Birth Package

As your birth doula, my goal is to provide you with constant support throughout your labor and delivery....

As your birth doula, my goal is to provide you with constant support throughout your labor and delivery. To do this effectively, I provide the following services:

BEFORE LABOR

We’ll meet together at least two times to get acquainted. During these visits we will define your hopes and plans for your birth, discuss options, concerns and ask questions. I can introduce you to some relaxation techniques to use during labor if you wish.

We’ll review your birth plan and discuss your options. I will provide objective information about topics that may be concerning you or that you would like more information on. I am available to discuss the pros and cons of your options and will support the decisions you make. I like to give you as much information as you need to help you make birth choices that are right for you and your baby.

I am available via telephone or email to answer questions and address concerns. We’ll discuss my availability around your due date. If an issue should arise, I always work with a partner doula. You will meet her at one of our prenatal visits.

When you go into labor, please call me anytime, night or day, and we will evaluate how you are doing and what our next step should be.


DURING LABOR

We’ll have early labor phone contact for information and for us to decide when and where to meet. I usually need approximately one hour to get to you from the time you call.

I will be with you continuously throughout the labor and birth and will use my knowledge and experience to provide you with physical comfort and emotional support. I can work with you in your home before you move to the hospital, meet you at the hospital, or participate in the midwife-assisted home birth of your baby.

I will help you have the birth you want to have, while also being aware of the flexibility that is needed during birth. I will let you know of the options that are available to you at any given moment. I will support your partner by offering reassurances, assistance, suggestions, and information as needed.

POSTPARTUM

I will stay until you are comfortable and your family seems ready for quiet time together which is usually 1 – 2 hours. I will help with the initial breastfeeding if necessary.

I will contact you by phone or email, whichever we decide is best to arrange a convenient time to meet for your postpartum visit. We’ll meet after the birth to review the birth experience, clarify events that took place around you, to admire your baby, and receive feedback from you about my role.

I live in Kent, WA and work primarily in South King County, Seattle, and the Eastside, but am willing to travel depending on your circumstances.



DOULA FEES

My fee for the services described here is determined on a sliding scale, starting at $1200. Contact me for more information. I do require a retainer fee of $600, due when you hire me as your doula, and the final payment is due at the first postpartum visit.

I offer Placenta preparation and encapsulation done 1-3 days after the baby is born. I also make Placenta Prints.

WHAT MAKES UP A DOULA’S FEES?

(Adapted from www.gentlebirth.org and bigbellyservices.com)

How a doula sets her fees is not understood by many people; I offer this information so that you have a better idea of what you’re paying for.

Hours

Couples having a first baby may imagine that their doula will only be spending a few hours with them during the labor and birth. In reality, an eight-hour labor would be considered pretty fast; most first labors last at least 24 hours. The average time I have spent with a woman for her labor and birth is about 13 hours. I spend another 10 hours in prenatal and postpartum visits, another hour or two in phone calls or email, and up to six hours travel time. Using those averages, my fee translates to an hourly rate of about $20/hour, before expenses and self-employment taxes.

Clients per Week

When I make a commitment to be available to attend you in labor, I have to limit the number of clients I put on my calendar so as to avoid birth conflicts and to ensure that I am reasonably rested when you go into labor. The rule of thumb for birth professionals providing in-home services is that one client per week is a full schedule.

Clients per Year

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, or have a commitment that I cannot miss, I have to add another four weeks during which I cannot accept clients. Occasionally, my clients hire me with my backup on-call during times that I may be unavailable. Candace Barber is my backup.

Being Self-Employed

Self-employed professionals income is only half of what they earn, after deductions for vacation and sick time, self-employment taxes, insurance, and business expenses. As you may imagine, my communication expenses are high – business phone, cell phone and computer connection. I also have typical professional and office expenses, continuing education expenses, and unusually high transportation expenses since I travel to peoples homes, hospital’s and birth centers.

Putting It All Together

Although I am dedicated to this work, being on-call all the time requires a very high level of personal sacrifice, including a willingness to be awoken after half an hour of sleep to go attend a labor for the next 30 hours. About 25% of my clients have some kind of early labor which starts and stops, resulting in multiple phone calls; often in the middle of the night. I never know what I’m going to encounter at a particular labor – I may end up wearing out my body supporting the woman in different birth positions; I may take catnaps sitting in a chair; I may eat nothing but crackers and dried fruit; I may end up holding a vomit bowl for someone vomiting with every contraction during transition; I may end up with blood, meconium or worse on my clothes. And the financial reward for this? The annual income of someone providing labor support services with a responsible client load and a strong commitment to being available for birth is 1/2 the number of clients per year times their fee per client.

Experience Factor

When I step into a birth, I bring not only my heart and training, but my experience from over 200 births and continual research on subjects relating to birth. As a doula, I must keep up-to-date on the latest studies, procedures, protocols, and policies surrounding birth and area hospitals and providers. Did you know that doctors, midwives, and nurses usually only know their way of doing things?

As a doula I see the variations from hospital to hospital, between care providers. Being able to work with many different care providers, I learn all their different approaches and tricks, which I think is unique to the doula profession. And considering that every birth and every family teaches me something new, I have a wealth of knowledge and skills to bring to each birth.

Bottom Line

Nobody’s getting rich doing doula work. But every doula should be able to make a decent living as a doula without making her life unbearable. I wish I could offer my services at a rate than everyone can afford, but that would require that I make even greater financial sacrifices than I am already making to do this work. I am a self-supporting professional, and my options are to earn a living wage working with birth or to have a more conventional job, which would pay much more. There are people offering doula services at significantly reduced prices. 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, 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 child. The most common cause of doula burnout is feeling overwhelmed by the commitment and uncompensated for ones time and dedication.

Advocacy Suggestions

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. Also lobby your State legislature to include doula services in state-funded health care so that low-income women have access to experienced doula support and doulas don’t have to further their financial burden by attending these births for free (that is what we do now). Additionally, you could talk with your midwife or doctor to encourage them to offer universal doula care to their clients. By hiring several doulas to be on-call for their clients, they could substantially reduce the cost per birth (and make their job easier). You could also advocate for the hospital to provide universal doula care, so that it would be covered in the same way as their in-house lactation consultants are covered. 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.