Doula Pricing and experience...

[vwmama]

I live in an expensive area. Anyhow I called a recommended midwife who will work as a doula for me in the hospital. BUT................. She wants to charge me $1700 but will except payments. I will be paying for 3 years! I don't want the post partum visits or the in home labor support, I just need someone at the hospital while I am in labor. I called another new doula who will charge $400 but doesn't have much experience.

Ds had a moderate shoulder dystocia which was horrible without any pain meds and my husband was left alone to deal with an induced labor which was problematic in many ways.

Do I need the more experienced doula to help me with labor positions to avoid another dystocia which one OB thought would certainly happen again... (meaning get a c-section!) Or can I have someone without experience there to help with relaxing only and not as much with preventing the complication of a stuck shoulder??? I would feel more confident with the midwife as my doula.

I am shocked at how high the price is for the more qualified one. I told the doula my husband had been laid off without pay or any $$ and we are still trying to catch up now that he is back to work. She is SO good I would really love to use her, how can I ask her to reduce her cost??

[pamamidwife]

Well, I charge much more than any of the doulas in this area because I am a midwife. That means that not only am I on call for my homebirth clients, but also for any labor support. In the case of one of my homebirth couples going into labor while I'm at a labor support birth, I pay another midwife to attend the other couple. Of course, it's not just about money, but it's about time and stress....It's time consuming and stressful at times to do support for couples in the hospital.

I would definitely ask about reducing her fee. Don't worry about asking - at least you would know!

Is there any reason why you wouldn't consider a homebirth?

Here's some good information on how to avoid a SD with your next baby: http://www.midwifemama.com/vertical_delivery.html

[Viola]

$1700! Wow! :eek It sounds like she is charging you because she has more experience, but her midwife experience won't necessarily help you. I mean, it will help you, but her hands will be tied working as a doula and not as a midwife with privileges in that hospital. My thought, and probably many will disagree with me, is that if you are in the hospital and experience some problems like shoulder dystocia, it will be up to you and your health care provider as to how it is handled. Your doula can be an advocate for you, but she won't have any say in the ultimate decisions. So if you don't think the extra money is worth it, I would just go for the cheaper one. I'd be just as concerned as to how much spiritual type of comfort and support she could provide as well as how much knowledge she has. I guess what I'm saying is just make sure that you aren't paying for something that you won't get to use.

Maybe you can meet with both of them and talk to them and get a feeling that way. If you could ask questions of the cheaper doula and assess her knowledge and willingness to go to bat for you, maybe you might feel more comfortable. But if you think the more expensive doula is worth it because she will be more assertive and more of an advocate, than go for it!

[Yin Yang]

WOW!! I pay $1800 my MW for homebirth!! Doulas usually charge around $300- $400 - and they are pretty much just your mental support, from what I understood. There is a big difference between midwife and doula.........I would not pay MW $1700 to be my mental support, that is nonsense I think.

[vwmama]

Since I am in California everything is expensive BUT I am so worried about having a difficult labor that the experienced midwife acting as a doula would be so much more calming to me. Whereas the new kid on the block wouldn't inspire confidence in me. We were left alone with us and pitocin last time and it went wrong so I really want someone qualified to help with positions that will aid in not getting this baby stuck!!

BUT I CANNOT pay that much $$$. SO I guess I will keep looking. I am finding a couple of experienced doulas for $500-$600 but they are booked on my due date.

I do agree though I would be paying for the midwife experience and she has no power in a hospital therefore I guess it is not a good idea. BUT I have to find someone experienced or else I am not going to be confident about the birth.

[Yin Yang]

I have to say it - I think you need to find that confidence within yourself in the first place!! You sound very scared and I don't think doula or Mw will help you with that! Confidence needs to come from your heart, you need to trust yourself and your body that you can do it and that no complications will occure. I wish you best of luck! Everything is going to be just find, you'll see! :love
Good luck,

[Sharon]

I'm in Seattle, not quite as pricey as some parts of CA, but not a cheap area either. Our doula is $550 and she's REALLY experienced. She's also a licensed RN...never worked as a nurse, just did the schooling. I would probably keep looking if I were you. I'm sure you can find someone who is cheaper and still experienced. In the meantime, I agree with Pavlina, search within yourself for strength and confidence. You can do it!!

[pamamidwife]

Definitely talk to the midwife about a sliding scale. Perhaps there is something you can work out - I know I have brought my fee WAY down for people before if they ask. :)

[Viola]

I really liked my doula and found her helpful even though I found out later that she had attended only a few births on her own before mine. I know she attended a number when she was in training. I found the support she gave really helpful, but I was not as knowledgeable about things as I am now, and I didn't have as strong opinions as to what I wanted. My doula charged $500 at the time, but she gave me a discount, so it ended up being only $450. We became friends and later on she was talking to me about how her fees had gone up. I lived in Orange county, CA and she lived in Riverside county, so she said she charged $700 for births in OC. I remember thinking that I'd probably find someone closer if she was going to charge that much. I was just a bit annoyed, but there is a lot more to it.

Now I'm in Reno and it seems like $500 is about the going rate for a doula here. But now I know what I need and don't need and what I want. I want someone who will not only will provide emotional support and comfort, but who is willing to help me with what I want and getting it because my husband is not really going to be supportive in that way. So I almost feel like I'm requiring more and I think it is worth paying for, but it isn't necessarily the knowledge that I need. Now I wish my OB could have the knowledge of a good midwife, but that's a whole different problem.

Hopefully you can ask her and she will lower her fee, as Pamamidwife suggests.

[candiland]

Welll.... speaking as a relatively experienced doula, even I sometimes get completely overwhelmed by the vibes and attitudes found in a hospital setting. If you have a pretty inexperienced doula, I would place my bet that she'd get kind of overwhelmed if stuff started happening that were not in your favor, kwim? It becomes so much easier to go with the flow of the hospital staff instead of really actively advocating on the mother's behalf... it takes someone who feels they know as much as the doctor does to make recommendations against procedures he or she may suggest. If you don't know TONS about normal labor and birth - which a homebirth midwife does, obviously - its really easy to second guess yourself, esp. when it comes to speaking out against a hospital staff member...
What was your first birth like? Did the shoulder dys. happen because you weren't in an optimal birth position? Were you induced, or did they do "purple pushing"? Did the doctor calmly request you get onto all fours, easily freeing the baby? If you understand the things that may have caused the dystocia to begin with, you can be more active in preventing it the next time. It's funny, because most ob's think reoccurence of dystocia is common; the homebirth/birth center midwives, on the other hand, rarely see it happen twice to the same woman....

[vwmama]

candiland,
I love your post! Yes I totally agree with you having given birth twice before, there were a ton of issues causing the dystocia.

I have also been hearing for 7+ mos how I would be a fool not to opt for a c-section. I have just changed OB's and think this new one is much much better.

My 1st birth in the hospital was a breeze as compared with the last one in a hospital. I cannot express how bad and terrifying it was. I am trying to be very positive with this one but we have had a LOT of stressful things happen this pregnancy. Dh will not even be able to take any time off after the birth.

I so agree that experience is important if you are expecting complications as they are with me. I am 36, baby again is big, and I have only met my new Dr. one time so far and my EED is 9/9/03. Less than 7 weeks to go. I have to feel that if it's just us and the doula she will know what to do to keep that baby heading in the right direction and she can help me with different positions. Something they wouldn't even consider last time.

Anyhow I will ask for a discount but wondered typically how much more does a midwife/doula charge as compared with a doula??? :confused: