Doula care is so beneficial, and is an evidence-based intervention with no known risks and a multitude of benefits to moms, dads, and babies. However, despite knowing how beneficial a doula can be to your birth, and wanting one for your birth, you may find yourself like the majority of families, and wondering how to pay for doula services. Here’s my suggestions and recommendations as you explore the options that work best for your financial situation.

• HSA/FSA/HRA accounts. You will need to check with your employer and/or account manager, but as a health-related service not covered by insurance, you may be able to pay your doula from your HSA/FSA/HRA. Typically, you would pay your doula, your doula provides you an invoice, you submit the invoice to your employer or account manager, and you receive reimbursement from your account. Sometimes you can write a check from your account, sometimes you can pay with your account credit/debit card.

• Health Insurance. This is not nationwide, but in some areas of the country, your health insurance will pay for doula care. If not, you may be able to file a request to cover doulas in the future. This is controversial, mostly due to unclear understanding of who the doula is working for in the case of insurance coverage. Make sure your doula is free to work for you, not bound by the insurance company’s requirements.

• Payment Plans. Your doula may be open to alternative payment plans. If the standard fee structure is 50% down and 50% due later, you can always ask for an alternative schedule.

• Trade/Barter. It doesn’t work every time, for example my family wouldn’t use a truckload of homemade pickles. And doulas are people with financial obligations and budgets too, so not every doula is able to accept a family photography session or crocheted sweaters in trade for doula services. But sometimes it works out well, so if you have an idea, it’s OK to ask.

• Baby Shower Fund. You can add a doula fund to your baby registry. Online options include the usual crowdfunding platforms like GoFundMe and IndieGoGo, but there are online baby registries like Babylist where you can add a doula fund to your online baby registry. And if online crowdfunding isn’t your jam, you can set out a donation jar at your shower.

• Discounts. Providing doula services is not free. For my own business, I have continuing education costs, maintenance of professional memberships and certifications, maintenance of this website (because I really don’t want to pay for the website with ads), physical supplies to replenish, vehicles to maintain and fuel, childcare to pay for, meals to purchase, schedules to rearrange if I need to go to a birth, unpredictable hours, and time providing skilled, personalized care that deserves compensation. Despite the need for compensation, many doulas also want to make doula care accessible to underprivileged populations and offer discounted services, a sliding scale, pro bono services, or other arrangements to serve low-income families. Just bear in mind that doulas have budgets and costs of doing business too and not all of them are able to do this every time they’re asked.

• Prioritize. What will benefit your family more long-term, a designer nursery, or a birth doula? Sometimes what we need is an honest reflection on what’s really worth our financial investment. I know that most families aren’t deciding between state-of-the-art changing tables and birth doula services, but if this does fit your situation, then this point is for you. If you’re relying on hand-me-downs and buying that new basic carseat is a struggle, then this point is not for you. I hope you hear my heart in this bullet point!

Hopefully this gives you some ideas on how to pay your doula. These are also ways you can pay for your childbirth education class. Get creative, get supported, and get educated!