doulas-what does your practice look like? - Mothering Forums

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Old 03-29-2011, 08:00 PM - Thread Starter
 
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Curious to know what other doulas offer in terms of pre and post natal visits?  Also, what do folks charge and how long did it take you to get to your current pay rate? I am just starting out and trying to figure out my options. Also curious about how people handle having small children and being on call???

 

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Old 04-01-2011, 12:44 PM - Thread Starter
 
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really...no one?

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Old 04-01-2011, 01:52 PM
 
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Curious to know what other doulas offer in terms of pre and post natal visits?  I offer three to four prenatals that are anywhere from 2-3 hours long (sometimes longer depending on the parents), and one postpartum visit which is usually about one hour long.  

 

Also, what do folks charge and how long did it take you to get to your current pay rate? Pay is really hard to share because it truly is so dependent on the area you live in.  If you are trying to figure out how much you should charge you would want to start by talking with doulas locally.  As far as how long it took me to get to my current pay that has been a slow process, but I also offer a lot more now then I did when I started in 2003.  Now I have lots more training and certification in childbirth education, new parenting stuff, and am also a massage therapist so offer extras there too.  My fee since 2003 has gone up $300.  I actually had one fee as an uncertified doula and then went up once I got my certification, and then went up when I became a certified childbirth educator and then went up again when I became a massage therapist and started offering that.  I didn't go up with experience, but went up with further education.  

 

Also curious about how people handle having small children and being on call???  It was very hard when I first started out although at that time my youngest was 2 yrs old, but now I just have one of my adult children care for the younger ones if the birth happens at night because my husband works overnights and if it happens during the day my husband is here.  Having reliable childcare is essential to being able to do this work.  If you are stuck worrying about your kids you can't be there for the mother 100%.


Michelle married to my highschool sweetheart and mom to: DD '88, DS '90, DD '91, DD '94, DD '97, DD '98, DD '01, DD '08, and DS'09

(Non-profit Organization Director and Program Coordinator / Doula / Educator / Massage Therapist)

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Old 04-01-2011, 02:25 PM
 
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I offer 3 prenatals - 1 for birth planning, 1 for breastfeeding, and 1 for newborn care. I also offer customized information by email (ie if they have questions they can't find the answers to I'll send them reliable links etc), and access to my library. I sometimes end up meeting with clients a fourth time if they really need the additional contact, and sometimes only meet with clients once after the initial consult/interview. I leave it up to the discretion of my clients.

I typically do one postpartum follow-up visit to wrap things up, but will make additional visits for extra breastfeeding support if they need it. I remain available by phone/email/fb etc for roughly 3 months postpartum.

I have always offerred flexible fees - telling clients what my fee is, and also reassuring them that I will go lower if that is necessary for them to have the doula care they desire. I charge $750 now, which is about the middle range for my larger service area. I will go as low as $450, which is what I need to charge to cover my costs, and is what I started out charging 7 years ago. I will do free births when needed, generally only for teens. I have raised my prices as I have gained experience, education, and in keeping with what other doulas in our area charge.
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Old 04-01-2011, 05:40 PM - Thread Starter
 
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great info ladies! nutter can ask what your costs are that need to be covered? i was planning on doing my first several births for free, but lots of people that i have spoken to are telling me i should charge a low fee. typically a doula around her charges between $600-900 a birth. I was thinking of charging around $200 to start, but some doulas I spoke with told me I should charge $400. What do you guys think? I have only been to one birth aside from my own two, but do have a good knowledge of pregnancy and birthing. i am sure i have a lot to learn as a doula though and i am working on my certification now. 

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Old 04-02-2011, 08:16 AM
 
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great info ladies! nutter can ask what your costs are that need to be covered? i was planning on doing my first several births for free, but lots of people that i have spoken to are telling me i should charge a low fee. typically a doula around her charges between $600-900 a birth. I was thinking of charging around $200 to start, but some doulas I spoke with told me I should charge $400. What do you guys think? I have only been to one birth aside from my own two, but do have a good knowledge of pregnancy and birthing. i am sure i have a lot to learn as a doula though and i am working on my certification now. 


I include the following in my hard costs:

maintaining certification
continuing education
marketing/PR
tools & materials
home office space
gas, mileage, parking
(some women need to include childcare costs)
- I calcutate these costs each year for my income tax, divide by the average number of births I have in a year, and the result is my average hard cost per birth.

I also include the soft cost of my time:
- how many hours do you spend with a client in-person prenatally, average birth length, postpartum?
- how much time do you spend on the phone or emailing/texting with a client?
- how much time do you spend researching answers to client questions?

Whether you pay yourself minimum wage, the same hourly rate as you make in a day job (if applicable), a rate comparable to what a similiar profession makes (like a personal support worker perhaps?)... doesn't matter so much as acknowledging that your time is worth something. The service would not exist without the time that you put into it, and so your time should be included as a cost IMO.
If you choose to volunteer all or a portion of your time, then I think it's important to let potential clients know that your reduced fee is a result of volunteering your time. Otherwise down the road it can lead to confusion amongst the public, and hard feelings between doulas, when one doula charges way less than the community average. Some doulas do all their births for free or very low cost because they feel it is their calling, or because they don't need the money. Which is fine for them, but if potential clients don't understand that these doulas are choosing to volunteer their time then it makes the rest of the doula community look like they are being greedy, overcharging, etc. That's been my experience anyhow. So volunteer your time if you want to, but make sure your clients know that you are volunteering your time because of where you're at in your life at this time, NOT because all doulas always volunteer their time. Of the 7 births I've had in the past 5 months, 3 have been volunteer births, and one was a reduced fee birth so I'm not opposed to volunteering when needed! But all those clients know that they received a service which was *worth* something. That's my two cents anyhow!
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Old 04-02-2011, 09:48 AM
 
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1-2 prenatals, 1 postpartum.  unlimited phone/email support.  I charge mid-range for my area.  

 

I have 3 kids and a VERY supportive husband with a flexible job.  I also have a neighbor who can watch my kids in a pinch.


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Old 04-03-2011, 08:50 AM
 
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I am a new doula also and attending births to complete my certification. So far I have done 1 prenatal (my package is 2 but this was their 3rd births and didn't feel anymore was necessary), email/phone support, and 1 postpartum. 

 

My first birth was free (she was a close friend), my 2nd birth was $100 and I am asking $250 for my 3rd birth. The range in my area for experienced doulas is $500-$1000.

 

The small children thing is the hardest part for me. I have a almost 3 yr old and almost 1 yr old. I have pretty good support and if I just can't find anyone to watch them my husband will stay home. I have asked a couple friends, relatives, and other doulas if I can call them to watch the girls. So I will just go down the list until someone is available. The hardest part has been the following day. I am so exhausted and it's hard to take care my kids but I manage. I am only doing 1 birth a month max until my kids are older.

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Old 04-03-2011, 01:36 PM
 
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Regarding fees while you're in training: When I started, I had heard stories about doulas putting a lot of energy into the prenatal visits for their unpaid certification births, and then not even getting called for the birth. My husband (who is a professor of entrepreneurship) told me that "people value what they pay for, and don't value what they don't pay for". 

 

I decided to print up my contract with the fee that I planned to charge after I had completed my certification ($400- the low end of the range in my area). Then during our discussion, I pointed that number out, explained it, crossed it out, and told them they could pay what they felt. That worked really well for me in that I felt confident that I was not overcharging them, and over the course of my 6 certifying births, I ended up earning nearly what I would have earned if I'd charged the $400. 

 

I also gift one birth a year to a client who would not be able to pay my fee, and plan to have reduced rates for 2nd-time clients.

 

Have fun!

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Old 04-04-2011, 04:24 PM
 
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Subbing to read after work!


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Old 04-07-2011, 04:48 PM
 
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Quote:

Originally Posted by Growing Mamas View Post

Regarding fees while you're in training: When I started, I had heard stories about doulas putting a lot of energy into the prenatal visits for their unpaid certification births, and then not even getting called for the birth. My husband (who is a professor of entrepreneurship) told me that "people value what they pay for, and don't value what they don't pay for". 

 

Yes, this is a big one.  My first client ever, I had two meetings with her, email consults, and lended her some books from my library. I found out via facebook that she had delivered her daughter, and the comments/photos surrounding it lead me to believe she actually invited another doula who was her friend along. She never called me, but said it was because the birth went too quickly. It was a 14 hour birth.

 

People do value you as an equal more I think when there is a charge involved, even if it's as low as $100. It helps them to see you as a professional. I think laying out your own costs for the clients as well helps, because it helps them to see the work that goes in. I I had a client wait to call me until she was already at the hospital, even though I had stresed several times to call me as soon as they thought she might be in labor so I had time to organize everything and get down there. Then I think they were a bit miffed that I wasn't there within 30 minutes.

 

The point-- yes, Charge a fee, even if it's a negligble one, and I do think the idea of going through your breakdown of costs is a very good one.


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Old 04-07-2011, 07:05 PM - Thread Starter
 
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This is great advice! I am glad to have some encouragement to charge because I was planning on doing a bunch of free births to start out. So I was thinking of charging $200 to start since that will at least cover my expenses. How do most people handle back up? Do you pay your back up doula a percentage of your fee for being available? And if you use the back up how do you pay her?

 

 

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Old 04-07-2011, 08:05 PM
 
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Originally Posted by jeninejessica View Post

Quote:

 

Yes, this is a big one.  My first client ever, I had two meetings with her, email consults, and lended her some books from my library. I found out via facebook that she had delivered her daughter, and the comments/photos surrounding it lead me to believe she actually invited another doula who was her friend along. She never called me, but said it was because the birth went too quickly. It was a 14 hour birth.

 

People do value you as an equal more I think when there is a charge involved, even if it's as low as $100. It helps them to see you as a professional. I think laying out your own costs for the clients as well helps, because it helps them to see the work that goes in. I I had a client wait to call me until she was already at the hospital, even though I had stresed several times to call me as soon as they thought she might be in labor so I had time to organize everything and get down there. Then I think they were a bit miffed that I wasn't there within 30 minutes.

 

The point-- yes, Charge a fee, even if it's a negligble one, and I do think the idea of going through your breakdown of costs is a very good one.


While I agree I also think that if people invest themselves in the relationship then they can value it too.  Many years ago when I was first starting as a doula I joined a group that offered doula services for free and many of the doulas had no calls, but I didn't have a single one.  I think the main reason for this was because I made sure they were invested in our relationship ju.  st as much as I was.  What I did to accomplish this was made my expectations very clear and then when I would leave the prenatals I left them with "homework".  I made them understand that I would not come back and do another prenatal or do their birth unless their homework was done (of course if they gave birth early I made the exception and went to the birth).  

 

I always called them the day before I was to do the next prenatal and ask them if they finished whatever it was that I left for them and if they didn't I told them we would have to reschedule and simply wouldn't do the next prenatal.  I found that really helped to get them invested in what was happening.  If they didn't do their homework, I would most likely have rescheduled.  It hardly happened that they didn't finish and in I believe almost every single case they assured me it would be done when I came, and I always reminded them that if I got there and it wasn't done I would simply leave.  

 

Some might say that is mean, but I wanted to work with people who wanted me to be there for them.  If they weren't invested I felt that my services would have been valued more elsewhere, and I let them know that.  Like I said I never once had a no call, while the group I worked in had many.  

 


Michelle married to my highschool sweetheart and mom to: DD '88, DS '90, DD '91, DD '94, DD '97, DD '98, DD '01, DD '08, and DS'09

(Non-profit Organization Director and Program Coordinator / Doula / Educator / Massage Therapist)

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Old 04-08-2011, 05:52 AM
 
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I do 3 prenatals and 1 postpartum visit with families.

 

I charge $600 and am willing to negotiate with people who honestly can't afford that. I was charging $450 until recently. When I first started out I was willing to do anyone's birth for free, but after the amount of work that I end up putting in, I think that people who are able to pay should pay.


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Old 04-10-2011, 08:35 PM - Thread Starter
 
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Loving all this great info! Can I ask what do peoples prenatal visits entail?

 

 

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Old 04-11-2011, 06:21 AM
 
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These are what mine consist of, but I am also very flexible and will add or subtract based upon the families needs. (Btw - the whole massage stuff is because I am a licensed massage therapist).

 

 

 
  • Prenatal One:

    • Healthcare provider compatibility

    • Learning what you really want for your birth and how to get it

    • Birth Planning

    • Happiest Baby on the Block

       

  • Prenatal Two;

    • Discussing interventions

    • What is in your doula's birth bag?

    • Practice comfort techniques
     
  • Prenatal Three:
    • Labor Support Practice
  • Prenatal Four: (optional-available in the full package only)
    • Pregnancy massage class - birth partners learn massage techniques to help mom

Michelle married to my highschool sweetheart and mom to: DD '88, DS '90, DD '91, DD '94, DD '97, DD '98, DD '01, DD '08, and DS'09

(Non-profit Organization Director and Program Coordinator / Doula / Educator / Massage Therapist)

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Old 04-11-2011, 05:51 PM
 
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In a prenatal we fill out a preferences sheet that has a bunch of options listed and how much they think they will want/not want that in labor, as well as a list of interventions with a range of options of how much they desire to avoid that particular intervention.  We talk about comfortable positions for the end of pregnancy and during labor, discuss when to call me, what times/phone numbers to use, if they want me to come to their house or prefer for me to meet them at the hospital.  

 

I send them my forms ahead of time so that they have time to do their own research.  My prenatals are not a childbirth class (I teach those as well, if they want one, but there's no way I can give them all the information they need in a 2-3 hour prenatal)


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Old 04-14-2011, 03:12 PM
 
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Momto9kidlets: may i ask what kind of homework you gave your clients? I think this is a good idea but was the homework concrete ? We were given exercises to practice in my CBE class and nobody did it...most likely because there was no incentive.

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Old 04-14-2011, 10:09 PM
 
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Momto9kidlets: may i ask what kind of homework you gave your clients? I think this is a good idea but was the homework concrete ? We were given exercises to practice in my CBE class and nobody did it...most likely because there was no incentive.


It depended on the client.  It might have been creating a birth plan, or if I knew they were meeting with their doctor it might have been to talk about their birth plan and have it signed, or it could have been to ask their doctor a question.  Sometimes I assigned taking a tour of their birth place - that was before the hospitals in the area made people sign up for scheduled tours.  It really depended on the client.  Sometimes the "assignment" just came out of the prenatal and the education portion I was doing with them.  It was never something that was so impossible that they couldn't complete it, but it was something that they had to do.  

 

As far as the incentive goes - it was simple....I called them the day before I was supposed to meet them (remember they knew this was going to happen because I told them) and they knew that if they didn't do the "homework" I simply wasn't going to come.  If I didn't come and we didn't finish the prenatals I wouldn't attend their birth.  I think the difference between what I was doing and a childbirth class is that we were working one on one, and I wasn't coming back to their house if it wasn't done.  With a class you can't tell someone to get out of childbirth class if they didn't do the homework.  There are no incentives in childbirth class, but in doula work the incentive was that they would have a doula present.  I won't lie - I had a few who tried to not do the work, but when I called them and they said they didn't do it I reminded them I wasn't coming and then they quickly found the time to do it.  Along with that I also made myself perfectly clear that I would call them the day before and if they didn't answer I also wouldn't come the next day because the phone call i made was also our confirmation that we were still on for our meeting.  So I also didn't do a prenatal if I didn't talk to them the day before because teens can "forget" and I didn't want to drive to someone's house and them not be there.  

 

My husband used to tease me because he said I was acting like I was their mom.  The benefit was that I was experiencing my own children being teens at the same time so I thought like a teen and strategized like a mom (thankfully none of my teens were horrible, but they made me think at times :o) )

 


Michelle married to my highschool sweetheart and mom to: DD '88, DS '90, DD '91, DD '94, DD '97, DD '98, DD '01, DD '08, and DS'09

(Non-profit Organization Director and Program Coordinator / Doula / Educator / Massage Therapist)

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Old 04-16-2011, 06:09 AM
 
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Curious to know what other doulas offer in terms of pre and post natal visits?  I do an informal "interview" visit for us to get to know each other and decide if we are a good match. Then 1-3 prenatal visits (depending on the couple/mother) and 1 postpartum visit. The prenatal visits consist of Q&A, discussing and lending books, birth plan prep, and going over positions/comfort measures and my doula bag. 

 

Also, what do folks charge and how long did it take you to get to your current pay rate?  I did 6 births for free as part of my training with ALACE (May 2007). I then charged $250 for my next several births and went up $50 per year as I increased in experience. It took me almost 3 years (and 30 births) to get to my current fee which was $350 as of April 2010. I was 3 months pregnant then and haven't done any births in the interim due to my pregnancy and the fact that I made an international move in June 2010 :) I'm planning on starting up again in November 2011 after my baby turns 1. 

 

I charge $100 up front at the first prenatal visit to cover my gas expenses and the prenatal visits. Then the remaining $250 is due at the postpartum visit. That way, even if they don't call me for the birth I still am compensated for what I've already put into the relationship. I've only been burned once, ironically by a "friend". She hired me and asked if she could pay me $50 at each of the first two prenatal visits instead of $100 all at once. I agreed, she paid me the first installment, and then went into labor early. THEN she called me to her birth (where I paid for the parking garage) and decided 2 hours later that she wasn't comfortable with anyone in the room besides her mom (she was single), and sent me home. She never paid the remainder that she owed (the other $50 and my parking stub), since she said "well you didn't attend the birth!", and I was super busy preparing for my move so I didn't bother trying to collect. 

 

As far as the "no experience, no pay" debate...as I said above, I did my first 6 births for free. However, I had a baby doula at my birth (I was her first birth besides her own 2), and I paid her gas expenses (childcare was free as her mother lived with her, otherwise I would have covered that also). I do firmly believe in doulas volunteering their time until they can offer experience to their clients. But I do NOT think a doula should have to pay out of pocket to attend someone's birth, like I did (I was young and passionate, and didn't care :D ). So that's my three bucks of opinion, and I'm not here to start a debate----there are really good points on the side of charging even if you have no experience. When I look back at my first few births, I cringe to think of the uneducated statements I made (innocently) and the actions I could've taken versus the ones I did. The services I offer now is ten times more valuable then the services I offered 4 years ago when I first began, IMO. 

 

Also curious about how people handle having small children and being on call???  I was childless when I practiced before, now I have a close friend who is willing to be an on-call babysitter. Unfortunately she is moving away in February 2012, so I will have to start networking now for a replacement once she leaves. I will drop him off at her house on the way to the birth. 


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Old 04-16-2011, 02:09 PM
 
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1 consultation, 2 Prenatals and a postpartum here

 

Consultation- just meeting, getting to know each other, give them the information about what I do, what I don't do and the statistics associated with doula care. 

1st Prenatal- talking about interventions, creating a list of birth preferences, talking about fears, worries, what the client is looking forward to, postpartum preferences and newborn care preferences

2nd prenatal- visit in their home to practice coping techniques, positioning and to talk about what to expect, stages of labour, etc. 

Postpartum- see how she's coping, how breastfeeding is going, talking about any issues or questions she might have, referring out to public health nurses or LCs as necessary


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Old 04-20-2011, 10:07 PM
 
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2 prenatal visits, 1 post partum visit.  Unlimited phone and email support.  I charge on the low end for our area at $400 thumb.gif


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Old 04-25-2011, 01:30 PM
 
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I offer 2-3 prenatal visits and 2-3 postpartum visits. I'm also starting out so I'm currently not charging :)


Amber ******

Birth Doula, Placenta Encapsulator, & Birth Photographer in Southeast Michigan

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Old 05-07-2011, 02:07 PM
 
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this is great info!  I am also just getting started (havent even attended any births yet), but am so looking forward to this journey!  I am leaning towards doing a couple freebies to start.  It sounds like 1 interview, 2 prenatals, and 1 postnatal is the norm?  And how many of you ladies offer an "extra"?  Like, massage, photography, and other childbirth education like bradley or hypno? 


Rockstar, hippie, pirate mama to W (3-2-10), wifey to S for 2 years and going strong

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Old 05-07-2011, 06:36 PM
 
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I offer childbirth education (hypnosis for birth and brio birth), happiest baby classes, infant massage classes, couples massage for labor and massage therapy (I am a licensed massage therapist - hence being able to offer those).  Oh yes and I am a postpartum doula.


Michelle married to my highschool sweetheart and mom to: DD '88, DS '90, DD '91, DD '94, DD '97, DD '98, DD '01, DD '08, and DS'09

(Non-profit Organization Director and Program Coordinator / Doula / Educator / Massage Therapist)

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Old 05-09-2011, 06:51 AM
 
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I offer independent childbirth classes, limited birth photography (included in birth fee), lending library use, and I'm a postpartum doula also. 


Proud wife to my handsome husband partners.gif Malachi David (2010) and Jeremiah Daniel (2012) joined our family via two lovely homebirths. Rainbow.gif Doula for 7 years and now finally an apprentice midwife! bellycast.gif 

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Old 05-10-2011, 08:38 PM
 
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Quote:
Originally Posted by Piratelady2525 View Post

this is great info!  I am also just getting started (havent even attended any births yet), but am so looking forward to this journey!  I am leaning towards doing a couple freebies to start.  It sounds like 1 interview, 2 prenatals, and 1 postnatal is the norm?  And how many of you ladies offer an "extra"?  Like, massage, photography, and other childbirth education like bradley or hypno? 



 

No CBE or anything like that, but I offer placenta encapsulation (for a discounted fee for doula clients), birth photography (for a $50 add on  VS $150 normal rate), and belly casting.


hippie.gif Hi, I'm Amber

Ava {12.20.08}  Levi {8.19.10}  Aspen  {EDD 7.21.13}

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Old 05-11-2011, 08:42 AM
 
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Loving all this awesome advice!  I'm also starting out and trying to decide what to charge.  I was discussing with a local doula if I should do my DONA certification births for free or for a discount and her advice was that no matter what my time is worth somthing.  When they first started studying doulas all a woman did was sit in the room with a birthing mother and smiled, she didn't say anything or do anything.  The intervention rates still went way down!  So just about anything you do is more helpful than just sitting in a corner and smiling!


hippie.gifmom to DS 9/8/8 sleepytime.gif, married to my best friend since 10/15/05 love.gif, asl.gif,lactivist.gif, After TTC #2 for a really long time we're expecting #2 in December!  Hope to h20homebirth.gif, Doula in the Indianapolis area, PM me if you want to talk!

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