What is racial justice in birth and breastfeeding?

By Brenda Reyes

Brenda ReyesThis 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.

Brenda Reyes, RN, CLC is the Program Manager for HealthConnect One (HC One). A well-respected and knowledgeable breastfeeding advocate, Ms. Reyes conducts breastfeeding peer counselor trainings, workshops for WIC and MCH case management staff, and trainings for front-line staff at health and social service agencies, and she was part of the HC One team which created the Hospital Breastfeeding Toolkit for Illinois’ State Perinatal Breastfeeding Quality Improvement Project. Ms. Reyes has served as both Secretary and Treasurer of the Chicago Region Breastfeeding Task Force, on the Advisory Board of the Center for Sustainable Health Outreach, and on the Illinois WIC Peer Counselor Advisory Committee. She currently serves as HC One’s representative to the United States Breastfeeding Committee. Ms. Reyes spearheads the campaign to reimburse all critical providers of breastfeeding support, including community health workers. She is also the mother of three wonderful children.

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