Pre and post-partum Doulas are sometimes contracted through hospitals, community health organizations, or insurance companies.  Most likely the Doula is hired directly by the parents. Doulas working under contract with birth parents usually charge a flat rate. Many use a sliding scale to assist those who may want a Doula but cannot afford one. Fees often include two prenatal visits, 24 hrs on call 2 weeks before due date, attendance at the birth and immediately post-partum, and a post-partum visit.

Many Doulas also teach childbirth education classes.  Child birth educators teach classes to aid expecting parents through the birth process and the post-partum period.  They usually work in community centers or hospitals but can run classes independently.