Hello All, I have to add my .02 here. I have worked for the last 8 years at a freestanding out of hospital birth center as labor and delivery RN, LC, etc. Of the women who receive prenatal care here, about 2/3 of them deliver at the local Level 3 hospital, the others at our birth center, where we do not use pain medication, and labors tend to proceed with little/ no intervention. My comment is an echo to Kathleen's recounting of Ina May Gaskin's story. It is very unusual for us to see a baby who won't latch on (though I can remember several, generally no more than about one a year). The majority of real difficulties we encounter are among our hospital birthing population. Martha Johnson RN, IBCLC Eugene, Oregon