Marsha asks:
"Should we be educating nurses and physicians or concentrate on mothers?"
I think we will find the anwer to this question when we think about who has
the power in our (medical) systems - and what power they have.  Some mothers
have some power in some systems.  Some nurses have some power in some
systems - they are often disempowered by docs and adnministrators.  Docs
generally have some power in most systems, but may be disempowered by
administrators or insurers.  I think our educative efforts need to be
targeted to our audience. Where mothers have little power to avoid
interventions in their births, they need information about how to minimise
the effects.  Docs sometimes feel that mothers demand intervention so it is
also important that mothers are informed properly of the risks (and
benefits) of a proposed line of treatment.  In some places, docs can refuse
a patient's request if there are insufficient medical grounds to support its
use.  Docs need to know about the side-effects of the interventions they
commonly use and to refine their skills in weighing risks (or empowering
mothers to weigh risks).  Administrators might need to hear from docs about
the effects of policy/procedures on care.  Insurers might need to be shown
how EBP can save them $risk exposure.  
Cheers
Nina Berry
Australia  

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