SLIDING FEE SCALE
Until death doula care is recognized as a covered service under a universal health care system, our services remain an out-of-pocket expense. At Mud Lotus Doulas, we fundamentally believe that everyone deserves access to compassionate end-of-life care and support, regardless of their ability to pay. For this reason, we offer a sliding fee scale in an effort to address issues of economic inequality. A sliding scale adjusts cost based on financial need with the goal of creating greater accessibility and economic justice for all.
How does our sliding scale work?
The dollar amounts listed reflect the real cost of the service. These are the prices that we would charge all clients in the absence of a sliding scale. If you have access to financial security, own property, and/or have personal savings, you would not traditionally qualify for sliding scale services. If you are able to pay for wants and spend little time worried about securing necessities in your life, you have economic privilege and power in our community. This price is for you.
Those in financial need receive the support of a subsidy. A lower fee on the sliding scale represents an honest acknowledgment by both the doula and client that their economic circumstances would prevent them from receiving our care if there was not a deliberate opportunity made for them to access services at a cost that is reflective of their economic realities. If you struggle to maintain access to needs such as health care, housing, food, child care, and are living paycheck to paycheck or are in significant debt, let’s work together to determine a cost that makes sense for you. You deserve a community that honors your price as equal an economic offering as one who can pay the full amount.
If you pay less when you can afford more, you make doula support less accessible to those in need. Being honest with yourself about your financial situation when engaging with sliding scale practices grows strong and sustainable communities. It also respects the labor of doulas who too have families to support and bills to pay. Further, when doulas are paid fairly, we are better able to invest more time and resources into expanding free and lower cost offerings.
When you can, consider offering a “pay-it-forward” price to help support financial accessibility for all. If you have the means, rounding up or adding a donation onto the actual cost of your service means you are directly helping to make doula service available to everyone who needs it. The “pay-it-forward” option is an opportunity to receive the benefit of our services while supporting your fellow community members at the same time.
We are willing to consider non-monetary forms of payment to help cover fees. If cash is a hardship, perhaps you can offer other gifts (labor, food, etc), depending on your particular circumstances and skills.
(Our gratitude to Alexis J. Cunningfolk for the infographic below as well as many of the ideas articulated here.)
Still not sure where to place yourself on the scale?
You may find it helpful to keep in mind the distinction between sacrifice and hardship as you consider your particular situation. If paying for doula service would be difficult, but not detrimental, it qualifies as a sacrifice. You might have to cut back on other spending in your life, such as going out to dinner or buying new clothes, but this financial sacrifice will not have a long-term negative impact on your life. If, however, paying for doula service would cause harm, such as not being able to put food on the table, pay rent, or pay for your transportation to get to work, then you are dealing with hardship. Folks coming from a space of hardship typically qualify for the lower end of the sliding scale. The distinction between sacrifice and hardship can provide useful nuance when considering access because it recognizes and respects that paying for something might still be a challenge, even if only in the short term, while giving appropriate space for those who are dealing with financial scarcity.