I hear it all the time. “We really want to hire a doula but……we aren’t sure if we can afford it.…we don’t know if it will be worth the money.…it’s just so expensive.”

It can be hard to understand why doula services cost what they do, especially if you’re just thinking about the actual time spent with clients. “If I hire a doula for $1,000 and see them for 2 hours before birth, 2 hours after birth, and they spend 8 hours at my birth, they’re making over $80/hour!” I’ve seen prices from $free.99 – $2,000+ out there! Understanding the true value of what doulas have to offer (both tangible and intangible) is key to understanding the investment you’re making when you hire a doula. It’s important to remember that you’re not just paying a doula for the time they spend with you (and this applies to birth and postpartum doulas alike). Most doulas own their own businesses in order to provide support for their clients. That means there are overhead expenses like software, travel costs, and taxes involved in doula support – in addition to the time doulas actually spend working with their clients. In order to stay in business and continue to do this work, doulas have to set their rates in a way that allows their practice to be sustainable.

Behind each interaction I have with a client, there is a wealth of knowledge and experience. When a question or challenge comes up in working with a client, I draw on my training, experience, and resources available to me help my clients work through it. Sometimes this requires additional time spent reading, researching, and talking to other perinatal professionals to learn more. Sometimes it even requires attending an additional training or professional development workshop. The time I spend actually talking or writing to a client about the issue is like the tip of the iceberg – there is a lot underneath the surface.

I prioritize continuous learning. It’s important to me to seek out opportunities for learning and growth in many different aspects of my work. The combined wisdom gained from these learning opportunities directly benefits the families who choose to work with a doula in Wilmington, NC, or anywhere for that matter.

Some doulas have areas of specialty beyond birth or postpartum doula work, meaning they’ve completed advanced training to be able to surround their clients with more thorough and informed care. I am a birth doula, but I also offer postpartum doula support, sibling doula support, and belly binding. I love being able to offer multiple services to my clients so they can get the help they need from people they already know, which adds so much value to the support I are able to offer the families I work with. A good part of my focus as people who work with families during pregnancy, birth, and the newborn time is providing nonjudgemental support. Often I am talking with clients about extremely personal and sensitive topics. Of course, I always do my best to talk about these issues with the utmost compassion and respect, helping parents feel seen and heard in addition to offering new information or a different perspective to help. This is true with birth and postpartum doula support. Whether you have questions about inducing labor, whether a certain type of childbirth class is right for you, what to do if you don’t think you’re making enough milk, or nearly anything else you can think of relating to pregnancy, birth, and babies… if you have a doula you trust on your side, you’ll always have a safe place to go to find information and support.

It takes time and training to develop the skills needed to communicate in a sensitive and nonjudgmental way with my clients (and of course I’m always learning and growing). In most cases, my clients don’t have other people in their lives with the unique combination of birth-specific knowledge and experience plus the skills (and motivation) to have supportive, nonjudgmental conversations about those topics with expecting and new parents.

The importance of compassionate, nonjudgmental communication is echoed back to us time and again through clients’ feedback:

“I was able to find Cailey through a couple of days of searching local doulas in the area. I knew as a first time mom I didn’t want to experience childbirth without the support of a doula, who would have my best interest as a priority during my labor. Being pregnant during the pandemic was stressful. So finding Cailey when I did was exciting and very advantageous for my husband and I. She was so pleasant when we spoke during phone consultation. She was clear in explaining what she offered as a doula and how she could support us before, during and after our delivery. She had no problem coming to our home and speaking with us and finding out how we were coping with the pregnancy. She also made it a point to include my husband, asking how he was managing with the pregnancy and validating his feelings and reassuring him if he had any concerns. She never pressured us based on what we wanted in our birth plan and she was always available during the time prior to my delivery. Cailey was right at my side during my entire delivery encouraging me and making sure my birth plan was being followed. Once I started active labor and had to push, she was the one to give me guidance on pushing, when the nurse was giving me mixed instructions. My delivery was a great experience due to her being present. She truly is great as a doula and she will ensure you are prepared for delivery and you are supported the entire time.” – A.I.

“I have a friend/family member who will be with me during labor. Wouldn’t a doula be an expensive redundancy?”

Some families have a loved one who is willing to attend their birth, often someone who has already experienced the birth process themselves. I think that’s wonderful! But… unless that person is actually a doula, they don’t replace the support a doula has to offer; and yes, this still applies even when your doula is just providing virtual doula support. The same goes for postpartum helpers – it can be so incredibly helpful and nourishing to have the support of loved ones in the whirlwind weeks of having a new baby! But unless those people are practicing postpartum doulas, they don’t replace the support a postpartum doula might offer. This works in the reverse as well! Including a doula on your birth team or in your postpartum support plans doesn’t replace the support of your loved ones. Many of the families I work with during birth have another loved one (or two) in the room with them, in addition to a partner (if applicable) and their doula. That support is definitely not mutually exclusive!

Of course, no one can guarantee outcomes of pregnancy, labor, breastfeeding, or any other aspect of the process of bringing little ones into the world. But evidence shows that having a birth doula can decrease pain reduce the use of certain medications and medical procedures, as well as increasing the likelihood of parents to rate their birth experience positively. Unfortunately, many parents describe their birth and/or postpartum experience as traumatic. As a doula, my particular focus is on softening around challenging moments during labor and the postpartum time. In particular, I have what’s called a “trauma informed approach”, meaning that I proactively follow principles to establish trust and build relationships in a way that helps to prevent trauma in birth and the postpartum experience.

This might sound a little intense. But I have to say that in working with many families having babies over the past few years, the issue of emotional and physical trauma stemming from birth and the postpartum period comes up again and again and AGAIN. I see it as a primary part of my role to contribute to an ounce of prevention against traumatic experiences for all of my clients as they navigate the process of welcoming a new baby into their family.

By focusing on helping my clients have a more positive birth and postpartum experience — even in the midst of challenging situations — parents have a better chance of coming out on the other side feeling like whole people. Even when difficulties come up along the way, I hope that my support helps parents cope and feel able to play a proactive role in their own birth and postpartum experiences. Maintaining a sense of self-agency throughout the challenges that birth and having a baby can bring is so, so important for the mental, emotional, and spiritual health of the people who will be raising the next generation.

Of course, this isn’t to say that if you have a doula you won’t experience trauma, or that by hiring a doula you have an automatic guarantee against negative experiences. But intentionally adding someone to your team who is compassionate and nonjudgmental, well-versed in the challenges you might face, and able to help you navigate the waters of birth and early parenthood is one of the most proactive things you can do to stack the deck in your favor.

For other reasons you might choose to have a doula, check out this blog post.

If you’ve decided you want to hire a doula but are still unsure of how to handle the cost, I have a couple ideas for you.

There are resources available for low income families!

First of all, I also want to acknowledge that for some families, most doulas’ fees are completely out of reach. While for some families it may be an issue of reconsidering priorities, for others paying a doula’s full fee is simply out of the question. It’s important to know that there is a HUGE range of doula fees. Many doulas (myself included) also offer reduced fee or sliding fee options for families who qualify for public assistance programs (like TANF, SNAP, or WIC). There are also organizations in some areas that pair volunteer doulas with families in need. Some doulas offer free or extremely low cost options when they are new to get experience. Of course in this particular case, the doula’s education and experience may be very limited, but there is still value in having someone there for support.

Many birth workers understand that people experiencing poverty, members of marginalized groups, and people of color are statistically more likely to benefit from the support and advocacy of a doula. If you find yourself in one or more of those groups and want to work with a doula, there are ways to make that happen! Feel free to reach out to us!

There are ways to make the investment in doula support doable! Understanding the value a doula brings to their clients can help the price tag seem much more reasonable. Having more background information about the education and experience of a doula you’re thinking of hiring can shed light on the behind-the-scenes value of their service – in addition to the time they will actually spend supporting you. Sometimes people who don’t understand what I do are shocked by the cost, but come around quickly when they learn things like doulas are on-call for 4+ weeks for every client People don’t consider that I don’t set time limits for how long I support people during labor or that I work with many families who have high-risk pregnancies or medical complications that may require additional support and availability from me.

You may be able to use your FSA or HSA to pay for a birth and/or postpartum doula. Call your plan administrator to find out the process for reimbursement or whether a letter of medical necessity is needed in order to pay for doula services with pre-tax dollars. Many doulas are able to provide a specialized invoice for reimbursement and/or accept payment by FSA debit cards.

Many doulas happily offer payment plans. My birth clients pay 50% of their chosen package when they book us, and the remainder by the postpartum visit included in any package. For those who wish to space things out a bit more after the initial deposit, I’m always happy to create a monthly (or even weekly) payment option so the second lump sum is smaller or spread out over a few months. For some families, breaking down the payments like this can help to make doula fees feel manageable. In my practice, I’m always happy to do this without adding extra fees for families who choose to set up a payment plan.

Consider “registering” for birth and/or postpartum doula support. Many baby registries easily exceed $2,000… and most parents will tell you that there were many items they registered for that they didn’t end up using. What would it look like to ask loved ones for their help to cover the cost of having an experienced, compassionate guide to help you navigate birth and life with a newborn? I’ve worked with several clients whose loved ones have paid for their doula support as a gift. In my mind, it’s one of the most meaningful things anyone could do for an expecting family.

Mindset is key. If you value the support a doula will bring to your birth and/or postpartum experience, you’ll perceive the price differently and may be willing to prioritize it over other less important expenses in your budget. But if you aren’t convinced that having a doula is right for you, you might end up resenting the fact that you are paying $1,000+ for something you don’t feel that you need. If you decide that a doula isn’t right for you, I would encourage you to spend more time exploring why you were called to look into doula support in the first place. But if on reflection you realize that doula support is something that really matters to you, it will be much easier to figure out a way to access the support you want while working within your budget.

Excerpts from this blog courtesy of Riverbend Birth

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