There’s a myth circulating that states doulas cost a fortune, so I thought I should write a blog explaining the reality of the situation and why we’re not going to make the rich list any time soon!.
Firstly I’d like you to have a think about what a positive birth experience is actually worth to you? I imagine if you’ve already had a baby and suffered some kind of birth trauma then you’ll think it’s absolutely priceless. If it’s your first baby then maybe you’re unsure of how important a positive birth experience may be.
You can go online and read the benefits of having a doula, here’s a great link explaining the benefits from Evidence Based Birth https://evidencebasedbirth.com/the-evidence-for-doulas/
So to try and explain further…I used to work in London and earn a great salary, it was a regular salary, set hours, great benefits, I travelled the world and had job security. As a doula I have none of these things, absolutely zilch!
I never know when a job is going to appear. I may have a birth booked in my diary and then not have another one booked for a couple of months, then I might be lucky and have a few close together. It’s the same with postnatal roles, who knows when someone’s going to need me and for how long.
We now need to talk about the hours I work. As a birth doula I’ll have an initial chat with the potential client for around an hour (it’s meant to be 30 mins but I love a birth chat and to really get to know my clients). If they hire me I then provide 2 x 2 hour antenatal sessions (which have been known to go nearer 3 hours each). I’ll then spend at least a few hours researching specific topics for the clients, chatting to them on the phone or via messages and supporting them in any way I can. I’ll provide unlimited support throughout.
We then reach the on-call period, this is when the majority of the hours stack up. Most doulas are on call from 38 weeks until 42 weeks (744 hours), but if possible most doulas will be with you outside of these times if your baby should make an earlier or later than expected arrival. During the on-call period a doula won’t be much more than an hour away from their client. Personally I stay close to home and don’t make many plans. There’s certainly no alcohol, no big events, late nights or holidays for me. I have my phone on 24 hours a day. Through the night I generally check my phone what feels like a million times, just to make sure I definitely had the sound on high! There’s also childcare to consider during this time. I have to have a strong back up system in place and it can be a stressful time for my family too. On an almost daily basis during this month I have to work out who will collect my daughter from nursery should I be called to the birth, or who will look after her if I get called out in the night, and my husband has to go off to work in the morning at 6am. During the on-call period there’s always something to think about, arrange or consider, so I can drop everything at a minutes notice. I’ve occasionally had to rearrange/cancel my pregnancy yoga classes and tell postnatal clients that I may have to rush off to a birth. I’d obviously then lose out on the money I was going to get for these roles.
I was on call over my 40th birthday and ended up having a take away and glass of orange squash at home…fun birthday! I’ve missed lots of social events and special occasions because of the on-call period.
Then we get to the birth, I’ve been known to spend 36 hours with a birthing person, a pretty long stint! It’s strange after a birth, after a long birth like this you can’t just go back to a normal day or even sleep straight away, however tired you feel. I find a lot of adrenaline will be running through me and I need a good 6/8 hours to wind down afterwards before the birth stops racing through my mind and I can begin to relax.
Even after a birth the work doesn’t actually stop there. I’m still available for calls, email, messages and general support for 4 weeks. I may get calls about breastfeeding, routines, “is this normal?”, sleep coaching and more. I then also provide a postnatal visit. This is meant to be an hour in length but invariably it’s a lot longer!
So to summarise the hours for a birth, it includes…
1 hour – Initial chat
2.5 hour – antenatal session (1)
2.5 hour antenatal session (2)
2 hours client research
744 hours on call
24 hours birth (see, I’ve not even used my longest one for the example or counted my wind down time!)
2 hours postnatal support and research
1.5 hours postnatal visit
That’s a lot of hours! It can be less but it can also be more. Even if we don’t do a full months on-call period we earn a lot less that the UK minimum wage!
You must remember how much we invest in our clients emotionally, I know doulas who’ve been in incredibly stressful situations and needed some counselling afterwards, it can take up a lot of head space and play on doulas minds. Doulas are naturally ‘helpers’, a lot of doulas go above and beyond the call of duty and find it hard to stop supporting, and do even more hours for some clients. I know I’ve talked a lot about the hours but it’s not just about that, it’s about the anxiety, stress levels and emotional investment that come with the role as well. Some doulas also perform extra duties, maybe going to medical appointments with clients for example, I know a doula who attended around 8 hospital appointments with a client.
Doulas charge between £500 and £3000 for a birth. Most doulas I know charge between £750 and £1200 and I’ve not even mentioned the costs doulas pay for advertising, training courses, supplies, hospital parking, petrol, and other costs (I come with a whole bag of tricks. Some doulas even have birth pools with them, I’m considering buying one for clients to use and this will cost me quite a lot of money).
In total for my example of time, that’s 779.5 hours of doula support! Let’s say you have considered a doula who’s charging £1000 and you think it’s expensive. Now have a think about what the cost is per hour for that doula! It’s hardly anything, and even if you cut the on all period in half it still doesn’t amount to much!
Something I’ve also realised recently is that I can probably only take on around 6 clients per year. One every other month is enough, particularly with long on-call periods. Overlapping on-call periods can be really stressful otherwise. When I take on a client I make a commitment to them to give my all, and I couldn’t do this if I had lots of clients at one time. Because of this I have to turn clients down, it’s tough turning down the extra money, but I want to provide the best service possible to the clients I already have and it wouldn’t be fair to have overlapping on-call times.
We do it for the love of the job, it’s never going to make us big bucks! I’ll be lucky if I earn enough to enter the minimum tax bracket in the coming years, and that’s including postnatal jobs and my pregnancy yoga classes, as well as births.
I also volunteer as a breastfeeding peer supporter and work for Health Watch Essex as a Maternity Patient Partner, trying to improve maternity services in my local area. I do this because I genuinely want to help and make a difference, I get no income from this at all. I was asked recently to attend a caesarean birth at the last minute and I agreed that I’d do this for free, just to help a family who needed some support, so I’m certainly not in it for the money!
I absolutely love what I do and wouldn’t go back to my secure, regular London job, even if they wanted to pay me double!