Client Code:CDP623
CDP Data Collection Form
EDD: 08/26/2021
First Pregnancy? - Yes
Where did the client give birth? Newport Hospital
Provider: Brenda Woods
Primary Insurance: IHN
Date of Referral: 08/03/2021
Doula: Kendra Meshnik
Meet and Greet Date: 08/03/2021
Method: phone
Date of 1st Prenatal: 08/05/2021
1st Prenatal Attended By: Client, Partner and Doula
Location of 1st Prenatal: Face Time
Time: 1
Notes:
Paperwork, fears, expectations, birth plan
Date of 2nd Prenatal: 08/10/2021
2nd Prenatal Attended By: Client, Partner and Doula
Location of 2nd Prenatal: Client's home
Time: 1
Notes:
demo and practice of positions and comfort strategies, things I have in my doula bag, C-sections, post-natal plan, who will be in birthing room
Total Prenatal Hours With Client: 1
Date of Doula Arrival: 09/02/2021
Time of Doula Arrival: 02:00
Name of hospital staff adding your arrival time to the chart notes: Don't know Don't know
Birth Attended By: Brenda Wood
Date of Doula Departure: 09/03/2021
Time of Doula Departure: 05:00
Name of hospital staff adding your arrival time to chart notes: don't know
Client birthed? Yes
Total Hours With Client: 27
Date of 1st Postpartum: 09/09/2021
1st Postpartum Attended By: Client, partner, Client's siblings, and doula
Location of 1st Postpartum: Client's home
Time: 1
Notes:
Processing and remembering the events of the birth.
Decision to accept epidural.
Healing from stitches.
Network with family.
Date of 2nd Postpartum: 09/18/2021
2nd Postpartum Attended By: Client, partner, partner's mother, and Doula
Location of 2nd Postpartum: Client's home
Time: 1
Notes:
Routing with baby.
Joys of having baby.
Soothing baby.