INFORMED CHOICES
MoonDragon Birthing Services & Woman Care
MDBS Maternity Care & Domiciliary Midwifery
Rev. Leather Dupris, BS Candidate, DEM, CCE
Owner & Director of Services
0 Boardman Street, #1
Salem, MA 01970
Office: (978) 744-5583
Fax: (978) 741-2015
Website: www.moondragon.org
Part 1: Disclosure of Background & Experience
I, Leather Dupris, hereby state that I am not a medical physician, registered nurse,
doctor of osteopathic medicine, or any other licensed medical practitioner recognized by
the laws of the Commonwealth of Massachusetts. I am, however, an experienced, trained,
primary care direct entry midwife (DEM), but I do not hold any type of medical degree.
Direct Entry status refers to the method of entering the profession of midwifery, which
means that I entered midwifery "directly" without having obtained a nursing degree prior
to practicing my profession as a midwife. In the Commonwealth of Massachusetts, midwifery
and homebirth is legal. There are no provisions for licensure in the Commonwealth of
Massachusetts for non-nurse midwives. I began my training in 1978 as a student to a
Naturopathic Physician, who was also in the profession of midwifery. He continued to mentor
my midwifery practice until his death in 1981. I have been a primary care, Domiciliary
(homebirth) Midwife since 1979. I am currently involved with obtaining the Certified
Professional Midwife (CPM) certification through North America Registry of Midwives (NARM).
I am a certified childbirth educator through Informed Homebirth (IH) and Informed
Childbirth Association (ICA) since 1980. I am certified by the Commonwealth of Massachusetts
as a Certified Nursing Assistant (CNA) and as a Certified Home Health Assistant (CHHA). I
am also an ordained minister and a high priestess of Wicca. I have my Reiki II Certification
and am a practicing Reiki therapist. I am also a Notary Public for the Commonwealth of
Massachusetts.
My formal educational background consists of being a Bachelor of Science candidate with a
specialty in Biology (Human) and Psychology (Women's & Family Studies). I also have a minor
in Journalism. I have a Certificate of Completion from Boston University School of Medicine
for their program in Biomedical Laboratory and Clinical Sciences. I am currently a Reiki
II Certified Practitioner of Reiki Therapy. I have also completed training programs and
certifications from Roche Diagnostic Systems for Amplicor PCR Diagnostics and Chiron
Diagnostics for HCV Molecular HCV bDNA Diagnostics. I was previously employed by New
England Medical Center as a Clinical Laboratory Technician, Lab Manager, and Research
Assistant for the Gastroenterology Department from 1993 until 2000 and the Allergy Division
from 1992 until 1993 as a Research Assistant involved in allergy research. I was a
member of the Boston Veterans Affairs Medical Center Animal Studies Subcommittee Research
& Development Program from 1993 to 1996. I have completed the Commonwealth of
Massachusetts program for Emergency Medical Technician - Basic (EMT-Basic) level of
Emergency Medical Service (EMS) response and transport. Other programs completed have
been Hypnobirthing Childbirth Education, Lamaze Childbirth Education, Bradley Childbirth
Education, Emergency Search & Rescue, Non-Violence Interventions, Domestic Violence
Support & Intervention, and the Red Cross Health Care Provider's Cardio-Pulmonary
Resuscitation (CPR) and NeoNatal Resuscitation (NNR) certifications.
My informal educational background consists of numerous seminars, workshops, conferences,
and other training and continuing educational pursuits regarding midwifery, maternity care,
childbirth education and medical and social issues. I have taken seminars about domestic
violence and abuse and filling out state certificates of birth and death. I have been
certified in Hazardous Materials, Chemical Safety, Fire Safety, Universal Precautions and
Radiation Safety through New England Medical Center.
My professional associations and support include, but may not be limited to, the
Massachusetts Midwives Alliance (MMA), the Midwives Alliance of North America (MANA),
the Coalition of Improving Maternity Services (CIMS), the Massachusetts Friends of
Midwives (MFOM), and the World Health Organization (WHO) recommendations for
midwife-based maternity care and the Massachusetts Midwives Alliance (MMA) and MoonDragon's Practice Guidelines.
Part 2: Disclosure of Practice & Philosophy
MoonDragon Practice
MoonDragon Birthing Services offers a safe, gentle, alternative choice in birthing for
healthy, low-risk, pregnant women and their babies regardless of religion, race, alternative
lifestyles, ethnic origin, or financial ability to pay for rendered services. Private,
personal care and in-home visitations are made as indicated by our practice guidelines
and more often when they are needed. We offer prenatal care and counseling, laboratory
testing, educational support and instruction, home-birthing services, and postpartum care
with breastfeeding instruction and support for approximately 6 weeks after the baby is
born. We will also perform emergency care, if it is indicated, and transport to a medical
facility of the client's choice under the direction of our client and her partner, if
needed. To view our
maternity care & practice guidelines, visit the
MoonDragon website or request a copy of the guidelines.
We do except some health insurances if they cover out-of-hospital births and midwifery care.
We do not accept HMOs or Medicare health insurances. We understand that many families may
have insurance that do not cover our maternity services and home health care, so with this
in mind, we do offer economical rates and flexible plans that will work with each individual
family's financial budget. Since we try to keep this a not-for-profit service that works
with low-income families, we do accept financial gifts and donations to help support our
efforts to provide quality care to financially stressed families. We also accept credit
card payments with Visa, MasterCard, Discover, and American Express.
MoonDragon Philosophy
We believe that birth is a normal and natural physiologic condition of the female body.
We believe that women are strong, capable, intelligent, intuitive, spiritual human beings
that are capable of caring for their own bodies and are able to birth their babies naturally,
gently, lovingly, and without medications and surgical or medical interventions. We strive
to emphasize wellness and preventive measures through education, nutrition, stress relief
and management, relaxation, and moderate exercise. We believe that women are able to give
birth in the comfort, security, and familiarity of their own homes in the supporting and
loving company of their partners, family, friends, and other children. Children are
welcome to be present at the birth, if decided by the birthing woman and her partner.
The birthing woman is in charge of her own experience and makes her own choices and
decisions about what she wants to experience or not experience during her labor and birth.
We are there to assist her in achieving her birthing goals and to be watchful and to keep
her experience as normal as possible. As a midwife, I see my function as "The Keeper of the Normal".
Part 3: Disclosure of Risks & Benefits
Risk factors and transfer protocol guidelines is available to each expectant woman and her
partner upon signing up with MoonDragon Birthing Services. This guideline is available as
a hardcopy printout or is available online at
www.moondragon.org/mdbsguidelines/prguide.html located on our website,
www.moondragon.org. This guideline will outline the
standards and protocols that we follow in handling problems that may arise during their
pregnancy, birth, and postpartum. We believe that 90 percent of all healthy women can give birth
naturally, gently, while in their homes with little or no medical interventions and no
medications. Homebirth with a trained, educated midwife has been shown to be as safe or
safer than a hospital birth while under the care of a medical physician for healthy low
risk mothers. However, as indicated by our risk factor guidelines, there are those other
women and their babies that will have a need of more intensive medical care under the
direction of a medical practitioner in a medical facility. Your midwife will be available
to answer all questions, concerns, and issues at any time during your care with MoonDragon
Birthing Services and assist you in making decisions about your options. If you need to
have medical care beyond the scope of our services, you will be referred on to other health
care providers.
Part 4: Acknowledgement of Responsibility
I, the undersigned expectant mother and my partner, if applicable, have been informed by
Leather Dupris, Owner and Director of Services for MoonDragon Birthing Services, about
the services that are provided for my use during my pregnancy, birth, and postpartum time
periods through MoonDragon Birthing Services.
I and my partner, if applicable, will be having a child and have voluntarily requested
Leather Dupris and her attendants, if any, to assist in the prenatal care, homebirth, and
postpartum care of myself and my baby(s).
I and my partner, if applicable, agree to take active part in my prenatal care by following
a healthy lifestyle, nutritious dietary plan, and obtain moderate exercise while under the
care of MoonDragon Birthing Services. I as the birthing mother agree to avoid alcohol,
cigarettes smoking, and recreational drugs during my pregnancy. If I do imbibe in any of
these activities, I will inform my midwife and understand that I am putting myself and my
baby at risk and may be referred on to other, more intensive, medical care and may be
at risk and unable to have a homebirth. I agree I will not use prescription, over-the-counter
drugs or medications, or herbals and nutritional supplements without first discussing my
options with my midwife. I agree to educate myself about my body, my pregnancy, and about
parenting skills. I agree to ask questions about any concerns I may have and to make my
own decisions about all aspects of my health care. I agree to be completely open and honest
about my medical, physical and mental health conditions and disclose any and all conditions or
situations that may have influence on my health and my pregnancy and my birth.
We have read all parts and sections of this disclosure. We understand the pros and cons,
benefits and possible hazards or complications that can arise during pregnancy or a
homebirth which cannot be completely taken care of in the home. Although problems may be
uncommon or rare, if in the event of such complications do occur, we understand that we
have been or will be given appropriate information so informed choices and appropriate
decisions can be made. We voluntarily accept all responsibility for these decisions and
the consequences of these decisions.
In the event of an informed decision to make a medical referral or an emergency medical
transport for a complication or problem, we agree not to hold MoonDragon Birthing Services,
Leather Dupris, and/or any of her other attendants responsible for complications, injury
or harm which might occur to their child or the mother during the pregnancy, during a homebirth,
or during postpartum. We forever release and discharge MoonDragon Birthing Services, Leather
Dupris, and her attendants from all claims, present and future, known or unknown, in
any manner arising out of the complications or problems regarding this pregnancy,
homebirth, or postpartum period.
In the event of unsatisfactory care on the part of MoonDragon Birthing Services, Leather
Dupris, or any of her attendants, we have the option of contacting the Massachusetts
Midwives Alliance (MMA) to report a grievance. This grievance will then be presented
before the MMA Peer Review Board for discussion and review. If negligence or inappropriate
care is found, necessary disciplinary actions will be by the MMA Peer Review Board.
Massachusetts Midwives Alliance (MMA)
Attn: Peer Review Board
57 Stevens Street
Stoneham, MA 02180
(508) 376-8201
We have read all sections of this disclosure and have discussed each section with each
other and Leather Dupris. We do hereby understand and acknowledge all information, terms
and ramifications. We execute it voluntarily and with full knowledge of its significance.
Date: ____________________, 20__________
________________________________________
Mother's Signature
________________________________________
Mother's Name (Printed)
________________________________________
Partner's Signature
________________________________________
Partner's Name (Printed)
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