Client Code:CDP637

CDP Data Collection Form

EDD: 10/21/2021

First Pregnancy?
  • No

Where did the client give birth? home birth

Provider: mid valley birthing

Primary Insurance: IHN

Priority Medicaid Populations (check all that apply):
  • Limited/No family support

Date of Referral: 07/16/2021

Doula: Heidi Donahue

Meet and Greet Date: 09/01/2021

Method: phone

Date of 1st Prenatal: 09/10/2021

1st Prenatal Attended By: Emma, Wyatt, Heidi Donahue

Location of 1st Prenatal: clients home

Time: 2 hrs

Notes:

introductions. explanation of what services a doula provides and what we do not, how the CDP works. Emma let me know what kind of support she feels like would be helpful for her during her pregnancy, and also during labor especially since she plans a home birth and has anxiety about the pain that will come during labor and birth. we talked about some of the physical comfort measures I could provide, as well as emotional things I could do to help her and Wyatt during the birth. talked about healthy families and what some benefits of the program are. they declined the referral and felt they were well equipped with knowledge and family support for when baby comes.
we discussed what our communication would look like going forward.

Date of 2nd Prenatal: 10/16/2021

2nd Prenatal Attended By: Emma, Wyatt, Heidi Donahue

Location of 2nd Prenatal: clients home

Time: 2 hrs

Notes:

discussed the birth videos they have watched and information they have learned over the last month, wrote out a birth plan together, and I showed Wyatt how to do counter pressure during contractions and they practiced together. gave them some "homework" of trying our different early labor positions together and having fun practicing things such as slow dance, and also see what feels the most natural for them. Wyatt was feeling really encouraged that he had some tools to use to help her during contractions before I get there. discussed positive affirmations, and writing some out for us to say to her during labor. talked about the things she wanted to buy for the labor and postpartum period.

Total Prenatal Hours With Client: 7

Date of Doula Arrival: 11/02/2021

Time of Doula Arrival: 06:00

Birth Attended By: Liz Baer

Date of Doula Departure: 11/02/2021

Time of Doula Departure: 15:30

Client birthed? Yes

Total Hours With Client: 9.5

Date of 1st Postpartum: 11/07/2021

1st Postpartum Attended By: Emma, Wyatt, Heidi Donahue

Location of 1st Postpartum: Clients home

Time: 2 hrs

Notes:

feeding/latching issues. babies weight loss. talked about tongue ties. discussed physical healing from the birth.

Date of 2nd Postpartum: 11/10/2021

2nd Postpartum Attended By: Emma, Wyatt, Heidi Donahue

Location of 2nd Postpartum: Clients home

Time: 2 hrs

Notes:

did a weighed baby feeding, mom felt very encouraged knowing baby was getting good amount of milk from the feeds. discussed baby care basics, emotional health with feeding issues.

Total Postpartum Hours With Client: 4

# of telehealth/in person visits during course of care: 5

# of text messages during course of care: 60

# of phone calls during course of care: 1

# of emails during course of care: 1

Date Created: November 11, 2021