The only problem with not speaking, is if we ignore it, we cannot change it.
This is not a bashing of hospital births. I have seen babies born at home
who cannot find their way to breast either. Midwives are not inherently
perfect anymore than ob's are. And even when they are indeed absolutely perfect
and everything that could possibly go right does, bad things still happen.
This is not about what birth a woman should have, it is about learning and
understanding how the type of birth impacts women and their babies. An entire book
has been written....Impact of Birthing Practices on Breastfeeding,
Protecting the Mother and Baby Continuum. Those of us who see that birth makes a
difference to the breastfeeding experience are not just making it up to bash
hospitals. We see it. This understanding does not mean all births in hospitals
are horrible experiences for the mothers and babies. And obviously we have
many on this list who thankfully make the difference in their hospitals and
thanks to those hard working breastfeeding advocates, mothers and babies do
succeed at breastfeeding. Unfortunately, not all hospitals have IBCLC's or even
nurses who have half a clue about breastfeeding.
I think it is Barbara Wilson Clay who reminds us that even normal is not
perfect. True, we would like to think it is, but we do know better. Natural
selection is no longer how we function. We would not want to return to the
day where mothers who needed a cesarean died instead. At the same time, we
want to remember that there is in fact a biological norm we can at least try to
honor and find a balance with.
I don't understand why someone would be offended by the passion of another.
I have read many posts by some who think very differently than I do about
some issues. If all I do is take offense at our differences, how will I learn
to accept the differences and also to learn from the experience of others. My
willingness to see that there is more than one right way challenges me to
never stop being open to changing my mind and learning something new.
It does not do our profession or the women we serve any good to make believe
nothing matters in birthing. That regardless of the birth, breastfeeding
will be the same. I know that nurses working in a hospital operate very
differently than I do. Being in a hospital setting demands a very different
mindset and also changes what they see. In private practice I have that 2 hrs to
sit and listen to the mothers, to really hear them and take the time to let
them work through what they really want to do. Nurses are often not that
lucky. I do have the time to hear their birth stories, to let them cry about what
they expected and what it was, to let them express the sorrow they feel...and
how foolish they feel for feeling bad when really, they are okay and the
baby is okay. When breastfeeding difficulties is just one more piece of what is
going wrong I have the hours to sit and listen. So, yes, I do find myself
getting frustrated at the system who sees the outcome, but only the outcome of
the first 72 hrs. Of course what they are looking at and working within is
totally different. Even the breastfeeding may be different and it may appear
that all is well, baby latched, and all is well. But, then the mom goes
home and in another day has the most damaged nipples you have ever seen, but
you don't always see them because you are a postpartum floor IBCLC without a
lactation center, and you never see them after they leave.
Then there are the women who leave the hospitals without ever having anyone
come help them latch on their baby. Budget cuts are the reason given for the
cut back in lactation services and lactation consultants on staff for full
coverage. Some are just running themselves ragged trying to fit in helping
with breastfeeding with the rest of their postpartum care responsibilities. So,
moms go home bottle feeding formula and buy a pump from the toy store on the
way home. Yes, it frustrates me. I am sure those working do not realize the
impact of all the interventions. They see a healthy mother, a healthy baby
and are so grateful another disaster was avoided. I do understand that. I
don't think I would have understood if I did not read Lactnet every day for
years now and realize that there are wonderful doctors and nurses with passion
who want to make a difference and want to see women and babies happily
breastfeeding. It never occurs to me that anyone taking the time to read and post
on Lactnet is part of the problem. I always assume they are working hard to
be the solution in their work place.
For there to be change, we must first recognize it needs to change. We are
asked to be change agents and advocates for breastfeeding, but we cannot make
a difference if we think the status quo is already perfect. I am not sure
what perfect looks like, but I am fairly certain it is not what I see in my
area.
Best,
Pam MazzellaDiBosco, IBCLC, RLC
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