Ever wondered why doula care costs what it does? Learn from a doula how much she costs, what that price includes, whether you even need it and how to budget for it.
Using a doula has been shown to help with labor and birth, yet only 6 percent of women use one, according to a Listening to Mothers study. So what gives? Aside from the fact that doula care is still a relatively new option on the maternity scene—only gaining popularity in the last 10 to 15 years, price is often a large factor for families, since fees start at about $200 and up.
A cost breakdown
Most professional doulas offer their service for a flat-fee, which includes an agreed-upon amount of prenatal visits, 24/7 on-call time at the end of your pregnancy, support during your labor and birth (whether it's 3 or 43 hours) and at least one postpartum visit. Other perks might, like prenatal yoga classes or the use of a birth pool, might also be included. Packages and services offered by individual doulas differ, but the key to the fee is the on-call time and continuous support.
Most doulas are on call for your birth for a few weeks, from when you are about 37 weeks pregnant until you deliver. Unlike hospital or birth center staff, private doulas don't work in shifts or on a set schedule—they follow your timetable. Emily Fontes, a doula and doula business consultant in the Seattle area, explains it this way: "I tell parents to think about having a job that they love. Imagine if their boss said, 'So there's going to be a change to your hours and payment. I'm not sure when I'm going to need you, so I want you to be on-call 24-7. I may call you in at 2 a.m. on a Sunday or 3 p.m. on a Wednesday. I won't know until it happens. I'm also not sure how many hours at a time I'll need you. Could be 6; could be 30 hours. Oh, and I want your salary to be the same no matter what. Would you keep that job? How much would you need to be paid for it to be worth it?' I think that really brings it home for families. Doulas deserve to make a generous wage for the contribution they make to a family's birthing experience."
Other factors that go into a doula fee? Expenses (like tools for that that all-important doula bag-of-tricks), taxes, insurance, and professional membership fees.
The majority of doulas are also mothers, so childcare is a large consideration, too. Kimberly Bepler, IBCLC, CPD, ICPE, and owner of ABC Doula Service in Portland, Ore. explains: "As much as this service is a gift of care, it is also an expenditure of skills and energy. Having a baby is a precious time, and it brings with it the idea that everyone needs to jump in and help out, which is wonderful. However, when someone is a professional, they aren't 'helping out,' but doing their job."
Budgeting for a doula
Depending on the area where you live, the price for doula services can range widely, from over $1,000 in cities like New York and San Francisco to considerably less in rural areas. There are many models of doula businesses, including volunteer doula programs, hospital-based doulas, agencies, cooperatives, and partnerships.
If you want to use a doula, there are a few different ways to work one into your baby budget. Ask if your doula accepts payment plans or charges on a sliding scale; request contributions towards her fee at your baby shower; petition your insurance company to cover doula fees, or include it in your flexible spending plan. Or, if you're willing to take the risk, a less experienced or student doula often charges a lower fee.
Many women have positive, supported experiences with doulas, so if it's what you want from your birth experience, chances are you'll be glad you made the investment.
Carrie Murphy is a doula and writer in Albuquerque, N.M.