Economics of A Doula's Fees Hours Most couples having a first baby may imagine that I'll only spend a few hours with them during the labor and birth, but most first labors last longer than 16 hours. The longest continuous time I've spent providing labor support is 40 hours. Average time spent with a woman for her labor and birth is about 14 hours. I usually spend at least another 12 hours in prenatal and postpartum meetings. Also, I have another few hours in phone calls, emails, and possibly research for my clients. When all is said and done, for an average birth, my fee translates to an average hourly rate of roughly $25/hour, before expenses and self-employment taxes. Clients per Month I have to limit the number of clients so as to avoid birth conflicts, to ensure that I am reasonably rested when you go into labor and to provide you with the services I promise. The rule of thumb for many doulas is that one client per week is a very full schedule. At this time, I have decided to limit my client load to a maximum of 1-2 private clients per month. The earlier you "book me" the better to ensure my availability. I take clients on a first come first serve basis. To be fair to everyone, I DO NOT consider myself booked until I have a signed contract and deposit . My Commitments to my clients and how schedules impact my client loadr When I put your due date on my calendar, I commit to being potentially available to you 24 hours per day until the birth, and for up to 2 weeks after the birth. If I schedule vacation time, I have to add a significant time padding before and after the vacation during which I cannot accept clients. There are weeks where I have to turn clients away and weeks where I have no births on the calendar. Being "On Call" Being on 24-hour call puts a lot of restrictions on my personal and family time. I always need to have my cell phone on me, even at my bedside at night to be available to you to answer questions or to learn that you may be in labor... I always have to make alternate plans "just in case" I need to leave a family function, sporting event or birthday party... I have to keep my car in top running order and with a full gas tank. I cannot have a glass of wine with dinner, because I may need to leave at moment's notice to drive to attend your birth. I may miss seeing visiting family or friends in that are in town, or have to leave a movie I wanted to see or leave a wedding to rush to your side… Being your doula truly involves a time commitment beyond the requisite visits and attending the birth. Consultant Factor The rule of thumb is that a self-employed professional's income is half of what they earn, after self-employment taxes and business expenses. As you may imagine, my expenses are high - business cell phone, computer connection, office expenses, transportation, birthing supplies, handouts, professional reference materials, professional membership affiliations, certification maintenance, training workshops and childcare - just to name a few! Unfortunately, doing "birth work" is not a lucrative field of employment--especially once all of the operating expenses are paid. Putting It All Together The annual income of someone providing labor support services is 1/2 the maximum number of clients per year times their fee per client. This is about 16 times the fee per client… before taxes, including extra self-employment taxes. Although I am dedicated to this work, being on-call all the time requires a very high level of personal sacrifice, time sacrifices, and never knowing what I will encounter at a particular labor - I may end up wearing out my body supporting the woman in different birth positions. I may end up with any combination of blood, meconium, urine, stool and amniotic fluid on my clothes, in my hair or on my body. Insurance Some insurance companies will reimburse you for service, most will not. You can talk with by your insurance company to find out if they cover labor support or doula services, I will be happy to provide you with documentation. I don't file claims for you. Reimbursement with a Flex-Plan (Cafeteria Plan, Section 125) Flex-plan covers medical costs not covered by traditional insurance. You can most likely get reimbursement this way. I can provide you with documentation to submit this claim. I do not file claims for you. Bottom Line I am a self-supporting professional. Labor support is an underpaid profession that cannot attract or keep talented, skilled individuals with low fees. If you end up selecting a doula who undercharges for her services, I strongly encourage you to pay her more than she is asking. She's worth it! Return: Fees for Services Index