BIRTHFIT for Everyone: Doula Support Application

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Our mission is to provide emotional, physical, and informational support in the form of a local birth or postpartum doula to optimize the well-being of the military mother transitioning through pregnancy, birth, and postpartum without her husband or partner.

If you are in need of birth and/or postpartum doula support, please fill out the short survey below.

Name *

First and last name

Email *

Physical Address
*

Phone number *

Date of birth
*

YYYY

Estimated due date
*

YYYY

Provider
*

Midwife

Freebirth

Required

Are you active duty?
*

Yes

If you are not active duty, do you work?
*

Yes

If you’re active duty, what branch? What year did you join? *

What city and state will you be in when you give birth? *

Is your husband active duty?
*

Yes

If he is not active duty, what does he do? *

If he is active duty, what branch? What year did he join? *

Will he be deployed or able to be at your birth?

Yes

Please describe your ideal birth experience. *

Please describe your current lifestyle, including fitness, nutrition, work, toddlers, etc. *

Are you seeking birth doula support or postpartum doula support or both? Why? *

Please list the doulas you are considering.
*

Submit

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