Saturday, September 12, 2009

Race, Class, and the Pregnant/Nursing Mom

Weekend Movie: 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. Hey, will you take a raincheck on a full reply? I have so many drafts on privilege, race, birth issues, access to care, etc. on the back burner.

    I heard Michael Lu speak this year at the CIMS Forum. His work is amazing. I was just talking to someone who had a criticism about the theory and research yesterday or the day before, which was interesting.

  2. From you? Always!

    I really want to look more into Michael Lu's work, for sure.

  3. What an important topic! Thank you for posting!

  4. In terms of breastfeeding access, I always wonder how an underprivileged mother with my similar circumstances would have been able to successfully breastfeed as long as I have. I've talked before about how I had to return to work and school 12 weeks pp, but I had a cushy job that allowed me to pump. Yeah, it sucked, but at least it was possible. How would a lower-income mother, with a job not-conducive to maintaining a pumping schedule, be able to breastfeed her child? Obviously she'd be set up to fail. And the doctor would give her some free formula to make it all 'better' and that would be the end of it. I see it all the time. Even the women who truly want to make the time to pump are not being allowed.

    We have laws against this in Illinois, but not enough employers are aware, or they find loopholes, OR they challange the mother to do something about it. Most mothers cannot risk their job to fight their employer, and certianly most cannot afford the lawyer to begin with -- and that's not even talking about all the supply issues that would be caused by that stress. Being poor automatically sets a mother up to fail at breastfeeding.

    I think we're doing an okay job at educating women, but without legal protection, not a lot is going to change.

    So with my law degree, I will be helping these women, and other women who cannot access services they need and deserve. There are almost no lawyers in this state (or any other) taking on pro-bono legal work to help women with reproductive justice battles, and I feel like I can contribute in this area. That's how I hope to affect change.

  5. just wanted to quickly say that as a low income woman myself. i have been able to access free lactation consultation services. don't know that it would be available in every community but i would think in many. additionally wic has breastfeeding peer counselors.

    i honestly don't know if medicaid covers chiropractic services or not. though i'll soon be finding out since i just got approved for regular medicaid (not pregnant medicaid which has less restrictive income qualifications)

    additionally my midwife attended birth center birth was fully covered by medicaid.

    i think there are resources available to low income women but care providers either don't know or don't care to let women know about them.

    we are forced to seek them out on our own and not everybdy does or is able to.

  6. "I think we're doing an okay job at educating women, but without legal protection, not a lot is going to change."

    Exactly right on, I feel. The above combination also leads to much of the guilt and defensiveness that get tied into breastfeeding as well, hence things like the Hanna Rosin article.

    Good points, Mrs. Culpepper, on some of these things being technically available but not properly promoted, and women not being informed.