Even more misunderstood is the value of a doula.
After all, why would you want to pay hundreds of dollars for someone just to focus on YOU, especially if you're in a hospital, or even having a c-section, why would you want a doula?
Well, there are lots of reasons why ...
Well, first remember that the midwife's job is to be there for you birthing your baby. To help you move around, watch for any red flags, and know what to do if any situations NEED interference or guidance, or rarely, medical intervention (certified midwives have life-saving tools and training, much like an EMT).
Your doula's job, on the other hand, has little to do with the baby and everything to do WITH YOU. Her title translates to "servant of the mother." Her job is to focus on you, and just you. Women who use doulas often have less complications and shorter labors.
In a home birth setting, she can help gently remind you of things you wanted to try, such as a birthing ball, different pushing positions, a hot shower, or a back massage. She can start the tub for you if she sees you're getting uncomfortable. She can help you remember birth affirmations (positive phrases) such as, "My body is made to do this" and "Self-doubt is the sign that it's almost over", which you can choose ahead of time.
In a hospital setting, she can help you keep your mind on the goals you had in advance. A good doula will ask, "Did you want time to think about that?" if a nurse is demanding you have something done, so you can be free of pressure before making decisions, and help with reminding you and your partner of the choices you'd made ahead of time about things such as methods of pain management, positions you'd like to try. She can remind you of things you'd intented on asking for, such as no mention of an epidural being made in your presence, that the wireless fetal monitors be used before they suggest you lay down. In essence, your birth plan. For example, if you're having back labor, rocking on hands and knees can help immensely, and that can be a part of your plan that your doula reminds you of, since in labor, stress can take over ... especially if the situation isn't kept stress-free (part of her job as well).
I wish I'd had a doula during my birth, especially for the time where my husband had to leave me by myself while he took my son to my friend's to be babysat. That was when I hit transition, and freaked out. The self-doubt got to me, and I had no one to talk me down or comfort me at that point, which a doula would have done.
She can even be your support during a c-section, to help you emotionally during both the surgery prep, and during the hard time after the baby's out, where often you can't see them, and the sensations are nauseating. She can help remind you (or your spouse) that you wanted the baby brought to you as soon as possible to initiate breastfeeding, or that your husband was going to keep the baby in his sight at all times and remind doctors that no formula or glucose was to be given. Or whatever things you might choose. Everyone has preferences.
The biggest questions is: Does a doula replace your husband/partner? The answer is absolutely, positively NOT. In fact their goal is often to help your partner be MORE involved, letting him know that putting gentle pressure at this certain point on your back can help, or showing him how to support you while you squat. Her goal is never, ever to replace your partner but actually to make him feel even more useful and important.
If you're interested in a doula, interview them during your pregnancy, and be discriminate -- you need to feel very comfortable with this person, or the point is moot. Your spouse should be part of the interview process as well.
If you're a military spouse and your husband is deployed for your birth, you can actually get a doula (for free) through Operation Special Delivery.
Did you or will you have a doula at your birth?