I have 10 (just counted them off) friends who between them have had 34 children and none of them got an epi when they asked, or anything near it. Many asked for it as soon as they arrived in labour and were yelled at, ranted at, pressured and generally stonewalled for hours. Some occasions they missed out as they got to transition first. Also, there's a shortage of anesthetists in many Australian obstetric wards so c-sections obviously get and deserve priority and people are missing out on requested epidurals. Then there are those who are conditioned to "hang on" as long as they can, then end up getting one on request. Many of those feel they shouldn't have been pressured to hold on but should have had it sooner. I also have 1 friend who is a midwife in a public hospital and who reports to me that for public patients midwives are encouraged to discourage epidurals as a cost-saving measure. Which, frankly, IS a failure of care as you rightly point out. So "ending up" with an epi isn't the only thing that matters, but getting one promptly on request and being fully informed that it is not adverse to have one sooner and you don't have to "hang on" unless you really actually want that. It is a common misconception capitalised on by public hospitals imho.

I respect your different opinion on what an ideal birth is, but I don't think we actually want anything much different for women. I'm just *more* concerned with the denial of epidurals which I'm entitled to be. That doesn't mean I want women to be denied homebirths. They're not incompatible.
You're right, - we don't want anything much different for women. We both want women to be empowered to have choice and basic human rights. We can both see ways in which this is just not the case in the current system. Like you, I find it confronting that women who desire an epidural are made to 'hang on' due to cost-cutting measures. That is not right - especially in an environment in which a woman is likely to be deprived of every other coping mechanism she needs to reduce her pain. Such as:
- privacy
- quiet
- access to deep water
- freedom of movement
- continuous emotional support and physical care, such as massage
- continuity of care from a midwife she knows and trusts, or at least a doula.

How ironic that women would be deprived of a requested early epidural for cost-cutting reasons - but also deprived of home birth options that are spectacularly economical. Go figure??

The problem I have is that the net result is women getting a hard time and sub-standard care, made to suffer needlessly, and being subject to coercion, regardless of whether they want to give birth in a birth pool at home, or have an epidural at 3 cm. Money is not the only reason women aren't getting their choices honoured in such scenarios. If it was, home birth and birth centre birth would be supported because it's cheaper. It's also about power. I understand your outrage, I feel the same. I want a better deal for birthing women. It's not that hard to achieve.