Are Doulas Worth It? Fees, Pros, Cons, Services Given & More

Are you interested in learning about all aspects of childbirth? Perhaps you have already chosen a specific birth plan, including your preferred pain relief methods and delivery location.

More and more mothers-to-be are putting their trust in doulas to make sense of this pre-baby overwhelm, but are doulas all they’re made out to be?

Studies have revealed that doulas can produce many benefits, such as lowering the rate of medical interventions, reducing labor times, and greatly easing the mother’s anxieties about childbirth. Doulas can be quite costly, however, so personal budget and birth plans will factor into the decision.

Whichever ideal birth scenario you have in mind, there are many ways in which a doula can help during your labor (and even beyond, depending on which doula services you require).

Want to learn even more about doulas? Check out our Top Questions About Doulas article.

Let’s find out what kind of services these are plus how much doulas cost, the pros and cons, and more.

Understanding the Purpose of a Doula

The term doula is sometimes used interchangeably with professional perinatal roles like your OB/GYN or midwife, making it pretty confusing as to what being a doula actually involves (or doesn’t involve).

Let’s clear a few things up about doulas — starting with their job description…

What Does a Doula Do?

In the weeks preceding their client’s due date, a doula acts as an advocate and go-between for the mother to ensure her birth plan (medicated or unmedicated, home or hospital birth, etc.) is understood and respected by her medical team.

Doulas will also answer any questions and concerns the mother has to help reduce fears surrounding childbirth.

Essentially, a doula’s objective is to ensure a positive birth experience for their client, so they will typically provide advice on pain and stress management, such as perineal massage and breathing techniques before and during labor, in addition to lending emotional support throughout the process.

What’s the Difference Between a Midwife and a Doula?

Midwives undergo “rigorous medical training before being certified by the American College of Nurses Midwives” explains Amy Kayler, midwifery director at Northside Women’s Specialists in Atlanta.

They are trained to deliver your baby and have knowledge of both common complications and emergency scenarios in pregnancy, labor, and birth.

Unlike doulas who mostly provide emotional and mental support, midwives schedule prenatal appointments to assess mom and baby’s health and cannot be substituted with a doula.

Benefits of a Doula

  • Research has shown that doulas can ease anxiety and pain during labor, improving mental outcomes.
  • Midwives and doctors change shifts, so your doula can take over when you need that extra emotional or mental boost.
  • Many doulas are trained in massage which, according to physicians, can result in a higher pain threshold and increased uterine contractions due to a stimulation of natural oxytocin in the bloodstream and brain.
  • Doulas are your cheerleader! They are there for emotional, physical, and mental support and can fight in your corner when it comes to preserving your pain relief and delivery preferences.

Disadvantages of Doulas

  • The expense – On top of medical bills, hiring a doula can be an unaffordable luxury depending on your circumstances.
  • Lack of medical expertise – Your professional labor and delivery team can field all the clinical/medical concerns you or your partner have, and in the moment, you could feel that you would rather lean on them than your doula.
  • Getting in your partner’s way – Some parents like mom-of-two Alexis from Bless Our Littles worry that a doula could get in the way of the shared experience between you and your actual birth partner:

“I knew that when I was in pain I would only want my husband there. I worried that this experience wouldn’t be about him and I becoming parents and instead be about the doula.”

What Can Doulas Not Do?

Doulas cannot perform medical tasks, provide medical advice, or make diagnoses of any kind.

They will not help deliver the baby, pressure the mother or partner into making medical decisions, or perform any clinical procedures such as vaginal exams or fetal heart monitoring.

How Do Doctors Feel About Doulas?

Some medical professionals feel that a doula’s presence can be a good thing as they help to fill in the gaps, such as providing massage, ice chips, etc., that can’t always be met due to the enormous responsibility of a nurse and midwife team.

However, patient studies have revealed that doulas can often be viewed with animosity and resentment by medical teams due to conflict over their roles and whether they are acting in the patient’s best interests.

Role of Doulas After Birth

Most doulas will help the mother in her emotional and physical recovery from birth as well as providing assistance with breastfeeding and offering coping skills for both parents.

Doulas can extend their services for a few days or even weeks and months after birth.

Is Having a Doula Worth It?

There is a lot of evidence to show that doulas can have a positive impact on birth outcomes, such as fewer rates of cesarean births, fewer epidurals, and reduced labor time.

Ultimately though, your specific birth priorities and financial circumstances will determine whether hiring a doula is worth your while.

A doula assisting a pregnant lady with floor exercises.

How Much Does a Doula Cost?

Depending on location and whether doulas charge per hour or a flat rate per birth, doula services can cost anywhere in the region of $800-$2,000 in total.

This covers things like call and text support, prenatal visits, unlimited labor support, postpartum visits, etc.

Are Doulas Covered by Insurance?

Generally, as doulas are not medical professionals, they don’t fall under “essential care,” so they won’t be covered by most insurance companies in the US.

You may need to file a reimbursement claim with your insurance company once the doula has been paid in full for their services.

What Is a Postpartum Doula?

Postpartum doulas assist in the overwhelming period after birth, helping in practical ways (such as preparing meals and light housework) in addition to aiding your physical recovery and providing breastfeeding support, as some doulas also train as lactation consultants.

Postpartum Doula Cost

Postpartum doulas may charge as little as $25 per hour or up to $65 an hour or more in larger cities. Rates will depend on their experience, training, and unique services provided.

Are Postpartum Doulas Covered by Insurance?

Doula roles are not classed as “essential care” so postpartum doulas are not usually covered.

However, some insurance companies are increasingly recognizing the positive impact of doulas on lowered birth costs with some permitting some form of cover/reimbursement for certified doulas.

You can learn more about requesting insurance reimbursement for doulas here.

Is a Postpartum Doula Worth It?

Postpartum doulas can offer the practical and emotional support you crave in those first crucial days and weeks after delivery, empowering your recovery and transition into motherhood whether this means assisting with latching issues or catching early signs of postpartum depression.

If you have a limited support network and childcare stresses, then having a doula around after birth may be a worthwhile expense for you.

Related Questions:

Can a Doula Deliver a Baby?

No. “We’re not medically trained to deliver babies or to know all the different signs,” explains birth doula and birth plan advocate Elizabeth Joy.

Instead, doulas provide emotional and informational support to their clients to help encourage a positive delivery.

Are Doulas Licensed?

Doulas are not formally required to obtain a license or medical training.

However, many doulas choose to complete doula training programs with organizations that provide certification such as DONA (Doulas of North America) International and ICEA (International Childbirth Education Association).

Closing Thoughts

As we’ve learned, doulas can have a positive impact on mothers during pregnancy and labor with many studies pointing to beneficial birth outcomes.

Remember though that while many doulas are certified and well-trained, they can never take the place of a midwife or nurse. They can also be quite pricey!

Consider what kind of birth you hope to achieve, and see whether a doula makes sense in your plans.