I think Rachel's got the right of it -- mothers need options and different mothers will choose different methods of milk expression, assuming those options are available and assuming the option is safe and effective at milk removal, based on individual differences. 

Personally, I HATED manual expression. Hated it. Really hated it. It was one of few options available when my babies were nursing; other options included the wonderful bicycle horn pump, the Lloyd-B, juice jar pump (if you haven't tried the heated juice jar, you haven't lived), etc. At least I got milk out while hand expressing vs. those other pumps, although I can't say I really let down. I'd have given anything for one of today's self-cycling pumps when expressing while working night shift. However, I had friends who could hand express 5-10oz in less than 10 minutes. (And please don't question my technique -- I had those firend "experts" observing my technique.) Also, one mother of premie twins in my LLL group of the late 70s used a bicycle horn pump and expressed all two babies needed for more than the 2 months it took her babies to get to breast. (And that was with returning to work immediately after their birth so she could take her LOA when they were discharged). 

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