Client Code:CDP779

CDP Data Collection Form

EDD: 02/14/2022

First Pregnancy?
  • Yes

Where did the client give birth? Eugene Riverbend Hospital

Provider: Dr. Balderman

Primary Insurance: IHN

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

Date of Referral: 11/08/2021

Doula: PhoebeSue Nordyke

Meet and Greet Date: 11/10/2021

Method: Phone

Date of 1st Prenatal: 12/16/2021

1st Prenatal Attended By: Phoebe

Location of 1st Prenatal: Zoom

Time: 1.5


General thoughts and wishes for birth. Spoke with client and main support person (best friend) about her role in the birth and the role client wants me to fill in conjunction with main support person. Discussed how pregnancy is going and current struggles with baby's father and how it is affecting her/her baby/her birth plans. Talked about support system for labor and postpartum. Discussed general coping mechanisms and reasons for wanting the type of birth she wants, and ultimate goals/desires for her birth experience.

2nd Prenatal Attended By: N/A- Premature birth


Unable to complete second prenatal. Client gave birth prematurely.

Total Prenatal Hours With Client: 1.5

Date of Doula Arrival: 01/05/2022

Time of Doula Arrival: 00:45

Birth Attended By: Phoebe

Date of Doula Departure: 01/06/2022

Time of Doula Departure: 16:10

Client birthed? Yes

Total Hours With Client: 11.5 hrs. Time was broken up with 2 visits to hosptial. First visit ended on 1/5 at 08:10 and second arrival time was on 1/6 at 12:25

Date of 1st Postpartum: 01/28/2022

1st Postpartum Attended By: Phoebe

Location of 1st Postpartum: Client Home

Time: 1


Discussed physical and mental well-being- how is her support? Discussed how NICU stay went and how they are adjusting to being home. Made sure she had community resources in place (WIC, SNAP, discussed Babies First program but client decided against for now). Talked about how family and friend support can help her as a single mom. Talked about how feeding is going, gave pumping tips. Baby still is unable to latch, but they are trying daily.

Date of 2nd Postpartum: 02/10/2022

2nd Postpartum Attended By: Phoebe

Location of 2nd Postpartum: Zoom

Time: 1


Talked about physical and mental health. Client is going to speak with doctor at her 6 week appointment in a week about checking iron levels and getting birth control and referral to a counselor to help with mental health. Went to ER in past week with abdominal pain, found out it was due to gallstones, will be having surgery. Talked about creating plan for support before/during/after surgery. Client is currently combo feeding while trying to increase breastmilk supply, discussed ways to try and increase it. Talked about how to use support system to help give her breaks, help with daily tasks, etc.

Total Postpartum Hours With Client: 2

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

# of text messages during course of care: 42

# of phone calls during course of care: 5

# of emails during course of care: 37

Date Created: February 11, 2022