How to pay for your doula

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A few years ago I began the process of cleaning up my diet and lifestyle. I started buying organic produce and sustainably caught fish, I started making my own deodorant, lip balm and cleaning products and I started thinking more carefully about everything I brought into my home and put into or on my body. Some things truly saved me money – making my deo and window cleaner, for example. Others, cost me more. Buying organic food was the biggest adjustment in that category for sure. Like many people, I thought, “ugh, why are organic veggies so expensive?” but then I learned a really important fact that changed the way I look at my food and the way it fits into my budget. In the 1950s, the average North American spent about 25% of their household budget on food. Other than housing, it was the single biggest expense for most people. Now contrast that with today, when most people spend only about 10% of their household budget on food and far, far more on toys, gadgets, clothing and other material goods. What that boils down to is this: organic food costs what food costs. Non-organic food is cheaper than food, it has been made cheap by factory farming, genetic modification and wide use of pesticides. As with most things, there are compromises that must be made for going the cheap route (eating pesticides that can cause cancer, GMO products that have not been thoroughly tested in terms of their impacts on health or environment, etc.). In other words, organic veggies aren’t too expensive, non-organic veggies are too cheap. This is an issue of priorities. If you think about the things that are most important to you and your family, does eating good, clean food come before or after electronics, the latest fashion or entertainment? If you make food and overall health a priority in your budget, suddenly the organic produce doesn’t seem that expensive after all.

Ok, ok, so eating well is a question of priorities, so what? What does that have to do with paying for a doula who wants $1000, $1200 or $1500 of your hard-earned cash to do her job helping you prepare for and supporting you through childbirth? Well, again, it’s a question of priorities. Think about what you plan to spend on your new baby – the bassinette, the crib, the toys, the onesies, the stroller, the jogging stroller/bike trailer, the slings and wraps, the diapers, the nursing bras, the blankies, the diaper bag – it really adds up fast. It adds up especially fast if you have to have the trendiest, the shiny-est, the hippest accessories available. Have you looked into buying your stroller from someone on craigslist? Have you approached family and friends about hand-me-down clothes and diaper covers? If you’re having a baby shower, you’ve probably registered for a lot of these things and your friends and family will be happy to shell out to get them for you. Have you thought about registering for doula fees? I’m not saying that you don’t need a stroller, but what if you looked at a simpler one that maybe won’t look as stylish to the other moms at the playground or that’s a little scuffed around the edges? Five or ten years from now, the stroller you buy will either have been passed on to another family, thrown away or it’ll be collecting dust in your attic. On the other hand, you will remember the day you gave birth and how you were treated and cared for on that day for the rest of your life.

But why does it have to cost so much?

The food analogy is especially useful in Canada where we have universal healthcare. When we go to a doctor or see a midwife or get a vaccination, we never see the bill. Many of us tend to see these things as ‘free’, not thinking about the fact that an epidural actually costs about $2000 all in, that a surgery may cost tens of thousands of dollars to perform, that a simple visit to a walk-in clinic costs about a hundred dollars every time. Many people think that $1000 for a doula’s services is expensive because they consider their midwife or doctor ‘free’, but their midwife is not really free and doulas are not paid with tax dollars. Imagine what you would ask for to be on-call 24 hours a day for up to four or five weeks per client alone? Now add to that expenses, research, several hours of prenatal and postpartum sessions and a labour that could last anywhere from a few hours to a couple of days. I love my job and feel privileged to be able to do it, but I have bills to pay and a life to live like anyone else and I can only take on a few clients a month at most in order to be effective in my work.

I know that it’s hard to make the things that nobody sees a priority – I believe that this is why most women spend dozens more hours preparing for their weddings than they do preparing for their births. Everyone you know sees your dress, the flowers, the decor. None of those people will see (not directly anyway) the incredible power you’ll know is inside you, the incredible gains to your self-esteem that will last a lifetime following a positive, empowering birth, the bond that you and your baby and your partner will share, or, conversely, the pain and potential trauma of a birth experience in which one is ignored, dismissed or even mistreated. Remember too, that your birth experience is also your baby’s birth experience. You and your baby are a team and preparing for a calm and gentle experience will benefit you both for the rest of your lives. A positive birth experience can also help you and your partner to feel closer and stronger as co-parents.

Hiring a doula will help you to have a calm birth in which you and your partner are actively engaged and in which you are able to self-advocate and get the compassionate care you deserve. The benefits of doula support are well documented and supported by a wealth of evidence. Making a doula a priority means making yourself a priority.

But what if I still can’t find the money to pay my doula?

All of the above being said, some people really, truly don’t have the money to pay for a doula, even after adjusting priorities and putting birth support before playground prestige. What then? I’ve already mentioned registering for your doula fees at your baby shower, which is a great and often overlooked approach. If you have extended health care benefits through your or your partner’s employer, that might be another option. Contact them and ask if they’ll cover your doula fees. If you have health spending account or ‘flex dollars’ in your plan they almost certainly will, but even if you don’t, there’s no way to know for sure unless you ask (and the more people that ask, the sooner doulas will be added to major providers’ standard lists – this is already happening in the US). Finally, talk to your doula. Many doulas are willing to work out a payment plan and some will even flex their rates for families in need. Remember though, doulas are providing a service – it is not an easy job; it requires compassion, skill, knowledge and a lot of self-discipline to be a doula – if you are asking for a discount, think to yourself, “am I really a person ‘in need’ or am I just trying to get a cheap deal?”. I have worked for free for refugee claimants and teen moms, I have flexed my rates for families on social assistance; I am not above making adjustments where it is warranted, but it is insulting to be asked to cut one’s rate by people with household incomes in six figures. Pay your doula her rate. It’ll be worth it.

Update: I recently learned that you can claim your doula fees on your income taxes as a medical expense. You won’t get everything back, but a percentage, depending on your overall expenses and income. Your doula must be certified in order for this to apply to you, so be sure to ask potential doulas about their certification status in interviews if you want this option to be available to you.

Related: A fellow doula breaks down fees into hourly ‘wages’

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