Good morning, Lactnetters,
The discussion is getting pretty interesting but I am not convinced after 35
years working in a hospital and married to an obstetrician that  hospitals
are really bad places for mothers to give birth, or babies to start life.
We have a long way to go - but then we've come a long way, also.  I know
that home births have come a long way from what they used to be when my
husband was born on the kitchen table in his parents small farm house after
which his mother bore the effects of that birth for a lifetime.

Not all doctors and nurses are unfeeling professionals who are incapable of
functioning as 'doulas'.  Yesterday, I helped an obstetrician and two nurses
spend the morning bathing a stillborn baby, dressing her in a lovely baby
dress (purchased by the nurses), putting a little gold ring on her finger
(purchased by the Dr.) and helping the mother, father and eight siblings
hold and say goodbye to this little baby.  We took pictures, made hand
molds, cried with them and tried to help the youngest understand something
that none of us understood.

Last week I helped a mother gently put her baby to breast for the first and
last time, as we shared a box of Kleenex.  The baby had a problem
incompatible with life and died peacefully in her mother's arms, at her
breast, surrounded by those family members invited to come.  Would it have
been better at home?  I don't know, but I do know that in this case, it
wasn't possible.

I am a Lamaze certified childbirth educator, an RN from an NICU, and an
IBCLC.  I have spent 35 years trying to make birth and breastfeeding within
the hospital setting be more human, humane and "natural" if you like that
term.   However, to use epidurals as an example, I can tell you that all the
education in the world about the problems associated with epidurals, and
knowing all the other non-intervention, non-pharmaceutical  tools for
dealing with a normal labor, does not convince the majority of mothers
experiencing pain not to have the epidural.
Even after careful education about risks, benefits, and exploring other
ways of dealing with normal labor, the bottom line is:   many moms deliver
in the hospital specifically so they CAN have an epidural.  Nobody (at least
in our hospital)  stands around with the epidural kit in their hands
pleading with the mom to have one.  This decision is still up to the couple,
and those who are advocates of home birth are just as negative about this
choice as the medical personnel tend to be about the decision to have a home
birth.

The same is true of breastfeeding.   I am obviously a true supporter and
believer in breastfeeding, kangaroo care, mother's milk over ABM, etc.  But
if, after careful explanation and education, a mother chooses to bottle feed
with ABM, I will bow to that decision and help her dry up.  I may not like
her decision, and feel in my heart that it is not a good way to go from any
standpoint you look at,  but it is not my choice to make.  One cannot stand
over a mother and insist that she breastfeed (or take her folic acid, or
stop drinking during pregnancy, or put seat belts on her three year old, or
put the baby to bed on his back)  Like all other health and human issues,
breastfeeding remains a personal and private choice which we can improve and
facilitate but not mandate.
My  complaint is when a mother has chosen to breastfeed and either she,
herself,  or the nurses, or her doctor, or a family member sabotage that
decision with poor advice and information.
Deanne (again)

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