WARNING: Settle in, grab a warm cup of tea, and bear with me... this post is LONG, but so worth the read!
"How much does a doula cost?"
This is a common question for parents, understandably so. Depending on your local market, doula fees tend to range from around $500 on the low end, to $1-2,000 on the high end. Typically this will include 2 prenatal visits, labor support, and one postpartum visit.
But why must it be so expensive? Having a doula is NOT a luxury. It is a necessity in today's birth culture. Doesn't this exclude low income families who need support? Doesn't this limit accessibility? Isn't this problematic and maybe even classist?
These are the questions I consistently ask myself. These are the questions I constantly ask other doulas. First, I want to talk to you about the basics of "Why" a doula is priced where she is... then I want to talk about how pricing structure can support low income families.
Here's the deal...
When I am on call to come to your birth for anywhere from 3-24+ hours at a time, at any hour, any day within a four week window, I can not have a full time or part time job. I can not go on vacations with my family. I can not leave town for a day trip. Doula-ing is a full-time job for many doulas. This is our source of income. This is how we pay our bills and feed our families (yes, even if we have a spouse that also has an income, this is still more than just a hobby).
Now, consider the time we put into educating and supporting our clients. Let's pretend the average birth is 12 hours of support. In addition to this, my clients get three 2 hour prenatal visits, and at least 2 postpartum visits. These visits include both skilled doula care and skilled lactation support. All of this in person support totals at least 23 hours of support. This does not account for the hours of research a doula may do for her client's specific concerns. This does not account for the flood of texts and emails and phone calls supporting the mother. This does not account for the continuing education a doula is regularly seeking to stay current and provide you with the best evidence based support and information.
So.... let's check in with the numbers...
Up to 720 hours on call to drop life at a moment's notice to arrive by your side.
An average of 23 hours of in person support.
Now let's consider childcare. When I'm on call for you, I need to have on call childcare arranged. These providers deserve to be compensated well for their on-call response, just as I do. My sitter is likely to be paid a *minimum* of $75 for responding when I need her. Depending on how long a birth lasts, that fee could range up to $200. I also have to secure childcare for each of those Prenatal and Postpartum Visits... so thats at least another $150+.
We're not even discussing taxes, state business licensing, certification fees, education programs, liability insurance, marketing expenses, travel time, etc....
Let's say the going rate is $1/hour for on call time and $10/hour (seriously low-balling a doula's worth here...) for actual support provided time... that would work out to around $950.
Now, I want you to consider the fact that I can probably take a MAXIMUM of 4 births a month, and that's only if I have a super reliable back up doula (who I would have to pay, but for these purposes let's not factor in backup fees). So 4 births a month at $950/client equals a minimum of 720 hours on call, 92 hours of support, and $3,800 gross income.
$3,800 Gross Income.
Subtract 25% for taxes = $2,850.
Subtract at least $35/month for liability insurance = $2815
Subtract at least $225/client for childcare (-$900) = $1915
Accounting for learning materials that I share with clients, books I provide for them, my up to date certifications and the hours of continuing education is impossible... But let's just pretend that all adds up to a humble $300/month.... We're down to $1615.
Now we aren't even accounting for the hours of marketing and back end business work. Let's pretend $1615 is the net income your doula "brings home". A percentage of that goes back to the business to keep it running. So lets say that's a meager 20%...
The doula we describe here is bringing home approximately $1,292 a month. That's $15,504 a year. That's below the poverty line. I could use this time to start a conversation about devaluing "women's work", but I'll save that for later. We're talking weeks on call, hours devoted to serving others for a maximum of $1200 a month??? What about the births lasting longer than our arbitrary number of 12 hours? What about those 2 day births? What about months where I don't book 4 clients? What if I only book 1? What if I book none?
How will this doula afford to feed her family, pay her bills, pay for health insurance (remember she's self employed!), have a safety net savings for when the car breaks down? What about paying for kids' t-ball, ballet, gymnastics, music lessons, etc.?
Now, personally I know that I would love to serve underprivileged clients who need and deserve a doula but can not afford $950 (let alone the higher fee it would take to generate a truly livable salary). So what's a doula to do?
Well this is another reason why you might see doulas charging even higher prices. Aside from the actual value of a doula for your birth, the price of a doula may be contributing to that doula's ability to provide pro-bono support for families in need. If I charged $2,000 per client, then I would be much more able to financially sustain my business and myself while taking on a client who needs to take advantage of a sliding scale or pro-bono work.
Thankfully, more and more insurance companies are paying for doula support to at least some degree! Hopefully in the future we will see this financial support grow to build a culture of a doula being both accessible for all and fairly compensated.
I understand the sticker shock when talking to a doula about her fees. I do. Heck, I don't even always like talking about fees half the time to be honest. But it is really important for clients to understand what goes into doula work. Moreover, it is important that clients understand the value of their doula. Most families will say their doula was worth every penny they paid and then some. Hopefully, now that you understand why exactly a doula cost "so much" you are more comfortable finding ways to budget and save to afford your doula.
If you're looking for a Birth Doula , Lactation Support, or Postpartum Doula in South Jersey, email email@example.com to meet with Jaimie and start your journey to motherhood with loving support by your side!
Jaimie is a proud mother and wife living in Pemberton, New Jersey. Jaimie serves the South Jersey, Central Jersey, and Joint Base McGuire Dix Lakehurst communities providing prenatal education for breastfeeding, postpartum breastfeeding support, birth preparation, labor support, postpartum support and photography. Jaimie is a Certified Breastfeeding Specialist, Student Doula with the Madriella Network, and former nurse. In the near future Jaimie hopes to add childbirth classes, placenta encapsulation, and other services to support and educate growing families in New Jersey.
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