Watch – First Food: Women of Color Removing Barriers to Breastfeeding
Thank you to the National First Food Racial Equity Cohort for your work and leadership. This video features HealthConnect One’s Brenda Reyes among other leaders. The video shows breastfeeding challenges faced by people of color and the powerful advantages of “first foods.”
I am here to free you just as Harriett Tubman freed the slaves,
To free your mind and body from the damage that made you feel no better than yesterday’s trash,
To free you from the plagued mindset that black lives did not matter,
To free you so that you can freely nourish and nurture your child wherever you are.
I am here to show that you need to be Bessie Coleman to take flight in your community,
To show you how you can conquer your fears and take your sisters and brothers on the flight with you,
To show you how making waves will create stronger communities, men, women and children,
To provide you with the tools to be the next Misty Copeland,
To support you, as you stand on your points to create a better life for yourself, family and community.
I am here to shout the truth as Sojourner Truth did until breastfeeding is normalized, racial equity has been achieved, and the lives of black babies and residents of Flint matter.
Stacy Davis, program coordinator at Black Mothers’ Breastfeeding Association, is an International Board Certified Lactation Consultant (IBCLC), with 16 years of community-based health care experience. She holds a Bachelor’s degree in Health Administration from Davenport University and is currently pursuing her Masters degree in Public Health. Stacy is a 2015 Ecology Center Health Leaders Fellow and committee member for the National Association for Professional and Peer Lactation Supporters of Color. Mrs. Davis is the mother to four sons: Lawran (15), Devahn (12), Jessie (6), and Jace (3). As one of the few African American lactation consultants in the state of Michigan, Stacy is committed to providing families of color with culturally-competent breastfeeding support.
For Black History Month 2016, HealthConnect One invited partners and allies to share how they have been influenced or inspired by Black women who made history.
We hope you will share with us, too!
Join us on Twitter this Thursday, Feb 25th, at 1:00 p.m. ET (12 noon CT, 11a MT, 10a PT) for a Black Herstory Twitter Chat, using the hashtag #BlkHerStory.
In preparation for our National Action Summit this week, we asked Georg’ann Cattelona, Executive Director of Bloomington Area Birth Services (BABS) and longtime ally, to share a few words on our theme, Shared Voices for Equity in Birth and Breastfeeding.
Georg’ann was one of the founding members of BABS and has guided its development as a vital resource for pregnancy, childbirth, and breastfeeding, serving families in south central Indiana since 1994. She also teaches numerous Childbirth Education classes and prenatal yoga. Georg’ann is a DONA-approved Birth Doula Trainer, a DONA-certified Birth Doula, and a Lamaze-certified Childbirth Educator.
Thank you, Georg’ann, for sharing your voice.
by Georg’ann Cattelona
Where do I see inequities in birth and breastfeeding?
Everywhere. Out in the open. Hidden. Found openly in labor and delivery rooms, where a mother’s anxiety or a father’s protectiveness is met with antagonism. Found lurking in the corners of postpartum rooms or clinics where a mother’s request for help is met with an absence of options. Leaking out of the words of care providers to each other: “Why is she being so difficult?” “She is just going to quit breastfeeding anyway.” There for everyone to see in body language and silent actions: the eye-roll, the talking to the machine and not the mother, avoiding going into the room, and stony silence. Responses like these given to some families but not to others.
Power differentials everywhere. In the rooms of women of color attended by women who look nothing like them. In the rooms of the rural poor or teen mothers attended by those who only see a set of problems in front of them and not a person. Care providers unaware of their own privilege, who “mean well” but are, unfortunately, blind to their racism and classism.
What can (or should) be done about these inequities?
Talking. Naming the sins of commission and omission. Being awake and aware to my own participation in white privilege. And above all else, listening. Making a place for women of color, for women living in poverty, helping them have access not just to care, but also to positions of leadership. So if I can train a doula or give information about becoming a lactation consultant to a woman who has been a teen mom, to a woman of color, if I can in some small way get them to the next stage of leadership for their community, then I want to do it. Speaking up about who is at the table at meetings. So if I can work to get these women involved, even if it is uncomfortable for me or others or makes me unpopular, then I want to do it.
What is one thing the person reading this can do to support equity in birth and breastfeeding?
Act as if “every baby is our baby.” Remember that every baby is also part of a mother-baby dyad. Treat them as a unit. Support the mother so she can take care of her baby. Remember that every day that a baby is breastfed is a day that baby is not in poverty.
And find something every day that moves us forward in this fight for equity in birth and breastfeeding. I can’t tell you what that particular action needs to be in your community, but I promise I will cheer you on.
This post is the fifth in a series leading up to HealthConnect One’s National Action Summit, “Racial Justice or Just Us? in Birth and Breastfeeding,” intended to encourage open, thoughtful dialogue about finding or not finding, working or not working towards racial justice during the vulnerable time of birth and breastfeeding.
What is racial justice in birth and breastfeeding?
I think about my children, the families I’ve had the honor of serving, the communities I have engaged with, and the systems that serve these communities. I have witnessed and I have experienced discrimination and racism.
Yes, I said it!
Before we address inequities in birth outcomes and breastfeeding success in this country, we must discuss the real issues that communities of color face and experience. How do we see teen moms? Women of color? Adults who completed fourth grade and went no further? Mexican immigrants? How do health care providers respond to patients with different types of insurance? Or to those who do not speak English?
I’ve heard the anger and frustration from some nurses about how Latina and Mexican women do not breastfeed exclusively and do not attend breastfeeding classes. When I asked one particular nurse who was providing these classes and in what language, and how the hospital was conducting the outreach, she responded that the classes were conducted in English by a white nurse. I asked if they had considered conducting a focus group or survey to address the barriers and solicit feedback from the community. She responded, “No.”
Problem 1: Why do we assume what the community needs without engaging them first? Problem 2: There is disconnection between the perceived need and the real community need. Maybe breastfeeding classes are not the best approach for this community. Problem 3: Cultural and language barriers. Why would a community member be motivated to attend a class not conducted in her native language? What type of outreach is being conducted in the community? We too often fail to acknowledge that institutional racism exists in this country.
The American Journal of Public Health had a special theme issue on Racial Disparities & Birth Outcomes, and this is the topic for many conferences. This is good. This is necessary. But what too often fails to happen is the changing of policies and systems that build inequity into birth and breastfeeding.
Racial justice begins with all women having access to the support they need to have successful pregnancy, birth and breastfeeding experiences – a system that respects, welcomes, and sees the value of community-based doulas and peer counselors – a system that reimburses community-based doulas and peer counselors for their extraordinary outcomes.
We have an opportunity to integrate community health workers into our current healthcare system. Are we all up for the challenge? I know I am.
This guest post is the fourth in a series leading up to HealthConnect One’s National Action Summit, “Racial Justice or Just Us? in Birth and Breastfeeding,” intended to encourage open, thoughtful dialogue about finding or not finding, working or not working towards racial justice during the vulnerable time of birth and breastfeeding.
I’ve witnessed the racial divide, first-hand, on many occasions. Once I was surrounded by the Klan and another time by a group of self-proclaimed “skinheads.” Both of these incidents took place in different regions of the US and at different times in my life. I was the son of a military man, so moving became a mere fabric of my existence and living in places like Alaska and Reading, PA often afforded me the uncomfortable opportunity of being the lone Black child in an entire school.
I am a breastfed child and now as an adult, I often ponder the conversation that may have taken place when my mother was pregnant with me. A 20-year-old Black woman, living in Japan, in 1972. What advice was shared with her? Who engaged the subject of breastfeeding? Was it a health care provider? Was it her Doctor? Was there a first-time parents support group available for her? The answer: None of the aforementioned. It was my grandmother who instilled the foundation from early on, and my father who encouraged and supported her. My mother told me of how there were white doctors and nurses who gave her some of the strangest looks and kept asking her if she was “sure” that she wanted to breastfeed.
Fast forwarding to 2013/2014, I can count the multitudes of conversations I’ve had with both white and non-white families on how assumption plays a major role in how healthcare providers approach the family of a soon-to-be new mother. On most occasions, when it comes to breastfeeding, the white families were approached as if they were already in the know, the father was ready to support 80-100%, the mother/mother-in-law was coming to help for three months…etc., etc. While the non-white families were usually approached with bottles and formula already arranged for them, with no mention of breastfeeding at all. I’ve heard testimonies of non-white families telling both the doctors and nurses that their goal was to breastfeed and yet the free formula was still carted into their rooms.
Why is this? Why is it assumed, on either side of the coin, that the mother/family is aware or unaware? For what reasons, other than prejudice, are a mother’s/family’s wishes not to have formula in her/their room dismissed? Why isn’t it protocol for every mother/family to be afforded the same information regardless of insurance, last name, ethnicity? It’s just information, right?
I have five children, two under the age of five, so I’m allowed (and delighted) to watch all of the cartoony toddler channels and the programs they offer. Watching these shows also allows me to see commercials for everything from cleaning products to infant/toddler formula. I’ve happened to notice that rarely are there any non-whites in the formula commercials. It’s usually a focus on white families with a splash visual of a non-white family. Which brings me to wonder: Why? If the healthcare providers and hospitals are mostly promoting formula to non-white families, then shouldn’t the formula commercials do the same? In actuality they do, ever since the civil rights movement; sublime messaging in the mass media has been a profitable marketing strategy. Promote as a “white” product and bingo — every other ethnic group will want to use it, too…because if white people are using it, then it must be good.
How can we change this thought process, to insure the best health for all babies born in the U.S.?
V. Kuroji Patrick is an artist who focuses on illustration and photography. He is the co-publisher of the children’s books, ‘This Milk Tastes Good!’ a breastfeeding nursery rhyme, which features an African American family and ‘I Won’t Eat That!’ about an extremely picky eater. Kuroji is also the father of five (two boys and three girls) and he is a community activist who educates others, from expectant teenage parents in attempting to desexualize the female breast to healthcare providers about the benefits of having dad in the breastfeeding conversation.
In February of 2013, Kuroji received the Liberated Muse ‘heART’ Award, which recognizes a member of the community who has used their creative talents to uplift the community while supporting the transformation of spaces into art places. He was also inducted into the Medela Breastfeeding Hall of Excellence as a Community Breastfeeding Advocate.
This guest post is the third in a series leading up to HealthConnect One’s National Action Summit, “Racial Justice or Just Us? in Birth and Breastfeeding,” intended to encourage open, thoughtful dialogue about finding or not finding, working or not working towards racial justice during the vulnerable time of birth and breastfeeding.
“The way a culture treats women in birth is a good indicator of how well women and their contributions to society are valued and honored.”
It has taken me a long time to formulate my thoughts around Racial Justice in birth and breastfeeding and whether we are working toward it, or not. Initially I was wrapped in semantics and wanted to dissect the term “Racial Justice.” I’ll start there.
Justice is what we all want. It’s righteousness. It can be a reward, but it can also be a punishment.
The problem with justice is that it can be so subjective, so black and white.
Justice (jus’tis) n.
1. the quality of being just; righteousness, equitableness, or moral rightness: to uphold the justice of a cause. 2. rightfulness or lawfulness, as of a claim or title; justness of ground or reason: to complain with justice
And, Justice can also mean:
3. conformity to this principle, as manifested in conduct; just conduct dealing, or treatment. 4. the administering of deserved punishment or reward. 5. the maintenance or administration of what is just by law, as by judicial or other proceedings.
“Americans define racism as individual, overt and intentional. But modern forms of racial discrimination are often unintentional, systemic and/or hidden.”
These forms of racism allow for a systematic silence on the effects of racism and racial inequality on non-white residents of the United States; or maybe it’s the silence that allows these new forms of racism to proliferate. Whatever it is, it’s this silence that makes Racial Justice work difficult yet essential to improving birth and breastfeeding outcomes for black and other non-white women and families.
I will not be silent.
Since the passing of the Civil Rights Act in 1964, one might be content to say that justice prevailed, but that is far from the truth. Most of the laws governing this society are based upon racist ideologies that are in everyday use in 2014 and have manifested in the inequities we see in the prison system, in education, and even in medicine.
The systematic denial that the history of slavery is still intrinsically entwined in every aspect of life in the U.S. today is why Racial Justice work is necessary. It doesn’t take rocket science to connect the dots and see that it is past time for the United States to make far-reaching changes, and bring equity to right its wrongs.
Racial Justice is a framework being used to bring equity and justice to communities suffering from racial inequities in the United States.
Racial Justice requires the use of plain language about racism to make systemic changes and bring equity.
Plain language. Breaking the silence. That’s a start.
“We know there are disparities — they are well documented — but we need to confront them and understand why,” says Dr. Adil H. Haider, co-director of the Johns Hopkins Center for Surgery Trials and Outcomes Research. “Even though it’s a sensitive topic, we can’t move forward until we acknowledge the problem. We need to have an honest discussion about these things instead of just trying to ignore them or pretend they’re not there.” (Janel Sexton, et al., 2011)
Hanifah Rios trained as a Direct Entry Midwife at Maternidad La Luz and has provided support to families who consider home birth as a viable option. Hanifah worked as Lead Doula and Program Manager of a Community-Based Doula program at Families First in Georgia until 2012. She played a valuable role in normalizing the “non-medicated birthing experience” for many young women.
It has always been Hanifah’s mission to advocate for and support women and children of all ages who have been traditionally denied equal access to care, free from judgment, regardless of age, race, sexual orientation, education and/or socio-economic status.
She believes that when the new mother feels loved, supported, and validated she will feel confident enough to ask for support and guidance as needed in her new role as mother, and doulas are excellent at providing just that to young women in the communities we serve.
Editor’s Note: Hanifah Rios is sharing her thoughts on Racial Justice with us in three parts. You will find Part Two right here exactly one month from today.
A lack of diversity in breastfeeding leadership means developing our own.
By Kimberly Seals Allers
This guest post is the second in a series leading up to HealthConnect One’s National Action Summit, “Racial Justice or Just Us? in Birth and Breastfeeding,” intended to encourage open, thoughtful dialogue about finding or not finding, working or not working towards racial justice during the vulnerable time of birth and breastfeeding.
In leadership there is the talking and there is the “being.” That is, who you are as a leader or leadership group speaks as much about your mission, core values and purpose as any written or spoken words. This holds true in the “first food” movement just as for any other. In order to be truly effective, the leadership among advocates and policy makers must be aligned with its stated goals. They must “be” the landscape they seek to achieve.
Lately, there has been much conversation about the 40-year long disparity between African American breastfeeding rates and that of non-Hispanic white women. The good news is, a new CDC report shows the gap is narrowing from 24 percentage points between the two groups in 2000 to 16 percentage points in 2008.
Such an improvement is noteworthy. But if the U.S. breastfeeding leadership really wants to close the racial disparity in breastfeeding rates, then the first place it must look is in the mirror. The first group it must evaluate is itself. How can we say racial parity is our goal if it doesn’t even exist among the leadership of the movement?
As we embark on innovative and more community-focused approaches to closing the breastfeeding gap, we need more black and brown faces at the table shaping policy, developing programming and spearheading culturally relevant outreach into our communities.
If we are to bridge the racial divide in breastfeeding rates, we need more experienced lactation professionals who can work directly with our population. The higher rates of preterm babies and other high risk births among black women often result in situations that require the medical expertise and specialized care of a certified lactation consultant. It is clear that they are an important piece of the puzzle. However, as I travel the country in my consulting work, I’m constantly asking everyone and anyone if they know of any African American IBCLC’s. Sometimes I use my intrepid journalism skills and other times I must use more grapevine and Underground Railroad-like pathways. In some cities, there are stories and urban legends of black IBCLC’s but few could actually name any names. At one point, I wondered if I was searching for black IBCLCs or for Big Foot. The latter may have been easier.
In order to create more equitable access to the first food for all infants, we need to have the uncomfortable conversation about unconscious bias and strongly entrenched ideas about power and privilege in the breastfeeding movement. We need to honestly examine the barriers to access, such as unwelcoming environments, the high costs of becoming a certified lactation consultant and a lack of mentors.
To this end, there have also been efforts at increasing the cultural competency of breastfeeding consultants and educators so that they can fully understand the cultural nuances of African American women and better serve their needs. This is an important step. Of course, the first step in cultural competency is challenging and suspending one’s own assumptions. It is no secret that the breastfeeding movement in general is a white-female dominated industry, and like any power dynamic, an advantage for some creates a disadvantage for others.
Closing that disparity for the sake of all mothers and babies, involves acknowledging that advantage has been created and maintained because of fears of power loss, a lack of status and perhaps the personal need to be perceived as a “good” people. It also means developing a true understanding of black mothers and seeing them beyond stereotypes or their circumstances.
It means not viewing the breastfeeding movement like an exclusive club with unspoken rules about who should legitimately be allowed into the club, what club members should look like and what credentials they must have for access.
“Once they’re in, it’s like they want to close the gate and burn the bridge behind them,” says one high level breastfeeding advocate who requested anonymity.
Somehow we have to do better. If the industry is truly committed to changing the breastfeeding landscape (not just maintaining the status quo) for all women, then the leadership must better mirror the real America and address the inequities in its membership so it can truly address the issues and inequities among all breastfeeding mothers.
This is the critical work the leadership must take on. But most importantly, as African American women and other women of color, we have to save ourselves. We have to develop our own leadership in our communities. We can’t wait for the movement to change its course, while African Americans babies continue to die at twice the rate of white infants. We need to shout from the rooftops in our own neighborhoods the importance of reclaiming our community responsibility for the health of our infants. We can use our own collective voice to demand that all mothers be allowed to truly “choose” their child’s first food without being subject to the marketing interests of pharmaceutical companies, and that our communities not be flooded with infant formula—the junk food for babies. We can transform our communities into first-food-friendly environments. We can change our breastfeeding narrative at a time when the collective health of our community needs it now more than ever.
Kimberly Seals Allers is an award-winning journalist, author and a nationally recognized breastfeeding advocate and consultant. Her next book, an in-depth examination of the American breastfeeding landscape will be published by St. Martin’s Press this year. Kimberly is a Food & Community Fellow with the W.K. Kellogg Foundation and is also the founder of MochaManual.com and Black Breastfeeding 360°. Follow her on Twitter at @iamKSealsAllers
by Tikvah Wadley, Program Coordinator, HealthConnect One
This post is the first in a series leading up to HealthConnect One’s National Action Summit, “Racial Justice or Just Us? in Birth and Breastfeeding,” intended to encourage open, thoughtful dialogue about finding or not finding, working or not working towards racial justice during the vulnerable time of birth and breastfeeding.
Growing up in a home where I was dark and some of my relatives were light or fair skinned, I always heard, “You are pretty to be dark skinned” – sounding like a compliment but also sounding like indifference, and sowing in me the seeds of light is prettier and dark is not. I remember watching my aunts and Grandmother combing my cousins’ and my hair. My cousins would receive one and two ponytails, and I would always receive three. I grew up and believed in my mind – they got less ponytails than me because they were light skinned and I was dark.
Not until I was older and had a conversation, I found out I received more ponytails than my cousins because my hair was thicker than theirs and it was a bit much to fit into one or two ponytails.
This was my first interaction on “dark versus light.” This seed was planted in my youth in my own home. However, it was cultivated and nurtured in my adult professional life.
It may have not been identified as “dark versus light” every time, but it was identified by “the haves and the have nots”. It still exists today in birth and breastfeeding.
I have so many examples of seeing the prejudice/pre-judging of families in the birthing room.
For example, I worked with this young lady on her birth plan and she expressed how she would like to deliver in water as she had seen on television. The time approached for her to deliver and she was hoping she would use the pool to help with contractions and ease of delivery. She was told that because of her insurance, she couldn’t deliver in the pool. If getting in the pool helps everyone, why is it withheld from this young lady? I thought to myself.
Working with many moms, with moms of all colors, accompanying them to their births – I have noticed African American babies are “bagged” to find out if a mother is using drugs. The babies of other mothers I have accompanied – non African American mothers – are rarely “bagged” for drug use.
In conversation with breastfeeding professionals, during a presentation about breastfeeding support for all families regardless of color, I asked, “Why aren’t African Americans and Hispanics supported in breastfeeding?” The answers were that African Americans are less likely to breastfeed because of their support systems at home and Hispanics will breastfeed but they will do both – meaning breast and formula.
We must decrease the barriers of support to all families and we must start with racial equality. These barriers, this prejudice, is everywhere. We must recognize it, call it out, and bring it down. It starts with you and me in Washington DC from March 4th through 6th.
Will you join me?
Tikvah Wadley, AAS, CD(DONA), BDT (DONA), as HealthConnect One’s Program Coordinator, is in charge of the upcoming National Action Summit in Washington, DC. A Certified Doula and Birth Doula Trainer through DONA, Ms. Wadley has worked in the community for over 12 years and believes in empowering women in today’s society. She has supported hundreds of women through childbirth and breastfeeding, and recently trained young women to become community-based doulas for youth in Chicago’s foster care system. With each training, she looks forward to meeting every participant and engaging the learning experience between mom and baby.