Around the world different systems are in place to regulate practice and
ostensibly to protect the population from people lacking in skill and
knowledge from doing harm.  I will go off topic now, and come back on, and
then go off again, for the purpose of drawing a parallel.
In the US, midwifery (for example) is regulated differently in each state.
So what is perfectly legal in one state may get you jailed in another.  In
the rest of the world it is generally done at the national level.  But
because of the history of midwifery in particular, it is not a good example
to use when discussing US credentialing and licensure.  Just my opinion, but
a reasonably informed one!
IBCLCs are not regulated by law in many places.  I don't know specifically
whether any jurisdiction in the world has a legal definition of what an
IBCLC may do, or a public regulatory body to dispense licenses based on
achievement of the IBCLC credential.  So there, the burden of educating
others about what those letters mean is on us for now.
There are also no aeons of tradition behind the IBCLC title, in N.America or
anywhere else.  Are they mentioned in the Bible or other holy manuscripts,
for example?  Were they active among indigenous peoples anywhere as such?
Were there any on the Mayflower, or among the captive Africans who were
taken slave, or in the covered wagons crossing the prairies of N. America?
How about in Asia?  The Arctic?  Don't think so, no.  But many other health
workers who comprise the kernel from which current professions have sprung,
were there.  So we are faced with trying to 'sell' something that hasn't
even been needed for most of human history as a specific profession.  We
need to keep our concepts straight, because we can't expect the public to do
it.

BTW, in Norway there is no such thing as a nurse-midwife, or a registered
midwife, or a licensed midwife, and certainly not a lay midwife.  Nursing is
at the moment a minimum entry level requirement to the field, hasn't always
been and may not always be, but is now.  But the title, the single word
'midwife' (in Norwegian of course, 'jordmor' which means earthmother :-))
means that the person has satisfactorily completed a specific program of
study AND passed the state licensure exam, or been granted the title on the
basis of foreign training which is documented to meet the same requirements
or better.  No one else can call themselves a midwife at all here if they
want to stay on the safe side of the law.  Quite a coup for the profession,
which is much stronger here than in N. America, but not as strong as in,
say, the Netherlands.  And in most of Europe and in the Netherlands, we
consider ourselves specialists in normal birth.  We know more about it than
doctors do and no one disputes that fact, least of all the docs!

Rachel Myr, jordmor, IBCLC
Kristiansand, Norway

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html