I just wanted to make a quick reply to the person whose hospital
anesthesiology department said that their new OB center's goal was to have a
95% epidural rate. One of the first steps to take is to contact your hospital
ethics committee and ask if this is an ethical practice, i.e. will it benefit
patients more than providing 95% of patients with a doula. Since epidurals
have known side effects, you will need to review your consent form to see if
all of these side effects are mentioned to the patient. If not, ask your
hospital's attorney if this type of practice is legal and if the hospital
needs to look at carrying more liability insurance.

Next, you need to inform your special care nursery or intensive care nursery
of this new goal so they are prepared for the increase in septic workups that
will occur when an increased number of women run fevers from their epidural.
If your hospital does not have a strong lactation support program, it will
need to implement one before you reach 95% of drugged babies.

If your hospital cares for patients who are insured within a capitated system
lots of money will be diverted to anesthesiology pockets rather than to pay
for the real cost of the hospital services.

For a review of the literature on labor medications and breastfeeding, see my
article in the Journal of Human Lactation, June 1997. The article was
mentioned in a publication called "Anesthesiology News." where the person
interviewed claimed that a review of their own literature constituted "broad
charges leveled against epidural anesthesia."

In this interview, "we" were called "shameless" and "agenda-driven!" Hum!!

Marsha Walker, RN, IBCLC
Weston, Massachusetts