The Divisiveness of The Atlantic Monthly's "Case Against Breastfeeding"

These are the kinds of debates I hate, largely because I refuse to take sides. Yes, I'm a doula. Yes, I have a bias for normal birth, and yes, that leads neatly into a bias for breasfeeding. But Hannah Rosin has some interesting points.

Having not done a literature review myself about the nutritional comparisons between breastmilk and formula, I am surprised, and frankly still skeptical, that medical meta-analysis is not overwhelmingly in favor of breastfeeding. And while I do know breastfed people and formula-fed people who are of equal health and intelligence, a part of me never questioned breastfeeding. Even if breastmilk were an utterly neutral liquid, it is what my body makes solely for my baby, who was also made by my body. In the natural order of things, of course I chose breast over formula.

But I like that Rosin is honest about the fact that breastfeeding is no picnic. Continuing to breastfeed your baby does require significant accomodations with work (many women will nurse for their maternity leave, and the return to work marks the end of nursing), patience from other children (how many times has one child needed something as soon as I settle in to nurse another?), the division of labor in the home, and yes --sleep. Episodically, I have been nursing for the last 7 years, for about a year and a half at a time. I cherish it, though sometimes I've been downright resentful that my husband can't nurse, too. And though it's been all natural and made-by-mom, one of my children has anaphylactic food allergies. Who would have known that until I eliminated her allergens from my own diet, my breastmilk was actually toxic?

And though I cherish nursing, not all mothers do. Though many of them want to, it is painful, and they cannot continue, regardless of the support of numerous lactation consultants. (And I am a little taken aback by the way Rosin diminishes lactation consultants. Perhaps it is because she doesn't understand how, LC's -- most of them nurses -- have assisted enough women with breastfeeding to meet the thousands of contact hours needed to be certified. ) For others, due to a variety of hormonal reasons, milk production is low, which can then lead to the relentless path of nursing-pumping-supplementing with the dreaded formula leaving no time at all to actually enjoy a newborn baby, but plenty of time to be anxious that the baby is dehydrated and starving. And for some mothers, mothers who are equally devoted to their children and absolutely selfless in ways of mothering that I could never be, breastfeeding requires mental and emotional space that is just too intimate, maybe even stifling. I have worked with too many women for whom breastfeeding was at the cost of their mental health, and I find that unacceptable. No amount of colostrum or antibody is worth that.

But what I find most upsetting about the article is not the article itself, but the comments that are being left in the blogosphere, comments that question Rosin's personal decisions, her parenting skills, and her devotion as a mother. The comments only prove that there are indeed breastfeeding fascists out there, as the author calls them. I don't like this debate because there is no answer, only judgment, and its a tension that I see in the birth world too often. It is the breast vs. bottle chapter, like the natural vs. medical childbirth chapter preceding it, in the book of how women deride each other's choices. Rosin's article shows that statistics can be used to prove a point as well as its counterpoint, but nothing is more salient than a community of mothers who feel supported and respected by their peers, employers, family members, and care-providers, so much so that they feel confident in the informed choices they have made and can resist the need to judge the choices of others.

Ummm, WHO delivered that baby?

I have been co-moderating a mothers e-group for a few years. It is a wonderful, supportive, and caring resource of information for moms in Boston. Every now and then, a newly pregnant mom asks for recommendations on an OB or midwife (usually an OB). The responses come pouring in, women sharing their stories about the tender prenatal care they received from one provider or the wonderful support given by the OB who happened to be on-call when they went into labor. But the one thing that makes me crazy is that this is said, over and over again: "Dr. (insert name) delivered my baby."

It doesn't matter how it happened: medicated or unmedicated, induced or spontaneous, vacuums or forceps. Mothers deliver their babies. Doctors and midwives attend births, assist births, catch babies, and perform procedures, but Mothers Deliver Their Babies! Even the babies who are born via the surgical skills of high-risk OB's, their mothers deliver them from the safety of their bodies, releasing them into the big, wide open, world to give them life.

Is it REALLY about the epidural?

When I tell people I'm a doula, one of the responses I get is a shake of the head, coupled with "Nah, I go for the drugs!" Or "Why should I experience pain if I don't need to?"

I loved this entry from the blog "Empowering Birth." What woman wouldn't want to walk away from her non-medicated birth experience with the sense that now she can accomplish anything in the world? What woman wouldn't want that feeling from ANYTHING? What mother wouldn't want that feeling for her daughter? The craving for this experience is what motivated me to have my third child with midwives at a birth center.

But as I delve deeper into the world of birth -- as a mother who has had three wildly different birth experiences, as a doula who has attended many births, and as an aspiring midwife -- I dare to say that it is NOT about whether a laboring mom gets an epidural. Pain is subjective. What one woman can tolerate for 24 hours, another may not be able to tolerate for 24 minutes. Is one woman stronger than the other? Is one woman's birth better than the other? A woman's body has the ability to grow and birth a child. There is, in fact, nothing more natural than that act of creation and birth, epidural or drug free, at home or in a hospital. Witnessing a birth is a phenomenal, powerful experience no matter how the birth happened and what circumstances led to its unfolding.

Because I am a trained mental health clinician, I know that people have all kinds of experiences and make very different decisions than someone else would in the exact same circumstance. None of it is up for judgment, and as a birth professional with a background in mental health, I'm very cautious about even the mildest suggestion that a woman who chooses an epidural is less-than or that the babies had a less-than birth. In fact, I'm very cautious about the suggestion that a woman who chooses an elective, first-time cesarean is less-than.

My birth passion is more focused on freedom of choices. Is a pregnant or laboring woman making a decision about her baby's birth out of fear? Does she have the supportive people she needs to form a circle around her? Is she making an informed decision about her body, which decades of trends and popular culture have taught her to dislike and distrust, if not abuse? Natural childbirth is not only about the epidural. It is about our culture; our love and reliance of technology over our instincts. It is about our need to control a normal, healthy process that should be allowed to take its own path and power and time, and intervening only when it is medically necessary. It is about a culture that focuses on liability and lost income or productivity more than the intangibles, like faith and trust.

Actually, I think that the last thing natural childbirth is about is that epidural. It is about all that is normal about birth. That we don't know when it will begin, nor do we know how long it will take. It can surprise us, and yet if we can remain watchful while still being patient and respectful of the process, it will reveal itself as all that it is meant to be.

Happy Birthday, to my Biggest Little Girl

Seven.

She was born seven years ago today -- tonight, actually, at 9:10PM. Seven years ago, to riff off of my business name, a mom was born. And as a mom, I've learned so much, now that I'm a mom 3 times. With my youngest, a mere 23 days old, if she begins to cry while I'm in the shower, it's OK. If I opt to stay in bed, nursing while half asleep in the pre-dawn hours instead of changing her heavy diaper, it's OK.

But my oldest was colicky the minute she came out of my body, and she remained stubbornly so until she was about 4 months old. As she wailed for hours, I would rock her, nearly begging her to tell me how I could make things better, because if she would just tell me what it was she needed, I'd move mountains to get it for her. Nearly hallucinating from lack of sleep while riding a post-partum rollercoaster, I would look at her and be so overwhelmed by her tiny might, yet so frightened of the powerful love and obligation I felt for her. I would alternate between wanting to put her back in my body to protect her and then wanting to completely shut off my feelings for her so that I would never hurt for her, dream for her, hope for her, or disappoint her.

And even though today we celebrate her seventh birthday, she will always be my first, taking me on my first trip around the block of motherhood. It's a burden she must carry, as the child whom her parents learn off of, who in the mix of sisterhood and birth order will always be the one who should "know better."

But she is also the one who holds my heart captive, who opened my eyes to miracles and all that the world has to offer, who taught me what it means to belong wholly to another human being. She split my heart open like the little bean plant she grew from a seed in her science class, reaching out and upward for the sun.

Happy Birthday, to the one who made me a mother.