When the woman who was my preceptor for my clinical experience in nurse-midwifery school was a student 14 years ago, she had to put up with the anesthesiologists coming around when her client would be 4 -6 cm or so and telling them "you don't have to suffer anymore. We can take away this pain". Of course, they never bothered to mention the down side of their interventions..... (BTW, in her area of rural Oregon, she was also accused of being a "witch". Sound familiar, fellow "cultists"?) We have a new (in the area one year) OB in town whose big selling point is the intrathecal he offers. I have no idea what he says in his office. He has a nurse who is also a nurse-midwifery student (but who looks to me to be tending toward the junior-doc model of midwifery -- gag) who "tries" to tell women about natural childbirth in her birth classes but somehom the message the women get is how wonderful intrathecals are. Hummm.... One of the things to keep in mind is that it is easy to sabotage a woman giving birth by 1)conveying doubt about her ability to give birth 2) making the process unnecessarily painful but keeping her attached to constant fetal monitors, in bed, hooking her up to IV's, denying food (and sometimes anything by mouth) and 4)by converying the attitude that birth is pathology! And this goes on daily, ad nauseum, in the average hospital. I believe that helping women to breastfeed is very empowering, but that the way birth is treated and the way that breastfeeding is treated and the choices this "management" entails are inextricably linked. Birth, like breastfeeding, is often primarily a confidence game! Women in this culture are not having confidence built in any aspect of their normal bodily functions. Look at all the debate over "treating" things like menopause. Think of the huge market our there in "treating" female complaints. It isn't that these modalities are not appropriate and reasonable sometimes, it is the treatment of almost every normal feminine function as potential pathology. Seems like a very subtle but effective way to excercise power over women to me. Well, off my soap box for the moment. Thank you everyone who sent me congrats on my recent certification as a CNM. To followup on the job offer I mentioned, I did accept the job with the rural doc though it means a long commute. My plans for a local practice have been temporarily derailed by local politics but I am very excited about the opportunity I do have. My job will include lactation consulting and well baby care of newborns up to the first 6 weeks at least. If anyone has some good newborn followup exam forms they would like to share, please email me privately. Ione Sims, CNM, MSN, IBCLC (who has also been blessed with 3 inches of powdery snow this AM) [log in to unmask]