Dear Friends:
    I think that we are starting to see a second generation effect here. I
mean that the teachers of today's OBs grew up in a more interventive mode, so
that is what they teach their students. Same with nurses, whose teachers learned
in the interventive era.
   In my private practice, it seems like the women that really perservere (
in the hospitals in my area, the 5th largest city in the USA) to have an
unmedicated birth have many hurdles to overcome with staff resistance and pressure
to conform to the technological birth model; so much so that women are now
hiring doulas as allies in the quest for an undisturbed birth.  As lactation
professionals, we spend time dealing with problems that are the consequence of
technology.
     From what I have read, a cesarean section doesn't in and of itself pay
more to the practitioner. However, it permits scheduling. In fact there is at
least one article about the value of scheduling and inducing to promote better
staffing patterns in hospitals.  This makes life convenient for the busy
practitioner; no nights, no weekends, go to the hospital in the morning, rupture
the membranes, hang the pit, go to the office and see clients, then come back
and get the babies out. How many hospitals in the USA have an 'induction day'?.
At a local hospital near me, Tuesday is induction day and the lactation
consultant spends Wednesday trying to wake up sleepy and injured babies.
    Scheduling surgery appeals to some mothers also.
    The emphasis on scheduling leads to a false belief that other things can
be scheduled and controlled. Unfortunately, babies will never fit into that
model. Breastfeeding will be forever more difficult with this model of
obstetrical practice.
     Sadly,
     Nikki Lee

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