After reading your editorial in the July/August 2007 MCN (32[4]), I felt I had to respond. Nurses have always been expected to act as patient advocates. When you tell us that it is not our place to interfere with the patient-physician relationship when a patient wants a social induction or an elective cesarean section you ignore several important issues. First and foremost, who is advocating for the baby? We have read a great deal recently about the challenges faced by the late preterm babies. Are the mother's wishes for a "more convenient" form of delivery more important than the welfare of the baby? I agree that it is unrealistic to try to change her mind when she presents to the unit, but I believe that nurses have a responsibility to try to impact public opinion. We support many other attempts to change behavior for the better. Why is this different?

I also think that it is irresponsible to ignore out-of-control healthcare costs to promote the concept that these more expensive interventions and their potential complications (for mother and baby) are a woman's right. Dollars spent for these unnecessary and costly interventions could be better spent on improving prenatal care and making it accessible for everyone.

Having worked in OB since 1975, I agree that romanticizing the way we delivered care in the past is not the solution, but I do not believe that we should embrace the "medicalized version of childbirth." I hope that other nurses will continue to see the value of encouraging women to allow their bodies to determine when and how their babies should be born if there are no medical reasons for intervention.

Thank you.

Sandra Dennis, MS, RN