Midwives of the Revolution

Explorations, analysis, and reflections on women's health, midwifery, and politics from a feminist, marxist lens


Leave a comment

[Some] Breastfeeding Moms Can Now Do More!

There has been much jubilation this week in the women’s health and lactation (and tech) worlds this week as a brand new “smart” breast pump that will be hitting the market this Spring got the tech world excited at CES 2017. While the Scary Mommy blog and Association of Women’s Health, Obstetric, and Neonatal Nurses were beside themselves with joy over the new Willow breastpump, I believe a healthy dose of skepticism about this type of product is in order.

What’s the big idea? It’s quiet and discrete–you can wear it under your bra, it’s wireless, and it has some cool tech features. It’s being pitched as a way to multitask while pumping. Imagine easily commuting, going to the movies, making dinner, or cleaning the bathroom while pumping! Great for busy nursing parents, right?!

willow-breast-pump

Willow has a beautiful design,and if such technology was developed and made available in order to actually improve working parents’ lives, including, say, being a covered benefit under state Medicaid programs that would actually help working class and poor women meet their breastfeeding goals, that would be great! And, you know, if it came with gains for our side like the Fight for 15 movement is fighting for, it would be even more meaningful.

Don’t get me wrong–as a supporter of human milk for human babies and a former (and possibly future) pumping and working mama, I am for easing the burden of expressing milk when needed. For instance, as a nursing mama, I did bring my electric pump to the opening night of Star Wars: Force Awakens last year–went straight from clinic to the movies and plugged in during the previews and opening credits! This pump would have indeed made my expression of milk easier. The critique that follows is more about lower wage women than about professional workers such as myself that could likely afford the Willow. In regard to the Willow, we must consider the following not just about our own potential personal use of the pump but about what it represents.

  1. Moms are under pressure more than ever to Do More. You’ve heard that cute phrase “mother’s work is never done”? Or perhaps are familiar with the concept of the “second shift” of women* having two jobs–one (usually under-) paid at work, then going home to be mainly responsible for housework and childcare? With the devaluing of care and women’s work generally, nursing mamas are producing even more value for the economy by making food for their infants that doesn’t have to be paid for (unlike artificial milk for babies, which can be exorbitant but is paid for by programs like WIC). This product allows the pumping parent to Do More while pumping. Sure, that may be convenient and beneficial for many mamas struggling to feed their children, whether working outside of the home or not. However, it strikes me that this product is a symptom (not a creator) of the general societal expectation for mamas to be Super Mothers. In this time of neoliberalism and very few social resources that would actually help parents raise healthy children like, say, socialized high quality daycare/other childcare, postpartum in-home nurse care, excellent local public schools, accessible healthy food for families, walkable safe neighborhoods, paid maternity leave (for at least 12 months like a civilized county) etc.–mothers are still expected to Do Everything to raise healthy children by: breastfeeding in spite of all odds, prepare homemade meals for our kids every night, and sacrifice everything to be the right kind of mother who balances career and parenting. No such standards are ever applied to men/fathers because Sexism.
  2. willow-working-mom

    Ah, the working pumping mother! She’s so efficient and beautiful and productive! You hardly notice she’s a working mother! Makes you wonder if the manufacturer looked at the federal laws on pumping before launching this marketing campaign, or if they are directing it to capital. 

    Let’s be real. While mothers who can afford it (see point #3, below) would likely benefit from a pump like this to get more done at home–though most pumping moms I know do most of their pumping while at work, except exclusively pumping mamas–the real and direct beneficiary of products like Willow are the corporations that don’t really want to support their employees’ right to undisturbed pumping time on the job that is (for now) guaranteed under the Affordable Care Act. Makes you wonder if the creators of Willow have just been waiting for the ACA to be closer to repeal in order to promote this product. In every circle of breastfeeding parents I have been part of, there are constant questions about workers’ rights to pumping time. Many people resort to working through pumping time (though not as discretely as they would with the Willow) because it’s just not practical to take proper breaks to pump (I myself usually did charting while pumping because there’s always charting to be done, and the extra charting time lessened my time staying late). This will only get worse if nursing protections are lost with the almost inevitable upcoming ACA repeal. Bad news for maternal and child health–and workers’ rights. But here’s Willow, and ready to accommodate your upcoming loss of rights! Wouldn’t you like to see your midwife while they express milk for their child?! Or have your latte prepped by a properly productive multitasking discretely pumping barista? Or groceries rung up by a pumping cashier?

  3. Retailing at over $400, plus and astonishing $0.50 per single-use milk storage bag, Willow will be cost prohibitive to the vast majority of working mothers. For a product that will make it easier to make pumping parents work through their pumping session, the least capital could do is subsidize this product. In a rational world, corporations would be made to bear the burden of the cost of such a product, rather than consumers. Sure, eventually, Willow would benefit under the current ACA requirement for health insurance to provide lactation benefits. But until then–or after, if/when ACA is repealed under the next Administration–Willow will be a privilege of a small minority of wealthier professionals who can afford it. I wouldn’t consider Willow a “game-changer,” as it’s being touted, unless and until it is free to all pumping parents who need it in order to meet their breastfeeding goals.
  4. Finally, one question about this product that I’ve seen raised by lots of mamas on breastfeeding forums has to do with the actual science of milk production. Willow claims that it senses letdown and then switches to expression mode (not far off from Medela’s technology), but many pumping parents have expressed (um, sorry) concern that it can be hard to actually produce more milk while focusing on things other than nourishing the baby you love. That’s why many people don’t like pumping–you are always having to measure your output against your baby’s nutrition needs for the next day, and for many, the pressure of making enough makes this a stressful rather than satisfying process. The pressure many of us feel to pump enough in our stressful parenting and working lives does more harm for milk production than good. Some may feel better getting things done while pumping rather than staring at the pump as it fills up, but I question the physiologic good of hooking a mama up to a pump so she can be disconnected from the thing her body is doing (expressing milk) while her mind can be focused on doing something else. This seems to suggest that our nursing bodies are just machines for milk output. Most of the writing I’ve seen on increasing milk production (and I have ear a lot of it while struggling with it personally) suggests focusing your mind on your body and your baby–prety much the opposite of what Willow encourages. I am reminded of the pumping women in Mad Max: Fury Road, who I swear must have all been taking domperidone–making milk for the society and able to do little else. They needed Willow to up their capacity as contributors to the patriarchy!

    fury-road-pumping

    Imagine a post-apocalyptic world with human milk a major source of sustenance and Willow at the ready to integrate pumping people into other productive endeavors!

  5. I hope the next phase of the women’s and reproductive justice movement will fight for paid maternity leave, and more collective solutions to infant nutrition and maternal health than are currently on offer under capitalism, and more specifically, neoliberalism. I hope we will be fighting for more leisure time for workers, so that we could start to imagine technology not to benefit the bosses and the war on women, but solutions for the common good and public health. Willow seems to me a symptom of a particularly American problem, whereas a society that actually values maternal-child health and in which mothers and workers actually have rights, would produce, say, workplace-based nurseries where nursing parents can feed their babies on demand and not be shackled to a pump during the workday at all. Or, say, hospital-grade pumps you could just hook up to (BYO parts), and more lactation lounges at your workplace or public locations like cafes, libraries, bars, etc. De-stigmatizing and promoting breastfeeding is not about individual decisions to nurse or breastfeeding in public, but must be part of changing the infrastructure of our society, and fighting sexism at every step, so that women’s reproductive work (pregnancy/parenting/nursing) can be separated from her life in a healthy, holistic way (yes, nursing parents and other mothers do need to get out of the house/be away from their nurslings sometimes).

    Some of these solutions exist in social democracies, and many of them have not yet been won anywhere, to my knowledge. Let’s not lower our horizons to hoping a product like Willow will lift busy nursing mamas from our drudgery, but use this as a way to vision a better way to integrate the needs of nursing dyads into society.

    *I am using “mother” and “mama” and “women here for linguistic ease. I do recognize that not all breastfeeding parents identify in these ways, and I seek to honor that in my writing. Most of the theoretical work about social reproduction and the second shift focuses on the care work of “women,”  and sexism has generally underpinned the war on mothers specifically. In the framework and sense of solidarity that I would like to put forward here, I do generally refer to women/mothers, because an attack on women and mothers generally underpins the war on parents of all genders, including gender non-conforming and trans* parents. I hope that as the movements for reproductive and gender justice grow in the coming years, they will help us develop more useful and inclusive language that helps capture the shared and also distinct experiences of sexism, misogyny, etc. of gendered oppression. And I hope you will read my piece with understanding and generosity toward my linguistic limits.


Leave a comment

Updates Galore!

I have made it past the 3 month mark…it’s hard to believe it’s only been three months. Almost four now, but still…

Here are some highlights and lowlights from my world these days…

1. Looking forward to the Socialism Conference.

It’s this weekend — an extended conference this year, it started today. But I can’t take any days off work until my six month work anniversary, so I’ll only be attending Saturday and Sunday. Here are some talks and featured events this year that I’m looking forward to:

Special Education & Disability Rights

Marxism and indigenous feminism

Women, race, and class: A history of Black feminism

Who needs gender? A Marxist analysis

Capital’s missing book: Social reproduction theory and the global working class today

Who cares: Work, gender, and the repro­duction of labor power

From criminalization to “rape culture”: Re­thinking the politics of sexual violence

From restrictions to criminalization: The fight for reproductive rights today

Capitalism, socialism, and mental illness

What should socialists say about privilege checking?

Microbes and Marxism: Capitalism and public health

“Obamacare” as neoliberal health care reform

…OMG there is so much! Obviously won’t be able to make it to all of those sessions, but those are some of the ones I thought might be of particular interest to readers, and which speak to some topics I’ve been thinking about/excited about lately.

2. I’m sick of the judging.

I feel like everyone I work with is burnt out and cynical. I’m sick of victim blaming, slut shaming, poverty-ignoring, moralizing attitudes coming from people I work with. Especially the OB I work with. It’s poisonous, and trying to figure out how to respond with fierce compassion. Patients and staff deserve to feel human. 

3. Getting into the hospital…

This will of course bring new challenges. Now, I kinda have it good. Getting used to being in clinic full time, getting to know my patients, learning what basic and expanded skills I need to have for clinic. But it will be nice, come September (fingers crossed!), to have hospital privileges so I can actually start to be present with my patients in the hospital. I still have to have a bunch of deliveries supervised by the aforementioned physician, and hopefully by some midwives I’ll be working with, but it’s good to know it’s on the horizon. 

4. Got a rad shout-out by the fabulous Feminist Midwife!

My friend, mentor, and trail-blazing hero over at Feminist Midwife gave me and a fellow red midwife a lovely mention in her recent post here, honoring the work of sharing the journey via the blogosphere. Thanks, FM!

5. Feeling appreciated

Though every day is emotionally and clinically challenging, it is also rewarding. I am feeling every day that I make a difference when I provide good care, and I can see it in my patients’ faces and in their continuing to come in for care and opening up to me. Another perk is outside of clinic — being known among friends, fellow activists, and family, as someone who knows some things about reproductive health — and who can be trusted to ask about it. Maybe it’ll get old one day, but I doubt it. I love those calls/texts/FB messages about family planning, pregnancy, and sexual health. So, thank you to those folks who have come to me with those questions, and I hope I have been helpful. 

Socialism Conference 2014 – Coming Up in Chicago!

Leave a comment

Socialism BannerSocialism 2014 Promo Pic

I’m really looking forward to attending this year’s Socialism Conference, which I have been attending annually since 1997. I always learn a ton of history, theory, and current events, and get re-energized for another year of struggle. Unlike many conferences out there, it’s truly participatory and accessible. …

OH, and if you need some famous people in attendance who will be speaking, you can look forward to seeing there:

Glenn Greenwald

Amy Goodman

Howie Hawkins

CeCe McDonald

Liliana Segura

Wallace Shawn

Gary Younge

Dave Zirin

Jill Stein

The entrance for the whole weekend is very affordable, and worth every penny. This conference can change your life — or at least give you new perspectives on the challenges of the movements, insight to history from a working class lens, and lots of positive vibes from being around so many bad-ass and brilliant anti-racist, anti-imperialist, anti-capitalist, and anti-sexist folks for the weekend.

Hope to see you there, fellow feminists, activists, marxists, and curious folks who want to change the world.


Leave a comment

Abortion should be available on demand, without restrictions, for everyone who needs it. I believe that while society still places limits on what a woman may or may not do with her own body, while women’s sexuality and reproduction are still in effect controlled by the state, any discussion of equality or empowerment is a joke. – Laurie Penny

Sums it up.

http://towardfreedom.com/51-global-news-and-analysis/global-news-and-analysis/3542-abortion-should-be-free-safe-and-legal-for-everyone 


1 Comment

“There are so many places in the world with no healthcare–how could our patients have all this access but not show up?”

This is a common refrain from my collaborating physician, a woman who has worked in this community for decades and whose spirit betrays her lack of ability to maintain empathy. I’m not sure what she had to begin with, but now it is worn pretty bare.

It was hard to imagine those first few weeks. It can’t be that bad, I thought. Most people probably have some level of interest in taking care of our health, have some buy-in. Especially pregnant patients, right?

***

Every week, there are patients who show up toward the end of pregnancy, realizing it’s time to have the baby, having not been in prenatal care for months, maybe at all. They know they need to get the baby out. But they didn’t come in for their second trimester anemia follow-up, the anatomy scan ultrasound, the diabetes screen. They didn’t necessarily take their prenatal vitamins and likely haven’t been eating healthy. Maybe they were smoking weed or drinking or having high risk sex. They don’t know if the baby is going appropriately or if the baby is “okay,” but they come in…they come in.

Everyone I work with, even those who have been working in this community for years, still seems surprised that our patients don’t reverence prenatal care the way they did, or the way they think everyone should. “I went for every one of my prenatal appointments, I took my vitamins, I showed up, why can’t these people?”

“These people.”

And it’s true. In the narrowest sense, all pregnant patients in my state can get prenatal  care. For undocumented mamas, it can be more difficult. No public health clinic is going to turn you away, that I know of. And for our patients, getting insured, getting Medicaid, is possible. Not saying the state doesn’t make you jump through hoops that may at times be humiliating and exhausting, but in theory pregnant women at least can get insured. But at least there is some assurance that the state will cover the cost of your care. It’s free!

And then there is coming in.

There is, of course, a wide variety of reasons patients don’t come in until midway through the second, or even until late in the third, trimester to establish care or to pick up where they left off after the initial dating ultrasound. I can’t pretend to understand all that goes on outside the clinic, in my patients’ lives, but I can say that moralizing about patients not showing up doesn’t actually help get them in the door or make them feel welcomed when they do show up.

No, this isn’t a rural community in subsaharan Africa, where there isn’t modern medicine. Oh, here, we have it all! We are in the heart of a wealthy American city!

***

…A wealthy city in which fifty public elementary schools were just closed, almost all in black and brown neighborhoods; in which the majority of my patients only ever see white faces in their health clinics, maybe their kids’ schools, and in blue uniforms; in which there are few grocery stores and terrible transportation systems in the neighborhoods that are majority people of color; where in some areas youth are tracked into the criminal injustice system and in others, they are offered the world.

When the City doesn’t really give a shit about you, doesn’t value your basic human needs, let alone your higher aspirations…why would you necessarily adhere to the proscribed regimen of care for the baby you are carrying?

And even in these terrible circumstances, most of our patients are active participants in their care — they show up, get excited each time they hear the baby’s heartbeat, they worry when anything isn’t normal, they ask great questions about their bodies and the life growing inside of them.

But just as you can’t compare yourself, who did everything “right” when you were pregnant, to the few patients that don’t show up for care, you also cannot compare these “delinquent” patients to those mamas in the (other) third world who would be so grateful to have access to the kind of care that our patients take for granted.

And what if your managed care Medicaid company has you tied to your primary care provider at a clinic where every time you meet with the doctor, you feel like she doesn’t have time for you, doesn’t explain where your cervix is, doesn’t follow up on your look of bewilderment with a simple question about how she can help you understand?

I might not keep showing up either.

***

It is frustrating and scary as hell to be a prenatal care provider in those situations. When you accept a pregnant patient into your care so late, you just don’t know what you’re going to get. Intrauterine growth restriction? Fetal alcohol syndrome? Uncontrolled gestational diabetes? Preterm labor? You feel like you’re scrambling to catch up, to find out what is going on physiologically, with the pregnancy, and what motivates the woman carrying the pregnancy. You worry she might expect everything to go perfectly, while it appears she hasn’t done her part to reduce risk, since you haven’t seen her for so much of her pregnancy. You might become the type of provider you swore you’d never become. You might not even recognize yourself after years of seeing the same social problems reflected in the faces of your beautiful young patients.

Until we fight for and win from the system quality affordable housing, excellent free public education, decriminalization of our youth and of blackness, safe and affordable food and water, expansive mass transit, and a single payer health care system, the circumstances under which we utilize any and all of these basic human needs will be less than ideal. And so will our provision of such care and services.

I look forward to working in healthcare in which women’s and children’s lives will be truly valued, and in which we will collectively trust, not scrutinize–but also, enhance–women’s decisions and lives.

For now, I am grateful for having a worldview that helps me find empathy alongside righteous rage against the system. I’m grateful for education that gave me the tools to provide evidence based care, so I can continue working to do my best for patients as they show up in my clinic, whenever they’re at in the lifecycle. I’m grateful for lunchtime office yoga or forest preserve walks that preserve my sanity. And I’m grateful for intersectional (anti-racist, anti-sexist, environmental justice approach) social and economic movements in the city, country, and world, that can make things better inside and outside the clinic walls. Because good lord, things need to get better, soon.