Kathy Kendall-Tackett wrote:

...We know that birth is more painful if she has no one to talk
her through each contraction.  Some husbands/partners are
overwhelmed by the hospital environment and cannot help.
Others, let's just say it, are putzes and are of no help (and
can make matters worse)...

Yes..and there are putzes on the staff who are of no help
(and do make matters worse). How many staff (nurses,
physicians) "believe" in unmedicated birth or know how to
"talk a woman through a contraction"?  (Also, how many
nurses who do are allowed to spend enough time?) If your
OB can't believe there are ways to help a woman have a
good birth, and that epidurals are the only tool he/she has to
"help you lie back and enjoy the experience"-- then how can
we expect women (or their husbands) to do so. Those who
work with pregnant women (myself included) are more
culpable since we "should" know.

I wonder if some obstetricians suffer from a sort of
post-stress reaction brought about by feeling overwhelmed
and helpless (from lack of knowing non-epidural means of
relieving a laboring woman's distress) that causes them to
rely on medications. Many (most?) have only a medical
model of birth,  and the use of epidurals may be a common
psychological response to pain (observed by the MD). Many
(most?) women in the US expect the medical model, even
with Lamaze training (they are, after all, in hospitals!) I think
this would make an interesting study topic for someone with
psychological assessment training.

In hearing of the positive results of doula-supported births, I
have been wondering about the possible long-term effects
such modelling of labor "management" could have on
traditionally trained obstetricians who are exposed to it. I can
only hope doula assistance becomes more available--so I
can see what the impact will be.

Margery Wilson, IBCLC
Finally we are having spring-like weather here in Cambridge,
Massachusetts.