Prenatal Support

If you know ahead of time that you will be having a C-section, you can do a lot of things to prepare. During your pregnancy, your doula will:

• Create a birth plan. Even during a C-section, you have a lot of options to review. Your doula will help you and your partner by giving you the information you need to make choices about your birth. You then will be able to discuss these preferences with your care provider so everyone is on the same page. Later this week, I will talk about the options that you have to consider when planning a c-section. 
  


• Prepare for your C-section. Your doula will spend at least two prenatal during your pregnancy. During these visits, a doula will direct you to information outlining what to expect before, during, and after your C-section. 
  


• Create a Postpartum Plan. Your doula will help you put a plan in motion for when your baby arrives. She will help you set up meal trains, help in the home, and any postpartum doula services you may need.
  


• Practice Relaxation Techniques. Your doula will help you learn and practice different relaxation techniques to use during your C-section. This will help maintain a calm and peaceful environment while you’re being prepped for the OR.
  


• Process any Fear or Anxiety. For some women, planning a C-section can be scary or disappointing. Your doula will work with you to help you process and confront any of these feelings before your C-section (if it’s planned)
  

Pre-Op Support

When you arrive to the hospital to be prepped for your C-section, your doula can:

• Help you and your partner navigate fears. If you are having a hard time with fear and anxiety, your doula can help you relax using various methods such as focusing on breathing, visualization, and massage. She will also be there to help your partner with any fear or anxiety before heading into the OR.
  


• Take photos. Your doula can take photos of the pre-op process so that your partner can focus all their attention on you and your impending birth. Documenting the whole process can be incredibly important for remembering and celebrating the birth of your baby. 
  


• Hand out Birth Plans. Your doula can ensure that everyone who will be in the room during your C-section has your birth plan so that they all know what your wishes are. 
  


• Keep Family Updated. Naturally, many family members may be at the hospital with you. Your doula can give them updates on your status during pre-op so that you and your partner can relax and focus on preparing for the OR.
  

Inside the Operating Room

Sometimes, a doula is not allowed to be in the operating room with you, but this is not always the case. Ultimately this decision lays with your anesthesiologist so discuss this with your care provider ahead of time. During your C-section, your doula can:

• Take photos. Just like pre-op, your doula can take beautiful photos of the entire process so that you are able to remember/celebrate the birth of your baby. This way your partner can focus on you. 
  


• Explain what is happening. Your doula can also regularly update you and what is happening as surgeons don’t usually do this. This way you know what your surgeon is doing and when your baby is being born. 
  


• Remind staff of birth preferences. While your doula cannot speak for you, she can gently remind staff/your partner of birth preferences. Surgeons and staff can be so used to normal hospital protocol that preferences can be forgotten during the birth. 
  


• Be by Your Side. If you do not want any photographs or information during the surgery, your doula can simply be at your side to physically support you during the birth. 
  


• If Your Doula Cannot be in the OR. She can coach your partner on how to comfort you and suggestions for photographs. She can remain with your family and encourage and support them while they wait for updates on you and baby. 
  

After Birth:

After the birth of your baby, your husband will likely accompany your baby to the nursery. Before surgery, you can discuss the possibility of your doula joining you for the remainder of your surgery/during recovery. This will need to be discussed during pre-op as your doula will need to scrub up. Other options of support after the birth include:

• Assistance feeding your baby. Your doula will help you with comfortable nursing positions if breastfeeding or she can help you with formula feeding guidelines for a newborn. Nursing can be especially difficult postpartum because of pain so comfortable positioning is key.
  


• Comfort Measures. Your doula can help with different techniques to be as comfortable as possible during your recovery.
  


• Postpartum Visits. Typically, because a doula spends much less time with you during your C-section than she would during a typical birth, she will likely come to your home at least twice for postpartum visits. During these visits, your doula will help you process any feelings or thoughts you have regarding your birth. She will help with feeding concerns. She may even help you with any chores or housekeeping tasks you can’t do during recovery. 
  

As a mom who has had an emergency C-section and a vaginal birth, I can say I needed a doula much more for my C-section. There are so many different demands and challenges that go with a C-section birth and I encourage any woman who is preparing for one to reach out to a doula. She will be an invaluable resource to you during your pregnancy, childbirth, and postpartum period.

My last post discussed why a doula charges so much. It can be confusing for some people to figure out how a doula sets her fee. Now that we have all of that sorted out, lets talk about the new problem: how in the world can you afford a doula if money is tight? There are thankfully several ways to pay for the cost of a doula if it is not necessarily in your budget!




1. Ask your insurance company if a doula is covered!
There are multiple insurance companies that are now reimbursing for doula services! This varies by plan and company so check with your provider before any other option is explored!

2. Use your FSA or HSA
Anyone with a FSA or HSA should look into being able to use the funds available for paying your doula costs. Many of them offer this option. 

3. Add doula services to your shower registry.
We add so many things we may never even use to our registries (how many of us end up giving away extra baby clothes??) Instead of letting people guess what you need, add doula services to your registry! Someone may just end up seeing this need and helping you take care of it!

4. Ask if your doula offers gift certificates. If so, tell your friends and family!
Always ask your doula if she accepts gift certificates! For the record, I do! All your family members need to do is contact your doula via her website and purchase the certificate. You would just need to bring the certificate to a prenatal meeting to redeem it for services.

5. Find out if your doula offers payment plans.
Most doulas understand that not everyone can just drop 600.00 in one sitting. I certainly do. Ask your doula about a payment plan. I, for example, am happy to sit with a couple and outline when they expect to make their payments. we just include it in your contract. As long as payments are made before I go on call at 38 weeks, then you're all set to go!

6. Barter!
Are you a photographer? Do you knit or make clothes? Are you a painter? Any skill you have at all can end up being your method of payment for a doula! I personally have bartered birth doula services in exchange for family photography sessions! It is a win-win situation for everyone!

7. Cut out non-essential spending (e.g. going out to eat) and save over time.
If you have exhausted all other resources and those are not options, one thing that will almost work is to put yourself on a budget. I find if something is very important to me, I make it a priority over things like new clothes, eating out, movie dates, etc. 

I hope this list helps reassure you that while doulas can be difficult for some families to afford, it is possible! Just be honest with your doula, and seek out help where you can!

Have you ever asked yourself, “why do doulas charge so much? I really want one and I know they're important, but I can't justify the cost!” 

Today I am going to break down the answer to your question! I will use my own fees and personal expenses as an example to illustrate what work is performed and how much of my own money is put into your support. For the example, I will use my "Birth Doula Support" package. It can be seen that the "C-Section Birth Support" package is set at the same fee. This is because while I spend less time at your birth, I spend more time with you during postpartum visits. 

Birth Support Package:

• Initial Consultation (Average 2 hours)
  
• Two Prenatal Meetings (Average 4 hours)
  
• One Provider Meeting (Average 2 hours)
  
• Assistance Creating Birth Plan (Average 2 hours)
  
• Phone/email Support during business hours (Average 5 hours)
  
• 24/7 on-call Availability from 38-42 Weeks: I cannot put an average time on this. Simply put, at this time I am unable to travel, drink alcohol, or make firm commitments of any kind. I must available to come to you at a moments notice.
  
• Continuous Labor Support (Average 14 hours)
  
• Immediate Post-birth Assistance (Average 2 hours)
  
• One Postpartum Meeting (Average 2 hours)
  


Personal Costs:

• Travel Time: Average of 25 miles one way for five trips ( 7 Hours)
  
• Gas Costs: (calculated using this MPG calculator, based on 25 miles one way for five trips: $50.00)
  
• Childcare: Average five trips (based on $20.00 per session: $100.00)
  
• Food: (based on an average of one meal while at your birth: $10.00)
  
• Hospital Parking: (average of $5.00)
  
• Materials for client (average of $20.00)
  
• PayPal fees: 2-3% ($12.00) 
  

Total Time/Money Spent:

When we add all of the time and money spent during my contract, we get these grand totals for the average birth:

Time: 46 hours
Money Spent: $197.00

So now based on my fee of $600.00, lets see how much I make per hour before taxes:

Current total fee for Birth Support Client: 600.00
Expenses: $197.00
Remainder: $403.00
Pay rate: $8.76 per hour before any self employment or income taxes are deducted.

So when you see a doula charging a fee you feel is too high, remember this breakdown. You are really paying for a priceless service! And I doubt anyone would ask a midwife or doctor to discount or waive their fee!

As a doula, I love what I do. I love my clients. I love being invited to participate in such an amazing moment in their lives. However, I also work very long hours, put forth a lot energy, and spend my families money in order to meet my clients needs. Doulas definitely deserve to be paid, at the very least, minimum wage for what they're doing for your family.

On Suze Ormon's show, a caller asked Suze if she could afford a doula. She ends with the conclusion that a doula is NEED and not a WANT! You can view the clip here.


Next week, join me in discussing the various ways to afford a doula if finances are tight!