You might balk at the idea of hiring a doula because of the cost, but consider this: Having a doula during your labor and delivery might actually reduce your medical bills by lowering your risk for medical issues that can cost a pretty penny. (This means more money to spend on the new baby!) Of course, you have to take the price of a doula into account -- for instance, if you pay a considerable fee for a doula but incur a comparable hospital bill, you're not going to save anything.
"When it comes to the different levels of training, reimbursement, and costs related to doulas, it's a Wild West scenario -- there is no standardization. Many doulas charge nearly $1,000 for their services, which is more than the doctor or professional midwife will personally receive from insurance for providing nine months of care," explains James Byrne, M.D., chair of obstetrics and gynecology at Santa Clara Valley Medical Center in San Jose. "Costs can be so variable that any potential savings might be burned up." Despite this, it's still possible that hiring a doula might benefit you, especially if she helps you have a positive birth experience that decreases the chance of serious situations. So if you're considering hiring a doula, you'll need to weigh potential costs against potential savings. Here's a breakdown of three main reasons that having a doula could help you save money in the long run.
Women who have doula support throughout labor are less likely to need various medical interventions, according to a 1999 study in the Journal of Women's Health and Gender Based Medicine. And the fewer medical interventions, the lower the price tag of your hospital and medical bills.
"If you have a doula present, you are likely going to the hospital only [when] labor is well-established, thereby preventing unnecessary trips back and forth from home," explains Latham Thomas, a maternity lifestyle expect and labor support doula in New York City and founder of Mama Glow (mamaglow.com). "The longer you're in the hospital, the more likely you'll be subject to interventions and pharmaceuticals such as Pitocin augmentation, a synthetic form of oxytocin, which usually makes contractions erratic and so unbearable for many moms that they opt for an epidural to take off the edge," she says. "A doula can even help the mom get her body into a comfortable birthing position, which will make a difference in helping to move the baby down. Doulas can also help the mom stay calm so she can relax enough to dilate."
Women who receive Pitocin and epidurals often have vaginal births, but complications can arise that lead to C-sections, an operation with hospital costs that are double the costs of a vaginal delivery. And a preliminary study presented to the American Congress of Obstetricians and Gynecologists in 2013 cited Pitocin as a possible (but not definitive) reason that more babies are being admitted to -- and staying longer -- in the NICU. But another 2013 study, published in the American Journal of Public Health, reveals that the presence of doulas help lower the need for a C-section by 40 percent and shorten labor duration, which reduces the need for medications such as analgesics, epidural anesthesia, and Pitocin, as well as the use of forceps or vacuum extraction. "Labor support appears effective in reducing fear and distress. In turn, this enhances the natural physiologic labor in low-risk patients," Dr. Byrne says.
According to a 2009 study in the Journal of Obstetric, Gynecologic, and Neonatal Nursing, moms who hire doulas are more likely to have their breast milk come in within 72 hours after delivery. They are also more likely to still be breastfeeding at six weeks than are new moms who didn't have the assistance of a doula. The early arrival and sustained flow of breast milk can end up saving you money on lactation consultations or formula. Based on research from the American Pregnancy Association, the cost of formula for one baby can range from $650 to more than $2,000 a year. Breastfeeding can also help save on medical bills down the road.
The American Academy of Pediatrics also states that women who breastfeed are less likely to have postpartum bleeding after birth. They have a decreased risk of breast and ovarian cancer, and they return to their prepregnancy weight sooner. Plus, a breastfed baby is less likely to contract illnesses such as diarrhea, urinary tract infections, Type 1 and Type 2 diabetes, and various cancers. Even though it's harder to monetize these benefits, the decrease in certain risk for complications and illnesses can contribute to fewer medical consultations and an increase in savings.
"Women with postpartum depression not only experience emotional costs, but they also have higher financial costs related to missing work, decreased productivity, and lost wages," Dr. Byrne says. The good news is that doulas can help: According to the 1999 study in the Journal of Women's Health and Gender Based Medicine, women who have continuous support from doulas are less likely to experience postpartum depression; that, in turn, helps reduce financial costs. In fact, a 2012 study in the Journal of Occupational and Environmental Medicine found that women who reported postpartum depression had 90 percent higher health-care costs than those who didn't battle depression. Bottom line: Having extra help during labor translates to a happier mom after the baby arrives, which benefits the newborn and helps prevent financial difficulties down the road.
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