Most of this time was spent in a partnership with the amazing Leigh Steele, under the name Desert Moon Doulas.

Now, as a midwife, I encourage all of my clients to enjoy the benefits a doula can bring, offering a discount to those who hire a doula.

Check out these statistics:

  • 50% reduction in the cesarean rate
  • 25% shorter labor
  • 60% reduction in epidural requests
  • 40% reduction in oxytocin use
  • 30% reduction in analgesia use
  • 40% reduction in forceps delivery

Information was obtained from Mothering the Mother: How a Doula Can HelpYou Have a Shorter Easier and Healthier Birth, Klaus, Kennell, and Klaus (1993).

Some of our favorite doulas are:

Lakisa Muhammad @ http://amothersworthbirthservices.com/meet-lakisa/

Lanita Ugstad @ www.ganeshyogagirl.com

Rose Day @ 480-835-8944