Right off, I'm a doula myself (though not practicing at the moment) and I'm very pro-doula. I've had a doula for each of my previous three births. I know all the benefits a doula can bring to a birth, and my DH has always enjoyed having the doula there! But I'm still uncertain and would love some feedback...
--I had a c/s with my first child... she was big, posterior, asynclitic, my water had broken on it's own a day before contractions started, and despite everything that birth ended in the OR. Since then I have had two hospital VBACs. This will be my third hospital VBAC and, because of the local birth climate, I will be traveling about an hour to a VBAC supportive hospital. This is where I had my second VBAC, and this birth is being attended by the same midwife group as during that birth (so while I can't be sure I'll have the same midwife as last time, I am familiar with the whole group and with the hospital itself). This midwife group is VBAC supportive, I have access to a shower/tub, they're ok with intermittent monitoring, I can eat/move/whatever as long as no complications arise.
--Money is tight. Very tight. Local rate for a doula is 600-1000 dollars (two prenatal visits, birth support, one pp visit). While there are sliding scales, and doulas willing to work with payment plans or for free during certification, because the hospital is so far away and gas is so pricey I don't feel comfortable asking for a reduced fee. We would pay the full amount and probably a bit more to cover gas.
--After three births, DH is comfortable being a support person/advocate and is really familiar with my birth philosophy/needs. He isn't sure how much help a doula would be this time round, especially if it was someone doing a certification birth (meaning DH would have more actual birth support experience than the doula). He is willing to do what it takes to get a doula if I want one, but he doesn't see a need for one outside of a "worst case scenario" where I needed a repeat c/s and he'd have to go with the baby. The hospital would not allow a doula into the OR with me after DH left, but she would be able to be with me in recovery.
--My births have gotten faster and faster... dd1 was 24+hrs of active labor (as in, 5cm or more), dd2 was 12 hours start to finish, ds was roughly 4 hours from start to finish. It is possible that a doula wouldn't make it to the hospital in time (especially given the drive, we live closer to the hospital than the currently working doulas so for them the drive would be anywhere from 1 to 1.5 hours).
--The doula we adore (and had at our last two births) no longer attends births. So we'd be hiring someone we'd never birthed with.
So... if someone told me they were planning a hospital VBAC without a doula, I'd probably tell them they were crazy. But now that I'm the person on the other side of the equation I just don't know! If money wasn't an issue I'd probably say "let's find one just to have one", but since money really is an issue... I just don't know. I know these providers, this hospital, my own birth experiences, etc. DH is comfortable in the birth suite, he's been there for me three times already, he has his "fighting face" ready in case the hospital or providers try to give me a hard time, and so on.
Any fresh eyes and opinions? I'm just talking myself round in circles!