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