Tuesday, December 8, 2009

Shameless repost: Race, Class, and the Pregnant /Nursing Mom

Well. Ahem. Sooo . . . if you're plugged into the same birth-blog-o-sphere I am, you know that the neighborhood has been all abuzz on race issues. She Who Shall Not Be Named Or Even Linked has been fomenting much of it (and needless to say, both derailing and monopolizing the comment threads, which is admitttedly her greatest talent), and sadly, a major casualty has been that two of my favorite bloggers, who each have tremendous things to offer the birth advocate community, went at each other's throats. (They're both in my blogroll, and they're both there to stay - you know who you are and I remain a fan of you both, like it or not, SO THERE.)

I've been following all the threads with great interest, finding some great new perspectives, but haven't added much of my own, as inevitably my points have been precipitated by another by the time I get a chance to weigh in. BUT, I will say that I feel class is at least as relevant as race (intertwined as it so often is), and I had some thoughts on the matter a while back - I thought I might as well go ahead and repost them, by way of officially entering the conversation.

As someone who is entering the field of birth and breastfeeding, however gradually, I aspire to make sure I am always being sensitive to these issues and making whatever small contribution I can to bridging the divides. So, here are my months-old brief thoughts on race and class issues, using breastfeeding as a particular and similarly affected matter.


Very important short film: How Racism Impacts Pregnancy Outcomes

I recently had a brief but thought-provoking conversation with one of my best friends, who works as a manager of a clinic that serves homeless people (quite an amazing, admirable place, by the way). We weren't taking about her work specifically, just chatting about parenting, as moms tend to, and the topic of nursing came up, as it tends to, and turned to my particular unusually challenging experience. I mentioned how helpful chiropractic care and craniosacral therapy had been to us, and while not discounting that kind of care (her clinic employs naturopaths as well as allopaths, so she certainly recognizes the importance of offering choices in care), she observed that it's impossible for her to see these kinds of circumstances without seeing the class issues that accompany them.

She does have a point, of course. I was able to seek out this care, at least in part, because of the resources that were available to me; due, again, at least in part to my class level, my education level, the type of community my peers are based in, and any number of other socioeconomic factors. We are by NO means rich, and frankly, we still have quite a bit of debt left from the whole ordeal, but still, we were able to some of the funds together, no matter how strapped it left us. Put an impoverished woman in my same position: would she be able to pay for a lactation consultant even once, let alone multiple visits? Would she have had information about what her options were? Would anything beyond visits to a pediatrician that are covered by Medicaid be considered frivolous by her family and other members of her peer group?

It's a complex issue, to say the least, and I thought of this conversation when I saw this brief video this week. Please check it out, and give some thought to how race and class might affect access to the care that has been important to you, and the services you believe are important for others. How can we help this to change?


  1. My husband and I went from being comfortable, if tight, to completely destitute (we managed to stay in our appartment just barely and only with family help) after our first baby was in the NICU for 32 days and wracked up a horendous hospital bill (before insurance about 1/2 a million.) Now I realize that I have a better education than the average poor person (3.9 gpa through 2 years of college and continuing to research and study as a lay person extensively), but I was able to find a chiropractor who would see me as a 'charity' case for a tax write off, a peer lactation consultant through WIC plus a professional lactation consultant who saw me for free under a state government grant, a county health nurse to make in-home visits to check on baby's healthy/developement, a in-home consultant on normal development through The New Parent Network (called different things in different states but availible throughout the USA), food assistance through WIC, and donated clothes, toys, and even a mayawrap baby sling. The programs, both public and private, are absolutely there for people without the means to still have access to pretty much anything someone 'with means' can access for the healthy/happiness of baby and mother. (almost everything I mentioned is availible nationwide if you look) Plus medicare in most states covers chiropractic work. I agree race seems to play a role (the statistics are pretty clear) in infant mortality and poor postnatal outcomes, but ecomonics only does if you let it. I think education and drive have a lot more to do with it than monetary means.

  2. Jespren, first, WOW, what an ordeal! I'm so sorry - what a terrible example of our health care system's failings.

    These are good points, and interestingly, someone else *just* made similar ones on the older version of this post.

  3. Thanks for reposting this!

    When I was teaching a class at a midwifery center recently, one of my students, a black doula from Atlanta, said that she had an experience in which one of her young black mothers had been really committed to breastfeeding, but as soon as the baby was born and her family was there, her grandmother, the matriarch, said "No granddaughter of mine is going to breastfeed." She went on to explain that there is a stigma still associated with breastfeeding due to its association with slave women being forced to be wet nurses.

    I have heard this association before in a hypothetical sense. But, it was really sad to hear of someone seeing it operate in person, and the other women of color in the class agreed, and another shared a similar story. She was from New York.

    The birth center where I trained had a very high breastfeeding success rate that seemed to cross color and class lines, but so did our staff and the other clients, so maybe an atmosphere in which breastfeeding was normalized with a diverse representation of folks helped. Most hospitals don't have poor women of color as lactation consultants, and breastfeeding isn't considered normalized, with formula only as an intervention when necessary.

    Also, if you factor in that many physicians think black women have unfavorable pelvises for vaginal delivery, so may receive more unnecessary cesareans, and may have higher rates of other complications, such as hypertensive disorders, they may have more problems successfully breastfeeding due to their cesarean section, which has been shown in some cases to matter.

    And finally, I am not going to say anything specific about any drama except that it is a shame. This is an important topic, and health care inequalities are more important than anyone's bad attitude.

  4. This is an important topic, and health care inequalities are more important than anyone's bad attitude.

  5. Amen, rAmen, Shalom, namaste and blessed be.

  6. I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.