Op-ed "Why We Need a Black Breastfeeding Week" at the top, with an image of the author at the bottom.

Op-ed: Why We Need a Black Breastfeeding Week

August is National Breastfeeding Month, and in the U.S., there’s also a time to commemorate and uplift Black Breastfeeding Week during the last week of the month. As with many similar commemorations, some might question the need for a separate event based on race. All babies can benefit from breastfeeding. Why the need for Black Breastfeeding Week?

Let me answer that question with one word: history. As a Tulsa, Oklahoma native, I’ve spent the months since the 100th anniversary of my hometown’s race massacre considering how tragedies in our past shape our present when it comes to healthcare in America.

Some of my work as Executive Director of the Tulsa Birth Equity Initiative focuses on helping communities understand our history and how we got to this place in our healthcare journey. It’s my job to increase access to Birth Workers of color as a way to address health inequities in Tulsa and build healthier families. 

Health and employment disparities in medical care

Black Breastfeeding Week organizers highlight that 75% of white women have breastfed versus only 58.9% of Black women, with a lack of diversity in the lactation field identified as a key part of the issue. Sadly, health disparities we see today are the result of decades of Black loss and missed opportunities for justice.

For many women, much of the first practical advice they receive around breastfeeding comes in a healthcare setting, at a clinic, or in the hospital shortly after delivery. Though advice and guidance from trusted family and friends is crucial, any problems or deficits are usually diagnosed by a doctor, midwife, or nurse.

For Black women, the chances that this medical practitioner will be a person of color are slim. As of 2019, only 2.6% of the nation’s doctors identified as Black or African-American, and in 2020 these groups accounted for a mere 7.3% of students enrolled in medical school. 

But do you know why these numbers are so low? Some might conclude that Black Americans can’t cut it in higher education, or they simply don’t choose to study medicine at the same rate. History tells a different story.

For example, have you ever heard of The Flexner Report? Also referred to as “Medical Education in the United States and Canada,” it was published in 1910 by American educator Abraham Flexner, with backing from the Carnegie Foundation. The Flexner Report has been credited for transforming and standardizing medical education. It called for significant improvements to medical education, higher admission standards, adherence to scientific methods in research and practice, and oversight by state licensure boards.

Racist beliefs in Flexner Report led to lack of Black hospitals, doctors

However, while it may have helped standardize medical care, The Flexner Report exacted a steep cost for medical schools without the funds to implement the changes.

Five of seven medical schools committed to educating Black physicians closed as a result of The Flexner report. A study published in August 2020 estimated that if those five schools had remained open, an additional 35,315 Black physicians would have entered the workforce in the years that followed, producing a 29% increase in the number of graduating African-American physicians in 2019 alone.

In addition, the medical schools that remained opened were unlikely to admit Black students due to Flexner’s beliefs about Black people and their role in medical education. In November of 2020, The Association of American Medical Colleges renamed their prestigious Abraham Flexner award due to his racist and sexist ideologies. In Chapter 14 of The Flexner Report, titled “The Medical Education of the Negro,” Flexner states that Black people should be trained in sanitation because he believed, “A well-taught negro sanitarian will be immensely useful; an essentially untrained negro wearing an M.D. degree is dangerous,” Flexner wrote.

Where did this lead? A report published in June 2020 by the Association of American Medical Colleges predicts a worsened doctor shortage of between 54,100 and 193,000 by 2033.

Changing outcomes

This all equals bad outcomes for Black patients. We know that a diverse workforce, training, and cultural competence are essential aspects of quality healthcare. Studies confirm that communities of color benefit from being seen by doctors of color.

The foundation of the U.S. Medical system was never intended to address our needs, support our families, repair our wounds and nurture our children. In other words, the system works beautifully for the people it was designed to support, and everybody else is on their own. Many people will overlook the role Abraham Flexner played in shaping the trajectory of the physician workforce, but if we continually fail to examine these lessons, we will struggle to move forward.

To solve a problem, we have to understand it. The Flexner Report may not be as violent as many of the historic crimes committed against Black people. Yet, its implications are still being felt today in ways both obvious and subtle, from the shortage of Black doctors to the appalling Black maternal mortality rate.

As we consider the solutions, it will take reflection and discomfort if we want to get at the nuances of the inequities we see today. So, yes, we need a Black Breastfeeding Week and so much more.

This op-ed was written by LaBrisa Williams, the Executive Director of the Tulsa Birth Equity Initiative, a HealthConnect One community-based doula replication site. LaBrisa is a 2021 Aspen Institute Healthy Communities Fellow. This article was originally published in The Black Wall Street Times.

Tikvah Wadley

Who are the Hidden Figures in the Black Birth World?

Hidden Figures is a movie that portrays women of color who worked at NASA with very important roles — yet were not acknowledged for their wisdom or their contributions to NASA’s great work.

At HealthConnect One, we believe that every community has its own leaders, who know the community’s language and hold solutions for the community’s challenges. A majority of the time, these leaders are not recognized for the important roles they play or for their contributions to the world of birth. I think of these leaders as Hidden Figures in the community and we would like to acknowledge them during Black History Month.

For example, if you read the questions below and someone comes to your mind, feel free to acknowledge!Katherine Johnson (played by Taraji Henson) was responsible for the calculations for an astronaut’s takeoff and landing but she was unable to use the restroom where her colleagues were and was forced to go to another building which was much further away.

  • Has there ever been a time you supported a mother and she wanted to deliver at a certain hospital but she wasn’t able to do so?
  • What did you do about it?
  • Were you able to turn this around for the mother? Was anyone?
  • Was there ever a time you were supporting a mother who wanted certain services but was unable to receive them because she had public insurance?
  • What did you do about it?
  • Were you able to turn this around for the mother? Was anyone?

Dorothy Vaughan (played by Octavia Spencer) was performing the job of a supervisor but she wasn’t recognized as a supervisor — she wasn’t “professional enough.”

  • Breastfeeding Peer Counselors support mothers in their communities and help them with the very first hours of life when the baby comes — and in some cases, with the very first latch. However, they are not seen as “professional enough” to be recognized as vital to their community. Does this make you think of anyone?
  • Can you remember a time when you helped a mother continue to breastfeed when she wanted to give up? How did you turn her negative into a positive?
  • Can you remember a time when you were disrespected and/or devalued as a Breastfeeding Peer Counselor? How did this make you feel? How did you turn this negative situation into a positive?

Mary Jackson (played by Janelle Monáe) went before a judge to present her case concerning racial equity and became NASA’s first black woman engineer.

  • What were you the first of?
  • Breastfeeding?
  • Going to college and graduating – were you the first in your family?
  • Were you the first to give birth in your family or community without interventions? Were you the first to become a Breastfeeding Peer Counselor or Community-Based Doula in your community, although it was unheard of?
  • Do you know someone who was the first to do any of these things?

Tikvah Wadley, AAS, CD(DONA), BDT (DONA), is a Certified Doula and Birth Doula Trainer through DONA, and serves as Project Coordinator for HealthConnect One. She has worked in the community for nearly 20 years and believes in empowering women in today’s society.

For Black History Month, we’re offering a platform for Black allies, partners and friends to share about the hidden figures in your communities. Have someone you want to recognize? Please share!

We will publish responses right here on February 28th. Thank you.

“History is the sum total of what all of us do on a daily basis,” says Margot Lee Shetterly, author of the book, “Hidden Figures,” in a Smithsonian article last Fall.

“We think of capital “H” history as being these huge figures — George Washington, Alexander Hamilton and Martin Luther King.” Even so, she explains, “you go to bed at night, you wake up the next morning, and then yesterday is history. These small actions in some ways are more important or certainly as important as the individual actions by these towering figures.”

~ Source: The True Story of “Hidden Figures,” the Forgotten Women Who Helped Win the Space Race, by Maya Wei-Haas