My Body, My Choice (Revisited)
The Women's March in DC received both praises and criticisms. The conversations on inclusiveness reminded me of an article I read during world breastfeeding month, titled "On Breastfeeding: My Body, My Choice". The article, which was edited following the original post, is available here.This response was fueled by the agitation I felt after reading this article during World Breastfeeding Week, reignited by recent conversations that continue to pull back the layers of identity and challenge oversimplified discussions on gender, feminism, and experience.
First, I agree that no woman, or anyone for that matter, should be "shamed or manipulated into giving another person the use of their body", including for breastfeeding. Breastfeeding is a choice. When people talk to me about their children, they usually make it a point to say "I breastfed" or "I am going to breastfeed" and I am of course elated to hear this because I am knowledgeable about the benefits. But again, breastfeeding is a choice and if you decide not to breastfeed, it is your decision. But what the author fails to connect, however, is that many women are not provided with the choice to feed their children, as desired, due to inequities, implicit bias, and other barriers.
Okay, so let's peel back the other layers of this article.
One's lived experience is as complex as the social conditions and constructs they are bound to. With that, her assertion that breastfeeding promotion is used to reinforce patriarchal beliefs that women should stay at home and out of the workforce, or that it reaffirms ideas that our bodies do not belong to us, is just not the case for myself or women who share my experience. The author states, in response to breastfeeding promotion:
"But there is also something much more subtle and insidious going on here, and it has nothing to do with science and everything to do with the ownership of women’s bodies.
Breastfeeding promotion is not just a public health measure. It is part of the War on Women — a concerted effort to essentialize them as mothers, ground them in their biology, and force them back into the home to be wives and mothers."
These concepts are so far from my experience as an African American mother, that it is almost as if they were written in another language. First, "Stay home and raise your children Black mother or stay home so you can breastfeed Black mother" because it is your duty as a woman is not a part of our collective narrative, or at least any narrative that I am familiar with in American history. Because throughout history our bodies have not belonged to us. Our bodies have not belonged to us since children were separated from mothers without the opportunity to breastfeed, since days of pseudo-scientific racism were used to justify rape and the use of our bodies for grotesque and inhumane medical experimentation, since forced wet nursing, or since created imagery that continues to misrepresent Black women today (Dr. Patricia Hill Collins and Dr. Joy DeGruy are great references here for elaboration). So breastfeeding for women who relate to this experience can actually be seen as an act of resistance and challenges the identity ascribed to African American women.
Moving beyond feminism, empirical research underscores breastfeeding as a public health issue. It is the most preferred source of nutrition because of the evidence supporting its benefit for mothers and babies. The author's claim against the evidence, depends on what is deemed credible. While RCTs, for example, are recognized as the gold standard in research, researchers acknowledge that randomization is not always feasible or ethical, like randomly assigning only some women within a study to breastfeed when this form of feeding has been elevated as the standard. To this point, there are study designs outside of randomized controlled trials that are modeled to strengthen and validate findings, as many of the studies used to better understand the benefits of breastfeeding over non human milk substitutes have used. The same research designs have been used to make health and medical claims for various other nutrition or health related studies, when randomization is not feasible, or even more, unethical (consider the Nurses' Health Study as one example). The author negates research supporting the benefits breastfeeding, then sites a few cross-sectional studies (weak evidence for causation) against the overwhelming amount of evidence that speaks to its benefits.
Further, I would argue that the point of lactivism is not to shame mothers or guilt them into breastfeeding, or certainly not to force a mother to choose between working out of choice or necessity. This only speaks to the importance of workplace policies that support breastfeeding mothers so there aren't losses of wages or career choices, especially since returning to work is one of the most commonly reported reasons for ending breastfeeding. We are mothers and we are doing the best we can to raise our children in the best way we know how, with the resources available to us. Mothers should not be shamed over their decisions to feed, breastfeeding or otherwise. The point, however, is to promote breastfeeding, which can be an uphill struggle, in a society where social and cultural conditions do not reflect breastfeeding as the norm. The point is to make sure that every mother has the opportunity to care for her child, including her decisions on feeding, and not just those in society with the most privileged. African American women, for example, have earlier breastfeeding cessation rates, which is not necessarily a reflection of their intended breastfeeding duration. African American mothers also report, at a higher rate, that they are told by physicians to formula feed and receive less support to breastfeed from medical professionals (Cricco-Lizza, 2006, Johnson et al., 2015, Spencer et al., 2015). The author acknowledges privilege that supports some groups of women in long term breastfeeding, but is blind to her own limited scope revealed through the language she uses to speak to the experience of all women. This is dangerous. as she appears to be completely unaware that her language adds to the marginalization experienced by women who exist outside of the privilege that she too is perpetuating.
" The pressure to breastfeed is woven into every piece of messaging a young mother receives, and securely entrenched in the culture."
This reads like the anti-feminist manifesto, the part where we do not seek to validate our claims through the voices of all mothers because African American mothers have noted the opposite, citing the lack of positive imagery and messages promoting breastfeeding among Black mothers (Gross et al., 2017, Spencer et al., 2015, Asiodu et al, 2015)
There are a few arguments that I will address briefly:
" This worship of breastfeeding as the culmination of natural, intensive motherhood is bad for everyone. It is bad for fathers, who are pushed out of parenting because they lack the equipment to breastfeed, and breastfeeding is painted as the key to parent-child bonding."
This is reckless rhetoric considering that fathers are a critical influence for a mother's infant feeding decisions. Fathers also don't menstruate or push babies out of their bodies. Are they left out of the birthing process as well? Are women then to be shamed for biologically having the means to birth and feed their babies? Yes, some fathers do feel left out and feel like they are not able to feed their baby if the mother is breastfeeding. This is why many agencies supporting breastfeeding provide information on how fathers can support the mother and be involved in the feeding process for breastfed infants, such as feeding the baby pumped breast milk from a bottle or participating in other aspects, like burping the baby.
"These women are talking about debilitating pain and emotional trauma, sometimes even coupled with long-term injury and disfigurement. And although these reports are anecdotal, studies have found that pain is the number one reason mothers stop breastfeeding."
Pain is commonly cited as a reason for breastfeeding cessation, but breastfeeding should not be painful. In fact, ongoing pain during breastfeeding is a sign that the infant is not properly latching correctly. When we say breastfeeding is painful, we only deter other women from initiating breastfeeding, since believing breastfeeding is painful is a common reason that women choose not to breastfeed. Instead, we should be making sure that all women have access to professionals who can assist when they experience breastfeeding difficulties.
Finally, in an earlier version of the article, it was suggested that women of color should be offended by being shown pictures of African women breastfeeding as a means to normalize breastfeeding. Personally, I don't take offense from being shown pictures of women in Sahara Africa breastfeeding. In fact, it can be both empowering and reassuring in seeing women who look like me, whether in Africa or other parts of the diaspora, breastfeed and to know that this is in fact part of a heritage that I am disconnected from. It serves to reclaim ancestral ties from generations lost and to reclaim knowledge on the experiences of black motherhood. It is insensitive, however, for someone who does not look like me to suggest what I should and should not be offended by.
Share your thoughts below.
Asiodu IV, Waters CM, Dailey DE, Lee KA, Lyndon A. Breastfeeding and use of social media among first-time African American mothers. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG. 2015;44(2):268-278.
Cricco-Lizza, R. (2006). Black Non-Hispanic Mothers’ Perceptions About the Promotion of Infant-Feeding Methods by Nurses and Physicians. JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing, 35(2), 17.
Gross, T. T., Davis, M., Anderson, A. K., Hall, J., & Hilyard, K. (2017). Long-Term Breastfeeding in African American Mothers. Journal Of Human Lactation, 33(1), 128-139.
Hill Collins, Patricia. (1990). Black feminist thought : knowledge, consciousness, and the politics of empowerment. Boston :Unwin Hyman
Johnson, A., Kirk, R., Rosenblum, K. L., & Muzik, M. (2015). Enhancing breastfeeding rates among African American women: a systematic review of current psychosocial interventions. Breastfeed Med, 10(1), 45-62. doi:10.1089/bfm.2014.0023
Spencer, B., Wambach, K., & Domain, E. W. (2015). African American Women's Breastfeeding Experiences: Cultural, Personal, and Political Voices. Qual Health Res, 25(7), 974-987. doi:10.1177/1049732314554097.