I was touched by Dr. Mira's post about the anxious mother who want to do the
right thing for her children, but seems to hold back when it comes to really
giving herself via breastfeeding.  I agree that such mothers are poorly
motivated by attempts to shame them into "doing the right thing."  That
probably feels intolerable and creates even more resistance in brittle
women.   I think such resistance stems from efforts to protect personal
boundries already blurred and confused by early emotional and perhaps
physical wounds.  Mira, as a woman, and as a powerful person (which is how
physicians are viewed) you have such an opportunity to help the woman heal
herself by taking the risk of really talking to her about how she feels, and
why she feels that way.  Feelings expressed have less power to dominate our
behavior.  With very little encouragement, I bet she would confide that she
is having a great deal of trouble emotionally, and you could gently steer
her towards counseling.

I don't see myself as a therapist, but it is certainly true that often I
spend most of a consult dealing with emotional pain.  It is messy, time
consuming, and sometimes I hear things which are hard to bear.  Yet birth
and parenting open up issues like nothing else .  People need assistance
during these times, and yet are often so afraid to admit it.  If we give
even a slight acquiesence that we will listen, they will begin.  It is such
an opportunity.  It may not "save" breastfeeding (altho sometimes it does!)
but helping a mother helps her children, and that is worth doing.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html