Pricing With Integrity: The Conversation Doulas Avoid (and Why We Can’t Anymore)

There is a particular kind of exhaustion that lives in doula work.
It’s not just physical.
It’s not just emotional.
It’s not even just about being on call at all hours or holding families through their most vulnerable moments.

It’s the exhaustion of giving deeply while quietly wondering if you can keep doing this.

Many doulas arrive at pricing conversations already braced for discomfort. We open our laptops, stare at the numbers, and feel the familiar tightening in the chest. We know something isn’t working, but we don’t know how to change it without betraying our values, our communities, or ourselves.

So we stall.
We rationalize.
We adjust everything except the price.

If this feels familiar, you are not alone. And you are not failing.

Why Pricing Feels So Personal

Pricing in doula work is rarely just about income. It touches identity, worth, and belonging. It asks questions we were never taught how to answer:

Am I allowed to charge this much for care?
Who might I exclude if I raise my rates?
What will other doulas think?
What if clients stop choosing me?
What if I’m not as good as I think I am?

These questions don’t exist in a vacuum. They are shaped by the reality that care work has historically been feminized, racialized, and undervalued. We have been taught, explicitly and implicitly, that caregiving should be motivated by love rather than skill, by sacrifice rather than sustainability.

In that context, charging fairly can feel almost transgressive.

The Myth of “Just a Birth Package”

One of the most damaging narratives in pricing conversations is the idea that doula services are simple, standardized, or easily comparable.

They are not.

Two birth packages can look similar on paper and be vastly different in practice. The number of prenatal visits matters. The depth of emotional support matters. The length of the on-call window matters. Whether postpartum care is included matters. Whether backup is guaranteed matters.

Scope matters.

When doulas compare prices without comparing scope, they often come away believing they are either charging too much or not enough, without understanding why. This leads to quiet underpricing, overextending, and resentment that no one ever names out loud.

We cannot build sustainable practices on comparison alone. We need context.

On-Call Time and the Invisible Cost of Availability

On-call time is one of the most misunderstood aspects of doula work, both by clients and by doulas themselves.

Being on call is not passive. It shapes how you live. It limits travel. It restricts scheduling. It changes how you sleep. It holds your nervous system in a state of readiness that is hard to articulate but impossible to ignore.

When we pretend on-call time is “free” because we are not actively working, we erase one of the most significant costs of this profession.

Restricted time is still time.
Emotional vigilance is still labour.

Ignoring this reality doesn’t make it disappear. It only makes burnout more likely.

When the Math Tells the Truth

Many doulas avoid breaking down their pricing into real hours worked because they fear what they might see.

But clarity is not cruelty. It is information.

When you account for consults, prenatals, emails, texts, admin work, on-call capacity, labour support, postpartum visits, backup coordination, and recovery time, the hourly equivalent of many birth packages is sobering.

If that number does not support your basic needs, your health, or your ability to rest between clients, the problem is not your resilience. The problem is the structure.

Burnout is not a personal weakness.
It is often a pricing issue.

The Quiet Fears Doulas Carry

Many doulas fear judgement from peers more than they fear exhaustion. In small communities, pricing changes feel visible and risky. We worry about being talked about, misunderstood, or quietly excluded.

Others fear losing clients, especially in regions where access to care is already fragile. The fear of becoming “unaffordable” can feel like a moral failing rather than a logistical one.

And underneath it all is doubt. Doubt about our experience. Doubt about our worth. Doubt about whether we’ve earned the right to ask for more.

These fears are understandable. They are also shared.

What we rarely do is talk about them together.

Why Silence Is Costly

When doulas don’t talk openly about pricing, everyone suffers.

New doulas undercharge because they don’t know what is reasonable. Experienced doulas stay stuck because they fear disrupting the status quo. Communities lose skilled care providers to burnout. And clients receive support from practitioners who are stretched thinner than they should be.

Silence protects no one.

Hard conversations, while uncomfortable, are often the beginning of change.

Raising Prices Without Abandoning Integrity

Raising prices does not require secrecy, defensiveness, or apology. In fact, transparency builds trust.

Announcing changes ahead of time, honouring existing contracts, and communicating clearly shows respect for clients and for yourself. You are not obligated to justify your worth or explain your entire business model.

Clarity is kind.
Boundaries are ethical.

Accessibility and Sustainability Are Not Opposites

Many doulas deeply value accessibility and worry that raising prices means turning their backs on their communities. This fear deserves care, not dismissal.

Payment plans and sliding scale options can increase access when they are structured intentionally. Limited sliding-scale spots, clear minimums, written agreements, and community-funded models allow doulas to offer flexibility without self-sacrifice.

Accessibility that leads to burnout is not sustainable care.
Sustainability is what allows care to continue.

An Invitation to Reflect and Speak Aloud

This is an invitation, not a directive.

Reflect on your pricing.
Look honestly at your scope.
Calculate your real hours.
Notice where guilt, fear, or comparison are shaping your decisions.

And then, talk about it.

Talk to other doulas. Ask what they charge. Ask how they decided. Ask what’s working and what’s not. Share your fears. Share your numbers. Share your questions.

We do not build sustainable care practices alone.

Pricing Is a Care Decision

Pricing shapes who you can support, how you show up, and whether you can stay in this work long enough to become the practitioner you hope to be.

It is not selfish to want rest.
It is not greedy to want stability.
It is not a failure to outgrow your old rates.

Pricing is not just a business decision.
It is a care decision.

And you are allowed to include yourself in that care.

If your pricing supported your nervous system instead of draining it, what conversations would you finally be ready to have?

Amy, Founder, Doula, Advocate & Mentor.