I work in a 110 bed community hospital where the OBs(5 of them) wanted to do VBACs.  We have one anesthesia provider on-call and a fairly active overnight Main OR schedule.  The OBs would only do a VBAC IF the patient agreed to epidural analgesia, effectively keeping the anesthesia in-house.  However, we declined to do this UNLESS the OB was also in house and the anesthesia provider had no Main OR responsibilities.  The hospital offerred to reimburse if another anesthesia provider had to come in but the OBs wanted to continue with the "30 minute" rule when applied to themselves.  I pointed out the hospital's legal liability in this and also pointed out that the hospitals small blood bank support (we do not do any trauma).  I also did an extensive literature search and documented the latest opinions in the general medical literature (NEJM) and well as the anesthesia and obstetrical literature.  After 6 months of rangling over this, the hospital administration sided with the Anesthesia Department.  Our OB Service is not busy enough to justify having 24-7 dedicated OB Anesthesia coverage.

The moral to the story is, do your homework, stand on firm medical grounds, and don't let yourself be bullied into doing something you know is wrong.