Client Code:CDP716

CDP Data Collection Form

EDD: 12/15/2021

First Pregnancy?
  • No

Where did the client give birth? Albany hospital

Provider: Dr. Hovey

Primary Insurance: IHN

Priority Medicaid Populations (check all that apply):
  • Medically high risk
  • Under 21 yrs. of age
  • Homeless
  • Limited/No family support

Date of Referral: 10/22/2021

Doula: Heidi Donahue

Meet and Greet Date: 11/03/2021

Method: phone

Date of 1st Prenatal: 11/12/2021

1st Prenatal Attended By: Heidi Donahue

Location of 1st Prenatal: phone

Time: 1 hour

Date of 2nd Prenatal: 11/24/2021

2nd Prenatal Attended By: Heidi Donahue

Location of 2nd Prenatal: Clients mothers home

Time: 1.5 hours


Talked a lot about her previous birth trauma and the removal of her daughter after she was born. We talked about her fears of this baby being taken away as well, and her losing all of her baby items when a friend stole them to be vindictive and then she had to leave that friends home, and is now staying in her moms trailer for now. we talked through her birth plan, and about the things that she feels would be triggering to her. we talked about breastfeeding, postpartum support plans, etc.

Total Prenatal Hours With Client: 4

Date of Doula Arrival: 12/10/2021

Time of Doula Arrival: 11:00

Name of hospital staff adding your arrival time to the chart notes: Amy RN

Birth Attended By: Dr. Hovey

Date of Doula Departure: 12/10/2021

Time of Doula Departure: 16:15

Name of hospital staff adding your arrival time to chart notes: Amy RN

Client birthed? Yes

Total Hours With Client: 5.25

Date of 1st Postpartum: 12/29/2021

1st Postpartum Attended By: Heidi Donahue

Location of 1st Postpartum: Zoom call

Time: 1.5


talked about how she is feeling physically and emotionally, ecspeciallt with the inviolvement of DHS which is triggering to her and her previous birth trauma. talked about breastfeeding and formula feeding of baby. she is complaining of physical pain but drs say to take Tylenol and she feels she needs more, but they are unwilling to help. I asked her again about healthy families and a referral to them and she declined. She declined the postpartum mood survey as well. She wasn't wanting to talk about birth control either, she said she just doesn't like any forms of them.

Total Postpartum Hours With Client: 3

# of telehealth/in person visits during course of care: 3

# of text messages during course of care: 200

Date Created: December 30, 2021