As far as Med/Surg: at the hospital where I used to work, a mom admitted to
med/surg could beg for a pump, and might get one eventually.  If it did
arrive, it was sure to be coated with layers of dirt and spilled
breastmilk.  The admitting physician would be sure to put mom on any/all
meds incompatible with bf.  The floor nurses would generally be very
suspicious of the whole "breastfeeding thing".  Moms were definitely on
their own and had to be very proactive.  Hopefully things have changed.

In another area, I had a client with bipolar disorder and an almost two-
year old toddler still nursing about 3x/day.  She was admitted to a psych
facility for mania and had to stay over 3 weeks.  Separated from her baby
the whole time because the facility was too far to travel to.  (Even dad
didn't visit every day.)  Mom begged constantly for a breastpump and was
refused.  She was told by practically every physician, nurse, and social
worker "just" to wean.  They didn't seem to understand how important
continuing her nursing relationship was to stabilizing her mood.  She then
changed tactics and told the health care team that she needed to pump to
prevent engorgement and mastitis.  She was finally given a manual pump on
her sixth day.  By then she didn't even bother pumping because she wasn't
uncomfortable any more (and her psych condition was still very unstable.)

She called me because her psychiatrist refused to consider meds compatible
with bf.  Luckily I was able to speak with the pharmacist for the psych
unit, who was extremely receptive and understanding to her desire to
continue bf.  I lent him my copy of Hale (of whom he had never even heard
of).  The pharmacist spoke with the psych. and they came up with a med
regimen for mom.  When she stabilized after discharge, Mom did have to sign
a statement that she was choosing to use some meds that were possibly not a
great idea for baby.  But she made an informed decision as best as she
could using Hale, and justifying those meds (can't remember which ones -
but Hale didn't rule them out) with the fact that she was nursing an older
child, not a newborn.

Of course she was told that baby would not be interested in bf when she was
discharged since it had been so long.  And not five minutes after she
returned home baby was at breast and didn't self-wean until 6 months later.

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