Setting Birth Doula Fees: A Conversation with Liz Farmer of The Doula Classroom

In this week's video chat, Liz Farmer from The Doula Classroom and I discuss the crazy world of money within the doula world. Listen in as we explore how doulas set fees, options for figuring out what will work in your practice, and how to avoid drama in the doula profession! Spoiler alert-it doesn't have to be crazy at all. Full transcript below video.

Liz: Hi Amanda!

A: Hey Liz. Thanks for having me.

L: Thanks for joining us. So, today we are talking about money issues and competition and drama in the doula world. And I think those three topics go hand in hand with one another. So, I guess we’ll start with money because that’s such a huge…such a huge point of contention for a lot of people. I feel like there’s a lot of people-I feel like there’s this whole spectrum of ideas on what a doula should or should not be charging. There’s anger if the doula charges too little. There’s anger charges too much. There’s, you know, hurt feelings. And that all, I believe, ties into how women- because doula field is largely made up of women-our internalized thoughts and feelings around money, around giving care that is nurturing in nature.

I know other professions deal with this too that are dominated by women. Caregivers, nannies, daycare workers, school teachers…any of those nurturing type of professions typically don’t get paid very well. Doula work is a little bit different because we’re not working with anybody else. We’re working, we’re typically-most of the time doulas are working for themselves. And so, there’s some schools of thought in the doula community that doulas should charge top market rates right from the gate. There are thoughts that a doula should do several free births. I mean it’s so all over the spectrum and it’s hard to know, especially as a newer doula, what to do, what to charge. Maybe there’s a standard in your community, maybe there isn’t. What are your thoughts?

A: And does that standard even matter? That’s really my...what boils down to my question right now. After being in the doula world for a while, I realized that what other people were charging actually didn’t affect my business, what I charged, how I worked with my clients.

But yea, I hear what you’re saying. New doulas-it’s so hard to figure out what to charge. It’s so challenging to..I mean it’s a hard thing to even have to come out of your body and ask somebody else “Hey, what are doulas making in this area?” Because there’s no public info on the general salary, so what am I supposed to do? How am I supposed to negotiate my salary with my nonexistent employer? Myself, right? It’s a really challenging place to be.

L: There’s this..there’s this thought that if, you know, even in communities where there are people who have money, who are wealthy, who have an expendable income that could afford to pay a doula $2000 or more potentially- that doulas shouldn’t charge a lot of money because that would mean that people who had lower incomes did not have those services available. What are your thoughts on that?

A: Yea, that’s really complicated. So, I truly believe in sliding fee scale models and what that can do. If people are new and they don’t know what that means or haven’t ever worked on a sliding fee scale before-or have never utilized someone else’s services while on a sliding fee scale- generally all it means is that your base rate, what you charge is one thing and you could potentially go further down from that charge or from that fee based on the client’s needs. I really love that model in total because it does allow for a lot of mobility for people who can’t actually pay that top fee. And yet, I also have never been able to do the sliding fee scale, like offer that in my own life.

L: And why is that?

A: Because I couldn’t afford it. So, here’s the sad hard truth about being a doula. Most doulas are struggling financially while being doulas. Whether or not they were struggling before, they’re struggling at least for a couple of years to get this business off the ground. Which is just part of being a business owner as well, unfortunately, in our country. It’s something that I mean I could talk about for days about our small business practices, our tax laws, everything, in our country. But I won’t. It’s hard. That’s the end all be all line there.

And so I think that, for me, in my business, being able to offer services at all meant that I needed to make a certain amount per month. I had to charge accordingly. Whether or not other doulas thought my fee was acceptable in our community. Whether or not some people…and we definitely had doula interviews where I had potential clients across from me at a table saying “You know, you have less experience and somebody else is charging less.” And my response to that has to be “Yea, but we all charge what we think we’re worth, what we think our services are worth, and what we need to charge to be able to have this sustainable business.” I’m the breadwinner in my family, which means I’m going to charge what I need.

It’s a hard conversation to have, but I do think no matter how much…so let’s just say in a community like LA, right? If the average doula charges anywhere from $1000-3000..if the average rate is somewhere in there, does that automatically mean that someone who could only afford a couple hundred won’t find a doula? I don’t think that’s true at all. I think there are plenty of new doulas out there who are willing to work on a sliding fee scale. I also think it’s true that plenty of experienced doulas want to take on lower income clients as well, as part of their practice. Because they know it’s important for the overall culture of birth and our whole world, right? So, I don’t think it disqualifies anybody from getting birth support. I just think we have to open our mind to expanding our thoughts on what it means to make a business sustainable and what it means to be able to serve the most number of clients. What it would take.

I’ll say one more thing on this specific topic. So, if I make $2000 a birth and that means that I can take on 2 free clients every six months, does that like even me out? It depends on who you ask, right? Or if I make $1500 per birth steadily, can I take on just a couple clients at a lower rate per year because that’s what my sliding fee scale can offer? There’s so many ways that this can be done and I don’t think there is a right way, honestly.

L: Yea, I agree with what you said. One thing that I feel like comes up a lot is that there are some doula trainings that I won’t name. What they teach is to charge top market rates as a new doula. So, you know, your first birth potentially as a certified doula would be $1500 or $2000 or whatever top market rate is in the area you live in. And I actually have no problem with that because honestly it’s none of my business what someone else charges. And it does affect my fee, but what I really