I'm thrashing out the options to help me cope with a c-section planned in Feb and a very large and heavy non-walking toddler, currently 18 months and will be 22 months at time of the birth. Doulas seem expensive, certainly a lot more expensive than au pairs, but if they are really good it might be money well spent.
Have also posted in the nannies/au pairs section, hoping to get as many replies and experience as possible.