{new #OutsideTheMomBox post} "Did I have a traumatic #childbirth?"

I read a terrific blog post recently that one mom wrote about her childbirth experience. Her labor was long but not concerning. Neither she or the baby were in any kind of danger. From all outside appearances, things looks fine. The exact opposite of how healthcare professionals define "traumatic childbirth". But to this mom, her childbirth experience was traumatic. This is an important distinction.

If we followed the legal definition of domestic violence in terms of providing services to those in need, very few women would ever get help. The legal definition of domestic violence is just that limiting. Similarly if we allow medical professionals to define (or not) our childbirth experience, many of us would not only not have the opportunity to process it but perhaps more of us would feel reluctant to name our childbirth as traumatic. Both are problematic when it comes to our mental health. 

{Funny how both are "women's issues", isn't it?}

We make birth plans, hire doulas, take a childbirth ed class...all things we do to claim our childbirth experience. Claiming your childbirth experience doesn't end when that precious baby arrives in the world! If you feel that your childbirth experience was traumatic for any reason, that is enough of a qualification. 

You have a healthy baby, right? So what exactly do you have to "complain" about? Talking about your childbirth experience (or any aspect of mothering for that matter) is not complaining; it's you taking responsibility for your healing, your self-esteem and your identity as a woman and a mother. As new moms, it's important to practice separating out needs as individuals from our role as a mother so both pieces of yourself are allowed to matter. We've never done this before. As an individual, you have needs, dreams and wants. They are important. But as a mom, you're often told that your needs don't count. But that doesn't mean that those wants and needs go away. They are still important; we just need to own them better and feel supported doing so. Talking about your childbirth is one way to do this.

No, my childbirth experience wasn't traumatic. I feel very lucky because I have known so many women who did feel that theirs was traumatic but didn't feel that they could talk about it or name it for what it truly was. (And certainly no one asks!) This void is why I've started offering trauma counseling. Trauma counseling is a time for women to talk about a trauma related to their pregnancy or childbirth experience. So if you need to claim that childbirth experience as traumatic, today or five years now, you absolutely should...and feel supported doing so.

As always, thank you for reading! I am grateful that you're here.

Life's Invisible Work

Even new moms understand pretty quickly that much of the work that they do for their child/children is often unnoticed. I've come to believe that mothering is often an invisible existence composed of simple, unremarkable actions that usually occur behind closed doors. Some of those acts are intentionally unobtrusive but most, I think, are not.  I call these acts of uncommon mothering "life's invisible work" or #lifesinvisiblework. 

{wiping...noses, bottoms, grubby hands. emptying the diaper pail. singing a song that will distract. ordering diapers, wipes, putting it all away. filling a bath.}

Sometimes the work of mothering isn't invisible...those times when we are actively engaged with our child: pushing him on the swing, mom/baby yoga, whooshing her around in the pool. But inevitably these kinds of opportunities shrink as our babies grow up. And so the bulk of our mothering work really is unseen. Does that matter?

Yes, it does matter. And the invisible work of mothering matters as a feminist issue because a) mothering is done primarily by women and b) because invisible work of any kind is usually ignored, marginalized or minimized...not to mention low paid.

{buying, trying, donating formula. breastfeeding. pumping. preparing bottles. talking to lactation consultants. pumping. buying new bras.}

bell hooks tells us that feminism "is a movement to end sexism, sexist exploitation and oppression." The work of mothering is easy to ignore, explore and oppress because it is so invisible. But if we allow this then we ignore the voices of many women, 4 out of 5 of whom will have children in their lifetime. And their voices are as important as who benefits from their invisible work: children and families. Mothering must not go unnoticed even if the work is often invisible.

{managing multiple schedules. reading labels. interviewing babysitters, nannies, daycares, schools. packing backpacks, diaper bags, snacks. car seat research. laundry.}

So, here's what we do: we make the unseen, seen again. We do that by writing, talking, Tweeting about the mothering work that we are doing. By sharing the everyday, unremarkable moments that make up the hours of our lives. And let's make it even more visible by using the hashtag: #lifesinvisiblework. Start in the way that feels most comfortable to you, perhaps on Outside The Mom Box Facebook page or on your own wall. Then dare to put it out there to others in different circles of your life.  Support those who do. See what happens.

What work do you do as a mother that is invisible? Leave a comment below.

Policing #Womens #Bodies: The #Pregnancy Version

Note: I wrote the following post in January 2013 but in light of Tennesse's decision to subject pregnant women to criminal charges should they use drugs when pregnant, it felt worth a re-visit. I've updated and amended the original.

Pregnancy used to be "just" a spectator sport in this country. We are fascinated by and fixated on pregnant women. We scan magazine spreads for famous actresses’ bumps and speculate "boy or girl?" Strangers ask us what we’re having, as if somehow connected to the reproductive process. People we meet for the first time reach out to touch our private body with a gesture that has–through this public feeding frenzy that is a woman’s pregnancy–somehow become permissible. (Ask yourself at what other time it is considered "okay" for someone to reach out and touch your stomach!) It’s a strange world we live in. But what has been formerly just annoying has recently taken on an even more dangerous tone with the criminalization of women's bodies should they do something "problematic" when pregnant. And that's a problem.

Parallel to this very public watch of pregnancy has grown an equally intrusive and even more concerning focus on the fetus. Yes, the fetus. Not yet a child and already we are seeing a preoccupation with its rights over those of the pregnant woman. Earlier this week, Tennessee became the first state in the country to move toward pressing criminal charges against a pregnant woman if she uses drugs. And there are so many more examples including:

•  a pregnant woman in Texas was slapped with a “DUI-Child Endangerment” when her BA level was less than the half the legal limit;
• Ditto for another woman in Memphis who also received a DUI;
• An Iowa woman who fell down the stairs and was charged with "attempted feticide" after she reported the accident;
• And in Mississippi a 16 year old girl whose baby was stillborn may receive life in prison when it was discovered that she used cocaine during her pregnancy.

Perhaps many of us also remember the case of Bei-Bei Shuai, who out of desperation, wondering how she would survive after her partner left her, attempted suicide.  Shuai, pregnant at the time, was charged with attempted feticide and murder in spite of her insistence that she had no desire to hurt the baby. I think it’s worth nothing that in many recent cases, the women in question are women of color. An article published in Mother Jones published just last year found similar examples with the majority of the cases involving women of color and lower income women.

The problem with policing (masquerading as “protecting”) of the fetus is two-fold:

1. Women are told in no uncertain terms that they aren't as important as their baby. That's scary. In my mind being charged with a crime related to fetus endangerment reminds me of A Handmaid’s Tale, the fictitious novel by Margaret Atwood where certain women are important only as vessels for new life, with no real rights of their own and completely disposable should they not get pregnant.  
2. Women of color and poor women are more likely be discriminated against than white women. They are more likely to be arrested and more likely for that DUI arrest, for example, to not be covered by media as the outrage that it is. As a white middle class woman, if I were charged with a DUI for child endangerment when I was pregnant, I would hire a lawyer to fight it. I have the time and resources to do so. Many do not. 

No one is saying that it's not a problem for a pregnant woman to do drugs. But as usual, our society looks to condemn first and ask questions later. The questions in these case should be related to circumstance and support. If you're a pregnant 16 year old doing cocaine, pregnancy is likely only the most recent of many challenges you've had in your short life. Think domestic violence, sexual assault, poverty, a lack of education and good healthcare, high stress, etc...all in a state like Mississippi which ranks 51st in the country on women's health issues. (North Carolina, by comparison ranks 36th.)

 Unchecked, this policing of women’s bodies will continue. What this means is that those of us who do have greater privilege must speak out, loudly and often. The surveillance will extend beyond women of color and lower income women to others like me (and perhaps you) as well. We are all in this together. We need to speak up on behalf of others not because we might be targeted next but (although we might) but because it’s the right thing to do.

Why We Need to Stop Saying "Breast is Best"

This post is adapted from one I wrote in June 2013.

Everywhere we turn, there is an abundance of information about the value of breastfeeding.  Breastfeeding saves lives and money, promotes good brain development and even helps mitigate the affects of tragedy or disaster, to name a few recently cited reasons why new moms should breastfeed. The assumption is since breastfeeding is best for baby, it should be The Choice for every new mom. That’s not the case, however, as this post will discuss. I love that breastfeeding is such a popular topic (I wish another public health issue- intimate partner violence – received as much attention and support!) but saying “breast is best” ignores and marginalizes the experiences of mothers who cannot breastfeed. 

Research tells us that there are no end to the benefits a baby receives when she is breastfed but what we don’t hear discussed as often, and which should be given at least as much attention, are the challenges that new moms face in breastfeeding. New moms encounter two kinds of challenges as they tackle breastfeeding for the first time: “general” ones (making sure baby has a good latch; dealing with an over-supply/under supply of milk; how to express efficiently, etc.) and “individualized” ones that are more complex and less talked about (the privilege of breastfeeding; negotiating the task of breastfeeding when you work outside of home; emotional and physical triggers involved with breastfeeding). Often the “general” challenges, while they can be emotional, are a result of a physical issue and can be an easier fix, with informed hands-on help.  Hands-on help can come from a number of resources including the family’s post-partum doula, a CLC/CLEC or IBCLC, a pediatrician, or any number of internet resources (such as this great video on maximizing production). For my purposes in this post, I’m going to leave “general” challenges aside and concentrate on the “individualized” challenges behind why saying “breast is best” is problematic. The focus will be on the US as that is my experience.

As a new or expecting mom, the assumption is that you will do what is best for your baby and choose to breastfeed. For many moms that means making the commitment to breastfeed during their maternity leave, if they meet certain criteria. Some moms also choose to breastfeed for six months, i.e. until baby is ready for solids (although the age indicator is arbitrary and one should go by baby’s signs of readiness instead.). Other moms have the goal of one year. One year is the time recommended by the AAP although the WHO recommends two years. Obviously behind any good intention lay many complicated issues, an important one of which is privilege.

Being in a position to exclusively breastfeed your child for any amount of time is a place of privilege. Note: for my purposes here I am defining “exclusively breastfeeding” as feeding baby only breastmilk, either pumped milk or milk directly from mom. Exclusively breastfeeding often takes substantial early effort to ensure success and while it becomes more effortless, maintaining an exclusively breastfed baby takes a considerable amount of time on the part of the mother.  Let’s look at both of those parts a little more closely:

• Breastfeeding may be the “most natural thing in the world” but it’s not easy.  Getting it right (pain-free for you and meeting the needs of baby) is learned.  Remember the “general” challenges (good latch, etc.) that I discussed above?  They may be “general” but these are often reasons why moms decide not to breastfeed.

• Time. Newborn babies should be fed 10-12 timeswithin a 24 hour period.  And even after the first two weeks, baby still needs to eat 8-12 times within 24 hours.  Even now at 13 months, Elisabeth nurses generally every 3-5 hours, although not as often overnight. That’s a lot of time that mom spends feeding a baby!

Given these two factors of time and effort, obviously then there will be some women do not have the luxury of choosing breastfeeding. Which new moms then will be disproportionately challenged more than other moms? Answer: poor women for three main reasons-

• Poor women are more likely to be employed part-time at low wage jobs (fast food staff, gas station attendants, etc.) which do not really support a breastfeeding mom, either because their maternity leave was short or non-existent or that the infrastructure of the job is such that 20-30 minute breaks to pump milk isn’t possible* even if employers are required by law to support a breastfeeding mom;

• These moms are also less likely to get the support that they need to fix those early “general” challenges because of: costs associated with that help; logistics involved with getting the help (transportation, finding the help, etc.); a lack of knowledge that such help exists and which laws and resources protect their rights as a mom;

• Finally, poor women are also more likely to have more than one child that they care for, either full or part time.

Poor women, then, are hit with a triple whammy of obstacles that often exist even before their baby is even born.  And these are the obvious obstacles.  Perhaps you can think of other obstacles such as culture and family history, an unsupportive or even abusive partner, an unhealthy body image and/or a history that includes mental health issues.

Consider the life story of a newly separated woman, Maria, for example. Maria breastfeeding is not a choice because:

• Circumstances: Maria’s baby was born early, started on formula at the hospital and the lactation consultant at the hospital didn’t visit Maria until the 2nd day of their stay;

• Resources: Maria works 45 minutes from her home and she doesn’t have the time to pump as often as she’d need to or the extra money for a pump and its accessories;

• Family: Maria’s sister watches the baby while she’s at work, raised her children on formula and thinks formula feeding is easier.

Breastfeeding, then, is clearly a privilege that not every woman has.  And this is the first of three reasons why I believe we need to stop saying “breast is best”.  When we make this assumption, we ignore the life story of the mother and in doing so marginalize and isolate her at a time when she is most vulnerable. This belief is the core reason why I started Outside The Mom Box: all too often our society disregards the needs of the mother as soon as she birthes her baby. Moms’ lives counts too…just as much as baby’s.

Until we have sufficient social systems (from milk sharing programs to lactation rooms in places of work) in place to fully support moms who want to breastfeed but cannot for whatever reason, then we have no right telling women that “breast is best”…and thus shaming moms who don’t, by “choice” or otherwise, breastfeed their baby.  Doing so is like telling a domestic violence survivor that she should leave her abusive partner but not provide her with the resources she needs: transportation, a place to go, food to eat or money for her cell phone.

Who am I then, and indeed, who is society, to tell Maria and others that “breast is best”?

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