Having come from the Los Angeles birth community, I was accustomed to the cultural expectation that doulas cost, and are worth, money. Of course, not everyone in LA county can afford doula care, but since doulas are so commonly used there, people are aware that this kind of support is of value. In LA, doulas charge anywhere from $800-2500+ for birth support, and about $30-50 an hour on average for postpartum care. Many offer payment plans, sliding scale to those in need, or start low and build their prices up as they gain experience. There are also several nonprofits who provide free doulas to at-risk populations.
Now that I practice in Memphis, where the cost of living is significantly different than LA (a big part of why we moved, but not the only one), the cost of doulas is also much lower. From what I have gathered over the past two years, doulas charge between $500-1000 on average here. Memphis is a city of extremes. Some of the biggest corporations in the country call Memphis home, and there is profound poverty as well.
The history of Memphis is inextricably linked to this contemporary landscape–that has to be acknowledged when talking about access to what is sometimes considered a luxury expense. Institutional racism must be acknowledged as well–so I will name it and name the fact that I am speaking to this subject as a white woman of privilege. I do not want to dismiss the reality and lived experiences of marginalized folks in this community. With that said, we know that the support of a doula can, especially for black women (and their babies) of all socioeconomic backgrounds, be a vital addition to the birth team. Fortunately, there is an incredible organization called Birth Strides, that offers free doulas to African American women in Memphis living in specific zip codes. CHOICES midwifery clinic (soon to be birth center!!!) also cares for a lot of our BIPOC community.
It’s also known that nationally only a small percentage of our total births are supported by doulas–because doulas are still unknown to some communities, because there is a lack of access to doulas, because doulas themselves struggle to stay in the industry due to financial hardships and burn out, and so on. There are many barriers to doula access for many people. I hope that will change, that the model will change, and that our entire medical system will become patient centered. A girl can dream!
The way most doulas work now is that individual doulas own their own private practice, so to speak. Most of us work as sole proprietors, or LLCs, and are hired privately by clients who find us via word of mouth/referral, social media, or google search. We may or may not be certified (that’s a topic for another post), we set our own rates, and we do not accept insurance (because we can’t–but sometimes our services can be covered/reimbursed).
For folks in Memphis who want to hire a doula, but are unsure if you can afford to, I offer the following suggestions and considerations.
1. Compare the cost of a doula to the cost of a wedding (possibly your own, though I won’t assume everyone is married). I see this comparison on many blog posts on this subject. A wedding, much like a birth, is (generally) one day. One very important, climactic day that initiates you into a new chapter of life. The difference is the expectation of expense. Everyone expects that weddings will cost money. Sure, there are ways to do it on a budget (I did!), and ways to do it for nearly nothing (hello courthouse! I did that too lol), but by and large you know you’re getting into something that will put you out at least a couple G’s. I have heard the national average wedding budget is $20k!!! The wedding industry notoriously upcharges everything–I saved so much money just by telling vendors/caterers/cake people that I was having a “party”. The W word is a surefire way to get gouged. So, think about all the money you (or someone you know) put into that special day. Now, think about the arguably more important day of bringing your child into this world–what are you willing to pay to have support for that experience? How do the average doula rates compare to what you paid your wedding planner?
2. Yes, babies need some gear and clothes, but most families I work with have so many baby gadgets, blankets, and other useless stuff that gets gifted to them by well meaning friends and family. Instead of wasting money on a fancy blanket your baby will only barf on (I mean, truly…), why not put doula support on your registry in addition to the essentials? I’ll write a post about registry essentials too, someday! Have your friends and family pitch in to pay for your doula so that you get what you need and not what will end up in a drawer for years to come, or get taken to Goodwill…
3. Call your insurance company and see if they cover/reimburse for birth or postpartum support. Ask if you can use an FSA or HSA to pay your doula. Ask your doula to provide invoices or any other paperwork that will help facilitate this process.
4. Look around your house for things you no longer need or use and sell them on Facebook market. You’d be surprised how much cash you can get just purging your closet or garage.
Ask your prospective doula if they are open to payment plans. If you connect with a doula who is out of your budget, but you really feel working with them is worth it, see if you can pay their fee over an agreed upon period of time. That way the doula can make their full fee (because doulas work HARD and for many of us, being a doula is our main source of income and that income is vital for our family).
5. Ask your prospective doula if they are open to bartering. Do you run a business that provides goods or services that your doula may need? Then put it out there that you would like to barter. There are many services that your doula may need–it’s always worth asking!
Be open to working with a newer doula who is looking to gain experience. I do encourage all new doulas to charge something, unless the client absolutely cannot pay at all (such as a teen client, homeless client, etc.). Attending your birth costs the doula time and money, and for this career to be sustainable, the doula needs, at the very least, their basic expenses to be covered. Many doulas have children who will require care while away for a birth or postpartum shift; there is gas, marketing expenses, food, the costs of trainings and continuing education, materials and tools, and more. If you cannot afford the average doula rate in Memphis ($500-1000), then look at your finances and calculate your max budget for doula services. Let prospective doulas know this is the most you can afford to cover their expenses. There will be doulas who are able to offer sliding scale–though not all can afford that level of flexibility. Just ask!
6. Can you have an amazing birth or postpartum experience without a doula? Totally–many people do. But with the birth and motherhood landscape being what it is in this country: with staggering maternal and infant mortality rates, with a culture of fear, with many families coming away from their experience traumatized, and with nearly 20% of mothers experiencing perinatal mood disorders (likely more, considering many cases go unreported), why not get extra support? Doulas can’t and don’t fix the broken system we live in, but we can make a difference, one family at a time. We can help you feel heard, can provide a positive perspective and presence, can help you figure out ways to make baby care more simple, can laugh and cry with you through the beauty and challenges of motherhood… we offer a lot, we are passionate, and are worth the investment.
If you feel strongly that a doula would be an important addition to your support system, then please consider those ways to make it happen for you. Talk to several doulas, see who you resonate with–if your favorite one charges out of your price range, rather than going for some you didn’t connect with who charges less, see where you can make adjustments to make hiring your ideal doula achievable. Maybe you sell that antique dresser that’s collecting dust in the basement. Maybe you add your doula to your registry and friends pitch in to cover what’s beyond your doula budget. Maybe you barter something. If you feel strongly about their support, you can make it work one way or another.
Though some doula as a hobby, for many of us, this is a career we hope to have for a lifetime. I want to change the thinking here in Memphis so that people take our work seriously, and have an expectation that it will cost money, and be a worthy investment. The birth of your baby is a life & soul changing experience, and you deserve to do it with the support, compassion, and knowledge that a doula can provide. If you are interested in hiring a doula for your birth or postpartum time, feel free to send me a message and I can help you find the perfect doula for you!