This is long, sorry!

Some information on birth doulas taken from: http://alace.org/article.html:

The most impressive aspect of this newest choice in childbirth is the effect of having another woman present with the family at birth. In a series of six clinical trials, the presence of doulas and/or monitrices resulted in 50% fewer cesareans, a 25% reduction in the length of labor; 30% less usage of pain medication, 40% less use of the drug pitocin, and 50% fewer Epidurals needed. In addition to the obvious contributions to the mother's comfort level and the potential for a less complicated, safer delivery - these statistics also point to enormous savings in light of the current health-care crisis.

A common concern for many is how the birth assistant affects the role of the father or primary support person at the birth. Contrary to what may be thought, the services they provide directly facilitates the family being able to give the love and attention that only they can give. The labor support provider brings with them a level of expertise gained from extensive training and study as well as experience from attending many other births. Having their continuous support often relieves the family of the pressure they may feel that to "be the experts" and frees them to feel and express their own emotions as they themselves witness the miraculous and challenging process of labor and birth. Among consumers who have utilized the services of a labor support provider, it is often the woman's partner who raves afterwards about the benefits of having the support at the birth.

Also, labor support providers do not duplicate the services of doctors, midwives or nurses in the hospital setting. Their job is to work in collaboration with the rest of the team to support the family in having the safest and most satisfying birth possible. While some birth assistants do monitor mother and baby's well being at home (as a means of determining all is well) - the main support they provide is to work with the mother and her labor in the areas of physical comfort and emotional encouragement. Because they do not have the larger responsibilities of the primary caregivers, they are able to focus on their work as they stay with the family throughout. In this way, the family is able to have at least one caregiver who is with them for the entire birth experience.

Generally birth assistants are used by families who begin their labor with natural childbirth as their goal and who desire a minimum use of technology. They recognize the value of staying home in the early part of labor, but may not feel confident in being completely alone once the labor gets started. Typically, the labor support provider will meet with a family during the final trimester of their pregnancy to get acquainted and to learn about prior birth experience, and their priorities for this birth. They may discuss the birth plan, supplies needed, and comfort suggestions for the final phase of pregnancy. Then, when labor starts, with the support of the physician or midwife, the family may choose to labor at home with support of the birth assistant, going to the hospital when active labor has been established. The doula then helps with the transition to the hospital and stays with the family until an hour or two after the baby has been born. Many birth assistants also provide a postpartum visit or services as well. In addition other services may be offered such as photography, video, sibling support, massage, etc.

Fees for this service vary widely around the country. Usually fees range from $150 to $500, but in some areas they may reach up to $750. Some women work on a fee-per-birth basis and others charge package fees and/or hourly. Most providers also make their services available, when possible, for free or on a trade basis to those who cannot afford it.

To choose a labor assistant, it is suggested that you meet with more than one in making your choice. As the invitation to be at your birth is highly personal, it is important that you feel connected to and comfortable with the one you choose. The women who do this work know that, and understand that one provider may be a better match than others for a particular client. Below is a list of suggested questions you may want to ask:

Are you certified? By Whom? For how long?
What did your training entail?
How long have you been practicing?
How many births have you attended?
Have you worked with my doctor/midwife before?
Have you worked at my chosen hospital/birth center?
What services do you provide?
Do you assess mother and baby well being at home? If so, are you certified, licensed?
What is your own philosophy about birth?
What is your on-call availability? Do you use back up? Work with partners?
How do I reach you in a hurry?
What are your fees and what do they include?

Links
http://www.bellywomen.net Free/Low Cost Doulas (plus it's my site so I'm doing some shameless promotion).
http://www.ALACE.org Association of Labor Assistants and Childbirth Educators
http://www.dona.org Doulas of North America
http://www.cappa.net Childbirth and Postpartum Professional Organization