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For my clients, I have set them up with either Sendy or PHPList and an MTA that doesn't care about adult content. If you keep an eye on bounce rates, and ensure that things are processed correctly, both of these self-hosted applications are exceedingly capable.
I used to get approvals via SES, but over the past few years, it has been very difficult.
I think the grand total cost per month for something self-hosted is like $35-50 to send about a hundred thousand emails.
For email templates I will put together MJML designs and those have good universal acceptance by clients.
I did have some luck sending mails from a mainstream provider, as long as there was absolutely no nudity or overt sexual content, but it's been a while. It's really not worth testing those waters unless you really want to.
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