Why Are Doula Fees So High?

A Doula’s Fees

Many people ask about the breakdown of professional labor support fees. I offer this information so that you’ll have a better idea of what your money is paying for.



Most first labors last longer than 18 hours; some can last as long as 40 hours or more. The average time I spend with a woman for her labor and birth is about 14 hours.   I spend at least another 6 hours in prenatal meetings and the postpartum meeting.  Phone calls, individual research and responding to e-mails often add another hour or two per client.  Second and third births are very often shorter but require quick action on my part.   I charge a lower fee for second/third time births.



When I make a commitment to be available to attend you in labor, I limit the number of clients I put on my calendar to avoid birth conflicts and to ensure that I am reasonably rested when you go into labor. I try to schedule only one or two clients per month which gives you the highest chances I’ll be free to be with you. When I put your due date on my calendar, I commit to being available two weeks beforehand and two weeks after that date. This means that when I schedule a vacation, I have to add another four weeks during which I cannot accept clients.



The rule of thumb is that a self-employed professional’s income is only half of what they earn, after deductions for vacation and sick time, self-employment taxes, health insurance, and business expenses. Communication expenses are high for a doula – I have a cell phone so I’m always reachable, a web site, and a computer with a high-speed internet connection. I also have routine professional and office expenses and unusual transportation and supplies expenses.  There are supplies I bring with me to your birth and give you at appointments and interviews.  In addition, I also have to be able to compensate a back-up if the need arises.



It’s important to me to keep up with all of the most current information. In order to attend conferences and training opportunities, I often have to limit the number of clients I can accept around the time I will be unavailable, thereby reducing the number of clients I can work with each year.  In addition there is no “company benefit” that pays for these seminars and conferences.



Being on-call all the time requires a very high level of personal sacrifice, including a willingness to be awakened any hour to go attend a labor for the next 9-18 (or more) hours.  Personal family events can be missed or interrupted for births. When I go to a movie with a friend, we have to take two cars, in case I have to leave suddenly for a birth. I can attend a party, but I’ll have to forgo that glass of wine and I have to bring a change of clothes with me wherever I go. In order to care for my children I have to arrange for another responsible adult to take over at a moment’s notice. I cannot take spontaneous weekend trips away from home, and even local appointments have to be planned around due dates so that I’m never far away or indisposed when a client calls in labor.


What you aren’t paying for is how much I care, which is priceless.

10 Reasons to Hire a Doula

Ten Reasons to Hire a Doula

There are many reasons why women hire doulas to support them at birth. The following list represents the top reasons a mother would choose to have a doula support her and her family at birth. You should consider including a doula as part of your birth team if any one of the following apply to you:


This is your first baby

A doula will act as your personal guide through this unfamiliar and exciting process. Doulas are trained and experienced at empowering mothers to have a positive birth experience. She will encourage, reassure and nurture the mother as well as provide vital information.


You expect to have a normal birth and/or are planning a natural (drug-free) birth

Studies show that a doula’s attendance at birth dramatically decreases a mother’s chance of having medical interventions, such as c-sections, labor enhancing drugs, strong painkillers, and confinement to bed.  Her confidence in you, the coping strategies, and the comfort measures she suggests improve labor progress and eliminate pain/fear based decisions.


Your previous birth was difficult, traumatic, or an unexpected c-section

A doula can build your confidence, help you gain understanding about your last birth, learn ways to improve this birth, and prepare & support you for a vaginal birth.  Her presence makes birth more peaceful.


You are having your baby in the hospital (OB/GYN or Midwife)

A doctor joins a mother when she has started pushing.  A hospital midwife has other patients to tend to.  The doula usually joins a mother at home when active labor starts or when the mother requests additional support. The doula provides a familiar continual presence for the duration of labor offering comfort measures, reassurance and encouragement.


You anticipate being alone at birth (no partner or family member to attend)

A doula can be a welcome and familiar face amongst many unfamiliar hospital staff. The doula is familiar with your expectations, hopes and concerns for birth. She can act as your advocate and primary support.


You feel anxious or fearful about your upcoming birth

A doula provides emotional support, listening to your concerns and providing reassurance and education about the birth process.  Her companionship greatly reduces the level of anxiety both parents may feel.


You believe you may have difficulties coping with pain

A doula has many strategies to share with a mother to help cope with the pain associated with childbirth. Massage, breathing techniques, and visualization are just a few examples of pain management strategies.


You feel that you and your partner will benefit from experienced support 

A doula can enhance a dad’s experience by helping him be involved at his comfort level. A doula can help the father share in the experience of birth with confidence and provide time for him to take care of his needs, such as sleep, food, and fresh air without leaving the mom unsupported.


You would like experienced help with breastfeeding

A doula is often especially experienced or trained in breastfeeding and will protect and promote the time and closeness required and will assist in getting the first nursing off to a great start.  She can help later as well.


You desire a positive birth memory

A doula can preserve your birth memory, fill in any blanks from your experience, and keep your birth moment sacred.  She will help you maintain a sense of control & active participation in your birth that results in an empowering experience.


Adapted from material by Michelle Dennill, CD(DONA) © 2008 Bloom Birth Support Services.  Copyright released for Doulas and their Clients.