Dear all:

As I was skimming the articles, I found one comment in passing that I think most 
decidedly needs to be addressed.  Along with all the other difficult areas of our work in a 
field where normal physiologic processes have been disrupted by the intrusion of 
marketing and misguided medical science, is the constant denigration of our profession 
by other health care practitioners.  In this case, I am assuming that the person who said 
this on Lactnet wasn't really intending it the way it came across.  But I want to 
Weissengerize the comment with an analogy.

What if I said "birth is a normal physiologic process".  Because birth is a normal 
physiologic process, perhaps we should leave women alone to do this by themselves and 
they would be better off without midwives or obstetricians. I think most of you would 
agree that midwives have a very important role in assisting the birthing process, and 
obstetricians in a well-designed health care system where they are called upon for 
medical emergencies also have a very important role in assisting the birthing process 
when it goes awry.  While we may find that such services are in need of improvement in 
many countries, I doubt we would all call for the elimination of these two professions.  In 
some cases, I do think some women are perfectly capable of delivering on their own and 
I have seen it myself on the side of the road in Buta in the Democratic Republic of Congo 
and in a little town in Ecuador and several moms here in Manhattan who gave birth on the 
bathroom floor.  Yet, I still know that appropriate assistance from midwives and 
obstetricians is helpful.

Yes, with any profession you can point to those who overintervene - I have stories about 
doulas, midwives, and obstetricians of individual cases where that has occurred.  But I 
would never extrapolate that to their entire profession.  I would, however, look at the 
system within which they work to try to determine ways in which the system could be 
restructured to reduce unnecesssary interventions.

Best, Susan

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