Protect and Encourage Lactation Support for All Women — Defend the Current ACA Provisions
Did you know that the ACA (Affordable Care Act) stipulated that access to lactation consultants must be covered? (ABA Health eSource)
Did you know that before the ACA, this was not guaranteed to be covered and that more often than not people had to pay out of pocket for a private International Board Certified Lactation Consultant (IBCLC) if they were able to find one in their area at all?
Did you know the ACA also stipulated that work places over 50 employees must provide a sanitary, private location for mothers to pump (not just a bathroom or storage closet) as well as unpaid break time in which to pump? This was also not common practice before the ACA.
Did you know The ACA also stipulated that a breast pump must be provided to all new mothers?
Did you know that in the United States the responsibility to learn about the benefits of, options for, and potential complications of breastfeeding falls almost solely on individual mothers?
These provisions apply not just to the public plans offered at healthcare.gov, but to all insurance plans nationwide. The ACA did not just offer insurance to those who did not have or could not receive coverage. It also instituted universal standards of care not previously in place.
To this day, ACA or no, there are still no diagnostic tests done to determine and predict potential breastfeeding issues or conditions that would make it impossible to breastfeed correctly. Many IBCLCs are excellent at solving these problems and provide integral support, but are often faced with staff shortages and lack of resources within the health care system. Issues that could be easily discovered with better diagnostics sometimes fall through the cracks. Also, many hospitals have lactation consultants that are merely trained and not necessarily board certified, which can lead to misleading and sometimes flat out incorrect advice. Even with the ACA provisions, a majority of hospitals and health care systems to do not offer adequate lactation support.
The result of all of this is that some mothers who can breastfeed give up too early because they are not given the proper information and support; and some mothers who, for various reasons, will never be able to breastfeed are forced to go through the traumatic experience of trying and failing.
Due to the difficult circumstances of our son’s birth, my wife would never have been able to breastfeed successfully without access to an outpatient IBCLC. The amount of lactation and post-partum support my wife was given while our son was still in the hospital NICU was essentially nonexistent and incredibly unhelpful. We were, in fact, very close to giving up shortly after being discharged. If my inspiringly intelligent and determined wife had not taken it upon herself to do endless research before our son was born, and if we hadn’t paid out of a pocket for a doula who was also an IBCLC and who helped us immensely before, during, and after the birth, we would not even have known that lactation support was available though the Kaiser Permanente system. Support that would not have been available without the ACA. It is worth noting that it was alarmingly difficult to navigate our health care provider’s system in order to find and communicate with our IBCLC, a point on which she agreed and commiserated. It is also worth noting that we are covered by relatively great Kaiser plan offered through my employer. Fortunately, due to the combined support from our doula, the ICBLC, friends and family, and a certain amount of determination on our part, my wife has successfully nursed our son for over one and half years and plans to continue.
The level of care offered to American mothers post-partum is shameful. We must not let any new healthcare legislation take away what small progress has been made.
