In my area (Stanislaus County Central Valley California) we have about 8
midwifes working in private practice with several OB/GYNS.  They deliver at the
two hospitals I attend.  None of them do any formal newborn care (although they
give advice with varying quality about breastfeeding and newborn care).

There are IBCLC's working in both hospitals.  Great folks but the LC notes
are not very accessible to the pediatricians and family practitioners taking
care of the newborns (notes go to the mother's charts which are not in the same
nursing stations as the newborn charts).  The LC's at both hospitals are
overwhelmed with work (one day last week there were 50 mother/infant dyads on one
post partum floor with only 1-2 LC's to cover).  So I go looking for them when I
have a particular concern about a dyad.

Pierrette Mimi Poinsett, MD
Modesto CA

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