Tuesday, February 17, 2009

Breastfeeding: shattered expectations

I just finished a reading for my breastfeeding class called "Shattered expectations: when mothers' confidence in breastfeeding is undermined". I have my critiques of it (mostly that I couldn't understand some parts.) Still, there were some interesting points they made, coming out of a metasynthesis of seven qualitative studies. Here are a few things that struck me as very true:

1) There are different discourses that take place around breastfeeding. One is a "breastfeeding is natural" discourse. It's natural - our species would have died out long ago if breastfeeding wasn't so darn easy! This discourse hides the ways that breastfeeding has historically been taught and learned, and the focus is on the mother's responsibility to do what's "natural".

Another discourse is the female body as machine. The breastfeeding woman is an isolated unit, a body. Her machine might function, but it will definitely need a lot of monitoring and repair. This leads to an intense (often medical) focus on timing, duration, and amount of breastfeeding - things you can measure. It also undermines a mother's confidence.

2) With these discourses interacting, women feel isolated and guilty when breastfeeding "fails". If breastfeeding doesn't come "naturally", what does that say about her body? I had a social worker who works on postpartum depression tell me she thought some women who had serious breastfeeding problems experienced gender identity crisis. If woman=mother=natural breastfeeding ability, is someone who can't breastfeed still a woman?

In so many ways in our society, we set women up to "fail" at breastfeeding. What puts women at risk of having trouble with breastfeeding? Cesareans, 1/3 of all mothers get them, check! Medications during labor, almost universal, check! Poor support in the hospital, check! No home visitors to support breastfeeding, check! Little breastfeeding training for doctors, check! Short maternity leaves, check!

But when breastfeeding doesn't work out, what do we hear women say? "I guess I just can't make enough milk", "Breastfeeding just didn't work out for me", "I was in so much pain and I felt guilty about stopping, but I just couldn't take it anymore". It makes me so sad to hear women say these things. Yes, individuals can overcome many of the barriers society puts in place and breastfeed. But why should we make it so they have to, and why should women blame themselves when they can't?

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