I am still waiting to figure out all the Scope of Practice discussion and  
since I haven't had one sent to me to read it and decide how it will truly  
effect me now and in the future I will continue to read everyone else's  
speculations and interpretations.
 
But someone addressed the Second Credential and compared it to ASPO/Lamaze  
"changes".
As a LCCE/FACCE long before I became a IBCLC, I need to speak to this  
misconception of a watered down Childbirth Educator credential.  
Lamaze changed how they pathwayed their credential.  It did not dilute  the 
credential and their is no second credential.  What has changed the  face of 
Lamaze is the technology of birth.  Epidurals, inductions and  cesareans as well 
as physicians who no longer refer patients to childbirth  classes and 
patients who no longer think that education is a realistic and  necessary part of 
their birth experience have changed the face of birth.   Childbirth Educators 
have had to become inventive and resourceful and work with  and around the system 
for years.
I remember when I started teaching 30+ years ago we ran classes 8-10  sess
ions now we do classes from 5 weeks to a weekender session. Why because this  all 
the clients want.  
I see clients who come for a tour, the film and learn about the epidural,  
then they drop out.
Couples come because they think it's like the ritual of birth...go to  
class....get your epidural...have baby and then see lactation consultant  
...breastfeed for 6 weeks....go back to work...send child to caregiver or  daycare.  2 
years...repeat process just no childbirth class.
This birth in South Florida.  Is it the same in the real America  ...maybe 
yes and maybe no.
Is it the same in the rest of the world.....NO! 
 
Same goes for breastfeeding what happens in America is very very different  
from the rest of the world.  Does it mean we are the correct ones. I think  
not.  We have much to offer and share, but we also have very much more to  learn 
from the sister countries.  
IBCLC needs to take that infamous global view point and apply it  generously. 
 American medical professionals are quick to take offense when  someone, even 
another professional questions how they practice or advise.   Just this 
weekend I had a patient who was being treated and her MD said that the  fertility 
specialist was his guidance on the treatment.  So did that  doc.  But after a 
procedure when I read back old orders to get see if he  would keep them I got 
"Who ordered that, I didn't" well it turned out the  fertility doc recommended 
and you did sign off on them several days  earlier...."I did not".  A lot are 
fearful of legal ramifications and I  have a strange feeling this is what is 
driving the S of P line of thought.
Get a global perspective and get some people with and with medical  
credentials but with lactation credentials and then a lawyer and add some people  with 
common sense...this is the panel of experts to rethink the S of P. Then  
remember the old adage, "If it ain't broke, don't fix it"....but this time I  think 
it's broke.
 
Enjoying the reflections of so many wise people.
Leanne Jewell RNC, IBCLC, LCCE, FACCE
South Florida

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