You’ve heard nothing but great things about doulas and would really love to hire one for your birth, but why do they have to be so gosh darn expensive? Well, let’s break it down. Let’s consider for a moment what a doula actually does. A typical doula package includes a consultation (1 hour – no charge if you end up not booking her), 2-3 prenatal visits including preparation and travel time (4-8 hours), attending the birth from the time the client calls until 1-2 hours after the baby is born (now this number is impossible to calculate or predict, but just an average of my last 8 clients was 17 hours; they ranged from 8-36 hours) and one postpartum visit (1-2 hours). Additionally, she’ll be communicating with you by phone or text whenever you have any questions or concerns about anything. So the amount of hours a doula will be dedicate to their client in total ranges anywhere between approximately 14-47 hours. Depending on how much she’s charging, her hourly rate may end up being less than the State of California’s hourly minimum wage.
Now let’s consider what a doula’s costs of doing business are. She is going to have absorb all of her transportation costs which can be extensive; it’s not uncommon for doulas to serve a geographic radius of 50+ miles, so in person visits and drives to and from the hospital can add up. Many doulas also have to arrange and pay for childcare which is always expensive, but can end up being at a premium given the extensive and uncertain amount of time she’ll be away at a birth. She has to pay for whatever ongoing education may be required to stay current on the latest and greatest evidence-based information, comfort measure techniques, etc.
She may also: Be certified with a professional doula organization and have to pay annual dues; maintain a website; invest in supplies for her doula bag; pay referral fees for leads. When you consider she needs to be on call for a client 24/7 for usually a 14-day period, which can be extended if the baby’s birth pushes a week or two past the guess date, it’s usually not possible for her to take on more than 3-4 clients per month. If she ends up having to call on a back-up doula to cover a birth then she will have to split her fee with that doula.
The birth work profession isn’t something people (usually women, but not exclusively) get into to make big bucks; it’s a labor of love. It’s a calling. They do it because they know their presence in birth rooms makes a difference; for the birthing person, their partner, their baby. They do it to be of service. It may seem like an expensive proposition, but doulas are trying to make a living doing something that they love and they’re up against tough odds to make it lucrative.
Of course, “expensive” is a relative term. What one birthing person may find to be cost prohibitive, another will consider a bargain and well worth the money. If you know you would like a doula but are unsure you can afford one, keep looking around. Many doulas work on a sliding scale and may provide discounts to members of the military, front-line health workers, special circumstances, etc. The fees doulas charge are commensurate with experience, so a less seasoned but by no means less committed doula, may be in your price range. And look at health share plans that cover the expense of a doula as another option.
Doulas want to be affordable, but they have bills to pay, too. If you think they’re too expensive, just remember they are putting their life on hold for an uncertain amount of time when they walk into the birthing room with you. They will hold space for you and your baby as long as it takes. They will provide physical, emotional and spiritual support as long as it takes. How can you really put a price on that?