• Orina H. Mann CNM, CFNP, MSN,

    Corresponding authorSearch for more papers by this author
    • Orina H. Mann was a lay health care provider for 17 years in her community in northern, rural Arizona. She received her BSN degree from Northern Arizona University in 1992. She studied nurse-midwifery at the University of New Mexico (MSN, 1995) and completed a post-masters certificate there as well (FNP, 1996). Her most recent practice has been provision of full-scope care as both a CNM and FNP in a primary care clinic in Showlow, Arizona.

  • Leah L. Albers CNM, DrPH, FACNM

  • Leah L. Albers received her nursing degrees from Vanderbilt University (BSN, 1971: MSN, 1974) She studied nurse-midwifery at the University of Medicine and Dentistry of New Jersey (1977). She was in full-scope practice for 11 years and then completed the DrPH degree at the University of North Carolina School of Public Health (1990) She is an associate professor at the University of New Mexico College of Nursing, and she has a joint appointment in the Deportment of Obstetrics and Gynecology, University of New Mexico School of Medicine.

Address correspondence to Leah L. Albers, CNM, DrPH, FACNM, University of New Mexico College of Nursing, Albuquerque, NM 87131–1061.


Epidural analgesia is widely available and increasingly popular in the United States for pain relief in childbirth. Although it provides superior pain relief for most women, it is not without significant short- and long-term side effects. It is costly and requires the use of numerous other technologic interventions. Because women have information needs surrounding childbirth and value self-determination, full informed consent regarding epidural analgesia should be a priority in patient care. The best time and place in which to accomplish this is during the prenatal period.