I read most the responses and realize the conversation has gone more to doulas and nurses, but I figured I would add another mom perspective. My DH will be out of town for my birth. I will most likely be with my mom, but she kind of freaked out at my son's birth. So I have decided to hire a doula. I want someone to help me breath, someone to say "you are doing great, you dont need to give in to that epidural yet". My mom cant do that and really my dh didnt do great either. When I told my l&d nurse I was thinking about an epidural she said, "good idea, no need to be a hero."
I have found a great provider that knows my desires, but I trust his medical opinion. When I told him I would be hiring a doula he told me that was a great idea and gave me a few business cards with ones he has worked with recently. Now I would not at all say he or my hospital is "crunchy". The cs rate is close to 30%, midwives are illegal, and bfing is the lowest in the nation. So there is a doc who can see the value and appreciate that sometimes a mom needs to bring her own support.