Friday, December 17, 2010

Should Black women feel guilty for not breastfeeding?

A new article in Science Online rehashed the recent study presented at the American Academy of Pediatrics annual conference this fall. You may recall the study claimed that there was evidence that black women "just don't want to breastfeed" and was based on surveying 62 black women in Camden, New Jersey.

The new article emphasizes again that some black women just don't seem to have the desire to breastfeed, and that the authors of the study think we need to find other motivational factors to "convince"  black women to breastfeed, since education doesn't seem to be the key here. The black women knew that breastfeeding was better, but still chose to formula feed. The authors suggest that black moms would benefit from one-on-one counseling in order to change their minds. Class is not mentioned overtly, but I can only assume we are talking about working class and/or very poor women here, since Camden, NJ is one of the poorest, most violent cities in America, having the distinction of having the highest crime rate in the country in 2009.

Now, I want to increase the black breastfeeding rates as much as any other breastfeeding advocate, but I'm curious as to what could be said to working class black women to convince them to try breastfeeding? Although it wasn't stated, would guilt tripping and shaming be a part of the techniques employed? I can't help but wonder what could be said to a woman who has no desire to breastfeed, even after understanding the benefits, in part because she probably doesn't have the kind of life that makes breastfeeding feasible in the first place.

I found this particularly interesting in light of a recent book I read, At the Breast by Linda Blum. Blum spent some time interviewing both white and black working class mothers on their attitudes about breastfeeding. The book was published in 1999, yet Blum found the same to be true: black working class women knew breast was best, had been educated by WIC counselors and their doctors, were surrounded by white colleagues who breastfed and still chose to formula feed. What was most intriguing for me was that the white working class mothers were wracked with guilt, while the black mothers were perfectly fine with their decision. She writes:

The Black mothers who rejected exhortations to breastfeed, seemed, in their telling, to be relatively free of the emotional anguish many of the white mothers expressed. In fact, as sociologist Carter suggested, rejecting medical advice may enhance some mothers' feelings of autonomy and well-being. Much of the mothers' discussion, however, was similar to that of the white mothers; they spoke of difficult life circumstances and a lack of the time, space and health that would help make breastfeeding a positive experience. This raises the question again of whether some mothers are better off rejecting breastfeeding--like these Black mothers--than feeling that they have failed at their motherly duty.

I can't help but agree here. Until we can change the circumstances for working class moms, how can we expect to convince them to breastfeed? Isn't energy better spent securing real paid maternity leave for women and laws to protect a woman's right to express milk at work, even at blue collar jobs? The women interviewed in Blum's book were janitorial staff at a large hospital, where the nurses were able to take breaks to express milk but they were not. When it comes to the working poor there is not even the guise of an even playing field. How do we expect breastfeeding rates to change when the life circumstances for these moms is still the same?

I also often hear breastfeeding advocates repeat this quote by Elizabeth Gene:“Women should not feel guilty if they are unable to nurse their baby, but they should feel guilty if they are unwilling to do so, and they should be intellectually honest enough to know the difference.”

So is this really where we are now? That even if you are being intellectually honest about why you chose not to breastfeed, we still want you to feel guilty? Only those moms who try hard enough get a pass? How does this help us increase breastfeeding rates, particularly for working class moms of color?

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