Posts Tagged ‘pregnancy & childbirth’

Nuts & Bolts: What exactly am I paying my doula for?

Monday, October 14th, 2013

Image credit: shipulski.com

Next to finding a good personality fit in a doula, financial concerns are probably the biggest factor in choosing which doula to hire, and many potential clients ask me exactly what the fee covers. In some ways, that’s an easy question to answer: “My fee covers x number of prenatals,  labor, birth, and immediate postpartum, and x number of postpartum visits, as well as unlimited phone/text/email support.”

In other ways, not so much. Doulas have to strike a balance between affordability for clients, and maintaining a sustainable practice. This can be tricky sometimes, and often takes a lot of time (and mistakes) for a doula to figure out how to structure her individual fee. Finding that happy medium is essential: 1) to prevent burnout from being constantly on-call, and 2) to reach the widest economic base they can.

Basically, a doula is going to base her fee on a combination of a few factors. Her experience, how many births she can take on in a month, and her business expenses are all part of the equation.

Now, no doula enters this profession thinking, “I’m going to make it rich doing this!” No, indeed! Doulas are all heart, and do this work because they can’t not do it. Beyond their hearts, though, a doula does have to consider the financial part of the equation, because it would be unwise not to. After all, just because she had a light month, as far as births go, doesn’t mean her rent won’t come due.

That said, I would like to explain, as simply as possible, what a doula’s fee covers–both for the client, and for the doula herself.

Nuts and Bolts–What the fee covers for the Client:

  • 2-3 prenatal visits.
  • Labor, birth, and 2-4 hrs. postpartum.
  • 2-3 postpartum visits.
  • The tools in her birth bag.
  • Unlimited phone/text/email access. A doula’s time spent just communicating with her clients can quickly add up to several hours a week in order to make sure the client has all the emotional and informational support she needs.
  • Usually four full weeks of on-call availabilty, during which she cannot leave the area, must take her own car everywhere, and cannot make any firm commitments.
  • Objective help writing a custom-tailored birth plan.
  • Continuity of care throughout pregnancy, labor, birth, & postpartum period.
  • A walking birth encyclopedia.
  • Someone dedicated to keeping the environment peaceful.
  • A skilled communicator that helps create positive dialog among members of the birth team.
  • Specific to the doulas here at Preparing for Birth: Guaranteed back-up doulas, and continuous access for the doula to an experienced mentor when things get “interesting.”
  • A professional person with an emotional investment in each client’s care, who answers only to the client–not to hospital staff, doctors, or other family members.
  • If you’ve had a doula in the past, what might you add to this list that your doula did for you?

Balanced with the above are the doula’s financial needs. In order to do such demanding work, doulas need to charge enough that they can take enough births to meet those needs, but not so many that they burn out. Let’s face it: Living on-call nearly 24/7 most of the year can get exhausting for anyone–no matter their profession. Below is a basic explanation of where the doula will put her fee to good use.

Nuts & Bolts–What the Doula needs the fee to cover so she can keep working:

  • Childcare, if she has children too young to stay home alone. Most doulas pay their childcare person by the hour, and if a birth is long enough, that can add up to a significant portion of her fee. It’s probably the single biggest cost factor in this work.
  • Her time. Probably the second-biggest cost factor when setting a fee.
  • A back-up doula, on the off-chance she can’t make the birth.
  • Phone & internet bill, including website fees.
  • Gas money & mileage on a personal car.
  • Office space, even if it’s in her home.
  • Basic business supplies (paper, printer ink, files, etc…)
  • Business checking account
  • Certification Fees
  • Taxes and state business fees
  • Birth bag tools, some of which are costly, and all of which need to be replaced periodically.
  • Promotional materials and marketing.
  • Continuing education.
  • Professional memberships.

Most doulas spend a minimum of four to eight hours with their clients prenatally, as well as another two to four during the postpartum period–not including phone calls, emails, or texts. When the time spent with a client during her labor and birth is factored in, many doulas will need their fee to cover anywhere from 16 up to 36 hours or more of time, in total. If that were the only factor to consider, let’s take a look at what a Colorado Springs doula “brings home.”

Doulas in Colorado Springs charge anywhere from about $300 up to $650, which is actually somewhat less than other cities in the U.S. of similar population size. Doula’s fees range from $500 up to $850 or more (some go higher than $1,000) in other comparable cities (based on an informal poll I took in a birth professionals group).

So, if hours were the only factor, a Colorado Springs doula grosses about $19.00 to $40.00 per hour, for each client, at the minimum amount of hours she might work. This is before any of the other listed factors come into play. When those are factored in, what’s left for her time is often less than minimum wage.

Do you know what? It’s worth it for doulas! It’s enough for many just to be there, in that sacred birth space, participating with a family the way they do. Quietly going about their doula business caring for and nurturing a new family in the moment of its expansion, melting into the background, and holding space for the mother-baby unit to hold their focus. There is nothing like that moment when a woman looks up at her partner, that wet baby held tight to her chest, with tears in her eyes, saying “I did it!”

Doulas love what they do, and they share that love and passion with each family they serve.

Taking all this into consideration, hiring a doula is probably one of the most valuable things a mother can do for herself. Forget the fancy nursery decorations, stroller, and extra stuff. Instead, a mother can invest in customized, top-of-the-line, evidence-based care by hiring a doula–and get the best deal of her life for one of the most important times in her life!

Wondering how to afford a doula? Keep an eye out for my next post, with tips on how to get creative with finances to do just that!

I had a lot of help in putting this post together, and I just want to give a shout-out to my fellow doulas at Preparing for Birth: Sarah York, Christin Yorty, Rachel Madrigal, and Jamie Nyseth. Each of these women serve as wonderful peers and fresh perspectives, and I am privileged to work with them. Click HERE to visit each of their profiles.

Grace & Peace,
Tiffany

A Voice of Love

Tuesday, March 27th, 2012

Image credit: super-pretendo.com

In American culture, it is becoming more and more common to see women becoming mothers alone.

This woman could be a teenager pregnant before she is really grown up. She could be a woman pregnant by a man she no longer loves. Perhaps she is a woman pregnant by a man who is not ready to be a father in any sense of the word. She could even be a woman purposefully choosing to start a family on her own. Whatever the circumstances, we either believe that every woman and baby deserve the best start or we don’t.

I believe that every woman I come in contact with as a doula deserves to have my heart and my hands as devotedly as she would if her circumstances were ideal. If, for example, she were the upright matriarch of a traditional, nuclear family.

As much as we wish it were not true, the fact is that not everyone has the advantage of a solid, stable, healthy marriage relationship in which to rear children. Sure, we can argue that these women “should have” made better decisions, and they wouldn’t be in such a tough situation. That they need to “deal with the consequences” on their own. They made their bed. Let them lie in it.

I call “hypocrisy.”

These women are already “dealing with the consequences” in the simple fact that they are becoming mothers. They don’t need to be “punished” or “taught a lesson.” They need love. They need to know that they are not really alone. That there are some people in the world who care enough about them and their child(ren) to reach into their lives and hold their hands.

Who, more than the single mother, could use my unconditional support? Who, more than a single mother needs someone to come alongside her, believe in her, and have a positive impact on her life? Who, more than a partner-less woman (for whatever reason), is at risk of becoming another statistic in the birth factories we call hospitals?

We all carry our own “should have’s” in life. All of us. And if it weren’t for the positive influences in our lives, we might be carrying even more “should have’s.” What keeps us from being that positive influence of love for others?

Pride? Selfishness? Hypocrisy? An over-inflated sense of self-righteousness?

There, but for the grace of God, go I.

Therefore, I cannot turn anyone away.

Regardless of the decisions that led a woman to becoming a mother, once they have chosen the tough road of bringing a new life into the world, they desperately need at least one positive, loving voice, speaking into their lives.

Even if I am the only voice of love in a woman’s life, I will be that voice.

Grace & Peace,
Tiffany Miller
CLD, CCCE