A doula is not typically covered by insurance, but their rates tend to be reasonable enough for most people to afford. Some doulas will offer fewer or greater services than others. For example, a local doula in my area will not speak to staff for her clients, but she will provide follow up care in multiple visits after the baby is born.
Having a doula allows your spouse or partner to focus more on you and less on what is going on around you. This means they can be there through the entire labor process to support and encourage you, without having to handle other details such as talking with staff, arranging the birthing pool, or other such matters.
Your doula can help you with pain relief by providing massage, breathing cues and assistance with different labor positions.
In the past, women often labored with the support of other women. In fact, in many societies, the men would busy themselves elsewhere while women took care of the laboring woman and provided all the care and support she needed. A doula acts in the same capacity as a friend or partner might, providing that support and encouragement.
Whether you are having a hospital birth or a home birth, a doula can help make the birthing process easier, more positive and less stressful.