We need to address many of these unnecessary intervention issues in childbirth classes. Remember the idea of empowerment? Empower women with the knowledge that they were made to birth and nurse children and that they, within reason, have a right to refuse any treatment, and change will occur. I strongly encourage every pregnant couple to arrive at the hospital with a well thought out BIRTH PLAN. I feel fortunate to work at a medical center whose OB staff is primarily nurse-midwives. The problem we see is that women walk in and demand an epidural. Because of this problem I was asked to discourage epidural's in the hospital orientation class I teach. I begin by saying that nothing is without risks and tell them that an epidural isn't a simple shot, there is a catheter threaded into the spine next to the spinal cord. I give them the limits of the epidural, including the fact that some do not take, they may interfer with pushing etc. I mention that LC's have seen feeding problems associated with epidurals. Caution has to be used when questions are asked to make sure that I don't overstep my bounds or scare them to death! I do go through the reasons an epidural might be needed, including CS. I end the discussion by telling everyone who is thinking about an epidural to make an appointment with the annesthesia department to discuss the risks and benefits of epidurals. (because labor is no time to discuss anything) I also tell them to ask for the worst case senario. So far about 50% have made appointments. Unfortunately, the number of epidurals is only slightly down. But it's a start :-)