"If you don't know your options, you don't have any." - Diana Korte
The Cost of a Doula (And How To Find a Doula for Free) Just how much should you expect to pay for your doula? Well, it depends on your location, but anything between $300 and $1,000 is typical, with the average being around $500 for an experienced, certified doula. Obviously, if you live in cities like Manhattan or San Francisco, the average costs go up, but they still typically land somewhere in this range.
For the time and services that goes into doula work, you get an excellent deal for your money. "Cost ranges widely throughout the US, based mostly on the cost of living," explains Megan Miles, a doula in Washington state. "Here in the Seattle area, prices range from $350-$1000 based on services offered and experience.Even at the high end of that range, I believe women are getting a bargain when you consider the prenatal time, time on call, time at the birth, and postpartum time."
Megan suggests that you can call a few doulas in your areas and ask them about their rates. Be sure when you're asking around that you're clear on what you get for that price, and what experience and training each doula is bringing into the birth. "Ask them about their included services and experience," says Megan, "so you can be sure that you are comparing true costs. If one doula includes two prenatal and two postpartum appointments, her services might be less than the doula that only includes one of each."
Doula Support is Priceless Most doulas are willing to work with you to help afford the service, so always ask about payment options, and whether or not they offer a sliding scale fee.
"I think moms should find the doula that is right for them, because even experienced doulas are willing to work on a sliding scale if money is a concern," Megan explains. "If a new doula feels like a good fit for your personality, then they might be the best doula for you. I hate to see new doulas dismissed because a family thinks they can pay more, and I hate to see couples who want a doula go without because finances are tight."
When it comes down to it, though, don't let money stand in the way of hiring the doula that fits you and your family best. Childbirth is a special time in your life, and a once in a lifetime experience for you and this newborn. Your baby, your health, and your memories and experience of the birth are worth the price.
Stephanie Soderblom, a doula for about 11 years in Arizona, encourages parents to put the cost of the doula in perspective. "I would ask them how much they spent on their wedding, or their vacation last year. How much did they spend on eating out last month? How much did they spend for their third television in their home? I would say that the birth of your child shouldn't be the time to get frugal and cut corners."
When comparing rates, don't forget to consider the extras that many doulas offer with their doula services. Photographs and video of the birth are sometimes provided. The cost for the photos or video may be included with the doula fee, or may be something extra. Make sure you find out, and when you sign a contract with your doula, the details of the payment for the extras should be clearly explained.
Some women have been able to get insurance to help pay for their doula. This is something that varies from insurance provider to insurance provider. You can ask your insurance company, or, better yet, the human resources' contact at your company who deals with insurance benefits. Most of the time, you'll need to hire and pay for the doula yourself, and then later approach your insurance company for reimbursement.
If your insurance company turns down your claim, appeal it. This may or may not get your doula covered, but you'll make clear to the company your interest in having doula services part of the benefit's package. They may include the benefit in the future.
Another option is to use your flexible spending account, if you have one. Check with your employer for more information.
Hospital Doula Programs An option for low cost or free doula care is to look into local hospital doula programs. Not every hospital provides this service, and sometimes there are restrictions on who can use it. Some programs are exclusively for teen moms, single parents, or new immigrants.
"Hospital programs are great for moms who are poorly supported in labor," Megan explains. "When a woman arrives at the hospital alone, or with family/friends who are unwilling or unable to be an active support, those doulas can provide priceless assistance. The mom must be able to open herself up easily to the doula's suggestions, and be willing to let her guard down with a virtual stranger.
"The downside to a hospital program," Megan continues, "is the fact that the mom and doula have no past relationship to fall back on in labor. I think that the bond that is created through the prenatal contact helps the doula in better supporting the mom, and helps the mom better trust her doula."
Before deciding to go with a hospital doula program, ask whether you're guaranteed a doula when you arrive, and whether or not you would qualify for the program. Also, you'll want to ask if the doulas work in shifts, and if the doula you're assigned when you come into the hospital stays with you throughout the birth. If the local program can't guarantee a doula, or if the doulas work in shifts (a serious downfall with hospital based programs), consider hiring a private doula.
One more thing to consider before choosing a hospital doula program is where you want your doula's loyalties. This is an important issue to consider, since one of the benefits of doula support is having an advocate. Stephanie Soderblom explains, "I would think it would be difficult for the doula to be loyal' only to the client and her desires and feelings if the hospital is paying her fees."
Low Cost or Free Doula Service It's often possible to find a doula for much less than the average, and sometimes, for free, if you're willing to use a doula who is just training.
Laura Johnson of San Mateo, CA, a new doula who has attended a 11 births so far, says the connection you feel with a doula is more important than experience. "In my opinion," Laura says, "it's purely a matter of feeling a good connection. The doula I chose [for my son's birth] was not very experienced (I think my son was her seventh baby), and I had met women who had attended closer to 100 births. But the one I chose was a person I liked and trusted."
Laura feels that choosing a doula who is less experienced can even work to your advantage. "You will get an enthusiastic person at a good price," Laura says. "Their value is still enormous if you feel a good connection. It's far better to have a less experienced person there, than no one at all."
When hiring a doula in training, you'll want to be extra sure to check out references. People you can speak with include the doula who trained her, the childbirth education instructor that taught the course she audited for her certification, and, of course, prior clients, if there are any.
Where can you find doulas in training? Asking other doulas in the area if they know of anyone new looking for their first few births is one way. You can also check with the local doula instructor, which you can find from the referral pages of most doula certification organizations. Since they helped train the newest doulas, they are an excellent resource for finding new trainees.
For uncomplicated births, a newer doula can be an excellent choice. You provide the opportunity for the doula to get the experience she needs, and you get excellent doula care for a very low price. However, if you're extra fearful about the birth process, or have any special needs or concerns about your birth, seriously consider finding the money for a more experienced doula.
"You can use a less experienced doula because you love her and feel that she will be able to best help you," Stephanie Soderblom suggests, "but your motivation for you care during the birth of your baby shouldn't be a financial one."
Jessica Oren is a certified Birth Doula (CBI) and a Family Herbalist ~ graduate of The School of Natural Healing. Founder of DAWN Foundation and North Texas Doulas. You can find her on Google+
“Although the popularly desired outcome is ‘healthy mother, healthy baby,’ I think there is room in that equation for ‘happy, non-traumatized, empowered and elated mother and baby.’” – Midwifery Today