I know that our hospital has long cited references (meaning I don't have these references at my fingertips) that by increasing nursing care, we can cut the use of medications and epidurals for delivery; and for a long time we did have 1:1 care for all patients who were in active labor (more than 4 cm).  But we were way over budget on nursing staff, and extra staff and premium staff and standby staff -- so we are back to taking care of 2 patients or more until one of them gets to transition, with little standby.
 Of course, this means we have increased our epidural rate.

Ironically, we get to 1:1 our epidural patients, at least for the first hour, or however long it takes to get their VS and babies stable after it has begun.

Oh, the travesty of "cost effectiveness"

Chanita, San Francisco