When it comes to support during labor and delivery, a doula can offer countless benefits. Although they're not medical professionals, doulas have a huge role to play in women’s health during the pregnancy and postpartum period. Overwhelmingly, research shows that continuous support and comfort from an experienced birth worker can improve birth outcomes by reducing your risk for C-section, birth trauma and even improving your newborn’s health.[1]
The trouble is, many insurance plans still do not fully cover doula services as part of routine pregnancy care, so you’re likely looking at paying for at least some of the cost out of pocket. Doula services can be worth every penny and every mom-to-be should have access to one — but for many families, they may be out of reach.
Luckily, there are ways to make working with a doula more affordable. Read on for more about doula fees and how to make the cost more manageable.
How much does a doula cost?
Most doulas work independently — they set their own fees and even decide what menu of services their fee will cover. This means what you pay (as well as what you are paying for) can vary a lot depending on the individual doula and where you live.
That said, you can generally expect to pay anywhere from $225 to $5,000, depending on the package of services you purchase and your location.[2] (Generally, doula services cost more in bigger cities or other areas where the cost of living is higher.)
Some doulas, especially postpartum doulas, might charge by the hour for a few visits to your home after birth. Being on call for your birth and staying with you through labor will be more expensive. For a birth doula, you can usually expect to pay between $1,500 and $4,000, depending on whether pre- and post-birth visits are included and where you live.
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Ways to make working with a doula more affordable
If those numbers gave you some sticker shock, don't panic. The cost can become more manageable with these strategies:
- Shop around. Try to interview multiple doulas and gather quotes from each. You don’t necessarily want to go with the lowest bidder, but this will help you gain an understanding of the ballpark costs where you live. It will also be useful for helping you think through what doula services you really want and need. For example, do you need unlimited access to your doula for questions during pregnancy, or will one or two pre-labor meetings suffice? You’re paying for the doula’s time, so these considerations can really change costs. Interviewing multiple doulas is also a good way to get to know someone. As with a therapist, it’s important that you find a doula you feel comfortable with.
- Ask about payment plans. Many doulas will allow for payment plans. This can help make the large cost more manageable by breaking it down into smaller payments over many months. The earlier you decide to hire a doula, the more time you’ll have to spread out the payments, so start your hunt early. Be open and honest with doulas you speak to about the cost challenges — many are passionate about accessibility and may work with you on the overall cost of their services.
- Create a doula fund on your registry. It takes a village to raise a child, as they say. Lean on yours for help paying for your doula by creating a fund on your registry.
- Seek a grant. Many organizations and even some group doula practices offer grants to help women in need access doula services. For example, the Military Birth Resource Network helps fund doula services for military families, while the National Black Doula Association (NBDA) is a nonprofit organization connecting Black families to certified Black doulas. And the Citywide Doula Initiative in New York City and HealthConnect One in Chicago are two examples of programs that utilize government or grant funding to pay for doula services for low-income women in need. In addition, there are a number of excellent doula and midwive organizations that are helping American Indian and Alaska Native mothers have safer pregnancies regardless of ability to pay.
- Check with your insurance. If you're insured by Medicaid, there is a good chance you may be able to get your doula covered, thanks to an ongoing movement to improve access to doulas. Medicaid currently reimburses for doula services in six states (Oregon, Minnesota, New Jersey, Florida, Maryland and Virginia). Eleven more states and Washington D.C. are also working on implementing reimbursement. While private insurers are still less likely to cover it, some companies will reimburse at least a portion.[3]
- Use tax-free accounts. Doula services are qualified expenses for either a Health Savings Account or Flexible Spending Account.[4] If you plan ahead, you can contribute more money to these accounts the year you plan on giving birth. You will need a letter of medical necessity to file your claim expense, so be sure to ask your doctor for one.
Many moms find that working with a doula makes a huge difference for the birth experience. With a little creativity (and a bit of research), finding a doula who fits into your budget is possible — and worth it.
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