What doulas need from their software, from sources outside Acuity Scheduling and outside Nexa:
Acuity Scheduling covers the booking side of a doula practice well. Its feature list includes online booking, custom intake forms, packages and subscriptions, deposits, cancelation policies, text reminders, a waitlist and Google Calendar sync. It also lists HIPAA compliance, with a Business Associate Agreement on the Premium plan. It does not list what Medicaid doula work depends on. That means tracking each doula's training, certification and CPR dates by state, recording each doula's NPI and enrollment details, and billing in 15-minute units against per-pregnancy caps with visit-type codes. Those caps include 28 prenatal units and 25 postpartum units in Kansas, plus one labor and delivery code every 280 days. It is a scheduling tool, so a doula would have to keep those records elsewhere.
Nexa has invoices, estimates, payment plans, a client pay portal through your own Stripe account, a CRM with notes and tags, a public booking page with intake forms, time tracking, and bookkeeping with expenses and profit and loss. It works offline and has a Spanish interface. It has no text messages, no Google Calendar sync (calendar export is an .ics file), no waitlist and no recurring booking series. Its automated emails and reminders send only while Nexa is open on one of your devices. It is software you own and run yourself, with no hosted support desk or vendor-run onboarding. Nothing in Nexa's feature set addresses state credential tracking or Medicaid unit and cap billing either.
Over three years Acuity Scheduling at $34 a month costs $408 a year, or $1,224. Nexa is $279 once, or $458.64 with optional Cloud Sync at $4.99 a month. Nexa is cheaper, but price is not the deciding factor here. A doula who mainly needs booking, reminders and intake should stay with Acuity Scheduling, because it has text reminders, calendar sync and a waitlist that Nexa lacks. A doula who wants invoicing and bookkeeping in one owned tool could choose Nexa. A doula whose income depends on Medicaid billing needs a different kind of tool: doula-specific practice management and Medicaid billing software that tracks credentials, NPIs, unit rates and visit caps by state.
Our read for doulas: Neither tool tracks state credentials or bills Medicaid in 15-minute units against visit caps, so Medicaid-billing doulas need doula-specific practice management and Medicaid billing software.
Read on each linked page in October 2026. Check them again before you decide; vendors change plans often.
Acuity Scheduling costs doulas $408/year at today's list price. Nexa is $279 once for invoicing, scheduling, CRM, time tracking and accounting in one suite — so after 8.2 months it has cost less than Acuity Scheduling, and you own it after that. What it is not: hosted-for-you software with a support desk and a roadmap you can lobby. That is the trade, and the rest of this page is the detail behind it.
Nexa is $279 once, about $23 a month over its first year. Its Drain Guard reads your expenses (from a linked bank, an imported statement, or ones you type in), finds the charges that repeat, and adds them up by the month. Keep or Cut then walks you through them one at a time. Cancel $23 a month of charges you'd forgotten about and Nexa has paid for itself inside the first year, before you count the Acuity Scheduling bill you'd stop paying.
It depends on what you find and what you cancel, so we don't promise a number. In our demo data, Drain Guard finds 5 subscriptions adding up to $110.13 a month. That is sample data, not a customer's.
The verdict for doulas: Neither Acuity Scheduling nor Nexa is the main system for this work; start with software built for it. Nexa only makes sense beside it, at $279 once against $1,224 for Acuity Scheduling over three years.
Scheduling, client records and invoicing are the pieces of that day. Some tools rent you each piece separately. A few — Nexa among them — bundle the lot and carry their own booking link, with no per-appointment cut. The sections below price both routes honestly.
None of that is a software problem you can buy your way out of in one click — it is why the tool you pick matters more than what it costs. Acuity Scheduling solves some of it. So does Nexa. The difference is what you are left holding in three years.
Today's list price is $34/month — $408 a year, from Acuity Scheduling's own pricing page. Every figure below is that price, multiplied. Nothing is projected.
Nexa: $279 once (or 3 × $99). Over the same three years, that is $945 less.
If Acuity Scheduling raises its price, the three-year cost goes up; if it cuts it, the cost comes down. We don't guess which. Add-ons, extra seats and card-processing fees are not included, on either side.
| Feature | Acuity Scheduling | Nexa |
|---|---|---|
| Invoicing | ✗ | ✓ |
| Scheduling | ✓ | ✓ |
| CRM | ✗ | ✓ |
| Time Tracking | ✗ | ✓ |
| Full Accounting | ✗ | ✓ (SIMPL) |
| Task Management | ✗ | ✓ |
| Works offline | — | ✓ |
| Price | $34/mo | $279 once or 3 × $99 |
| 3-Year Total | $1,224 | $279 |
| You own it? | No — stop paying, lose access | Yes — forever |
✓ and ✗ for Acuity Scheduling come from its own published feature list. — means the feature isn't in that list, which is not the same as Acuity Scheduling lacking it: check with them. Three years is at today's price.
Straight from Acuity Scheduling's own feature set. If one of these is the reason you pay them, that reason does not disappear because Nexa is cheaper.
Acuity Scheduling is the better call if you need intake forms specifically, or if your team is large enough that per-seat pricing still beats buying software outright.
Acuity says it is for "anyone in the business of time," from solo practitioners to multi-location teams. It lists beauty, business services (consulting, coaching), wellness, fitness, visual and performing arts, and education. (acuityscheduling.com)
What people outside Acuity Scheduling and outside Nexa say:
Read on each linked page in October 2026. Check them again before you decide; vendors change plans often.
Software doesn't do the actual work — it automates the business around it. And that part is the same for every doula: find the work, manage it, bill for it, get paid. Each step has a tool — and the right single tool runs the whole loop, so the handoffs are automatic and you get back to the actual work. Tap a step to see what gets automated.
An inquiry becomes a proposal becomes a signed engagement — the terms and the retainer set.
The work you're paid for — with the hours, tasks, and expenses tracked against the engagement instead of reconstructed at month-end.
The work becomes the invoice — the hours, the add-ons, the materials, the deposit credited — totaled and sent, instead of re-typed at 9pm.
Paid by card or link, the deposit credited, and what's overdue chased — without you doing it by hand.
You can stitch four separate subscriptions across these four steps, or run one tool that does the whole flow so a booking becomes a job becomes an invoice becomes a payment without re-typing. Either way the goal is the same: less time on the business of the business, more on the actual work. (Nexa is built to be the one — but the honest options for each step are above and below.)
This is the connection that makes the rest worth it. A doula's job already holds the services, the hours, the add-ons, and the materials — so the invoice builds itself from the work instead of you re-typing it at 9pm. Toggle an add-on or nudge the hours and watch it recompute.
You didn't write this invoice — the job did.
Acuity Scheduling plus whatever else you're paying for:
Email yourself this comparison?
The median doula earns $35,000/year. At $408/year, Acuity Scheduling is a recurring slice of that — paid again every year, whether the year was good or not. Owning the same jobs outright is $279 once, and the slice stops.
Nexa is $279 once. Invoicing, scheduling, CRM, time tracking, accounting — all connected, built for doulas. You own it like you own your Birth bag supplies.
An honest fit check — because the wrong tool is worse than no tool.
The honest fit: if you're a solo or small doulas business that owns its tools and is sick of renting software, Nexa replaces your whole stack for $279 once. If you're scaling into a large team with dedicated admin staff, a bigger platform may fit better — and we'd rather tell you that now than sell you the wrong thing.
Your people are already online — swapping real numbers, tool picks, and war stories. Here's where to find them.
Active community — tool picks, pricing, and day-to-day questions.
Open on Reddit →Active community — tool picks, pricing, and day-to-day questions.
Open on Reddit →Active community — tool picks, pricing, and day-to-day questions.
Open on Reddit →Scheduling, client records and invoicing are the pieces of that day. Some tools rent you each piece separately. A few — Nexa among them — bundle the lot and carry their own booking link, with no per-appointment cut. The sections below price both routes honestly.
I support families through pregnancy, birth and the first weeks after. A client relationship starts months before the due date with a couple of prenatal visits: talking through their hopes for the birth, their fears, who will be in the room, and comfort techniques we practise together. From about thirty-seven weeks I'm on call around the clock, with my phone on at all times and childcare arranged for my own kids, because labour starts when it starts. During labour I'm with them for as long as it takes, sometimes twenty hours: suggesting positions, massage and breathing, keeping them informed and calm, and helping the partner support them. I'm not a medical provider, and I'm clear about that; my job is support, and I work alongside the midwife or doctor. After the birth I help with the first feed and visit in the following weeks to talk through the birth and check how everyone's coping. Most families pay a package fee in instalments, with a deposit to reserve their due date, and I only take a few clients a month so I'm never at two births at once.
Real doulas near you who run their business on Nexa — book directly, no platform fee. Are you a doula? Post your business and get found in your area — $2.99 one-time. Or browse every doula on Nexa →
The tools of the trade — each a one-time buy that earns its keep for years.
You paid for these once because good tools last. That's the bar your software should clear too — priced like a tool you own, $279 once, not a subscription that costs more than your kit every year.
We build a doula's guide the same way every time, and we'd rather you trust it than take it on faith. Nexa is our product, so the test we hold ourselves to is simple: a tool only "wins" a job here when it genuinely does that job better for a doula — and where something free, open-source, or buy-once does it better, we say so and link you to it. Where Nexa falls short (payroll is the honest example), we name the alternative outright.
Found something out of date? Prices change and we don't catch every move the day it happens. This guide is published and maintained by the Nexa team; if a figure here is wrong, tell us and we'll fix it — getting it right matters more to us than the sale.
For solo doulas and small teams, yes. invoicing, scheduling, CRM, time tracking, task management, and full accounting — all for $279 once. Acuity Scheduling may be better if you have a large team (10+) or need enterprise-specific features.
Acuity Scheduling has features like Intake forms and Package and subscription billing that some businesses rely on. For most solo doulas, these aren't dealbreakers.
At $34/month, Nexa pays for itself in 8.2 months. After that: $408 saved every year.
Yes. Nexa is $279 as a one-time payment, or 3 payments of $99 ($297 total). Either way it's a one-time purchase — no subscription, no recurring fees ever.
Own your tools. Stop renting your software.
Get Nexa — $279 Once