The past two times I have given birth, it was a my rural hospital, and it was just me and DH. They do maybe 3-5 births a week, and have a pretty small staff. DH felt pretty confidant that he wanted to be my primary support person, and so we decided to go at it alone. We wanted it to be just the two of us for most of the time- and it was. The nurses stayed out of the way, and the doctor had not yet arrived by the time DS was born, so DH delivered him and then we called for the nurses.
We decided to have a doula upon finding out that I was pregnant with twins. With our past two births, the nurses did the APGAR test with the baby in my arms or DH's arms, but basically when we found out we were pregnant with twins, we couldnt figure out the logistics of being able to keep both babies with us (pending that there is no need for them to go away for medical treatment). We basically decided to get a doula so that there would be someone there after delivery to hold a baby and someone to advocate for us in case of emergency c-section, so that DH could either stay with me or stay with the babies.
I searched for a doula and talked with a few, and then decided that we'd rather use my very, very good friend who is also a homebirth midwife. She's been there through some of the best and worst times of our lives, and I think she will be perfect to have there for the twins birth. Ill gladly hand one of my babies to her while Im delivering the other :) Plus, Im sure she will be great for encouragement throughout the labor, as well as awesome at giving a second opinion medically.
I wish hospitals had doulas on call :) Everything was fine for my past two births, but when I was laboring with DD there were about 3 hours where DH could have seriously used some support. He was exhausted and out of ideas. But, we really liked being alone for most of it- just someone there for those three hours would have been great.