We 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!”
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 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 a doula has with a client, there is a wealth of knowledge and experience. You can almost imagine something like this:
When a question or challenge comes up in working with a client, we draw on our training, experience, and resources available to us (both written and interpersonal) help our clients work through it. Sometimes this requires additional time spent reading, researching, and talking to other perinatal professionals to learn more. The time we spend actually talking or writing to our client about the issue is like the tip of the iceberg - there is a lot underneath the surface.
We prioritize continuous learning. Since we began practicing in 2014, we’ve averaged a combined 130 hours of continuing education each year in live trainings alone (not counting many hours spent reading and learning on our own). That’s more than 3 40-hour work weeks! It’s important to us to seek out opportunities for learning and growth in many different aspects of our work (as you can see from the list of continuing education activities on our “about” page). The combined wisdom gained from these learning opportunities directly benefits the families who choose to work with us. There is tremendous value in those 130 hours each year.
Some doulas have areas of specialty beyond birth or postpartum doula work (see above about continued training and education). Meaning they’ve done advanced training and learning to be able to surround their clients with more thorough and informed care. We are birth doulas, but we also offer postpartum doula support, childbirth and postpartum preparation classes, breastfeeding help, car seat education, and more. We love being able to offer multiple services to our clients so they can get the help they need from people they already know, which adds so much value to the support we are able to offer the families we work with.
A good part of our focus as people who work with families during pregnancy, birth, and the newborn time is providing nonjudgmental support. Often we are talking with our clients about extremely personal and sensitive topics. Of course, we always do our 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 our clients (and of course we’re always learning and growing). In most cases, our 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 our clients’ feedback:
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. We think that’s wonderful! But… unless that person is actually a doula (read more here), they don’t replace the support a doula has to offer. 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 we work with during birth have another loved one (or two) in the room with them, in addition to a partner (if they have one) and their doula. That support is definitely not mutually exclusive! (If this is something you’re thinking about, check out this blog post: 8 Savvy Ways to Manage Visitors at Your Birth.)
“An ounce of prevention is worth a pound of cure” - Benjamin Franklin
This quote speaks to the reason many families choose to work with a doula, both in birth and in weeks following.
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.
How doulas help to reduce trauma
Unfortunately, many parents describe their birth and/or postpartum experience as traumatic. As doulas, our particular focus is on softening around challenging moments during labor and the postpartum time. In particular, we have what’s called a trauma-informed approach, meaning that we 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 we have to say that in working with hundreds of 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. We see it as a primary part of our role to contribute to “an ounce of prevention” against traumatic experiences for all our clients as they navigate the process of welcoming a new baby into their family.
By focusing on helping our 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, our 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, we have a couple ideas for you.
For low-income families: there are resources available!
First of all, we also want to acknowledge that for some families, doula fees are completely out of reach. While for some people 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. Some doulas offer free or extremely low cost options when they are new to get experience. (Of course in that case, the doula’s education and experience may be very limited, but there is still value in having someone there for support.) There are also organizations in some areas that pair volunteer doulas with families in need (for example, Joy in Birthing Foundation in Los Angeles and For the Village in San Diego). Many doulas also offer reduced fee or sliding fee options for families who qualify for public assistance programs (like TANF, SNAP, or WIC). 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!
For other families: there are ways to make the investment in doula support doable!
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. 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. Believe us: parents and doulas alike have a MUCH better experience when families value the support we have to offer!
If you decide that a doula isn’t right for you, we’d encourage you to spend more time exploring why you were called to look into doula support in the first place. If you come to the conclusion that you were only seeking doula support because someone else recommended it but you don’t really see the value in it, then perhaps you can find a way to let yourself off the hook of other people’s expectations. But if on reflection (and after reading this post) 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.
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 we do are shocked by our fees, but come around quickly when they learn things like doulas are on call for 4+ weeks for every client, or that we work with high-risk families, or that we don’t set time limits for how long we support people during labor. We hope this blog post has also helped to explain some things in that regard.
As one of our clients said, “Honestly, working with a doula was an expense that was somewhat out of our budget but we went forward with it because of the insistence of my friends with children. We will never regret passing over the $800 stroller for a second-hand one, but we would have deeply regretted not having Megan and Marlee in our lives. Working with them has simply been the best thing we could have done for ourselves and our baby.”
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 (ourselves included) are able to provide a specialized invoice for reimbursement and/or accept payment by FSA debit cards.
Many doulas happily offer payment plans. Our birth clients pay 50% of their chosen package when they book us, and the remainder by 36 weeks of pregnancy. For those who wish to space things out a bit more after the initial deposit, we’re 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 our practice, we’re 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? We’ve worked with several clients whose loved ones have paid for their doula support as a gift. In our minds, it’s one of the most meaningful things anyone could do for an expecting family.