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- U.S. cesarean birth rate declines slightly
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Doula Programs:
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Birth & Parenting News: Genetics Website
The CDC has launched a new Pediatric Genetics website! Designed to be research-based, user-friendly, and up-to-date, some of the new features of the site include:
- Easy-to-read information on genetic disorders, family health history, genetic counseling, and newborn screening.
- A compilation of important data and scientific publications.
- Individualized page for health professionals.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
The Doula Business Advisor: Sliding Scales
Some doulas choose to offer a sliding scale for fees for doula services. Let’s consider how to implement a sliding scale for your doula practice.
Sliding scales can be a bit tricky. I have experienced mixed results with them. For several years I offered a sliding scale for my doula services. When presenting the option of a sliding scale, state the value of the service up front. “I charge $800 for my birth doula package of services.” Then you can say something to the effect of “In consideration of folks for whom this fee presents a hardship, I will waive a portion of the fee, as follows . . .” This language is important because it allows you to state your worth, and it is a more accurate description of what you are willing to do—waive a portion of your fee.
When devising your scale, play with the numbers a bit and come up with something that seems reasonable to you. Be really clear about your bottom line, and keep it simple. You don’t want to get into the nitty gritty of their finances and hear all about their college loans, overall debt load, mortgage payment, tax problems, and so on. Clients need to be presented with guidelines during the initial interview. Once hired, I ask them to self-identify their birth-fee amount, and I draw up the contract accordingly.
In my experience, I found that most clients put themselves at the top of my scale. On occasion some took advantage. Since I was committed to making my services available to as many families as possible, and the honest and caring folks significantly outnumbered the dishonest manipulators, I was able to continue to offer the sliding scale. To play devil’s advocate for a moment, however, I will say that I’m guessing your mortgage payment doesn’t “slide” from month to month, nor does the price your local grocer charges for milk. You are not required to offer a sliding scale.
The Doula Business Advisor blog is designed to support the establishment and long-term sustainability of private doula businesses. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Doula Programs
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Birth & Parenting News: Cesarean Data
A special article in the January 2011 edition of the journal “Pediatrics” provides a summary of the most current vital statistics data for the U.S. This year, the “Annual Summary of Vital Statistics 2008“ includes a special feature on differences in cesarean delivery rates according to race and Hispanic origin.
According to the report, cesarean deliveries continued their twelve-year rise in 2008, making up almost one-third of the births in the U.S. A range of reasons for the increase are cited, including mother preferences to doctors’ fear of lawsuits. Cesarean deliveries have increased 56 percent since 1996!
Other key findings in the report include a decline in the overall birth rate, with births to teens aged 15 to 17 declining two percent from 2007 to 2008. Births to unwed mothers represented 40.6 percent of all births in 2008, an increase of almost one percent, and the proportion of babies born early went down three percent from 2007 to 12.3 percent of all births.
Rates of multiple births were the same as in 2007, and infant mortality declined from 6.75 per 1,000 live births in 2007 to 6.59 in 2008. The report is compiled by the National Center for Health Statistics and the Johns Hopkins Bloomberg School of Public Health.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
The Doula Business Advisor: Bartering
When doulas are approached by clients who cannot afford fees for doula services, there are several options available to them. Today, we continue a series of blogs on how to address this challenge with clients.
Bartering for services may be one option to consider. I have bartered my services for car repair, massage therapy, graphic design, haircuts, and cleaning services. On the other hand, I turned down the offer to exchange palm reading for doula services, as palm reading is not something that I value. The barter should be equal in value.
The one downside to bartering is that it can contribute to sticky or murky relationship boundaries with your clients. Once bartering enters the picture, your client is in your life in a new way. The relationship is no longer just about you meeting their needs; they are meeting your needs too. Money is cleaner, less personal, and the boundaries are clearer. Be prepared to have a harder time bringing closure to a professional relationship that has crossed this line. If the barter/payment is extending into the future, by definition you do not have “closure.”
To be continued …
The Doula Business Advisor blog is designed to support the establishment and long-term sustainability of private doula businesses. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Doula Programs:
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Birth & Parenting News: Breastfeeding Vision
“Breastfeeding: A Vision for the Future” is a new initiative of the United States Breastfeeding Committee (USBC), aimed at increasing awareness of the importance of breastfeeding and the support needed from all sectors of society to achieve national breastfeeding goals. The vision draws attention to gaps in U.S. policy and outlines nine crucial objectives that must be met to fully address the barriers faced by mothers. The goal of the USBC is to reach more than 15,000 individual supporters of the vision before launching it as a tool to support media and legislative advocacy efforts. Learn more about the initiative, or sign on as a supporter.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
The Doula Business Advisor: What If They Can’t Afford You?
In my last Doula Advisor blog (March 8), I discussed the problem of couples who desire doula services, but are challenged by the doula’s fees. I want to urge doulas not to engage or support an entitlement mentality. There should be an exchange of energy. Here are some options for handling this situation.
Typically, I ask for something in return. For example, currently, if someone wants to take my childbirth classes and can’t afford the fee, I might offer the option of bringing a healthy snack to class to share with the other couples, or helping me at the office with some copying and assembly of course materials, or providing a deposit up front to hold a spot for them and then writing me postdated checks on the first night of class. The payment plan is proposed by them, according to what they can manage, and then I hold onto the checks for deposit until the date they are written for. Perhaps doula business owners have tasks that they need help completing?
Be sure also to explore insurance reimbursement options and strategies with your clients. Some clients may have Health Savings Accounts, Medical Reimbursement Accounts, or Flex Accounts available; doula services may qualify for reimbursement under these pretax medical savings accounts.
To be continued …
The Doula Business Advisor blog is designed to support the establishment and long-term sustainability of private doula businesses. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Doula Programs: Cultural Competency
Doula program administrators are often seeking resources to assure that doula volunteers working with the program are offering culturally competent care. The Maternal and Child Health (MCH) Library at Georgetown University has updated its Culturally Competent Services Resource Brief. This guide contains links to federal agencies and other organizational websites, along with descriptions of resources. Also featured are selected resources developed by the MCH Library including an annotated bibliography on culturally competent services, links to minority health organizations and non-English-language materials and resources, and information on racial and ethnic disparities in health.
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.