Dear Jennifer,

I'm sorry but I do have to interrupt your discussion of certified professional midwives vs. certified nurse midwives. The CNM in our area are VERY invested in breast feeding and do an excellent job of creating a "normal" birth (if there is an "normal") even within a medical setting. I prefer the term "a gentle birth". They actually also serve and even MORE important role which is to give as gentle and non-interventional a birth as possible to women with high risk pregancies. These conditions include pre-eclampsia, gestational diabetes, VBAC, premature labor. Please don't forget that preganacy and labor can be dangerous. I agree that it has been over-interventionalized, but there are still very real risks and not all women have the choice of delivering at home. Similarly, not all women are willing or able to take the risk of delivering at home. Please don't discard these women as having  no "hope for a normal birth". At the same time, please don't discard all the women for the past millenia who have died in childbirth. 

The "system" is not going away but CNMs in our area are doing their best every day to tweak it and to alter it for the good of the women that they serve. They take patients whom the CPM's cannot or will not see and they give some wonderful experiences to these women. Their percentage of successful breastfeeding moms is very high in my practice.

Sincerely,

Kate
Kate McIntosh MD FAAP
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