In response to the issue of money and epidurals: I agree but....it is
entirely possible that anesthesia will become part of the blanket coverage
type insurance in which a flat fee covers everything and there is no fee
for service. Hmmm...now what will that do for "the constant source of
income?" It will become a financial liability to have all your patients
receive epidurals. Doulas on the other hand...much less expensive...about
as effective...none of the side effects!

The L&D system in the US might be in for a major overhaul...and we, as LCs
need to be there when it happens...promoting Doulas as an alternative to
epidurals. This is suggested at the end of M. Walker's (1997 JHL, 13 :2)
review of the literature on anesthesia and lactation. Kennell and Klaus
have also looked at the cost savings associated with the use of
doulas....it is astounding. I can tell you right now...the anesthetists in
our system do not like the Walker article! Why ? They get the financial
implications better than we do!

Susan Keith-Hergert RN, MS, CPN, IBCLC
Mercy Health Partners
Cincinnati, Ohio

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html