Relle, I'm finding the same as you - I'm about 100 miles (2-3 hours in my slow car) from the CBD and out here, few people have heard of doulas. I have advertised extensively, but this first year of being a doula so far from the city is pretty slow going. I would love to find a few more clients but on the other hand, I'm being patient because I know we offer a great service at low cost and the idea is bound to catch on. I would have loved a doula but because I did not know about them, I ended up having 2 or 3 women friends at each birth, and they really were my 'angel women' - my doulas. In hospital or out of hospital, I think that nurturing support is lovely to have at a birth.
I really love this work and I hope we all have full hands and full hearts doing what we love - supporting and empowering mothers.