I often find that even my most prepared and determined students in childbirth
classes opt for epidurals based on information and advice they receive during
labor.  I think one thing we can do to decrease epidural rates and length of
time epidurals are in place is to promote doulas.  Even if we can't tout all
the benefits of doulas in class, we can certainly say that studies show they
decrease C-section rates, length of labor, and satisfaction.  Those are all
politically correct ideas.  Those are the same advantages I promoted when
after attending a doula workshop, I introduced the doula concept to our
nurses.  They were initially skeptical about the doula taking over dad's role
as coach and about the doula trying to keep the mother from having medication
if she wanted it.  However, Penny Simkin's seminar had prepared me to meet
these objections, and the nurses went away with an acceptance of the doula
concept.  For those of you who weren't at ILCA last year, a mega-analysis of
seven large studies on doulas (women who stay with, comfort, and encourage a
laboring woman throughout her entire labor) showed a 60% reduction in
epidural rates and a 50% reduction in Cesarean rates to name just two
advantages.  Bonnie