How Can I Make My Doula Services Affordable in a Sustainable Way?
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Kaely Harrod 00:04
Welcome to doula Tips and Tits. This podcast is a place where we answer one question about doula work, both to support you and to help you support your clients. I'm Kaely Harrod. I've been supporting families in this perinatal space since my oldest was born 12 nearly 13 years ago. I am a birth and postpartum doula childbirth educator, lovely cheerleader and a doula coach. I love guiding and supporting doulas as they work out their doula business. It is a tremendous joy to be trusted in this way. Thank you for joining us on this journey. Hello, and welcome back. Today I am answering another question that I received from one of the doulas who attended my masterclass and did a strategy call with me. And that question is how can I make my Doula services affordable in a more sustainable way? And I think this ties very much back to all of the episodes I've been doing on cost and charging and burnout and things like that. So I want to talk through a couple different things to think about so similar to many of my episodes, this is not an episode that I'm going to tell you do exactly XYZ. And that's the only and best way to do it. Right. For one, I don't actually believe in that. Because I don't think there's only one way to do something. And I don't think there's a best way in most cases. But I do want to give you some things to consider. And to sort of weigh like what is your circumstance? And how can you do this in a way that does not cost you your body or your family's finances or create a greater instance of burnout for you. So a couple of things to consider. First of all, I think access to doula care needs some equity. Right. And so I do not believe that doulas are a concierge service for the wealthy. That is not at all what I think at the same time, I would say in the DC area, mostly I get hired by fairly wealthy people, right. And so I think sometimes we think about doula care being affordable. And we have a mismatch with who we are actually serving. So for me, it wouldn't make sense for me to build in more of an affordability model in my just everyday client load, because my everyday client load is not the clients who need that right now. That's not everybody. So that's not what I'm not saying that's everyone's circumstance. But I want you to evaluate first and foremost, if you are in fact serving clients that have financial need, okay. The other thing is, are there any programs in your area that are offering some form of subsidized or otherwise funded doula services? Now, that looks like a few different things. So some, some places have like community doula work, some places have nonprofits that do do the work that like, subsidize it, where there's either a sliding scale or something like that on the client end, and then the doula side, you get paid a certain amount. And that makes it a little bit more sustainable. Sometimes I've heard of a few hospital based programs that are like, free for the person who's pregnant, but the doula gets paid. I've heard of a few hospital programs where it's free for the person who's pregnant, but the doula is a volunteer. But it's like a shift. And so you're not like on call for that person. You're doing it like, you know, today, I'm going in from five to seven kind of thing. And whoever is there in labor and needs doula support, that's who I'm supporting. So it's not quite the same as having like, when you have a private client, you have that continuity. But that's one of the ways that it's offered sometimes as a community service. More and more in the US, the Medicaid systems are covering doulas. I could do a whole nother episode on that because there are some significant barriers for the doula to that being sustainable and and worthwhile. But that's another way to do it in a way that like your clients have access for either no fee or a very reduced fee. But you are still getting some kind of payment because the reality is this month, this work costs you some money. And so unless you already have all the money and you truly want to do this as a volunteer, then you do need to financially sustain the business in some way. Right. Another option is to have some kind of a equity model that includes a sliding scale. Now, I've seen this done a variety of ways. So I'm just going to give you a couple examples of what I've seen. By all means these are not the end all of how to do a sliding scale. So I've seen one example where people were like the doula or the midwife or practitioner talks about the full extent of the cost for their services. And why the cost is that and then kind of breaks it down, where it's like, the full cost of our services is x, right? So let's say $5,000, for a midwife team for like a home birth. And then if you aren't able to pay that, if you pay this, like $3,000, this is what that covers, right? If you're not able to pay that, and you paid $2,000, this is what that covers. So what I think that does is in a really helpful and tangible way, break down what's not getting paid for when someone pays the lower amount. That doesn't mean, that person who can't afford more than 2000, should feel badly about that. What it does mean is that if someone actually can afford the 5000, they should try to make that work, right. Because if you're breaking down to the 2000, you're maybe not paying for like the midwives time with you, or you're not paying for the insurance for the business or something like that, right. And so there is a very real kind of tangible definition of what the money is covering in that model, right. Another model that I really like, is when you say, basically, like this is the sliding scale, you put yourself on this scale. So there's no financial data being exchanged, etc. If you're on the higher end of the scale, you're actually covering the cost of my services, and covering the ability to have some people on the lower end of the scale, because a lot of people value giving back. And so if you have the built in option to have someone hire you who has financial means, and they can actually contribute towards someone else getting you at a more affordable rate, or even for free if that's what your if that's what your scale is, then a lot of people will do that. One thing that I have done over the years, is to have an option of donation. So my clients or my community members have the option of donating towards services for lower income families, that has allowed me to do some pro bono services, it has allowed me to do some really reduced fee services, there's a few midwife groups in the area that know that they can have me they can recommend me to a client with Medicaid at a significantly reduced rate. That's a way for me to not have to deal with finances, financial, like information, right? Like, I don't want someone to have to come to me in my business and be like, Let me prove to you that I need this service, right. And so if they are seeing a midwife through the Medicaid program, they've already done all of that paperwork. And I don't need to have any kind of verification, right. And so that's also one way to do it. So what I want you to think about as you're thinking about this is how to build it in to your business, so that it's sustainable, so that it's something that you can do really well at a high capacity in terms of your like emotional state, right? And so that it can be sustained over a long time. And, and even I mean, one way that I think some people think about this is like if I right now charge $800. Right, which I don't charge $100. But I mean, if someone charges $800 for birth, and there may be planning to do like three births a month, right? Well, then, if they're wanting to do some pro bono births, or some really reduced fee births, they could charge 1600 For the people who have the money to pay that and do one free birth every single month and get the same amount of money. Right? And so actually, they would get more money. I can't math is not my thing. But if you're doing 803 births, and then you do two births at 1600 You are in fact making more money.
Kaely Harrod 09:40
And so you could do two births and get more and be able to afford the cost of having a third person without being completely burnt out because you are taking on more clients than you can actually handle right because it's a disservice to yourself but also to your clients. If you're taking too many people, they're not getting good care. And they're especially not getting good care from you if you're wishing you didn't have so many, right? Like, it's completely different. If you're a doula, and you're like, I take five people a month that I love it, and it's wonderful, and it's great. And it's my favorite thing. And if you're a doula that like wants two people a month, and you have for every single month, you probably hate that, right? And so that's not sustainable on lots of levels, but also that you're not setting your clients up to have really good support, because they feel that resentment, you know, like, you're, you're like, I really wish I wasn't at this birth right now. And that's not a great thing to bring, right. That's not a good energy to have. It's not a helpful way to arrive at someone's breathing location. So I realized this conversation has a ton of nuance. So I would love to hear from you. If you've used any of these models, what your experience has been pros and cons. We can all learn from each other in this because there is again, not one perfect way to do it. I do very much believe in equity and access. And so that's a conversation that I would love to continue having with you all. And I would love to hear like what are your follow up questions around this so until the next episode, I wish you wonderful consent filled experiences. Thanks for joining us for this episode of the doula Tips and Tips podcast. If you learned something today or had an aha moment, we'd love for you to share that on Instagram and tag us at Herat doula, so we can celebrate alongside you. If you found this podcast helpful. We would so appreciate you taking a second to leave a rating and review on your favorite podcast app that helps other doulas find us as we do this work together. This podcast is intended as educational and entertainment it is not medical advice or business advice. Please consult your own medical or legal team for your own needs around
Cost of doula services is a hot topic. As you know, I care deeply about people being paid well in this work. I do also care deeply about equity and access to doula care. I just firmly do not believe that should happen at the expense of the doulas. We need better systems in place to support families who have less financial resources and ALSO support doula work as a sustainable and well-paid career.
I’ll step off my soapbox for this episode. I’m not going to rant about our broken healthcare system, but I do believe that it is deeply broken. Today’s episode goes into a few ways people offer lower cost services in a way that is more sustainable. There’s not a perfect way to do this, so this is a brainstorming session of sorts. I’d love to hear your favorite ways to create this type of equity in your business!
Episodes About Doula Pay:
Episode 94: How Much Do Doulas Get Paid?
https://www.harroddoulaservices.com/kaely-daily-podcast/how-much-do-doulas-get-paid
Episode 97: Doula Burnout: How Do Doula Rates Impact Burnout?
https://www.harroddoulaservices.com/kaely-daily-podcast/doula-burnout-how-do-doula-rates-impact-doula-burnout
Key Takeaways:
Some people use sliding scales
Some people use grants for nonprofits to allow for services to be free or low cost and still pay the doulas
Some people use donations where people can donate toward services for others
Some people have specific lower rates for people on Medicaid or other Social Services
There’s more than one way to do this!
CONNECT with Kaely on TikTok or Instagram
https://www.tiktok.com/@doulacoach
https://www.instagram.com/Harroddoula/
This podcast is hosted by the Birth Prep Blueprint - comprehensive Childbirth Education for expectant parents to feel calm, prepared and confident about labor and birth. Podcast listeners (that’s YOU!) get 10% off! Use the link below and coupon code PODCAST
https://www.harroddoulaservices.com/birth-prep-blueprint
** The Birth Prep Blueprint is offered for only $20 to anyone who qualifies for any kind of social services (meaning that a family has a lower income to the point that they would qualify for WIC or SNAP or Medicaid, etc.). No need to disclose your income, just which service you qualify for and the link can be sent right over. Just email kaely@harroddoulaservices.com to learn more.
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Kaely Daily is produced by Kaely Harrod of Harrod Doula Services
It is sponsored by The Birth Prep Blueprint Childbirth Class
Music by Madirfan: Hidden Place on Pixabay
