stressful doula search-- how to value this service?

[janevar]

Hi everyone,
I have some financial stress right now; 1/2 my maternity leave is unpaid and I am the sole breadwinner since DH has been unemployed for a few months. But I live in NYC, where everything costs more, including and especially DOULA's!! I am already 33 weeks and so it's getting down to the wire, but i'm having a hard time figuring out how much to budget for a doula.

The Doulas who have attended more than 100 births regularly charge over $1000 here-- and it is not at all uncommon for the "top" doulas to charge $2000.

I understand that I could find one who is less expensive because they are less experienced but because I am planning a homebirth I am not sure how I feel about lack of experience.

I am stingy by nature and I don't really know how to value this service. I know this will sound irrational but if I have a <10 hour or easy labor, i will feel stupid spending a month's rent on someone. I could technically afford up to $1500 but i would much rather spend less than $1000.

Any thoughts?

[karen1968]

What is it you are hoping a doula will do for you at a home birth? How many midwives are scheduled to attend your birth? Do you have other support people? What about the "lack of experience" (and it might not be as much of a difference as you think) bothers you?

Personally, I don't see the point of using a doula for a homebirth. For my first birth, a hospital induction, the doula was useful in helping me make decisions, esp. as I got more and more tired (it was a 64-hour induction). She was able to get food from the cafeteria for DH, and she helped me with massage and counter-pressure during contractions. She took pictures during and immediately after the birth.

For this birth, a homebirth, we expect two midwives and an apprentice to show up (of course, they might not all attend if there is another birth). We are not hiring a doula, although we are thining of hiring a "kid doula" to look out for our son so that DH can concentrate on me and the birth. Because we are at home, food and rest are less of a problem than they would be in a hospital. If I felt the need for a support person, indvidual services (such as massage) and a personal connection would be more important than the number of births attended. JMO.

[IAMommy]

I agree with Karen1968. I just had my second homebirth and hired a doula, and I regret it. She missed the birth, and in her contract she says if she misses it, you get half your money back, but now she is trying to only give us 1/5th. So, not only was she not there, we have to have the stress of negotiating a rate.

Do you have a friend that could act as a support person? My friend who could have done that for me was too far away, but maybe you have someone nearby?

[mediumcrunch]

As long as there will be an apprentice midwife or 2nd midwife at your homebirth I wouldn't bother with a doula. As long as there is one woman there in addition to your primary midwife I think you'll be fine.

[lotusma]

i agree w/ what's been said. you typically don't need a doula for a homebirth. your midwife, and her birth assistant(s) will work w/ you. talk to them at your next visit and get their input (reassurance).

doula's attending women in hospitals, otoh, are a very vital component to a positive birth experience and are worth every penny, imo.

[limette]

I didn't have a doula for my first birth (attempted homebirth) and I totally regret it.

The midwives here don't show up until you are heavily in labor and aren't really there for support. I am positive that if my doula had been there I wouldn't have transferred in early labor and wouldn't have ended up with a c-section.

I hired a doula for my second birth (she had only attended a handful of births) and she was amazing. Showed up as soon as I was sure I was in labor, was very supportive and helped me out however she could. We did end up transferring at 9cms (I had an really evil midwife that time) but she made she all my wishes were respected at the hospital as well.

So for me it was definitely worth it, lack of experience wasn't an issue.

[starkyld]

Another NYC homebirther here. The NYC homebirth midwives usually work solo, so the OP probably isn't anticipating any attendants other than her midwife unless she hires a doula.

I'm not hiring a doula for my homebirth and I feel very secure about that, but I also have a phenomenal relationship with my midwife and feel extremely secure with her. My husband is my labor support person and has prepared with me for all of the challenges of labor. He took a birthing class sequence with me, we've worked on comfort measures, and I'm looking forward to birth being an intimate event between me, my husband, our child, and our midwife.

If I were anticipating a hospital birth, I would absolutely have hired a doula, regardless of the expense (and I also have an unemployed partner, plus my maternity leave is unpaid). I don't think having a doula is nearly as essential for a homebirth as a hospital birth, as long as you have a midwife you really trust. You won't need advocacy in the same way and a lot of the comfort supports are in place already since you're in your own home.

OP, please message me if you have any local questions--I could put you in touch with my childbirth prep educator (who trains doulas & could make recommendations) or with my friend who is a fantastically trained and competent doula (but whose fee is more than you've stated you want to spend). Depending on what neighborhood you're in, I might also have some other resources for you.

[janevar]

thank you all for your thoughtful responses. My MW will have an assistant at the birth, but she has made it clear that she strongly believes everything will go better with a doula. She is not going to come until I am in active labor and has made it clear that my physical comfort is not her priority-- the health of me and LO is. I like the idea of a doula for a long labor-- even with a mw + backup/assistant nearby.

There are some complexities surrounding transfer in NYC right now-- basically, the most mw-friendly hospital has closed, and everyone is a little freaked out about what that means. Especially for non-emergent transfers (e.g. 34 hrs of back labor & need a break), I feel like having a doula that can come advocate for me in the hosp (the mw might be totally shunned) would be important.

Sigh. Who knows. There is one woman I like a lot and I think she'll charge around $1200. I think i have to suck it up and pay the money and just call it an insurance policy in case of transfer. But I appreciate the input & I'll keep thinking it over.

Thanks again. I heart MDC.

[Bubblette]

We're having a homebirth, this will be our first child and we are hiring a doula. My midwife is constrained by the group she works with and can only stay with me for a max of 16 hours (preferably only 12) during labor. My doula however, can stay as long as she feels capable of staying- no regulations. I also wanted a doula in case of transfer, which historically in my area is more common among 1st time moms.

We are very tight finically, and the way we did it was to interview doulas and pick the one we liked the best after weighing the pros and cons. Our top two were charging VERY different prices, mostly because of experience. We went with our guts and ended up with the less expansive option. BUT if the one we had really loved was the $1000 one we would have sucked it up. If you feel you need a doula, go with one you're most happy with within your budget.

It was important to us to also look at what was offered. The doula we ended up with is not only happy to help clean and tidy up a bit, but refuses to come over without brining food (which I tell her not to!!!). She loves to cook, and has genuinely been taking care of me since we started our relationship. The other doula we almost picked has been doing this over 7 years, in two countries, and done well over 1500 births and was an amazingly calm presence. I really liked her too!! but she is much more labor and lactation support only. My mom is dead, we're not in a town with any relatives. So our doula being more "motherly" was an advantage over the doula with much much more experience. So I think you really have to weight what makes the most sense for what YOU particularly need. Hope that makes sense, and helps a bit.

[Altair]

I'm also a NYC homebirther (well, attempted) and a now non-practicing doula. I practiced here for 10 years.

I do think that a NYC homebirth, with all the particulars that are unique to our current situation... a doula is a BIG help. I was so, so SO thankful to have mine during my 3 day long active labor. My midwife is simply amazing, but she comes later and she cannot be 1-1 with me the entire time because she needs to keep her energy up for the medical issues (even though she was incredibly competent with emotionally/physically helping me, it is a large load for one person plus partner to bear). Having a doula made sure everyone was at the top of their game for those 3 long days, one entire day of which was transition. We really needed all hands on deck.

Now, from being a doula I didn't end up having to pay for one who would have charged thousands, but with my non-paid maternity leave I hadn't budgeted as much as the most expensive doulas cost. In all honesty I DON'T THINK IT MATTERS. You want someone who clicks with you, period. Someone with whom you feel calm just being around. That doesn't have to be someone with 100+ births. It could be someone with 10 births who just has an energy that really works for you.

I'd put my feelers out for doulas at the beginning of their career, and especially ones that use a sliding scale. When I worked as a doula I always had a sliding scale and most people paid me somewhere on it, but not at the top.

[blake201]

janevar, I hear you. I also live in NYC and was planning to have a doula. We did a big search and actually found one for $800--but then we found out that the birthing center only allows two support people, and that has to be my husband and mother.

Have you considered a less-experienced doula? Birthday Presence in Brooklyn can refer you to doulas who charge from $300-$800 with varying levels of experience. And a friend of mine actually recently told me she has a friend who will charge nothing because she is still working on getting a certain number of births.

[jessieb503]

From what I've read here it seems like it totally depends on your midwife's approach. I told my midwife I was getting a doula for my homebirth and she said, 'why? I will be there the whole time with another midwife and an assistant.' She has been to over 1200 births and has only had 7 doulas present! I was shocked. So we have chosen not to get one and they are only about $500-800 here.

If YOUR midwife strongly recommends getting a doula then I would do it. Its your birth and although it is expensive you'll forget about it once you are holding that little bundle in your arms. AND you don't want to regret not getting one in the end. It will be better to have peace of mind.

[blake201]

Yes, jessieb503 has a point as well--it depends on the midwife. My midwife group enjoys working with doulas, but once I get to the birthing center they pretty much do a lot of the stuff that a doula would do, and will stay with me almost constantly. So they told me if I did hire a doula she would be most useful in the early stages of labor at home.

[intrepidmother]

I had a doula and she was only with us for 3 hours. If I had gotten an expensive doula and only needed her for 3 hours, I would've felt like it was a waste of money (to be honest). If you're worried about the money, maybe you can negotiate the cost in the contract. My doula had a section in the contract that if it went over a certain amount of time, we would pay her an extra $100. There may be some leeway in the price. But I also agree with other pp. You need to feel comfortable with whoever you get.