From a post, Wed, 3 Sep 2003 12:51:23 EDT

"Some good news for military.   Pregnant women will no longer be held to have
to use military facilities and the military facilities are now going to 
update
and be consistent throughout the various bases with their care--long overdo!
The idea is to now compete with the civilian hospitals for patients since
they can now go where they want.   Not sure when this is effective."

I have been on Active Duty for the last 9.5 years and was raised moving from 
place to place as my father served 21 years.  This is my last week on Active 
Duty as I have two young children and wish to pursue my Masters' in Lactation 
Consulting.  That is the background for my comments.

Although I agree with Ms.Buoncristiano-Thai that consistent care from one 
base or post to the next is desperately needed I disagree that having military 
facilities compete with civilian facilities is the right route.  The Department 
of Defense (DoD) will never have the funding available for large private LDRs, 
the latest pumps, videos, and other equipment that many women find attractive 
when comparing a private civilian L&D with the military treatment facility 
available to them.

For too long the services have received a bad name in the treatment and 
services they provide to women and children.  I gave birth to my daughter (2.5 
years) at the only American hospital in the Republic of Korea.  There are two LDR 
rooms and one, four bed, postpartum room.  The care I received there was 
outstanding and the staff was very accepting and supportive of my wish to not have 
drugs, rooming-in and breastfeeding.  My daughter wound up being medically 
evacuated (MEDEVAC) to Tripler Army Medical Center in Hawaii for major 
neurosurgery when she was four months old.  Again, the staff and HCPs were incredible.  
My daughter was in ICU post-op for six days and on the PEDs ward another four 
days.  The entire hospital stay she was kept on a full size bed so I could 
nurse her (she was required to be prone or supine the entire time the wound was 
healing).  There was never a doubt in my mind that any of the staff would have 
done anything and everything possible to ensure our breastfeeding continued 
and my daughter was given the best possible treatment.

I now work as a volunteer at William Beaumont Army Medical Center at Fort 
Bliss, TX.  I teach a weekly BF class in the OB/GYN clinic and assist women on L&
D or once they are home.  There is no IBCLC on staff but there is an effort 
underway to change that.  Beaumont has the only LDRP in town, rooming-in is 
mandatory, PEDs do rounds in the mother/baby room, most nurses have attended the 
Texas Department of Health Phase I and II breastfeeding training.  There isn't 
another hospital in town that comes close to Beaumont in terms of support or 
policy in support of breastfeeding.  I am also a labor doula and have seen 
first hand two other hospitals.  As a member of a group in El Paso, SWABA 
(Southwest Area Breastfeeding Advocates), that is dedicated to educating the public, 
HCPs and mothers on the benefits of breastfeeding, I get an inside perspective 
of the struggles and obstacles that the IBCLCs and other breastfeeding 
supporters are up against here in El Paso.

Darnell Army Medical Center at Fort Hood, TX (the largest troop installation 
in the Army) supports the most deliveries of any Army post.  They have a 
midwife clinic and a weekend PEDs clinic.  Fort Bragg, NC (the second largest troop 
installation) follows mothers who are having breastfeeding problems to ensure 
they receive timely and accurate assistance in resolving issues, they also 
send home a comprehensive, easy-to-read book on common breastfeeding questions 
and problem solving techniques and a checklist for feedings/BM/wet diapers etc. 
 Madigan Army Medical Center at Fort Lewis, WA has an IBCLC on staff (also a 
list member :) and she has implemented fantastic policies for the L&D and 
their NICU.  And, of course, Weed Army Medical Center at Fort Irwin, CA is one of 
the few American hospitals to be designated Baby-Friendly.

Are there many discrepancies from one treatment facility to the next, of 
course.   Will that ever be fixed, probably not.  Do women who receive treatment 
at a military facility always get the best care available in their area?  Maybe 
not.  All of this also applies to private and public civilian treatment 
facilities as well.  


My personal opinion is that the military should take the example that Weed 
set by attaining BF designation and the policies and procedures that have been 
established at Madigan and make them apply to every military hospital.  They 
would have no need to "compete" with civilian hospitals.  The military does not 
operate their hospitals as a business.   There are plastic surgeons on staff 
at the major regional Army facilities not for cosmetic enhancement of the 
military population but so that the surgeons are competent and practiced when they 
must do reconstruction of battlefield wounds and injuries.  The military is 
here to support the warfighting soldiers first and their families second, not to 
compete with a money making industry.


A letter to your congressional representative that military facilities should 
follow the lead of Madigan, Darnell and Weed Army Medical Centers would be 
greatly appreciated by many young soldiers and their families as well as by this 
soldier and her family.

Christie Pillado
El Paso, TX


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