Marie, thank you for sharing this painful episode with us. In the days
since you first posted, this situation has bothered me very much.  Your
updates have increased my discomfort.  I have tried to sort out what has
troubled me so much about it.  From a distance (physically and emotionally)
it's easy to make suggestions, and I hesitate to jump in without knowing
all the pieces, but here are a few thoughts.  Use what is helpful and
discard the rest:
        First, I worry that this mother's life may be at risk.  Granted,
her story has changed with each encounter, and we don't know really what is
accurate.  But I would want to be sure there is some mechanism in place to
assure her safety and that of her baby, including if she leaves her
husband.
Does she have family, friends, or other helpful support people?
  She also needs expert counseling and therapy, both to help her deal with
the losses in her previous birth and parenting experience, and in the ways
she is dealing with people now.  Obviously, her current behaviors insure
that her needs are not being met.
        Second, I was concerned at how quickly each participant in this
distressing situation was ready to accept the mother's account and blame
the other party (nursery staff, anesthesia staff, postpartum staff, father,
etc.) To me, this sounds very much like the "splitting" that occurs with
families with borderline personality disorder.  Simply put, they foster the
division of helpers by placing all the "good" attibutes on one and all the
"bad" on others.  This is not consciously done, but does lead to everyone
blaming the other units or caretakers for the problems.  Perhaps some of
our Lactnetters with therapy backgrounds could comment on this mechanism,
as it affects many of us in our varying work situations and can cause
difficult problems in communication and working together.  In the long run,
families are not helped when this is going on.

        Third, what has happened to staff communication and support
for/with each other?  With a devastating history like this mother's, it
would seem imperative for preplanning to take place from her prenatal care
providers to the labor/delivery, postpartum and lactation consultant staff,
to try to support this mother and to help insure the success of this birth
and breastfeeding experience. (Even if no one knew of her later-stated
dangerous and isolated current home situation).  Why were you even asked to
see her without being told some of her earlier history?
        Would it be possible to call a conference of those who were
involved to try to sort out things after the fact, and to plan how to deal
with similar situations in the future?  I understand how hard this might
be, when you and others have been so badly hurt.  But perhaps if all could
share (over doughnuts and coffee) how you felt, and talk about how you
would like for questions or misunderstandings to be dealt with in the
future, some long-term good could come from this.  You would know and
appreciate each other better, and next time the nurses might call you
directly and quickly and be less ready to believe one person's assertions
about others' behaviors without question.

I hope that you have lots of wonderful encounters this year that help to
balance out this awful one, and that somehow the staff finds ways to show
they appreciate and value all the contributions you make.

Anne Altshuler, RN, MS, IBCLC and LLL Leader in Madison, WI