Are Doulas for Rich People? The Reason Why Doulas Cost a Pretty Penny

Having the conversation about doulas being luxuries is a hard one to have, especially when black women are dying at astronomical rates from pregnancy-related complications and doulas are now being called to action to help. Often times doulas are the ones convincing people to invest in birth support which can make it hard to know if they are really worth hiring or just another unnecessary expense. I’ve seen women go back and forth about how doulas should be free or paid very little.

Here’s some things to think about when suggesting that doulas aren’t worth the money they charge.


1.In order for a doula to become good at what she does she has to either take a really great training which often are NOT free, and/or get a decent amount of experience. Once she then becomes a “good” doula she has already accumulated bills of her own. This could either be from childcare costs (paying someone to watch her child while she’s attending a birth) or from the cost of training. Fortunately, many organizations offer scholarships so this can be avoided for some but not all. Many organizations also charge fees in order for doulas to keep their certifications.
COST: Childcare + Doula Training + Fees
2. For a healthy, low-risk woman, a OB/GYN will come in to check her dilation maybe 2-3 times. Then the OB will come in for the actual delivery. This all adds up to no more then 1-2 hours spent with the actual patient. Meanwhile, a doula is literally by the mother’s side through every contraction for HOURS. Now, of course, the difference in training level is huge but when we look at this from the perspective of work. A doula is doing a lot of work (with a low-risk, no complications labor) compared to an OB. This doesn’t mean that doulas are the same as doctors and therefore should be paid the same, definitely not! But it does beg the question, what exactly are we paying the doctor to do in a low-risk pregnancy? If they are there on standby, just in case something happens, well aren’t they doing less physical “work” then a doula? Should they be doing that work for free? Just ponder on it..
COST: Physical Labor Support + 12-48 hour shifts (or longer)
3. A lot of women say that doulas should be covered by insurance or provided for free at the hospital but this is a conflict of interest. Doulas are there to solely support the mother. If insurance begins to cover doulas that might come with better rates but a hefty price to pay when doulas have to start abiding by rules and regulations from insurance companies. At that point will it even be worth having a doula? Or will they just become another person who’s concerned about liability and keeping their job rather then serving the mother.. There are creative ways around this, and I do believe it’s possible to get insurance to help with the cost of a doula but it has to be done in a very mindful way so as not to impede on the independence of the doula and autonomy of the mother.
COST: Steering clear of conflict of interest
4. If a doula wants to really become great at what she does and do birth work full time she needs to be paid to support herself. How can a doula support someone else for hours on end when she has no money? How can we expect doulas to pour from an empty cup? If we do want full time doulas that get paid nothing or very little then we are basically saying that the only people who can be doulas are people who have wealthy enough partners/families who can support them. What’s interesting is that there are so many doulas that do offer free birth support. The bigger problem is that many expectant mothers aren’t aware of that and therefore don’t know where to look to obtain a free or very low cost doula.
COST: Work with no pay.
5. Doulas have existed since the beginning of birth. Women have always supported one another through pregnancy and parturition. What has changed is the way we do birth. Instead of passing down ancestral wisdom and indigenous practices we’ve turned over the entire event of having a baby to the medical field. The United States has a history of etching out midwives by alluding to their lack of medical knowledge. In fact, many of the first obstetric doctors were less experienced the “granny midwives” who didn’t receive formal medical training. This history has affected our collective psyche. So many women grow up believing that best person to handle their normal bodily functions is someone who has been deemed intellectually adequate by a medical system that has severe racial prejudice and socioeconomic bias. This conversation goes much deeper than doulas, but this is the tip of the birth iceberg.
COST: No paid overtime for fighting the patriarchy.
At the end of the day I don’t think women need to be bickering over wether or not a doula is for rich people or not, we need to be thinking outside the box. The maternal healthcare system has cornered women into having options that don’t suit their needs. It’s not because doctors are trying to keep women safe, it’s because the medical system especially obstetrics and gynecology were built on the curiosity of slave owners that had no real desire to help women. In all honesty, I believe that we need to create a new system that puts mothers in the center of the care rather then the bottom of the totem pole. It is at that point in which I think we will see a shift in the value and accessibility of hiring a doula
Disclaimer: It’s really hard for me to talk about this because I’ve seen struggle. I’ve seen women who have nothing. No support, no money, no way out. But I’ve also seen families that are not rich but are not financially savvy. Families that could be a in a different financial situation if they had better guidance on how to spend and save their money. It can be difficult to talk about this knowing that everyone’s situations are so unique and I respect the fact that while some women genuinely cannot afford a doula. While some women can afford a doula but will say they cannot afford it because they aren’t able to figure out a way to make it work for their current financial situation or they just might not see the value in it and therefore cannot not afford to spend money on something that they don’t see to be valuable.
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