Coach Smith here. Yes, birth is over-medicalized in many places, and
under-medicalized in others. Those in the "birth advocacy" community have
known that for 30 years. Here's a proposal for a New Year's Resolution for
2008:

 

There's one tool in our collective toolbox that has never been effectively
and broadly applied to the increasing overuse of birth practices, and that
is large-scale REPORTING OF BREASTFEEDING OUTCOMES. We on the "postpartum"
end of things are in the business of helping mothers and babies breastfeed,
which starts by listening to the mother and helping her work through
whatever happened during birth, AND helping her and the baby with
breastfeeding. Whether or not the procedure or practice was "needed" is
somewhat irrelevant after the birth has occurred. However, as lactation
consultants we deal with the results of the intervention (or lack thereof)
on a daily basis, therefore we have a unique opportunity - perhaps even an
obligation - to bear witness to what we see, and to provide feedback to all
providers of maternity care. I do not believe that women consciously make
decisions that are harmful to themselves or their babies, or that maternity
professionals deliberately engage in practices that are harmful to their
patients / clients. So, let's assume for 2008 that sharing information is in
everyone's best interest. 

 

Therefore, be it resolved that in 2008 lactation professionals (1) WILL
WRITE follow up letters to all pertinent providers.  Describe what you see /
deal with as you would in any other follow-up letter to the primary
provider(s). You may elect to include citations where research evidence
exists on any relationship of a birth practice to an outcome you are seeing
clinically. And (2) WILL NOT attempt to point fingers or lay blame (on the
mother for her choices, or on the provider(s) for his or her actions), which
is counterproductive at best, and NOT HELPFUL. 



I am the only living author of the only academic text that documents the
relationship between birth practices and breastfeeding outcomes. Most
research on birth practices explores the effect of the practice on the
mother or baby (in general) but not on lactation or breastfeeding. There are
still major gaps in the research in this particular body of knowledge. The
late Mary Kroeger and I wrote "Impact of Birthing Practices on
Breastfeeding" in 2003. I will be writing the revision of this book in 2008.
I've begun to collect stories, research and other material already. Please
contact me privately for more information. 

 

Disclaimer: I have a financial interest in this topic because I receive some
royalties from sales of "Impact of Birthing Practices on Breastfeeding." 

 

Happy 2008!

 

Linda J. Smith, BSE, FACCE, IBCLC

Bright Future Lactation Resource Centre Ltd.

6540 Cedarview Ct, Dayton OH 45459 USA

(937) 438-9458 / fax (937) 438-3229

 <http://www.BFLRC.com> www.BFLRC.com

 


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