Sorry to repost-apparently this email was scrambled before.

In my mind, the single most important activity going on in a hospital
post-partum unit should be breastfeeding. Since neither birth nor
breastfeeding is a medical event, then the most important practioner
available to all moms should be an IBCLC. As I see it, the whole
medicalization of birth, followed by the medicalization of the pp period,
including bf'ing is one of the most destructive aspects of American culture
(and those foolish enough to copy us).


Frankly, if we just had midwives attend all births, practicing in the
midwifery model of care (not doctors masquerading as midwives), we wouldn't
need so many of us either. That is the world I want for my children--not more
medicalization. I have no interest in being a nurse, nor do I wish to see it
deemed necessary or beneficial for IBCLC. I agree with
Gonneke--specialization, where useful, should take place within the
profession, otherwise it is just a meaningless certification. I admire, respe
ct and value great nurses in any medical field that requires them. I
personally believe they can be more important to healing than doctors, and
often are far better advocates for patients in my experience. But, birth is
not a medical event, nor is breastfeeding and I think the fewer medical
people involved in any way, the better.


BTW, I was thinking about lactation specialization the other day and how, in
my mind, retesting undermines this. If the test only assures minimum
competency, how does one ever specialize? And how do ever know that an IBCLC
has achieved more than minimum competency? Years of experience by no means
guarantee this. In my opinion, retesting is false reassurance and means
little. As for specialization, if you spend years studying a particular area
(say, NICU), you may not need to know much about the other areas, yet you
have to retest on the whole spectrum. What assures your competency in your
area of specialization? And where is any value being placed on
specialization? Personally, I see myself as specializing in holistic
lactation, as the tools I use reflect this, yet very few IBCLCs know much at
all about these things. If I look at our system of retesting, the area I have
spent so much time learning about, and even pioneering to a degree, is
meaningless for my certification. This makes no sense to me at all. I really
do feel that I am in a field that is ever more alien to me, that reflects
less and less my experience and understanding of breastfeeding and may in the
end become just one more cog in the wheel of the medical birth machine that
causes so much human suffering.

Jennifer Tow, IBCLC, CT, USA

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