Childbearing women or husbands of childbearing women

SKing

Silver
Nov 22, 2007
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Seems like I come on here in spurts but I have another question.

Doula mania is starting in the Dominican Republic, we are closer than ever to getting Midwives accepted. Word has gotten out about "Midwives for the Dominican Republic" (my organization) and "Doulas Dominicanas" (which I am a part of even though I'm not Dominican hehe).
About 2 weeks ago I was part of a wonderful homebirth here in Santiago with a wonderful physician. He was quite hands off as he was not sure what was expected from him and let me do my "thang".

Anyway, my question is...now I get several emails a week from pregnant women here that want me to be with them during their labor and birth. They want a doula or midwife, and they want someone in the hospital with them to be their advocate and explain to them whats going on, especially expats. The hospitals are mostly now allowing us doulas in with our clients. I have the woman ask the doctor about it prenatally to feel them out, to see whether they are accepting or against it.

Anyway, the homebirth I "attended" was a friend and so I did not charge her but of course, in the US and everywhere else, Doulas and Midwives charge.

I have no idea what to charge people. I would like to know, for the women, what would you feel comfortable paying here in the DR for a doula during your labor and birth? And for the men, what would you think is fair to have someone with your wife during that time.

I would see the client 2 or 3 times prenatally just to go over how they want their birth, what they expect from me, how their doctor is, etc. I usually go to the client at THEIR convenience during the labor, for some women that's really late in the labor, for some its really early. I stay with the client during the whole labor (unless I get there and they are only like 2cm) and for 2 hours after the birth of the baby to help with breastfeeding, assisting the mom in washing up, making sure the bleeding is under control, etc.

Since most are hospital births, most clients do not want to go to the hospital until the last minute. Therefore, being a L&D RN and Midwifery student is an asset because I can check the client and let her know how dilated she is whereas regular doulas can't do that. Also, I can check Fetal Heart rate, and do different clinical things that the average doula cannot do. Then the client can go to the hospital when she's 8 or 9 cm and her risk of being talked or pressured into a C-section is much lower (C-sections for babies whose heads are already engaged and in the pelvis are much harder than C-sections for babies floating around in the uterus during early labor).

Of course, there's more involved but that's the jist of it. I'm just at my wits end trying to think of what to charge and I'm getting more and more requests. In the US, a doula package is usually $800-$1,500. I have no idea what to charge here. Also, once I think what a regular doula would charge, then I need to add just a smidge for the extra clinical skills that I bring to the table. This is excellent for women who want to go to the hospital "at the last minute", they don't have to guess about when the time is right, and they have a clinically experienced nurse with them in their home who can keep track of their labor and also who can recognize and identify deviations from the normal and know if its necessary to get to the hospital a little earlier.

I have no idea. If anyone has any suggestions for DR doula pricing...please let me know. I don't want to make it financially a burden for any woman but I also don't want to low ball myself as it is very hard work.
Thanks again,

SHALENA
 

Mauricio

Gold
Nov 18, 2002
5,607
7
38
In SD you can get a doula during labor. Why don't you find out what they charge? I think I remember the gynecologist of
my wife offering her that service (his wife would be the doula) for 30,000 pesos. We didn't go for it though while being our third child.
 

SKing

Silver
Nov 22, 2007
3,750
183
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Thanks a lot. I figured it would be about that much. I emailed the doulas I know in SD, just hadn't heard back from them yet and one client has emailed me twice about cost. So that gives me a good idea.

Ha! Jeepeta and mansion, I wish! LOL

SHALENA
 
Shalena,
I used a doula for the birth of my second child and she was great. For those of us who want a more natural experience I found her useful with her knowledge of different calming birthing techniques instead of taking medication right away, I didn't pay her as much as $800. With all due respect especially with the lack of affordable medical care wouldn't you want to make it more affordable? That would bring you more business even though you may not make as much right away. It would also make you more accessible, for someone like me for instance who has 4 kids and crazy enough to think about having one more. I would definately want to use your services. Here I am an expat in a new country, we're from the same country so I would feel comfortable with you. You would come to my home, which would allow me to stay with my family as long as possible, ideal! However that would cost me at $30,000 peso - $705.00us. Shalena I couldn't afford that here, lol. Maybe do it on a sliding scale, woops there goes the Democrat in me. Maybe you and your group can start a series of branches throughout for this service. Like I said, my doula was very helpful <3 Healthcare is on the up and up everywhere...
 

SKing

Silver
Nov 22, 2007
3,750
183
63
Kareline,
I am a busy woman, LOL. The amount of free care, free supplies, education, and free doula-ing (is that a word?) that I do when I am here (meaning off of work every other week) would blow your mind.
I don't want to rob anyone, but I don't want SD doulas charging the upper class 30,000-45,000rd while I'm sitting in Santiago giving my services away. I'm not speaking about the poor or lower class here. Having a doula has become the "it" thing in middle, upper middle, and upper class DR. These doulas are charging this much and don't have half of what I bring to the table. Doulas have no medical training, they are trained to provide continuous physical, emotional and informational support to the mother before, during and just after birth.
I still have free services and of course if someone was of a lesser income I would work with them.
Monday I have a meeting with the sindico (spelling?) of a campo of Santiago who would like me to start giving prenatal classes in their hospital. He heard about me from someone, who told someone, who told someone, etc... He will supply me with a room in the hospital and help me as much as possible. The girls that will be enrolled in my class will be my top priority as the majority are adolescents. I will be doula-ing them during their labors for free, baby supplies for them that come out of my pocket, fruits and bottled water for the classes out of my pocket.
So, I understand what you're saying but we're talking about a different class of people. The rich want doulas and they want them now LOL. But I do my fair share of charity like most people on this boards.
I'll see what the SD doulas tell me when one emails back :) I'll keep y'all up to date.

SHALENA
 

SKing

Silver
Nov 22, 2007
3,750
183
63
Maybe you and your group can start a series of branches throughout for this service. ...

BTW, we have this already. We are called "Doulas Dominicanas" and the strongest presence is in Santo Dominigo, Santiago, and San Francisco de Macoris. We are all in the process of certification with DONA International. Once we are certified, we may be able to branch out and begin to teach other women who are interested in becoming doulas but right now we are all so busy, as I said, having a doula has just taken off in the DR in the last 6 months or so and everyone is getting calls and emails.

You can see us on facebook at https://www.facebook.com/Dulasdominicanas
Let me know if you like our logo, it took weeks of back and forth emails for us to decide on it!

SHALENA
 

La Rubia

Bronze
Jan 1, 2010
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As you think about pricing, I would keep in mind how much a doctor charges. Obviously, that varies, as will the amount of services each client requires. You walk a fine line in that your background, education and training make you more qualified than you can probably charge for. Yet, because of that background, you will be in high demand. I agree that you can't give away your services, and in some ways charging ex-pats a respectable amount helps subsidize your work with the poor and speaks to your credibility. (In that some think if gringos are doing it, it may have more worth or validity.) I'm not an expat, but could easily see how paying you $RD30,000 would be well worth it.
 

La Rubia

Bronze
Jan 1, 2010
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Having a doula has become the "it" thing in middle, upper middle, and upper class DR.

That seems like an interesting development since you've started reporting your experiences. Let's hope it's not a fad, but a trend that is here to stay. I'll wonder out loud how much we can credit you with that, because it seems like you have had quite an influence!
 

william webster

Platinum
Jan 16, 2009
30,247
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Agree Rubia, Shalena's influence has not gone unnoticed...

Shalena, does it need to be a flat fee or can you break it into pieces?
Maybe by the hour or even by various services?... like 2-3 hour chunks

Pre-partem and post-partem... is that English ? Like doula-ing ?
 

SKing

Silver
Nov 22, 2007
3,750
183
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agree rubia, shalena's influence has not gone unnoticed...

thank you guys. I cannot take all of the credit. I am involved with some great women here and we all have tried very hard to change the way of thinking about childbirth here in dr. They are on the ground more than i am also, with me running back and forth to nyc :)

shalena, does it need to be a flat fee or can you break it into pieces?
Maybe by the hour or even by various services?... Like 2-3 hour chunks

i was thinking of that also, at least for smaller income families.

pre-partem and post-partem... Is that english ? Like doula-ing?
lol...actually, the words are
antepartum - the period during pregnancy, before giving birth
intrapartum - the time period during labor and birth
postpartum - the period after giving birth to the baby

shalena
 

keepcoming

Moderator - Living & General Stuff
May 25, 2011
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Hourly rates may work better for some but I would think a flat rate (in my opinion) would be a better option. Maybe have a "floating" flat rate say between $20,000-$30,000 depending on the " package type" the client wants.
 

keepcoming

Moderator - Living & General Stuff
May 25, 2011
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Because Shalena brings a bit more to the table as far as being a LD RN then she could offer a couple different packages and/or plans and base the flat rate on that. Give the client a couple of options. Of course Derfish your idea of a "package" is adorable. The idea is to offer this great service but still be paid for your time, etc..
 

SKing

Silver
Nov 22, 2007
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Hourly rates may work better for some but I would think a flat rate (in my opinion) would be a better option. Maybe have a "floating" flat rate say between $20,000-$30,000 depending on the " package type" the client wants.

This sounds great....I can already see my brochure in my head LOL

So I can have different levels. That sounds like a great idea!!!

SHALENA
 

raquelbelle

New member
Aug 8, 2013
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In the past year I used a doula and midwife for my home birth in northern US. Doula was $500 USD, which included prenatal massage and postnatal lactation support. Midwife was $3200 USD. I had FSA and Insurance money that covered, but I know they also worked on a sliding scale, and were willing to barter. They didn't want to exclude those that may have really needed the support. Speaking of support-I'm a US BSN/RN with a background in Emergency if you ever need a hand, give me a holler :) Good luck, always great to hear of someone supporting the mamas!