How a doula sets her fees is a mystery to most people. I offer this information so that you have a better idea of what you are paying for.
(Adapted from www. big belly services.com)
Hours: Couples having their first baby may imagine that their doula will only be spending a few hours with them at the labor and birth. In reality, an eight hour labor would be considered pretty fast; most first labors last 12-24 hours. The longest continuous time I have spent providing labor support is 36 hours. The average time I have spent with a woman in labor is about 13 hours. I spend another 10 hours in prenatal and postpartum visits, and two or three hours in phone calls and/or email, and up to eight hours in travel time. Using those averages, my fee translates to an hourly rate of a little over $18, and this is BEFORE expenses and self employment taxes. My fee is the same even if your labor lasts 24 hours or more, and even if we have several "false alarm" trips to Labor and Delivery.
Clients Per Month: When I make a commitment to be available to attend you in labor, I have to limit the number of clients I can put on my calendar so as to avoid birth conflicts and to ensure that I am reasonably rested when you go into labor. The rule of thumb for birth professionals providing in-home services (compared to someone working a shift in a hospital or sharing call with another provider) is that one client a week is a full schedule. Because I am a mother with small children, I find that two or three clients a month is a full workload.
Clients Per Year: When I put your due date on my calendar, I commit to being available two weeks before your due date and two weeks after that date. This means that when I schedule a vacation, or attend a conference, or have a commitment that I cannot miss, I have to add another four weeks during which I cannot accept clients.
Being Self Employed: The rule of thumb is that a self-employed professionals income is only half of what they earn, after deductions for vacation and sick time, self-employment taxes, and business expenses. My communication expenses are high for a cell phone. I also have typical professional and office expenses, continuing education expenses, and unusually high transportation expenses since I primarily travel to people's homes.
Putting It All Together: Although I am dedicated to this work, being on-call all the time requires a very high level of personal sacrifice, including a willingness to be awoken after half an hour of sleep to go attend a labor for then next 24 hours. About 25% of my clients have some type of early labor which starts and stops, resulting in multiple phone calls---often in the middle of the night---and even a trip for all of us to the hospital. I have to have childcare lined up in advance and be able to even call someone in the middle of the night if I have to leave. I cannot take week end trips away from the area and even day trips to the mountains or a neighboring state if I know that I am on call. I never know what I am going to encounter at a particular labor---I may end up wearing out my body supporting the women in different birthing positions, I may take cat naps sitting in a chair, I may eat nothing but a granola bar and nuts ;I may end up holding a vomit bowl for someone vomiting with every contraction during transition; I may end up with blood, meconium or worse on my clothes. Thank goodness I LOVE my work!
Experience Factor: When I step into a birth, I bring not only my heart and hands and training but my experience from birthing ten children myself. I know how labor can be unpredictable, and I KNOW how it feels to labor in many situations. As a doula and child birth educator, I must keep up to date on the latest studies, procedures, protocols, and policies surrounding birth and area hospitals and providers. Did you know that doctors, midwives, and nurses usually only know their way of doing things? As a doula, I see the variations from hospital to hospital, between caregivers, and over time. Being able to work with many different care providers, I learn all their different approaches and tricks, which I think is unique to the doula profession. And considering that every birth and every family teaches me something new, I have a wealth of knowledge and skills to bring to a birth.
Bottom Line: No one gets rich doing doula work. There are people offering doula services at lower prices. They are either offering less time and services, are still in training, have less experience, or are in a financial position to offer free services. I will happily provide a list of references for those who would like to talk to my past clients.
