Tuesday, July 15, 2008

Can I Afford A Doula?

This question is a big one in the doula community and I am sure for those deciding whether or not to hire a doula.

A better question would be can I afford not to hire a doula?

With the c-section rate sky rocketing and the financial burdens that accompany having a c-section it might be seen as penny wise pound foolish not to hire a doula.

The World Health Organization believes that c-section rates should not exceed 15%. Currently the statistics show that 30% of all healthy pregnancies are ending up in c-sections in the United States. Most of them are unnecessary.

In NYC the rate is closer to 50%.

We are one of the most educated generations. Most moms-to-be are going to birthing classes and reading tons of books and yet the c-section rate is climbing.

Acoording to womensenews.org, in 2005 the average cost of a vaginal birth was $5,574 compared to $11,361 for a c-section.

I know I know...YOU aren't paying for it, your insurance company is.

In the June 1, 2008 edition of the NYTimes, writer Denise Grady tells us that many insurance companies are dropping women who have had c-sections because they are pretty much a guarentee that another c-section will be incurred due to the pressure from hospital policy, not medical evidence. So where does having a c-section lead you then?

Aside from the financial aspects of having an unnecessary c-section the physical risks are as follows:

- blood clots, strokes, emergency hysterectomy, infection, long lasting pain, fertility problems, placental problems in later pregnancies such as ectopic or abruptions.
Generally the recovery time is six weeks without complications.

babies -
- breathing problems, surgical injury, reduced breast feeding and asthma in later childhood.

I think it is really amazing just how many books moms today are reading. However, much like reading about how to ride a bike, it's just not the same until you experience the situation.

Childbirth has so many variables today that one cannot possibly be expected to know how to handle them without a trained doula by her side. There's so much pressure to follow what the doctor wants you to do and those of us who have been to many births know that there is very little consistency in what those protocals are. The only consistancy most of us do find is the push to comply with interventions that have a high rate of ending in c-sections.

That is why study after study for more than 30 years have concluded that having a doula with you even when your spouse is available and supportive, halves your chances of having an unnecessary c-section as well as shortening labor time and pain levels.

A great book to get you started on the truth about birth is by Ina May Gaskin called Ina May's Guide to Childbirth.

In NYC currently the average cost of an experienced doula (10 or more births is ) $1500-$3000. A Trained Doula with less than 10 births and/or going for her certification usually charges $500-$800. On Long Island the average charge is $1000-$1500 for an experienced doula.

Doulas visit with you before the baby is born to discuss your birth wishes, work with you from the time active labor starts until one hour after the baby is born, and visit again once to see how you are doing and give you information on postnatal support professionals if needed. Doulas are also on call the two weeks leading up to your due date and take unlimited emails and calls from you.

The average hourly wage for most doulas fees amount to $10-$25 an hour and in most cases about one-weeks salary in the NYC area.

We understand that in some cases for some income levels this is not affordable. If you earn $30K or less in the NYC area these fees can be adjusted. Many doulas will also do volunteer births for teenagers.

For middle income couples a trained doula might be your best option while those earning slightly less might ask for reduced fees or payment plan options. If having a doula with more than 10 births is very important to you then hiring a doula at the higher range of the fee scale will be necessary.

Each doula comes with unique experiences that will be invaluable to your birth of your baby regardless of the experience level of that particular doula.

For more information on my doula services please visit www.nycdoulaservice.com