Costs of Doula Care

Hundred Bill CornersWhen you see those two lines on your pregnancy test, many things race through your head.  For a lot of moms-to-be, the cost of having a baby is at the forefront. Anticipated expenses include nursery furniture, decorations, car seats, strollers, high chairs, layettes, and the latest baby monitor. Even worse, you might be subject to high deductibles, co-pays, and out-of-pocket expenses.  You might be a mom who wants the sweetest maternity and newborn pictures you can imagine.

Where does paying for a doula fit in?

Doulas make planning easier.  Just like wedding planners or tour guides, doulas do pregnancy and babies.  A doula brings the added, scientifically proven benefit: her (or his) presence through pregnancy and birth lowers your risk for needing interventions and a cesarean section and lowers the risk of your baby needing to visit a special care nursery. A professional doula helps you affect your birth outcome.

Let’s take a look at what I, as your doula, offer to you:

  1. A relationship and time to build it.  I meet with you monthly along with other clients, and depending on your package, two to five times privately.  By the time you give birth, we will be friends, and I will understand your hopes and fears as you make this transition to parenthood for the first or fifth time.
  2. Plenty of room on my calendar so I am less likely to be at another’s birth when you begin feeling those first pressure waves.
  3. Complete availability to you via phone, email, and text during pregnancy and for a specified time following birth.
  4. Complete physical availability to you while you wait for your birthing time to begin. This means I do not go out-of-town, on vacation, or somewhere where my phone won’t work. This means that if you call me while I am in the grocery store or meeting with another client, I will immediately go home, arrange for last-minute child care (from an on-call babysitter that I pay to be ready), and come to your side within two hours. As you can imagine, this limits my activities. I am happy to do it, though, because you need the benefits of having continuous support.  No OB, midwife, or other person (even your mother) is able to do this.
  5. I do not change shifts. I am capable of staying by your side, no matter how long your birthing takes. Except for bathroom and snack breaks, I stay with you, always. This means my family and other responsibilities are put entirely on hold.
  6. I have a lot of birth information in my head. I do not offer medical support or advice, but I do know how to help your back feel better, how to listen to your fears, and how to reassure you that what you are experiencing is normal. I know how to use physical and verbal cues to help you achieve a deeper level of comfort during your birth.
  7. I try to play an active role on a community level to make options and choices available to you. Through the East Alabama Birth Village, which I co-founded, I am trying to raise awareness in this community about what options exist and don’t exist for mothers like you.

What does this level of service cost me?

  1. Child care costs, both day and night. I pay a sitter to set aside her obligations and be on-call for me, just as I am for you.  This costs more than regular child care, especially when I call her overnight.
  2. Supplies cost. The tools I use that make you more comfortable cost money. Tub liners, rock warmers, massage oils, and the bags to carry them in are not free.
  3. Mileage. The wear and tear and cost of fuel for my car adds up as I meet with you each month, and at your home from 1 to 7 times, and at the hospital 1 to 2 times.
  4. Lost sleep. If I attend your birth for 24 hours, I have missed a full night’s sleep.  I have to find ways to catch up, and sometimes that means paying a sitter and housekeeper to work for me while I rest.
  5. Training costs. I am continuously learning new ways to be a better doula. I am training now as a bereavement doula, and learning ways to use the rebozo for comfort and progress.  I just sat for the Lamaze certification exam and am awaiting those test results.  The cost to take that exam was high.  I paid high costs to become a certified doula through DONA, and just like any other profession, maintaining that certification requires that I invest in contact hour classes. I spend a good bit of time networking with other doulas and learning from them.
  6. Time.  I spend a lot of time emailing, texting, and talking with you over the phone and in person.  How often can you talk directly with your doctor or midwife? I spend this time talking with you during your pregnancy and after your pregnancy. How often can you talk to your other caregivers after your baby arrives?
  7. An unpredictable home life. Because childbirth is unpredictable, my entire family must be flexible with plans.  If I am asked to be somewhere, I usually have to agree with a caveat: only if I’m not at a birth.  I once spent Christmas morning at a birth when I had family coming into town to celebrate a 50th wedding anniversary, and I was obligated to arrange $400 worth of flowers (I paid a back-up doula to take my place after 12 hours so I could go home and decorate).
  8. Business costs. I pay for liability insurance, business licenses, and other permits needed to professionally operate a small business.
  9. Taxes. About 1/3 of my gross revenue immediately goes to self-employment taxes.

I have been a doula for over 2 years now, and I’ve learned so much.  I started out charging $250 per client.  I must have been HIGH.  For the past two and a half years, I have been in the red, and I can’t sacrifice myself for that any longer.  You will find other doulas that cost less than me.  But I wager they will not be investing in their skills as a doula, and they will soon burn out not making a living wage.  I want to make a living wage doing the work I love. I don’t want to take valuable time from my family and other responsibilities and not be paid fairly for it.

Some doulas believe that this comes with the territory, that the unpredictable sacrifices of the doula life are what we sign up for when we decide to do this work.  Some doulas and mothers think we should continue to sacrifice ourselves because we are meant to be servants to mothers, and they need and deserve us.  The thing is, the doulas who subscribe to that philosophy only stay doulas for a short time.  A human can only pay to be a doula for so long.  I am an excellent doula, and I intend to be here for the long haul.

I hope this post helps you consider why I have now set my prices higher than others in this area and state.  You can be reassured that when I am working for you, supporting you in the pregnancy and birth you want, I am not feeling burnt out or jaded. I am there with a full heart and mind, knowing that my work is appreciated and valuable to you.  That is more comfortable for both of us.  And if you need a payment plan to make things work, we can explore that. Just contact me if you have any questions.  And always remember: Mama, you are strong.

 


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