As a both a birth attendant and a mother who chose for herself 4 unmedicated vaginal deliveries, I have a lot of interest in the use of interventions in childbirth. I also just finished reading "The Impact of Birthing Practices on Breastfeeding," and was interested to read the research on the effects of bhildbirth interventions on breastfeeding. (And also a little disappointed that there is not more high quality research available.) Before I entered private practice and was required to practice a more interventionalist style in a teaching hospital, I thought if I just explained the risks of interventions to moms, they would naturally choose to have as little intervention as possible. I also used to think women who were educated about the risks of artificial feeding, would naturally choose to breastfeed. Turns out neither were necessarily true. Birthing culture in the US is focused around a medical model where women expect to need a lot of medical help to have a baby. Infant rearing culture is focused around the "things" one needs to have a baby. Simply providing knowledge cannot often change these culturally held beliefs. I can talk until I'm blue in the face to some women about the risks of childbirth interventions, and they will continue to insist on epidurals and inductions. They arrive to the labor suite with absolutely no coping skills whatsoever, and often refuse all non-drug pain relief measures (walking, position changes, shower, massage, etc.) For me, trying to practice in a non-interventional manner is pretty difficult when so many of my patients not only don't value normal childbirth, but insist that labor be "pain-free." These are the same women often who I can talk until I'm blue in the face about the risks of ABM and they will continue on instead with some variation of "formula-fed babies are just fine" thinking. It is easy to blame HCPs for medicalizing childbirth, and in truth many may be to blame for promoting medicalized birth. But I find in my own practice that many women insist on clinging to a model of relationship where the HCP bears all the responsibility. Add to that the litigation situation here, and it's no shock that doctors have become interventionalist. While I most enjoy working with moms who have done their own research, and who want my support for as normal a birth as possible, these women are in the distinct minority here at least. We tend to often harp on the role HCPs play in pushing interventions, but HCPs are not the only ones to blame. A cultural shift is needed! Jennifer Tieman Family Physician Mom to 4, including nursling Caroline Rose born 5/31/03 *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html