Doulas can help improve the birth experience. How do I find and pay for one?
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Welcome to the final installment in our doula series! In part one we discussed how a doula can support you. In part two, we outlined how doulas are part of the solution for improving labor and birth outcomes, including how our agency collaborates with doulas. Today we’ll cover how you can find and pay for a doula.
At what point in my pregnancy should I find a doula?
Earlier is better, but it’s not too late, even if you’re in your third trimester!
Image credit: Tracey Russell
I recommend that someone establish with a doula as early as possible in their pregnancy. This allows the doula to get to know the client and their partner, understand their birth preferences, and provide continuous support throughout the pregnancy, labor, and postpartum. Some doulas may have limited availability, so it’s best to start looking for a doula as soon as you decide you want one.
Mariela Quesada Centeno, manager of Roots4Change says, “…we often say [you should hire a doula] as soon as you know you would benefit from one. This is particularly true for immigrant women, and first-time moms, who often need support in understanding the politics of medicine, their available resources, routes to navigate health care systems.”
Where can I find a doula?
There are many paths that can all lead you to your future doula! Our doula partners tell us many folks find them through simple online searches. Several local organizations and early childhood home visiting programs can provide referrals to doulas and scholarships to help pay for their services. Others find their way to a doula through word of mouth, a healthcare provider, or online registries:
To connect with a doula, you can ask for referrals from friends, family, or healthcare providers. You can also search online for local doula organizations or directories such as DONA International, DoulaMatch, or DoulaCircle. When choosing a doula, it’s important to find someone who you feel comfortable with and who shares your values and goals for childbirth.
Because all doulas are different and provide a variety of services, it’s smart to have a quick interview with a doula before you hire them. Nurse Uno, full-spectrum doula and owner of A Doula Just for You, says, “I encourage the birthing person to interview perspective doulas until they find a doula that best meets their needs and that they are compatible with.” DONA International, a doula certifying organization, has examples of questions you might consider asking in your interview.
How can I pay for a doula?
A doula’s pricing will depend on the services they are providing. In our area, a typical range for labor and delivery support is about $1,000-$2,000.
There are several strategies to pay for a doula:
Insurance. Check with your insurance provider to see if they cover doula services. Unfortunately, most do not, but this could change in the future. Chandra Lewis, a full-spectrum doula and owner of Reimagining Full Spectrum Doula Services, says some clients have doula services allowable with their HSA/FSA, so that may be an option for you as well.
ConnectRx. ConnectRx Wisconsin is a free program that provides support, including doula services, to eligible pregnant, Black women in Dane County. “Ask your doctor to be screened and referred to Connect Rx, [and email] the maternal health program coordinator, Micaela Berry Smith, at Foundation for Black Women's Wellness to inquire about doula services,” says Jones.
Via referral, through early childhood home visiting programs, clinics, and other local organizations. If you are working with a clinic or organization during your pregnancy, they might be able to refer you to a doula. If you need help paying for a doula, ask your referring organization about funding options.
Working directly with your doula of choice. Some doulas may have scholarships, sliding scales, and other payment strategies. For example, Chandra Lewis says, “I work to make doula services accessible to a broad range of individuals, addressing socioeconomic disparities. This involves offering sliding scale fees, seeking grant funding, or collaborating with community organizations to ensure that financial constraints do not limit access to quality care.” Check with your doula about funding strategies.
Out of pocket. This means you pay the doula directly for services. Jasmine M. Jones, doula, owner of Amir’s Angels,and a Foundation for Black Women's Wellness doula supporting ConnectRx Wisconsin says, “If birthing persons feel that they cannot afford a doula and plan to have a baby shower, one of my suggestions is asking attendees to donate to a doula fund at the shower, or simply in a registry invite.”
How we can support doulas and doula care for everyone
These existing systems of cobbling together funding and referrals for doula care are not ideal. We envision a future where it’s easier for everyone to access these services and where doulas are more comprehensively supported. We love how Mariela Quesada Centeno, manager of Roots4Change, outlined this future:
Image credit: Mariela Quesada Centeno
I have no doubt that doulas should be part of the fabric of care offered to every pregnant person in ways that are accessible to them. I am also objective in saying that for pregnant people are able to have the support of a doula, it will require multilevel and multidisciplinary movement, including:
Image credit: Roots4Change
Federal policy: in Medicaid, Medicare, Child Health Insurance Program (CHIP), and the Indian Health Service programs and coverage
State level: Medicaid expansion (Wisconsin in one of the 10 states that have not adopted expansion); ensure just and equitable doula compensations and reimbursement rates; provide state-wide dissemination efforts to inform people about doula services, its benefits, and ways to access support; reduce barriers for doulas of color and doulas in rural areas to access cultural appropriate training, among others.
Private sector (health plans, insurers, and employers): foster access for doula services, develop incentives for employees, educate clients/employees about the benefits of doulas, invest in doula’s services.
Philanthropy: support doula programs, particularly BIPOC, LGBTG+ lead programs and programs located in rural areas in ways that meet the nuances and needs of these communities; commit funding and capacity building support using anti-racism, anti-colonialism, and gender diverse models.
Community and parents: community organizing is essential, as it provides the stories, the heart, and the power to push for political, policy, and financial change.
In summary, to answer the question above: Who supports the doula? The answer is a village with political, financial, structural, and people power!Although, the needle has moved in positive ways for doulas, the hill ahead is still steep.
Image credit: Tracey Russell
Image credit: Mariela Quesada Centeno
Image credit: Roots4Change