In my mind, the single most important activity going on in a hospital post-partum unit should be breastfeeding. Since neither birth nor breastfeeding is a medical event, then the most important practioner available to all moms should be an IBCLC. As I see it, the whole medicalization of birth, followed by the medicalization of the pp period, including bf'ing is one of the most destructive aspects of American culture (and those foolish enough to copy us).

Frankly, if we just had midwives attend all births, practicing in the midwifery model of care (not doctors masquerading as midwives), we wouldn't need so many of us either. That is the world I want for my children--not more medicalization. I have no interest in being a nurse, nor do I wish to see it deemed necessary or beneficial for IBCLC. I agree with Gonneke--specialization, where useful, should take place within the profession, otherwise it is just a meaningless certification. I admire, respect and value great nurses in any medical field that requires them. I personally believe they can be more important to healing than doctors, and often are far better advocates for patients in my experience. But, birth is not a medical event, nor is breastfeeding and I think the fewer medical people involved in any way, the better. 

BTW, I was thinking about lactation specialization the other day and how, in my mind, retesting undermines this. If the test only assures minimum competency, how does one ever specialize? And how do ever know that an IBCLC has achieved more than minimum competency? Years of experience by no means guarantee this. In my opinion, retesting is false reassurance and means little. As for specialization, if you spend years studying a particular area (say, NICU), you may not need to know much about the other areas, yet you have to retest on the whole spectrum. What assures your competency in your area of specialization? And where is any value being placed on specialization? Personally, I see myself as specializing in holistic lactation, as the tools I use reflect this, yet very few IBCLCs know much at all about these things. If I look at our system of retesting, the area I have spent so much time learning about, and even pioneering to a degree, is meaningless for my certification. This makes no sense to me at all. I really do feel that I am in a field that is ever more alien to me, that reflects less and less my experience and understanding of breastfeeding and may in the end become just one more cog in the wheel of the medical birth machine that causes so much human suffering.  
Jennifer Tow, IBCLC, CT, USA