The Cost Of Fourth Trimester Childcare: Potentially $40,000 And Up

The cost of childcare is high. The cost of fourth trimester childcare, the three months after your baby is born, may be the highest! Not only are you dead tired during the first three months after you baby is born, you may want to spend up to get some night doula or au pair help.

As our boys played at the playground, I struck up a conversation with the mother who is expecting her second child in a couple of months. We talked about to extraordinary high cost of childcare.

I was also curious to hear about how she and her husband planned to manage caring for two kids under three years old on their own.

She said they planned to “hire a village” to help them during her fourth trimester, which is the difficult three-month period after a child is born.

The Fourth Trimester Is Tough For Mothers

During the fourth trimester, mothers can suffer postpartum depression. If the birthing process was particularly difficult or if a C-section is required, a mother might be unable to move easily or carry heavy objects for at least the first month. Sleep deprivation is all but a certainty as a baby wakes up every 1-3 hours on average to feed.

The expecting mother mentioned her second pregnancy has been more difficult than her first. With one little monkey running around all day, she is worried she won't have the necessary energy and time to take care of her toddler and a baby concurrently. Her husband works a full-time job and often only has an hour at most in the morning and two hours in the evening before and after work to help out.

When I asked her how much they planned to spend on the village, she said about $40,000. But she wasn't certain whether she would go ahead and spend that amount since $40,000 is obviously a lot of money for childcare over just a three month period.

As I may face this dilemma one day, I thought it would be a good idea to graph out where $40,000 could get spent and whether hiring so much help during the fourth trimester is worth it.

The Cost Of Fourth Trimester Childcare

Here's the cost of fourth trimester childcare for this particular mother in San Francisco.

Birthing Doula: $2,000 (one-time cost). The birthing doula's job is to help the mother have a more comfortable birthing experience. The doula helps the mother breathe, keeps her company during the entire hospital visit, helps her relax, fights for the mother's rights against nurses and doctors during times of stress. The $2,000 cost is fixed whether the mother goes through a short or long labor process.

Day Doula: $40/hour, $3,200/month. The day doula's job is to care for the newborn baby while the mother recovers and/or looks after the toddler. The daytime doula specializes in infant care during the first three months. This mother plans to employ a daytime doula for 20 hours a week.

Night Doula: $50/hour, $9,600/month. The night doula works eight-hour shifts a minimum of five nights a week. Her specialty is feeding the baby every 1-3 hours, making sure the baby is properly burped after each feeding, bringing the baby over to the mother to breastfeed when needed, helps with pumping/bottles/cleanup, and making sure the baby's nasal passages are clear for proper sleep. The night doula will usually work from 10 pm – 6 am or 11 pm – 7 am. The mother plans to hire a night doula for six nights a week. Although she could hire a night doula for her minimum five nights a week to save $1,600/month if needed.

Babysitting: $25/hour, $1,200/month. This mother plans to utilize a babysitter three times a week for four hours a day. The babysitter's main job will be to care for the toddler while mom recovers, rests and/or spends time with the baby.

Total cost per month: $14,000.

Total cost for the fourth trimester: $42,000 + $2,000 = $44,000.

The Benefits Of Hiring Help During The Fourth Trimester

Paying $44,000 for fourth trimester childcare help equals $63,000 before tax at a 30% effective tax rate. Ouch. What a strain such an expense is on the working parent! The ideal age to have a baby is around 32 because by then, you will have 10 years of savings and investments under your belt.

I'm assuming that most readers here would balk at the idea of paying $44,000 for three months of childcare help either because you raised two or more kids on your own, had grandparents or other family to help out, have amnesia on how difficult the fourth trimester was, or are simply envious this couple can afford to pay for so much help.

This mother laid out some reasons why they are strongly considering hiring so much help.

  • No grandparents or siblings to help out. Everyone is more than a five-hour flight away and are busy with their own lives. Yes, it's sad that they're not getting more family support during the fourth trimester, but that's what happens sometimes.
  • Husband has an arduous job and can only take a couple weeks of parental leave.
  • Their marriage is strained because of her husband's stress at work and the difficulty encountered thus far raising their son. The father feels dad-guilt and has no outlets for his feelings.
  • Suffered through several weeks of postpartum depression after her first pregnancy. Expects to suffer through postpartum depression again.
  • She went through a difficult birth with her first that required post-op treatment and extra bed rest.
  • At 40 years old, she has lost energy and strength.
  • Her husband is now 45 years old and also doesn't have the same amount of energy as when their first was born.
  • If there's one time to spend money on an easier life, the fourth trimester is it. Don't let honor and pride get in the way of a better life.

Their main benefits of hiring childcare help are:

  • Will allow both her and her husband to sleep more during the first three months.
  • Should reduce the amount of misery in the household and better protect their marriage from falling apart.
  • May reduce the risk of Sudden Infant Death Syndrome during the first few months given someone alert and rested will always be watching the baby.
  • Should enable them as parents to pay more attention to their toddler and thereby lessen the disruption in that relationship.
  • Will help with sleep training, which should improve the quality of lives for everyone if it works. The couple's first child didn't take well to sleep training and is still not a great sleeper.

To Hire Childcare Help For Big Money Or Not?

Average monthly cost of childcare
Source: Fatherly

My first reaction upon hearing the cost of help was: no, save your money. But as I listened to the reasons why they are strongly considering hiring help, I felt that spending $44,000 over a three month period might be the best money they could ever spend.

I vividly remember both my wife and me delirious for the first three months of our child's life due to sleep deprivation. I was constantly paranoid about my boy suffocating in his sleep. Therefore, I refused to sleep for many nights.

My first mental breakdown happened during my boy's third month of life. No matter how hard I tried to put him to sleep through rocking and singing, he kept waking up soon after I laid him down. This went on for hours in the middle of the night. I felt like I was failing as a father.

Both of us ran on adrenaline, and thankfully, as stay at home parents, neither of us had to be somewhere else. In this mother's case, her husband still has to be away at work and they also have a wild toddler to take care of.

As a parent, I often think about how much I would spend to ensure that my child is happy and safe. That answer is always: whatever it takes. Therefore, if it costs $44,000 to keep this family's baby safe, their toddler safer, and their marriage intact, I think they should go ahead.

Affording Fourth Trimester Childcare Help

The Cost Of Fourth Trimester Childcare: Potentially $40,000 And Up

The difficulty of raising a baby won't last forever. You also get the most bang for your childcare buck during the fourth trimester. Therefore, you might as well spend the money where it counts the most.

For those of you thinking about hiring a lot of care during the fourth trimester, I would actively save up the estimated cost so you can pay for the care in cash. Do not go into debt to pay for care. Instead, reduce the amount of care in order to live within your financial means.

To determine how much you can comfortably afford to spend on fourth trimester care, I would take your annual household income and multiply it by 10% – 15%. In this family's case, they need to earn at least $293,000 – $440,000 in annual household income to afford its $44,000, 3-month cost.

Maybe some of you may only require one month of fourth trimester care. While others might want to extend the intensive care to six months and beyond. Everybody's situation is different. It's up to you to plan ahead and decide how much you can afford.

All I know for certain is that fourth trimester childcare is one instance where money can buy happiness. Or, at least less misery!

The Childcare We Hired For Our Second Child

For our second child, my wife and I ended up paying for a birthing doula who helped us with our first child. It was a waste of $800 because our second came so quick and we were more confident parents.

But we did higher a night doula for four months. The first three months were worth it, but I started feeling financially stressed because she cost $8,000 – $10,000 a month and then the stock market crashed in March 2020.

Now that two and a half years have passed since spending $32,000+ on a night doula, I feel the childcare expense was worth it. The fourth trimester had some extremely hard days. We're still going through hard days now as our daughter wakes up multiple times a night. In fact, I wouldn't mind paying money to get some night doula help again so we can both sleep more!

Readers with multiple children: How did you manage to care for your children during the fourth trimester? What was the cost of fourth trimester childcare? What did you do if you had no grandparents or other family to help out? If you didn't hire help, do you regret not doing so? How common is revisionist history where we forget our pain and suffering?

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59 thoughts on “The Cost Of Fourth Trimester Childcare: Potentially $40,000 And Up”

  1. I have 3 kids- 11, 9, and nearly 2. We didn’t hire help in the 4th trimester for any of them and we had limited family help during the day, once a week or so. The first two were born while I was in my 20s and while there were a few substantial difficulties (nursing issues, c-section for the 2nd), we managed pretty well. The 3rd was a whole new ball game. I had a difficult pregnancy, delivery, and then she cried all the time and wouldn’t sleep. Adding this onto already taking care of 2 kids, and it was too much. I was able to make it through ok but in hindsight it would have been money well spent to have hired help for at least something- meals, driving my kids to and from school (which took an hour each way, with the newborn in tow), cleaning- something. Postpartum experiences are really different, and if you’re having a hard one and need the help, there should be absolutely no shame in hiring out for it.

  2. Send the older kid to a regular daycare for much cheaper than a daytime doula. That gets you back to only caring for one kid by yourself all day. (We both work so my daughter already goes to full time daycare and will not stop when I’m home on maternity leave for the second kid)

    As for the rest of it, if your marriage is already strained under the stress of work and raising a child, it is not a good idea to add another child. Too late for this family, but others should consider birth control a much better cheaper route than a $40k suite of doulas.

  3. Yes, agreed larger houses are more expensive in the bay area, but the cost delta is just so large it makes sense to buy the larger house if your planning on having kids.

    $40/hr nanny x 45 hrs x 50 weeks = $90k/year
    Au pair = $20k/year
    Delta $70k/year

    Assuming you have help until they are in school 5-7 years for a two child family.

    This is $350k-$490k total delta.

    So assuming you upsize the house and get another bedroom, as long as this cost is under $500k you should be coming out ahead.

    In then end you will still have the house, which is an asset that in theory is still worth $500k more than the smaller house should you decide to sell later in life.

    Secondly, the $500k for the house would be amortized over a 30 year period (assuming mortgage) as apposed to 7 years, so the family cash flow would be significantly better during this expensive time.

    You are essentially paying your family first, rather than the nanny by going with a bigger house.

    1. Most excellent point, and it should be in a new post sometime in the future.

      We would’ve definitely kept our old house if we had our son while we were still living there. But biology doesn’t always cooperate.

  4. My family chose to go with an Au Pair for our identical twin girls.

    Rough cost is around $18k-20k/YEAR for 45 hrs per week of childcare.

    Unlike daycare, it becomes more economical as it is a fixed cost rather than a per child amount.

    So 1 kid – $20k/kid
    2 kids – $10k/kid
    3 kids – $6.7k kid
    4 kids – $5k/kid

    And so forth

    Much more economical than daycare that charges per child, and about 1/2 the cost of the nanny.

    The only other cost would be that they live with you, so you need to have their own dedicated bedroom and you need to provide them a means of transportation (bus pass or spare car) to go to classes, etc.

    1. I agree. Makes sense. Just need a large enough house, which can be a problem in expensive places like San Francisco or New York City.

      I had a large enough house in San Francisco until I sold it in 2017. It was three stories, so you could spread out even though it was quite vertical. Our current house is a little bit too tight. But I’m working on a solution to accommodate.

  5. I have two kids, currently age 4 and 1. My husband and i both have full time jobs. My husband got 6 weeks leave and I have 12 weeks leave for both. We live in SF with immediately family all 5/6 hours flight/drive away.

    With the first baby, my mom came and stayed with us for 5 months and helped. Then my in laws came and helped for another 2 months, and my husband and I took our leaves later so we stretch it to she was 10 month then got a full time nanny. The pros/cons of staying with the in-laws versus having help. Something has got to give, we choose having the help.

    I read many people don’t trust nanny, I had reservations, but our nanny was passed to us through family, so she had a history with the family, she saved us. Because now she is my 2nd baby’s full time nanny. But even if I didn’t have this family nanny, i’d still get a nanny and train them, I always knew I wanted more than one kid, so able to find good help and set up a network with my first was important to me as all the work i put in setting up my support will come in handy as well when I have my second baby.

    With the second baby, things were easier for me, as the second direct latched well and as a parent i was not as nervous with SIDS therefore I was a more relaxed mother. I had a difficult birth with my first one, so actually suffered a bit of post partum depression for about a week, not long. With my son, it was smooth sailing as he was an easy birth. And caring for him was easy peasy.

    But still, with all the help I had with the first born, that first year of her life it was a strain on my marriage. There were lots of arguments and discussion on baby caring duties and household chores. and we were both tired.

    With the second baby, we figured it out. I am a more relaxed mother, my husband is now a more automated father/full partner.

    It sounds to me this mother is traumatized by her experience first time around, and with the strain on their marriage is researching all the options she has available to her disposal.

    I think that is great. But think most likely she won’t need all those help. The second time really is different from the first time, you are a wiser parent, you are suffering still from the mistakes you made so you won’t make them the second time. and b/c you didn’t make as many mistakes it gives you back your sense of self as a mother and you are a more relaxed confident mother, same for the husband.

    It’d be more useful to me to have a baby sitter come help with the toddler, have people cook/clean instead of having a night doula, especially if the mom plan to breast feed.

    Just having a baby sitter come every day to take your toddler to the park for 1 hr is sanity as the toddler won’t be disrupting you or the baby. Or have the baby sitter come for a couple hrs while you shower or use the bathroom peacefully.

    If its $20 a day, 4 hrs a day 5 days a week, for a year that’d be around ~$22k. That 4 hrs is magical. You can nap, you can do chores, you can grocery shop, you can take shower all peacefully.

    The bigger question is more they will have 2 children, even if they made it through the fourth trimester, things WILL NOT get easier. As their children grow, the daily chores do not get less it evolves but definitely don’t get less. It seems if their marriage is strained etc the couple probably need to sit down and have a major attitude adjustment in how as husband and wife they tackle and face this new chapter in their life as parents.

    Now that I’m a mother of 2, i tell my friends or new parents that things do not get easier, they just evolve.

    You may change less diaper, but u get more talk back. You don’t have to feed them but you have to parent them. So its never ending, if the husband is tired all the time and basically not as involved, this mom will most likely need constant help to not resent her husband.

  6. I think that support during those early years is so important.

    My husband and I do not happen to live near family, as we are in the DC area and our families are in Texas, Arizona, and California. We have 3 kids, and have been fortunate to be able to hire help over the years to help us juggle everything (although we did not have the extent of help that the lady in the park mentioned.) :-)

    I can really see why so many people deliberately choose to live near family once they have kids, as it can be expensive to be able to hire help. Having help is so valuable for quality of life – parents and child — in those early months. It really does take a village to raise a child.

    Living in DC, I’ve noticed something interesting about the impact of hired help on your quality of life. I meet a lot of Western Europeans whose jobs move them around the world (like people who work for embassies of different countries or World Bank employees). I’ve always found it interesting when they say how much they loved living for many years in places that might seem a tiny bit undesirable (like Libya, Romania, Russia and Thailand), etc. But then they explain the reason that they loved living in these countries — because you could hire so many household employees for so little money. So these otherwise middle-class people had cooks, cleaners, babysitters, and even drivers. It made their lives very pleasant to have all of those extra sets of hands, and they didn’t care where they lived. Once the kids got a little older (like elementary school years), then the families hoped to be placed in the US. But once they got to the US, they could no longer afford all of that household help, and so they found it to be a letdown.

  7. My wife and I are of similar age and currently have a 5 year old. For this and other reasons, we’ve decided to just have 1 kid. Even with 1 kid, the costs and juggling child care is really tough.

  8. We have three high need children, they all have autism. So my two girls where cry babies who cried non stop day and night, which was very hard on us. On top of that my two girls were born only 18 months apart, so again, this was a very difficult time for us.
    When we had our first baby I was 26 years old, and I m happy I was so young. I think my youth helped me stay strong during those non-sleep years. We didnt have the cash to hire extra help, me and my husband did all ourselfs, he working fulltime and me working 4/5.
    When my second girl was born I as laid off from work, and in fact this saved us: I could stay at home with the baby and our toddler!
    After one year I got a new job, parttime this time. Those were great times.
    7 years after my first girl we got our third child, a boy. When he was born we didn t need to work anymore because we are FI. I really enjoyed my time with the new baby and with the other children this time! Now we have all the time in the world to take care of all the children!
    In hindsight I dont think I would ever spend that much money on hired help. I actually never even hired a babysitter (my oldes daughter is 11 now), we did everything ourselfs with verylittle help from anyone.
    If we can do it with three high need children, anyone can do it with two regular children.

  9. Ah, the MGTOW way to FIRE is so easy. No childcare expenses, low housing expenses, no chance of having 50% of my net worth stolen.

  10. As someone who had postpartum depression with both my boys, I applaud this woman for doing what she needs to protect her sanity. The negative thought patterns embedded during this time take years to undue. You don’t come off the antidepressants and return back to normal. Still working through the effects of the depression on my mental wiring…
    2 kids. 8wk/6wk maternity leaves (husband took 1wk). Some meals brought from friends. Neither kid slept through the night till 9 months. Took 1.5 years after the second to be able to come off the antidepressant. Still married. Highly recommend waiting 2 years after children are born to decide if you want to leave your spouse or not

  11. Anthony Tolbert

    Hi Sam,

    Great post, as this topic has been on my mind lately. My wife and I are expecting our third child in February, we currently have 2 boys ages 1 and 3. I am 32 and my wife is 28. Our situation is a bit unique in that I work a 2 week on, 2 week off schedule. While working I am gone 100% 24/7 so she is all on her own. We got lucky with the first 2, I got a month with the first and 3 weeks with the second but I don’t think we will be as lucky when the third comes. I know it is going to be hard on her and it stresses me out thinking about it, I know it’s on her mind as well.

    While we both are young and have the energy to do what is needed I am quite aware that while I am gone it only takes a little bit of sleep depravation for her to begin to feel as if she is drowning. We do have family close by but can not always depend on them for any consistency.

    This post opened my eyes to considering hiring more help. Although hiring more help is easier said than done, I do believe if we start now we should be able to have some help lined up by the time our baby makes his or her arrival. For us its not so much about the cost of the help but the availability of quality and dependable help.

    Thank you helping me to realize we should get a move on this sooner than later!

  12. The amount of mental stress that we go through during the period of trying to get pregnant, then the pregnancy stages, then the recovery period, and the “fourth” trimester has significantly aged us both mentally and physically. Our body has weakened (back, hips, even more so for my wife), mentally we were drained for pretty much 180 days without rest, and financially – the cost of daycare/pre-school has become burdensome…

    1. It is insane to spend 40k which covers two YEARS on daycare costs for an infant, in just three months. I’m sorry but what is the mother actually DOING with her kids since she has hired everyone to watch them? At those prices? I had two kids in my mid thirties 18 months apart, no family to help. Both parents, in CA, get paid parental leave. So nobody has to rush off to work right away.. What is wrong with the husband that he won’t take his time off to be with his son? You are supposed to be sleep deprived. That’s how it goes. It’s nature. My children were cared for each at 12 weeks old by a full time home daycare at $1000 per month just five years ago. Because I went back to work. I was bored and needed social interaction.
      There went my excuse to be depressed and feel sorry for myself. Babies NEED their MOM especially during the first three months. You won’t get that time back. So stop making excuses and actually spend that time with them, exhaustion and all. Every second I was not working, I was holding and bonding with my kids. and we still have a great bond today.

  13. Our son is almost 5 months old. I took a new job where I could work from home a couple months before he was born. My wife got six months maternity leave. We have both sets of grandparents within 30 to 90 minutes.

    All those advantages and it is still very difficult.

    I can see why someone in this woman’s situation would spend whatever it took to get through those few months, especially with a shaky marriage.

    Sleep deprivation is a form of torture. If it takes $40k to not do or say something that will wreck the marriage while sleep deprived, it probably shakes out as a positive financial decision in the long run – not to mention a positive emotional decision for the family.

    The other aspect of this that people don’t look at is the impact on the doulas and babysitter. This family will be putting $40k directly into 2-4 other family’s pockets. So there is a familial, emotional, and societal benefit to this family spending the money.

    Sounds like a good deal all around.

    1. Congratulations on the little one Drew! And congratulations to both of you for getting through the fourth trimester.

      Things should get better and a little bit easier over time. So hang in there.

  14. Hi Sam!

    Interesting post. As you may recall, my wife and I have done the new baby thing 4 times now, with varying levels of financial resources. For our first child (in 2009), we agonized for weeks over whether to spend $75 for a changing table; for our fourth child (in 2017), we spent much more freely to get what we needed, including support help around the house (e.g., extra babysitters for the older kids). We were in a very different place for finances and life — for #1, having more time than money, for #4, having more money than time — so I’ve been through the full range and can appreciate both sides.

    Spending $40,000, like in your article, might make sense if you think about what it buys for that family. It sounds like the husband is very high income and intends to keep working full time during the 4th trimester (not ideal, perhaps, but a personal choice). I’m guessing he earns quite a bit more than $40,000 for the quarter, so is making up for not being there personally by getting help in his place might make sense for their situation. For others, with lower income or outside opportunities, I’m sure $40,000 sounds crazy high, because they wouldn’t be close to making up for it by having one person working. I like your rule that uses a percent of earnings, because it puts the number in perspective.

    Still, I think most families can get extra support for a lot less. Your figures make sense and probably apply for SF. The doulas at $40-50 are truly luxury expenses. But, taking a more reasonable $20 an hour for babysitting and help around the house, hiring 40 hours a week for an entire quarter would help out a lot for just $10,400 (= $20 x 40 x 13). Hiring that support for the whole first year would be $41,600 (= $20 x 40 x 52). For many families, I think they can get that extra 4th trimester boost they need for much less than $13,333 / month. Parents can absorb a lot of parenting effort, but having an extra person to allow for naps, rest, or spending time with the toddler seems like money well spent.

    What are the chances we’ll be seeing FS Jr #2 in the foreseeable future? Cheers!


    1. A professional nanny would not accept $20/hour in a big city. Heck, I live in the Bay Area suburbs and wouldn’t. If families want to pay for professionals, it will cost more than $20/hour in a high cost of living area. $25 is a reasonable wage here. If they can afford it, great. Otherwise, they can do it themselves or hire a teenager to help out for a lower amount.

      In lower cost of living areas, I’m sure $20 would be a good wage! But NYC, SF, Seattle, LA! etc. have a much higher cost of living and being cheap to save a few bucks for care of your CHILDREN seems excessive.

      1. Yes, agreed. That’s consistent with my experience in the Boston suburbs, where professional nannies range from $20-30 an hour and babysitters range from $10-20 an hour. I expect wages in SF and NYC to be higher. My point wasn’t that the figures are inaccurate, just that there are more affordable options like babysitters and cleaners in the $20 an hour range compared to more luxury options in the range of $20-30 for nannies or $40-50 for doulas.

  15. Wendy Keesling

    It’s hard to take this serious or to have any sort of respect for the family who suggested to spend $40k in baby’s first 3 months. We have 4 kids (2 year old twins, 4 and 5 year old). We are business owners of a plumbing/ hvac company in a low cost of living place. We make over $250k per year net profit. So we could afford more help if needed. I’m a stay at home mom/ office manager of our business. Husband could only take 1 week off for each of the births. Early months are hard, but flexibility of schedule is needed. If I could do it with 4 (2 being twins!) it’s hard to believe people with only 1 or 2 kids stressing out so much. Just be flexible and rest when baby rests. Don’t mean to sound judgmental, but 1 or 2 kids and singletons at that are no big deal!

    1. It’s OK. Judging other people without knowing their full background is human nature. We believe that just because we can do it, other people can. I’ve read a lot of mommy forums during my son’s first year, and was scared away.

      I’m impressed you were able to take care of all the kids yourself. Well done. I’m also impressed your husband only helped out for one week off after each birth and you guys are still together!

      1. We had our first child when my husband was a medical resident working 110 hours a week. Our first was a horrible sleeper and I was up for hours during the night- I had to quit my job because there was no way I could function. We did have both my parents very near by so that was very helpful. My first didn’t sleep through the night until he was almost 2! We didn’t dare have a 2nd child until he was 5 years old. That baby slept! The last child came 3 tears later and he was colicky! Anyway my husband is an anesthesiologist and had to work overnights and late call every week- newborn or no newborn. I did it all. We did have a baby nurse for one week after each child was born, but honestly, I wouldn’t have trusted anyone with my infants if I wasn’t around. We’re still married. I knew what type of job my husband had and I knew what I had to do. We’re still married 39 years later.

  16. Given the circumstances and financial ability, I think they should definitely hire all the help. We only have one child and hired house cleaning help, meal delivery and sometimes babysitters so I could go to appointments or to the store once in a while. It was extremely helpful. I could not breast feed, so my husband and I were able to share feeding duties and worked out a schedule where we both got at least 6 hours of sleep. We are in our 40’s, so we were still tired, but functional most of the time. I also spent money about two months before our child’s birth to have a coaching session with a newborn specialist. She helped me to make sure we had good plan for having a good sleeper (and he is!) and to find the right organic formula (no reflux! which is at epidemic levels in babies right now). Which products to stay away from, etc… That 3 hour session was worth way more than I paid.

  17. If forking out $40k is a non-issue, then I’d rather have the day-time doula for more time during the week and/or getting house cleaners/cooking helpers, and not having the night time doula at all if the mother plans on exclusively breastfeeding herself. The mother can get some shut-eyes during the day too.

    If one is going to exclusively breastfeeding which means the mother will wake up every 2-3 hours anyway, why bother with a night time doula? Just co-sleep with the baby. I co-slept with my firstborn and am currently co-sleeping with my twins. Now I just turn to them when they cry for food — often I sleep through their feedings and don’t even wake up.

    The first month or two was the hardest when their neck support was weak and want to eat at the same time, I had to sit up multiple times at night and feed them on a nursing pillow (the only feasible way to feed them simultaneously without them having good neck support themselves) — I imagine that would not be necessary if the said mother only would have one newborn to deal with.

    SIDS is rare with healthy newborns if the respiratory system is well-developed and a few well-implemented preventative measures (eg. no random pillows, blankets anywhere on the bed near the baby).

  18. Lisa Kelsey

    If I had their marital and mental health issues and no family help I would certainly spend that amount of money. It would be an investment for their future relationships with each other and the children as well as the father’s career and the mother’s health. Personally I had 3 children in under 4 years as a single mother by choice (ivf). My mother helped me a lot but that was it. My youngest child has severe autism with a severe intellectual disability (IQ of 20-35). He is 6 years old and cannot talk, is still in nappies and can’t feed himself so it is now that I could do with more external help! In Australia we have the NDIS but that only covers 6 hours of carers a week and I use all those hours on the days I work to get him ready for school and pick him up from school. Ultimately I will also have to house him for life. So my only concern about someone depending a lot of money in assistance at the beginning of a child’s life is they might need that money later down the track to assist the child.

  19. Those numbers boggle my mind. Kid #1 we lived close to a lot of my family, but there was no daytime/overnight help from anyone. Kid #2 was two years later after we had moved from Tx to Md while my wife was pregnant and lived in her dad’s house. He had the basement, and we had the first floor. Even though we lived under the same roof, he was the director of a 2 year program at the University of Maryland, and I was working full time. He helped a little with the older one on the weekends, but it was pretty much up to my wife (stay at home mom). Kid #3 came three years after #2 and after we had moved back to Tx, but in another city with family 4+ hours away. My wife and I handled that one alone. Spending money to take care of our kids during the day or overnight never even crossed our minds.

  20. It’s great that they can afford to hire help. That’s the way to go if you have the fund for it.
    We didn’t spend that much because we got time off and we had help from my wife’s parent.
    – I got 8 weeks off.
    – Mrs. RB40 got 12 weeks off.
    – Her mom came up for 3 weeks.
    – Her dad came up for 2 weeks.
    Then we sent him to daycare when he was 6 months old.

  21. I probably had the same feelings as you Sam when I read this story.

    At first I was incredulous that someone could even consider spending $40k to take care of a child for the first 3 months.

    But without knowing the finances of this couple (if they are multimillionaires or billionaires, who am I to tell them what to do with their money) it is hard to say if this is a bad move or not.

    If going without this care truly leads to a divorce, then by all means this is well worth it as a divorce would make $40k seem like peanuts.

    As a parent of a single child I can’t imagine the complication of having a 2nd or more child that might not be on the same sleep-wake cycle as the others. If you have bad luck there could be potential for at least 1 kid to be up 24/7 in the house and that would create a ton of strain.

    Given that the majority of the population has more than 1 kid, has 1 or both parents working, and cannot afford this 4th trimester care and still hold together the household, I am afraid that there won’t be much sympathy directed to this particular couple.

  22. Wow! 40k spent just so you can get a little shut eye or function at your job? What’s the main priority here?
    Unless there’s extenuating circumstances, its your responsibility to handle this new life. Will it be easy? Nope. Will it be hard? Yep. Will you be a better person in the long run for the experiences? Absolutely.
    Maybe my mindset comes from a different time but it boils down to taking responsibility and prioritizing. Love that new life or lives. Give of yourself. You’ll live through it. Then you’ll have memories, good and bad, of the time spent with your little one.
    And yes, we raised 2 boys.

    1. Cool. How long did you and your partner stay at home when they were first born to raise them? And did you have any help from relatives?

      If you could afford to pay $40,000 for help, would you or would you not? Thanks

      1. I received 2 weeks to stay home, she received 3 months. We used a daycare for about another 2 months so she could return and finish out the commitment. We both decided that we didn’t like having someone raise our child. She stayed home primarily but worked from home part time. Financially it was tough, but the important thing was our 1st child.
        It was about the same with our 2nd, except this time, it was much harder on her physically/emotionally. I worked it out with my company to where I was closer if she needed me (ie in town and not traveling).
        Her mom was closest; about an hour away. No other family in-state. The next closest was about 5-6hrs away. Yes, Granma came over but it wasn’t for babysitting unless the wife needed to go to the doctor. Absolutely no over night watching until the kids got much older, ie sleeping through the night
        No I would not pay 40k. I asked the missus as I typed this, she laughed and said thats ridiculous.

  23. Our second baby is 10 days old and our first child is 3.5 years. We hadn’t even thought about hiring any help. I have increasingly thought we need to hire cleaners but haven’t gotten around to researching it. My wife has a year of maternity leave and I have about 2 months off work from a combination of paternity leave/excess annual leave etc. My wife’s mother is here from China for 6 months and does quite a bit of cooking and a little bit of looking after the 3 yo but adds lots of disruption too…. My family (my brother etc, parents no longer alive) is on the other side of the world We have a friend who is helping with driving the 3 yo to daycare and stuff. She is thinking of having a child as a single parent soon…. He is in daycare 4 days a week. Actually, so far it seems easier than the first time around. I am getting much more sleep as I am not sleeping in the room with the baby from the start this time. My wife can call me on the phone if she needs help in the middle of the night but so far hasn’t. Both times were a c-section but last time she was much more cautious about lifting the baby than this time. During the day she can have a nap for several hours while I look after the baby. We’re on a mix of pumped breast milk and formula this time, which is easier than all direct breast feeding last time. So, now I can feed the baby when she naps in the day…. Also, this baby is much better at sleeping it seems.

    1. That’s great parental leave for both. And if you can get your mother-in-law to do a lot of work, that’s good too.

      In many scenarios in America, mothers do not have one year of maternity leave. We do not have mandatory paid time off. It’s up to the companies discretion. The most is three months off usually.

  24. We live in Canada and our combined family income when we had our child was 150k CAD which is not high but it is about double the median income for our city.
    The plan outlined by the lady in the park does sound like from another planet although I would imagine it makes sense in the context of her specific undisclosed income.
    I had a C section in my late thirties and zero help from anyone family friends or even my husband who had a stressful job and needed to sleep.
    Time spent with my baby is a blur because of lack of sleep in the first 3 years actually but I remember the trauma of the surgery and the first few months in perfect detail 10 years later. This is why although I love my child more than anything I decided not to repeat the experience.
    My case is extreme I suppose, there was no one close to ask for help and I couldn’t trust a stranger like a nanny. I agree that people should take all the help they can afford.
    I didn’t want to put the child in daycare at 1 year old when the so generous Canadian maternity leave was finished so I flew in my mom from out of town and spent about 25000 CAD on housing and living expenses for her for 2 years. I just wouldn’t trust any doula nanny or sitter with my child, I never used a sitter.

    1. That’s great you got your mom to help for two years.

      Unless I missed it, how did you manage to take care of your second child after the C-section and what are the age differences? Did grandma help with the second too I guess?

      1. Hello,
        I did not have a second child, I assessed the effort not feasible under my specific constraints.
        I probably would have been able to soldier through another pregnancy all alone in my early 40s but I just couldn’t deal with the prolonged lack of sleep.
        It’s always other people that have babies do full nights after a month or so and I found the advice “nap while the baby naps” completely useless for me.
        Now we can afford a house in one of the most affluent neighbourhoods and my child goes to private school. House would have still been feasible but private school with 2 kids definitely not. My daughter feels lonely without siblings so pros and cons…

    2. I was in your situation with my first – unexpected C-section & several other post-birth incidents that were hard to recover from, new in town with no help from anyone, and a husband who chose to leave me alone rather than staying to help for the week that has been promised. So hard and so traumatic. The first day I was at home by myself with the baby I had a relapse, and could not get to the phone or the baby to take care of her. This should not have happened, and “being tough” was not good enough. When I had enough strength and clarity of thought to try to find help, there was none available, regardless of how much I was willing to pay. Not even a babysitter for a couple of hours. (No doulas then, and the few child-care providers in town were all full.) How I needed and longed for a little help. I needed someone to take care of me. There were many times when I thought I should flag down a car and give them my baby, out of desperation. I feel jealous that the lady you were talking with had so many sources of help available to her, regardless of the financial cost.
      After a few weeks things improved. I was healing and I found someone to take my daughter to for a couple of hours a week (bliss!). But, I did not have another child for 6 years. It took a lot to talk me into that. Thankfully, the second was a natural birth and things were completely different for me – healthy, available childcare that I took advantage of, and a baby who was easier to take care of.
      I wish that every mother had an abundance of help. Everyone would benefit from it, and for those in a difficult situation, it would make all the difference in the world.

  25. I’d spend money to hire all these ppl in a heartbeat if I didn’t have any support from friends or family. If they can afford it, this is good place to spend it – given their situation.

    I’d also ask the mom to consider getting cooked food delivered by personal chef – or get it prepped for easy cooking during the week.

  26. A birthing doula is a must and it is an outrage that one isn’t covered by medical insurance.

    In my opinion, a day doula + a night doula + a babysitter is excessive, but I guess if you have 0 family or friends nearby, that’s what you do.

    For the birth of our second child, we did already have a nanny in place 4 days/week. I was on bed rest for the full 3rd trimester and fortunately had opted in to a short term disability policy the year prior. We feel very fortunate that we were able to keep our nanny for our toddler while I was stuck in a horizontal position for several months.

    After I was up and moving around again, we took our kids out with us most times. Other times, we had lots of friends who volunteered to hold down the fort for a couple hours so we could spend time talking about our kids instead of talking over them lol

  27. Thank goodness for the NHS! We are from the UK and I was encouraged to have my third child at home. I had a doctor and midwife at the birth, the midwife came in every day for 2 weeks and the health visitor (a qualified RN) then took over periodically. But I was also entitled to a “home help” for 14 complete days for which I paid a nominal sum. As our other 2 children were 5 and 8 and at school, we had her for about a month, probably longer as we could cope at weekends.
    That child was and still is a delight as we were all relaxed. She is now a mother herself, in the UK where paid childcare is still available. I am so glad that she had her babies there.
    Paid help with childcare is an obligation for every civilized nation. We depend upon the next generation for our wellbeing.
    Thank you Sam for supporting the well-being of childcare and recognizing that it is the job of the whole community.

    1. I just couldn’t stand reading these comments any longer. Sorry if I offend anyone but… “childcare is an obligation for every civilized nation”???? Are you crazy??? Not in America, where people should be responsible for themselves…I, myself am tired of paying for every one (including people who shouldn’t be here) else who can’t be responsible for their own family. I knew after my first child that it was not going to be financially wise to have another child, so I didn’t. Why can’t other people?

      Sam, if you don’t post this I understand. Sorry but I am not a liberal or socialist.

      1. It is all very good to be “responsible for yourselves”. I am 77, in good health, but aware that I am now dependent on the future generations. We need up and coming youngsters to continue to build this nation, but the birth rate is plummeting as people decide to have fewer children. I was a science teacher for many years and now still substitute in my local schools.
        I am also aware that disease knows no boundaries, even Queen Victoria’s husband died of typhoid along with the great unwashed of London. So unfortunately, we do have to deal with the sick who have inadequate health care through no fault of their own.
        Incidentally, the NHS brought in free family planning clinics in the 60s. There was uproar! But when the fuss had died down, it was found that there was a huge drop in abortions and unwanted pregnancies, resulting in enormous savings.

  28. We have two kids and I kid you not, my wife and I were both hit with a wave of depression that lasted well beyond the fourth trimester for each kid…

    Don’t get me wrong. Our kids are one of our greatest sources of pride and joy, but it’s extremely hard in the first six months ESPECIALLY if you 1) have no means to hire help or 2) don’t have family around to help

    The amount of mental stress that we go through during the period of trying to get pregnant, then the pregnancy stages, then the recovery period, and the “fourth” trimester has significantly aged us both mentally and physically. Our body has weakened (back, hips, even more so for my wife), mentally we were drained for pretty much 180 days without rest, and financially – the cost of daycare/pre-school has become burdensome…

    It doesn’t end.

    So the question then is, is all of this worth it?

    For us, 100%. We would do it all over again but no more than two. We always wanted a big family (3 or 4 kids) but we got a huge reality check.

    Makes you wonder how the folks did it back in the 50s where 5-7 kids were the norm. Crazy…

    1. Hi Jeff,

      Thanks for sharing. I COMPLETELY empathize and understand where you’re coming from regarding depression and the difficulty of raising kids during the first six months, if not longer. This understanding is exactly why I wrote this article. One, it should help expecting parents better prepare for what’s ahead, b/c it is harder than most folks can imagine. And two, I want to talk about the cost to our wallets, health, and happiness.

      We got to go into parenting with EYES WIDE OPEN, b/c we owe it to our kids who don’t know better.

      I don’t think many parents will ever regret having kids. But boy are things tough in the beginning, especially without family or friend help.

      Another vote to have kids younger rather than older too.

      My lower back is always sore… but that might be b/c I play softball and tennis 3X a week. Hah.

      How old are your kids now?

      And perhaps being able to pay for fourth trimester care is one of the biggest benefits to having money.

      1. Indeed on going in with eyes wide open. You can read all the books and tips on parenting, but it’ll never adequately prepare you because the lack of sleep, lack of energy, the lack of social interaction, constantly being in survival mode throws everything out the window. Imagine being cash strapped or having your spouse go through PPD? So yeah – money will definitely help :)

        My kids are now 5 and 1. Just when one is getting easy, we decided to have another LOL

  29. We had three kids three years apart each. My wife chose to be a stay at home mom. We had no close family support. It was no big deal. We didn’t hire any outside help. Kids are not complicated, they need love, attention and as they grow, discipline and accountability. I pitched in before and after work. Those were tiring times for sure, but also lots of fun. Its pretty hard to mess up parenting if your mental and physical health is good. Obviously if something serious is involved like depression or physical limitations then its an emergency and outside help is absolutely necessary. But I think those are fairly rare cases. For most 20-30 year olds a little sleep deprivation is an inconvenience. I’ll admit it felt worse to me then, but I was a typical whiny young adult back then too, much tougher now.

  30. My third child is now four months old, which means that my wife and I just finished the fourth trimester for the third time. Our oldest child is currently five years old, so these kids are fairly close together. We have no family or other regular support within 1,000 miles, so we bear the entire burden. I am an attorney and my wife stays home with the kids. My jobs during those times provided the following levels of paternity leave for those children: 2 weeks, 0 weeks, and 1 week.

    With that background out of the way, my opinion is that we would certainly spend that money if we had it set aside already and were under the same circumstances that the woman in your story described. With the first two children, my wife and I gutted through the fourth trimester on our own. We felt that we should be able to handle it – after all, hadn’t our own parents done the same? But it was incredibly hard. The lack of uninterrupted sleep caused me added stress about potentially missing some important detail at my job due to fatigue, and generally made both of us worse spouses and parents during that stage.

    So after baby number three, I insisted that we try hiring some help. We hired a housekeeper to come by weekly for the first six weeks, and a baby sitter to come by whenever my wife felt like she needed some extra help with the older kids (which ended up being about once a week, though sometimes only once every two weeks). The added help made a difference for us. Sometimes even a short respite to catch your breath before charging back into the chaos of parenting can really help. My wife was able to focus more on the brand new baby, and I spent fewer of my after-work hours cleaning up the house from each day’s activities.

    We will consider hiring even more help if we have another child. I don’t make the necessary salary to spend $40,000~ hiring help, but I fully support someone who does make that sort of money spending it to maintain their sanity and their marriage during a difficult time.

    Also, now having had several children and watched friends do the same, I will say that many people simply do not appreciate or even realize the level of help that they have received from friends and family. For instance, they might undervalue having one or both sets of the child’s grandparents close by, ready and willing step in for last-minute child care while the parents run errands, clean the house, or just catch up on sleep. Small regular breaks like that would be huge! Or perhaps they had family or friends come by and assist with the housekeeping or childcare for the older children. I’ve met many people who received all of this help, and they are the first to turn up their noses at the idea that anyone could ever need to hire help post-birth.

    1. Such a good point about how those who criticize the hiring of help may not realize the extent to which they’re getting back-up support from nearby family members.

      I once read a study that reported that hiring cleaning help (for 2-4x per month) is the best and easiest thing couples can do to promote marital harmony.

      Finally, I related to your point about “gutting through” the fourth trimester on your own with the first two kids. My husband and I used to consider ourselves to be in “survival mode” during those early months. In hindsight, maybe we could have found more support.

  31. I have two kids 20 months apart. My alternate suggestion would be to pay for daycare for the toddler, and have a daytime doula. Since she will be recovering, the quality of time that she will spend with the toddler during those initial months are going to be poor and sleep deprived, if not bedridden, based upon what you have mentioned. The toddler would learn more, gain some independence, and have more fun in a new environment. The mom would be able to enjoy as much as possible those initial months and hopefully also get rest. Even if they pick up the toddler early, they have that choice and can favor quality over quantity.

    1. Sending the toddler to daycare for the first time with a vulnerable newborn in the house is not a great idea. The amount of germs and sickness he will bring home is definitely not worth it.

  32. Wow I must live on a different planet than the audience for this blog. My parents raised three kids in succession with only the occasional high school babysitter for help.

    1. We had help from grandparents who live nearby so paying for help was never an option. Revisionist history very common though at the time of sleepless nights it was known it would be a very time limited issue & so it was.

  33. Daniel Cohen

    We have two kids. My wife was a stay at home mother so she took on the responsibilities while I worked. It was really tough for both of us for 6 months after each kid.

  34. I have three kids and totally get what this woman is considering. When we had our third we hired a night doula 7 nights a week. We also have a pt nanny who helps take our older ones to school during the day and their after school activities. Things get crazy with multiple kids in the house and newborns are crazy adorable but incredibly exhausting. Someone always needs something at every hour of the day/night and the more hands on deck the better. People who have a lot of family nearby should definitely lean on them for support. But I totally get how sometimes that doesn’t work for whatever reason and hiring outside help can be a huge life and sanity saver. It can get very expensive but I agree you get the most bang for your buck when they’re still in diapers!

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