What kind of release do you have them sign as your doula clients?  As an
IBCLC, I barely say a word to a mom before I have her sign that I can
communicate with her physician/midwife, just the standard thing, so I could
send the letter directly without a second thought.  Might be worth
considering if you don't already do it.  That said, it is sometimes a good
thing, depending on the mom's relationship with her dr, to have her carry
the letter herself, because it can be a good lead-in to a conversation, if
the mom is feeling up to that.

Lynn Carter OFS LLLL IBCLC\
Missouri, USA

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