I pumped for 10 weeks with my twins and 15 mos with my daughter due to milk removal issues. Right now I'm using a homemade SNS type of thing nursing my almost-7 mo old twins because I never made quite enough milk for them so yes people do do hard work to nurse their babies and it isn't super easy for everyone. Is it worth it? Yes, very much so to me and my family. A lactation aid or SNS to me has been a huge lifesaver. It's complicated at the beginning but once you get the hang of it it's the best thing ever because you don't have to deal with bottle flow preference and much much less likely to have breast refusal (which I dealt with for 5 mos with my daughter and it was the most difficult problem we ever faced and trust me we had problems).
We stopped waking our twins when they were over 5 mos old. Maybe we are on the old end of the spectrum but I didn't want to hurt my supply and in the beginning they would have gone 5-6 hrs without nursing and that is really not OK for wt gain.