Martha, I totally feel for you! I have almost the EXACT same situation in Northern Nevada. This year we finally got another doula, and progress is slow, but I feel it's improving.
Here are my biggest tips (what I did/still do)
1. ADVERTISE! This doesn't mean spending loads of money. I put up brochures on grocery store bulletin boards. I make the brochures on my computer (they look great! All I have is Microsoft Works and I print on "flyer paper" from Wal-Mart). I put mine at the grocery stores, library, coffee shop, try to think of places moms go and then ask the management for permission.
2. WORD OF MOUTH! Tell people who have big mouths all about what you do! Convince them of the greatness of doulas and they'll convince everyone else! I use my sister. She works at Wal-Mart and asks every pregnant woman she sees if she has a doula. She then explains what doulas are and how to find one! She even told a lady who works for an OB here, and now my brochures go out in his welcome packs and are in his lobby! 
3. Write a letter to your hospital's marketing director. Tell them who you are and what you do and propose a presentation. Do it for your CBE classes also if the hospital doesn't have classes. The OB dept and the marketing and/or administration dept are TWO DIFFERENT DEPTS! They probably won't even know that OB doesn't like doulas! I should have done this sooner. Someone suggested it to me and I never did it. Then I met the marketing director by chance- our kids were on the same soccer team. Now she's a HUGE resource for me!
4. Library!!! If they have a meeting room they might let you have it to teach classes. My library has been so good to me. See about donating some birth books, they would probbaly be very grateful! Ask them if you can put some brocures at the counter. Buddy up to a librarian also. Just chit-chat about what you do! That's what I did and now when women come looking for birth books my librarian freind tells them about doulas!
5. Act kind and dress nice. Seriously! As much as you'd like to bite the heads off of medical staff for being rude and not knowing about doulas, etc, keep your cool! Be sweet, but not cheesy. State what you mean, but watch your tone. I've had to learn this. Really hard in a town where in high school I was a rebel and a "wild child"! People who knew me then can't believe how I am now and I still feel I have a less than perfect reputation! I always think before I speak and make sure I respect others while receiving the respect and kindness I deserve. Also, if you dress well, and keep yourself well presented, it does wonders. I know this sounds weird but I am one of these "go to walmart in my pjs w/ my hair tied on top of my head" types and sometimes I get the impression that people are thinking, "THAT'S the doula???" I never dress fancy, but I do brush my hair more! 
Hope this helps a little. Great thread! I totally get your situation!
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Abby Lindsey Mommy to Soren, age 8  Certified Educator of Infant Massage Certified Lactation Counselor (CLC)  CPST (Certified Child Passenger Safety Technician) Safe Kids
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childbirth instructor 
). Are there other doulas in your area that might be interested in joining you so you can all have a chance to introduce yourselves, talk about what doulas do/don't do and answer any questions they have?
