Client Code:CDP797

CDP Data Collection Form

EDD: 01/22/2022

First Pregnancy?
  • No

Where did the client give birth? Lebanon hospital

Provider: Dr miller

Primary Insurance: IHN

Priority Medicaid Populations (check all that apply):
  • Medically high risk

Date of Referral: 11/29/2021

Doula: Heidi Donahuee

Meet and Greet Date: 11/30/2021

Method: phone

Date of 1st Prenatal: 12/05/2021

1st Prenatal Attended By: Heidi Donahue, Jessica barker

Location of 1st Prenatal: clients home

Time: 2 hours


talked with Jessica about her struggles medically and emotionally this pregnancy. We also discussed a lot about her previous delivery and birth. Explained how the program works, talked about what support looks like to her and what she feels would be helpful for her to have from me. explained the roles of a doula and what we do/don't do.
talked about the healthy families program and she declined.

Date of 2nd Prenatal: 12/29/2021

2nd Prenatal Attended By: Heidi Donahue, Jessica Barker

Location of 2nd Prenatal: clients home

Time: 2 hours


developed a birth plan, and talked about all the things that are important for her to happen this time around. discussed all the complications she has been having lately, and I offered a lot of emotional support. I asked her about filling out the aces, she declined though she shared some information about some trauma from her past and we talked about potential triggers during labor.
I explained when to call me, when I arrive during labor, what happens in the event of an induction or cesarean.

Total Prenatal Hours With Client: 9 hours

Date of Doula Arrival: 01/19/2022

Time of Doula Arrival: 13:00

Birth Attended By: Heidi Donahue

Date of Doula Departure: 01/20/2022

Time of Doula Departure: 01:45

Client birthed? Yes

Total Hours With Client: 13 hours

Date of 1st Postpartum: 01/25/2022

1st Postpartum Attended By: Heidi Donahue

Location of 1st Postpartum: clients home

Time: 2.5 hours


discussed emotional well being after after the labor and birth, how she feels about it ending in a cesarean. helped her with latch of baby, and offered breastfeeding support. sat and listened her process the birth.

Date of 2nd Postpartum: 02/01/2022

2nd Postpartum Attended By: Heidi Donahue

Location of 2nd Postpartum: zoom

Time: 1.5 hours


discussed healing from cesarean. she had an allergic reaction to something from the birth and we discussed that and how things are healing. talked a lot about breastfeeding, pumping, feeding desires and goals. talked about how she is doing emotionally and how things are going with her older daughter adjusting to being a big sister

Total Postpartum Hours With Client: 6

# of telehealth/in person visits during course of care: 1

# of text messages during course of care: 450

# of phone calls during course of care: 2

# of emails during course of care: 0

Date Created: February 4, 2022

Birth Summary


Jessica went in for induction on 1/18/22, and I had been communicating with her via text as the induction process was going on. on 1/19, she wasn't progressing much so they inserted a foley balloon, and then thing started picking up and she felt ready to have my in person support. I arrived at Lebanon hospital at 1:00pm, and around 2:00 the foley bulb fell out and they increased her Pitocin. things were still progressing slowly but her contractions were painful so I helped her with back massage while she was on the birth ball for quite awhile. I also used low back sacral pressure to help with the contraction pain. the plan was for her dr to arrive at 6:00pm to break her water so at 5:00 we got her into the tub and lowered the lights, added soft music, and she sat in the tub while eating a snack. I used the shower head to spray the hot water across her low back in the tub after she was done eating. we got her out of the tub and onto the bed right before the drs arrived and she decided it was time for an epidural. she received the epidural right around 6:00pm, and shortly after the drs came and broke her water and she was 7 cm dilated. she continues to labor in the bed with her epidural and we spent time talking, and I gave her a hand massage with lemon and coconut oil. each time the drs came to check on her she wasn't progressing with cervical changer so we got her into multiple positions such as fowlers, all fours into a squat, some spinning babies positions and she hadn't progressed with cervical change after 3 hours and baby was showing signs of distress with heart decel's so the drs consulted with a surgeon and they decided it was time to do a cesarean birth.
baby Maia was born at 11:59 PM and was healthy and had great Apgar scores. I met Jessica in recovery, and she was struggling with nausea and was so exhausted from being up for over 30 hours. she wasn't really able to hold her baby or attempt to breastfeed on her own, so I assisted with her boyfriend holding her breast correctly and getting baby attached ointo the breast to feed while encouraging Jessica to just close her eyes. She was so tired that she was just not understanding anything we were saying really and she said she was just fighting so hard not to close her eyes, so I encouraged her that it would be completly fine and safe to close her eyes and fall asleep. so she did that off and on while her boyfriend helped hold the baby onto her breast. after Maia was dine feeding I helped get her safely nestled uo next to mom in her arm while the rail of the bed was up. I left at 1:45 AM and mom and baby were falling asleep and doing well.

Date Created: January 25, 2022

Invoice Form (Credentialed Doulas)

Invoice Date: 02/04/2022

Check All Services Provided:
  • Global Package: 2 Prenatal, Birth, 2 Postpartum