In a message dated 11/14/0 6:43:47 PM, [log in to unmask] writes:

<< I was approaching this issue from the assumption that the c/s is
necessary (for instance breech presentation or previous c/s with a
vertical uterine incision).  As per the literature and ACOG
guidelines, a necessary scheduled c/s should be performed after 39
weeks gestation or earlier IF fetal lung maturity has been documented
(via analysis of the amniotic fluid obtained through an
amniocentesis).>.

Danny,
With bf, as a way to placate those who believe their is *some* need for AIM,
we hedge our bets, by saying, unless "medically necessary". The reality, of
course, is that there would be no need for AIM, if there were milk banks
available and utilized. And that "unless medically necessary" grey area tends
to give those who are not so supportive of bf the opportunity to see many
more "medically necessary" situations than there really are. We have the same
tendancy to say the same kind of thing about cesareans--to be avoided unless
"medically necessary". Then we proceed to have a greater than 25% cesarean
rate (on the rise again) and see many "medically necessary" opportunities to
cut babies out of their mothers' bodies. Those who practice in the midwifery
model (including some highly-prized OB's) know that breech presentation is no
excuse for a cesarean. I think we need to be very careful in accepting a
non-normalized approach to birth and breastfeeding, b/c in so doing we
collude in condemning those mothers and babies to medicalization w/o options.

<<Unfortunately, not all c-sections are necessary.  Obviously, from the
standpoint of a number of issues (including breastfeeding) the OB is
not doing the mom or the baby a favor. >>

Exactly. As someone who runs workshops on healing birth trauma, I can tell
you that the emotional wounds many mothers carry are often harbored for
years, if not a lifetime. The way a mother births undeniably informs her
mothering, as well as her sense of self.
Jennifer Tow, IBCLC, CT, USA

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