Having someone attending to your every need during labor and delivery and after the baby arrives home sounds awesome, but will hiring a doula break the bank? Not necessarily. It's a matter of doing your homework and finding the doula who's not only right for you but will also fit in your budget. Here's a look into the important financial matters related to doulas.
Regardless of where you live, almost anyone who wants a doula can hire one, though the price of doula services varies greatly depending on your location, the doula’s experience, and the specific services you're seeking. For instance, in large cities such as New York and Los Angeles, a birth doula (one who's hired to assist you with labor and delivery only) can cost $3,500 or more. In other parts of the country, though, you can find a doula for an average price of $500. If you're looking to hire a postpartum doula (one who's hired to assist you after delivery with lactation support and recovery), the average price can be $25 to $35 an hour, with possible room for negotiation, depending on how many hours are needed. Some doulas may even be willing to work for a nominal fee, or even for free.
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Yes, many doulas-in-training are willing to accept very little payment or even none at all just to gain the experience of participating in a birth and delivery. "In order to become a certified doula, the doula-in-training must go through a certification process, which is kind of like apprenticing," says Sunday Tortelli, president of DONA International and a birth doula in Cleveland. "They are required to attend births and provide doula services, so some doulas are willing to volunteer to earn their certification quicker." Ask your childbirth educator and hospital if they know of volunteer doula programs in your area. You can also check on the DONA website (dona.org) and check with your local hospital and birth center to see if they provide a referral.
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Absolutely. "There are a lot of creative ways for this to work," Tortelli says. You might give your doula a small retainer fee in advance and then pay the rest by the time of the birth. You might also be able to pay in installments. Some mothers even barter with their doulas – for instance, if a mom-to-be is a Web developer, she can offer to create the doula's website for free in exchange for her assistance during birth. Ana Mojtahedi of Scranton, Pennsylvania, wanted a natural birth when she was expecting her daughter, Adalee, and knew that hiring a doula would help achieve that. She couldn't fit it into her budget at the time, so she had to get creative. "My husband and I are public interest lawyers, and the doula we wanted to hire needed wills drafted for her and her husband," she says. "It was a win-win situation because we drafted the wills for her in exchange for the full extent of her services." Work with your doula to figure out a plan that's right for both of you.
"There's currently no standard reimbursement from insurance companies," Tortelli says. "It's worth trying – some will reimburse parents if they submit a claim. Just remember that it's hit-or-miss." In other words, no insurance company will say upfront that they'll cover the cost of a doula. And in the vast majority of cases, they won't. In rare instances, a person might be able to argue with their particular company and wind up getting some coverage. But "parents who hire a doula should have the expectation that it's an out-of-pocket expense," Tortelli says. Oregon became the first state to pass legislation that requires Medicaid to reimburse for certified doula services. Minnesota and New York followed suit, with laws that went into effect in 2014 and 2019 respectively. Families covered by Medicaid in these states could receive partial or full reimbursement. As of 2019, several cities including Brooklyn, Philadelphia, Baltimore, and Portland provide community doula services to low-income and at-risk women to help drive down infant mortality and provide maternal support.
A doula's services can vary, but if you hire a birth doula you'll typically get the following: one or two in-person prenatal visits (sometimes a postpartum visit as well), access to the doula's phone and e-mail to ask questions before labor, and her dedicated attention during the birth process, explains Latham Thomas, a maternity lifestyle expect and labor support doula in New York City and founder of Mama Glow. So whether your labor takes 20 minutes (lucky you!) or 20 hours (yikes!), a doula will be there to support you: helping you find the most comfortable position, providing a light massage for pain relief, and being your cheerleader and advocate.
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