I am a little behind in reading my lactnet posts (as usual) so forgive me if this is not timely but I felt that I had to speak up for CNMs.  I am the mother of three, all delivered by CNMs in hospital.  I had no epidurals, no pitocin, no IVs, no episiotomies, no continuous fetal monitoring and two of my three deliveries were medication free (at least until after the baby was born, I have the annoying habit of hemorrhaging postpartum).  With each delivery my baby was placed on my chest and nursing staff was gently dissuaded from carrying out their usual routine until I had time for bonding and breastfeeding.

I practice in a hospital and as an employee of said institution I am constrained in my practice.  For instance, if I were to inform all of my patients of the unhealth of formula feeding or the underhanded and unethical practices of formula companies ala Marsha Walker I would probably lose my job.  So I don't discuss it unless the patient brings it up.  That way I remain to continue to advocate for my patients. Midwives too, are similarly constrained by the physicians and hospital hierarchies that control their practice.  While I am sure that there are less than optimal CNMs, I believe for the most part that the compromises that they make to stay in practice, like continuous fetal monitoring for example, mean that they "live" to advocate for their patients another day.

One last point: some of the midwives that I work with have told me that their increased use of epidurals is patient demand driven.

Just my two cents
Stacy Miller-Leonard RN,MS,IBCLC
Chicago suburbs

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