It is very common here in the USA to be asked to list ones physician. Only
occasionally does a mother question why I obtain consent to share her or
baby's information with their healthcare providers. My explanation has
always been that it is,  (as I have always believed, and have been taught to
do by esteemed LCs speaking at ILCA)  a requirement of my profession. That I
am an axillary healthcare provider. That I will be sending an assessment to
either the pediatrician or OB or GP or CNM, etc. or a combination if I find
each to have a problem.  Up until this Lacnet discussion I have always
believed that I could lose my certification if I didn't send timely reports.
I'd sure have a lot more time if I didn't write these reports! As a private
practice LC, who goes to mothers homes, here in the state of Georgia, USA  I
rarely see easy problems that are fixed immediately with positioning, for
example.  They pay me out of their pockets. Insurance does not always
reimburse them. They tend to wait until their difficulties have progressed
before calling in a private LC. Often they have already seen their
physicians or LCs in other settings for the problem.  Most of my referrals
come from other LCs, LLL, or lay midwives. I plan to continue what I have
been doing until such time as the IBLCE informs me differently.

To those who were mortified that I turned away two mothers  (only 2 !) but
offered telephone help until they found help elsewhere, I would say that I
believe we have legal, ethical and moral obligations.  I've been helping
mothers by phone for La Leche League for 32 years.  Thousands of them.  My
conscience would not permit me to leave a mother with no help at all.  At
the very least, I would hope that I could offer information to preserve the
milk supply or ease discomfort or prevent a baby from starving, without
losing my certification, or incurring the wrath of my colleagues.

Anne Grider, IBCLC, LLL, Private Practice, Marietta, Geogia, USA




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