Dear Friends:
    Claire's post about the money that childbirth brings to an institution 
was interesting..........and not applicable to the Philadelphia area, where 
there used to be 17 facilities birthing babies and now are only about 9. Hospitals 
have closed their maternity units because they are "non-productive" in terms 
of dollars. Malpractice costs are one factor in this; some insurance companies 
are reimbursing the same monies for vaginal birth as they are for cesarean 
section.
    Part of the reason for abuse in health care is overworked, undernourished 
health care staff. I remember when I started working as a nurse in labor and 
delivery; nurses received a uniform allowance, weekend and holiday pay, shift 
differential and some other perks. When medicine went corporate in the 90s, 
all those things were taken away. Keeping a unit slightly understaffed is a  way 
to get 1.5 worth of work from each employee. When staff is overworked, it is 
easy to be irritable.
    This can be part of the reason that nurses resist breastfeeding. They 
have too much to do to spend half an hour sitting with a mother; it is faster to 
give a bottle. And then there is more charting about breastfeeding too. Nurses 
and other medical staff don't realize that the work could be so easy; just 
put most mothers and babies in bed together skin to skin, and leave them to 
figure out breastfeeding together. Be available to give suggestions and a cup of 
tea. Measure both their vital signs while they are skin to skin. 
    warmly,

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Adjunct Faculty, Union Institute and University, Lactation Program
Film Reviews Editor, Journal of Human Lactation

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