The new health care  laws are saying that insurance covers lactation, but we have not been able to make that work. Similar to when the laws said they would cover breast pumps, it was a year at least before the conduits were created for it to actually happen.  I have worked with many moms and even been on the phone with insurance companies. The catch is that in order to bill insurance, you need a code and we do not have one to use. Lactation professionals were using some codes for a while and people were getting reimbursed but then we found out, and I found out direct from my certifying body, Healthy Children Project, that we cannot use codes as we are not clinicians. You may hear of a friend that did it. That is either an old story, in a different location, or the lactation person was affiliated with a medical practice such as a pediatricians office and can then bill through that. I do not have any such affiliations so I cannot offer you a receipt with any billing codes on it.

Basically, if you are seeking doula and/or lactation support, you can and should expect this to be an out of pocket expense. I can provide an official receipt for services if you request and you can submit it to your insurance, and I encourage you to do so. But know that it will probably be denied for reimbursement. 

So what if you want this care and cannot afford it? There are a few options here. Some people just make it happen. They save up, make other sacrifices, and/or ask friends and family for help. I've had clients get help affording doula care by putting it on their baby registry. I know I'm biased but $1000 towards doula care is way more useful than $1000 towards a stroller. Another option is to go with a less expensive doula. There are great choices as the NYC Doula Collective, of which I am a member and a mentor. There is also Doula Match and www.freeandlowcostdoulas.com. Yes, a less expensive doula is less experienced, but that does not mean you cannot find a great connection. While there is definite advantage to having a more experienced doula, there is also value in not adding a stress to your life during this time by committing to pay more than is comfortable for your family. 

So how much is doula care? In NYC right now it ranges from free to $10,000. Newer doulas charge around $500-1000, and the more experienced doulas like myself charge around $2500-4000. You can get a sense of average doula fees here at the NYC Doula Collective where we price according to competitive going rates and experience:
http://nycdoulacollective.com/labor-support/.  If you look around their website you will also find me on their tier 6 doulas page. Once you are sure of your price range, I suggest seeking doulas in your range and not meeting doulas out of range in case you find you really love them and put yourself in a pickle. 

Choosing the right doula for your growing family is an important decision. I hope this information can be helpful with your selection process. 

Lots of love, 
Maiysha

No matter what you read or study or hear, there is no way to really explain the emotional intensity of the whole thing. Then the added pain, fatigue, confusion and emotional "come to Jesus" I call it. Birth really serves you your own butt on on a platter. There is no where to run, no where to hide, no space for denying anything that is coming up, it's coming up. It's also an emotional invitation, to really go deeper. To experience life on a deeper level. On a real. I so love this work for it's realness. It also invites me to go deeper and get closer to the essence of all things human and nature and God and creation. 

If we could do the birth without any fears for the baby and mom, it would be so much easier. So the marathon parallel too many people draw, again, it's nothing like a marathon. In a marathon, you are not worried about your life and/or the life of your unborn mystery faced child. That little detail my friends, is what makes this so much harder. 

Again, an invitation. An invitation to trust. An invitation to look God in the face and not try to control or dictate, but surrender. And in that, you feel that infinite power and it can be so scary. I remember I compared my contractions to those crazy rolling summer thunderstorms. Those storms really remind you who is in charge here. When I lived down by the beach I used to go to the end of our block during those summer storms that shake the earth and stand on the rocks in thunderstorms and just experience just how crazy powerful mother nature is. Strong, scary, both life giving and powerfully destructive at times too. She gives and she takes away. She tornadoes, and hurricanes, and she thunders and lightening. But it's not a punishment, it just is. It's just the waves, and you have to ride them, you cannot conquer them, we are a part of this cycle, not the boss. She's also sunshine on beaches, and flowers that bloom exquisite colors, and the animals, the amazing patterns of fur, feathers and scales, and the seasons, and the awesome wisdom in a newborn's eyes. She is all things and we know that. 

The rain will make you wet, the waves will sweep you away if they want to, the sun will make your skin feel hot, and your birth will take you where it will. Smell the amazing perfume of the flowers, look up into that rain bravely with your bare face and enjoy the magic that is nature, all around you, and inside your body as well. 

And we are human. So we make houses, and we evacuate before hurricanes, and go indoors during storms, and put on sunscreen to avoid sun damage our skin. And we give birth with hospitals and technology. That's all fine and good, and we must always remember that we are still part of this divine, intense, strong and powerful natural world and existence. 

With love,
Maiysha