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(Adapted from www.bigbellyservices.com)

The average time I spend with a woman for her labor and birth is roughly 14 hours (but could range anywhere from 8 to 40 hours). I spend, on average, another 10 to 12 hours in prenatal and postpartum visits, an hour or two in phone calls and emails, and up to five hours of travel time. With those averages, my fee rounds to an hourly rate of about $25/hour, before expenses and self-employment taxes.

A self-employed professional's income is only about half of what they earn, after deductions for vacation and sick time, self-employment taxes, business and insurance expenses, business phone, cell phone and computer connection. I also have typical professional and office expenses, continuing education expenses, and high transportation expenses (since I primarily travel to people's homes).

When I go to a birth, I bring my heart and hands and training, accompanied with my experience and continual research on subjects pertaining to birth. As a doula and educator, I keep up-to-date on the latest studies, protocols, policies and procedures regarding birth, hospitals and providers. As a doula and being able to work with many different care providers, I see the different variations from hospital to hospital, between care providers, and over time. I learn all of their different approaches and "tricks," which I think is unique to the doula profession. And the fact that every birth and every family teaches me something new, I have accumulated a wealth of knowledge and bring many skills to each birth.

So, the bottom line here is that nobody's getting rich being a doula, but every doula should be able to make a decent living without making her life unbearable. There are some people offering doula services at significantly reduced prices, but they are either offering less time and services, are still in training, or are in a financial position to offer free services. If you need free doula services, there are many ways I can help you find a free doula; otherwise, you are doing future birthing women a disservice by making labor support an underpaid profession that cannot attract or keep talented and skilled individuals. If you end up selecting a doula who is undercharging for her services, I strongly encourage you to pay her more than she is asking; otherwise, she may not be around to help you with your next birth.

Doula services are rarely covered by medical insurance plans, even though the statistics prove that doulas can save insurance companies lots of money by reducing the use of medications, interventions, time in the hospital, and surgical (Cesarean) births. You can talk with your Human Resources representatives to ask them to lobby to include all doula services as a covered option in your plan. By all means, tell everyone you meet about the support you received from a doula - spread the word about doula care so that more doulas are needed and are well-paid and can continue their work for generations to come.