A few days ago I wrote:
<In my midwifery practice (mainly homebirth, a few hospital births) I will not agree to attend a birth unless the woman plans to breastfeed.>
and I explained why.
Kirsten wrote:
<Just out of curiosity, if a woman was truly unable to breastfeed (say, double mastectomy or starting chemo), I assume you would make an exception?>
Of course that would be a special case, and I would not be even mentioning breastfeeding to a person for whom it was not possible.  But I don't think it very likely that a woman in this situation would be planning a homebirth anyway.  
What a challenge!  The basic philosophy of midwifery is to be *with woman* -whatever her situation.  But as midwife I cannot provide the specialist medical care, and in situations requiring medical supervision I am happy to work collaboratively within a hospital setting - the doctors advising the woman on her medical needs and I seeking to empower and support her.
Thanks for asking.
Joy Johnston, FACM IBCLC
Midwife and Lactation Consultant
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www.webrider.net.au/~aitex/joy.htm