You’ve heard how valuable having a Doula support you during your pregnancy, birth, and postpartum can be. You’ve done your research and you’ve found one that you connect with. And then you see what she charges...
You may be wondering why - she’s not a doctor or a nurse, why are Doulas so expensive? Doulas do things differently than most medical care providers - they commit to personally be at your side when you need her. To do that a Doula has to carefully calculate how many due dates she can accept in a given month to avoid having labors over lap. Additionally, she is living her life on-call when her clients are due. She doesn’t travel, she stays within cell coverage areas, and she alters her family and social life to ensure she can be called away at a moment’s notice. Your OB likely has days and hours they are working (and being paid for those hours) and hours when they are not working (and not expected to suddenly be at the hospital). Doulas carefully calculate how to make that lifestyle work for them, and most Doulas live on very modest incomes.
Well there are things you can do to get help paying for a Doula.
Medical Insurance
Medical Insurance is increasingly adding coverage for some or all of a Doula’s services. Call your insurance carrier to understand your coverage.
If your plan includes Doula coverage, be sure to understand what criteria your Doula may need to meet to be eligible. And, understand if your insurance requires your Doula to file claims directly or if you will pay out-of-pocket and seek reimbursement after services are complete.
Medi-Cal began covering Doula support in 2023. They provide for 11 visits (prenatal or postpartum) plus labor/birth support. Doulas must be enrolled with Medi-Cal and bill the program directly. You can find a list of enrolled Doulas in the [Directory](https://www.dhcs.ca.gov/provgovpart/Pages/Doula-Providers.aspx). Medi-Cal Doulas are not permitted to charge their clients anything additional, so if you are covered by Medi-Cal, your Doula support is available for free!
Kaiser Permanente in California launched Doula coverage for commercial plans in January 2025. They aligned their process and coverage with the existing Medi-Cal program, 11 visits plus labor/birth support. If you have Kaiser, contact Member Services to confirm that your plan includes this benefit. To be eligible, the Doula must have an NPI and a tax ID number. Most Doulas have both.
The benefit currently allows for Doulas to direct bill or Members to seek reimbursement. Many Doulas find medical billing daunting, so finding a Doula who will bill directly may be challenging.
Under this benefit, Doulas are permitted to charge separately for non-covered services, such as childbirth education or on-call time.
You can use [This Calculator](https://www.douladeja.com/kaiserbenefit) to estimate out-of-pocket expenses using the Kaiser Benefit in Northern California. .
Other insurers have varying degrees of Doula coverage. Some may require formal certification. Be sure you are clear with your carrier about whether the certification must be with an organization on their list, or if there is flexibility. Or even whether the Doula needs to be _trained_ or _certified_. Also be clear if coverage is standard, or if you need a Letter of Medical Necessity from your doctor.
Supplemental Wellbeing Benefits
Supplemental wellbeing benefits are fairly common with major employers. Offerings like Carrot, Maven, and Stork Club, along with many others, often include coverage for Doula support. Each will have their own requirements for Doula eligibility, but common things include formal training, continuing education, and ongoing practice.
Most of these programs require that you pay out-of-pocket and see reimbursement after all services. Your Doula will need to provide a receipt for you.
FSA/HSA
You can use pre-tax dollars in an account like an FSA or HSA to pay for your Doula, but you need to have a Letter of Medical Necessity from your doctor. Speak with your OB about why your specific medical history or concerns will be benefitted by having Doula support. Your doctor will provide a letter that you will submit to your FSA/HSA carrier for approval.
You will need to pay your Doula out-of-pocket and seek reimbursement from your FSA/HSA, as Doulas are unable to take payment directly from those accounts.
Gifts from Friends or Family
You might consider registering for your Doula support as part of your Baby Shower or other celebrations. Some Doulas will accept this model of payment directly, or you can ask for the contributions in cash to pay your Doula. There are also flexible online registry sites that have a function for a customizable cash-gift.
Find a reduced cost Doula
There is a philosophy among Doulas that accessibility to this support should be universal. To that end, many Doulas maintain a scholarship fund, have a sliding-scale fee, or are open to discussions of a discount if her fees are a hardship for you.
Alternatively, you might consider a Doula who is trained but not yet certified or newer to the profession and charges a lower rate than more experienced Doulas. Many expecting parents assume that they should try to get the most experienced Doula they can find or afford, but in reality there is magic in a new Doula. A new Doula is eager, freshly trained, and often more generous with her time and talents than someone who turns away clients often. And keep in mind that the research on the benefits of Doula support don’t have anything to do with her experience or birth-count or extra certifications. The research is about the impact of continuous, compassionate support throughout labor and birth. Your nurse, your OB, your midwife will come and go, even change shifts, but your Doula is committed to you _personally_. A new Doula has all the heart and skills to provide that support. So focus on finding a great fit with the heart of your Doula, not her years of experience or certifications.