Don’t breastfeed? Didn’t have an unmedicated birth? Congratulations, you’re in the majority!

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Yesterday I wrote about the fact that midwifery philosophy has been notoriously unsuccessful. Despite tremendous rhetorical efforts to demonize inductions, epidurals and C-sections, the rate of all three has only increased. Breastfeeding professionals have been similarly unsuccessful. Despite aggressive promotion of exclusive, extended breastfeeding — involving both hospital and government backing — exclusive, extended breastfeeding rates are still quite low in many industrialized countries. More women try breastfeeding, it’s true, but most stop when they find it’s painful, inconvenient and, most importantly, doesn’t satisfying their babies’ hunger.

What’s going on? Despite relentless pressure on women to avoid childbirth interventions and infant formula, the vast majority of women have pushed back.

Campaigns to promote unmedicated vaginal birth and breastfeeding have largely failed except in one area: peer pressure exerted through social media. But those women are not your peers.

Why?

Many women don’t believe the claimed “science” behind natural childbirth and lactivism since their own experience as well as that of their mothers, sisters and friends, contradicts it. Although epidurals, C-sections and formula are claimed to have “risks,” those purported risks are so rare that most people have never met anyone who experienced them.

Most women reject the sexist notion that their pain does not matter as much as the pain of men. If men aren’t empowered by the agony of passing a kidney stone, they reason, women aren’t empowered by the agony of childbirth.

Many women reject the traditional view, beloved of both religious fundamentalists and advocates of a “natural” lifestyle, that women are obligated to use their bodies to serve children regardless of the physical and psychic cost to themselves.

So the aggressive campaigns to promote unmedicated vaginal birth and exclusive, extended breastfeeding have largely failed except in one area: peer pressure, particularly pressure exerted through social media.

Many midwives and natural childbirth advocates routinely pathologize women who refuse to conform to their dictates. In Pushing Ecstasy: Neoliberalism, Childbirth, and the Making of Mama Economicus published in the journal Women’s Studies, Kate Rossiter explains:

…[W]hat on the surface may appear to be an ethic of care that empowers women in their choice-making ability is in fact a tactic that individuates and ultimately disempowers women …

Rossiter notes:

…[T]his discourse juxtaposes two images of the birthing mother: one wild, and one under technocratic gaze; one pure and authentic, and one living uncritically and irresponsibly within contemporary culture. Paradoxically, in order to access this wild self, the mother must work very hard to regulate herself and her surroundings in order to ensure that her ecstatic potential is realized… This is a mother who, through her diligent preparedness has optimized her natural capacity to birth … This is the mother who forgets herself in the face of her baby’s needs, and, crucially, enjoys this erasure of her non-maternal self…

It pathologizes women who refuse to go along, attempting to shame them into conforming:

This model holds no place for alternate reactions, such as ambivalence, grief, or anger. Rather, the implicit correlation is that deviation from the ideal of the ecstatic mother marks some kind of failure or pathology—suggesting that the birth circumstances were not optimal, or the mother’s hormonal system is somehow faulty, or that she herself is not a natural mother.

Women who can’t or don’t want to breastfeed are similarly pathologized.

Sunna Simmonardottir notes in Getting the Green Light: Experiences of Icelandic Mothers Struggling with Breastfeeding:

This idea that women have a ‘natural ability’ to breastfeed is culturally very strong but at the same time is counteracted with messages about the possible ‘faults’ that the women possess. They are discursively situated as both ‘natural’ and ‘unnatural’ at the same time, and in order to successfully breastfeed they have to rectify those unnatural faults often by going through quite technical processes, involving a range of breastfeeding aids such as breast pumps, artificial breasts and finger- or syringe feeding systems.

There is tremendous effort expended in shaming these women to force them to conform:

Should a mother exercise her own agency and decide for herself that the best thing for her would be to give up on trying to breastfeed, she runs the risk of being constructed as the villain, the selfish mother who didn’t want to inconvenience herself for the sake of her child. The biggest sin according to this cultural script of good mothering is not trying hard enough and giving up without a fight…

Social media like Facebook and Twitter can and do provide support for women who wish to pursue natural childbirth and/or exclusive, extended breastfeeding. But it often seems that they devote nearly as much effort to vicious criticism of women who don’t share their views. The tremendous number of likes, share, and approving comments may give these women the impression that they are part of the majority and may result in shame and guilt in those whom they attack.

But social media is not the real world. In the real world most women choose and enjoy epidurals, follow the advice of their obstetricians, and welcome any interventions that might assure the safety of their babies. In the real world most women use formula at least some of the time. In the real world, women who consider themselves more than the sum total of their reproductive performance are too busy working or caring for their families to waste time avidly liking and sharing posts that disparage women who make different choices.

People are swayed by what they think their peers are doing. Women who chose epidurals in labor, who requested C-sections, who couldn’t or wouldn’t breastfeed their babies often feel shame because they are the “only ones” who didn’t fulfill the script. But they aren’t the “only ones,” they are the majority and can find comfort in numbers.

Just about the only area in which natural childbirth and lactivism have been successful is in promoting peer pressure, particularly on social media. But the truth is that natural childbirth advocates and lactivists are not the peers of most women. Their peers are the majority of women who made the exact same choices they did.

  • Coconuts

    I come from Brazil, my country holds the first place in C-sections in the world. in the private sector, more than 80% of woman have elective c-sections. In the past 10 years people went nuts with the natural birth speech, imported from US and Europe. But Brazilian woman, those that can take their own decisions, choose a c-section. There are many reasons for it but I would say: pain, safety and pelvis preservation. It has been like that for decades. Suddenly all these woman were choosing c-sections because they were “brainwashed” by evil doctors, in fact, after much campaign the number droped around 10% in the private insurance sector, still, people are insisting in the fact the the 80 % something elective c-sections are not woman’s decision, but someone else. Because sure, that can be the only answer: woman don’t know what’s best for them. I am part of this group: I had an elective c-section that went perfect ( brazilian doctors are masters in quick, perfect c-sections, by the way a brazilian ob also mastered the cut as it is today leaving and almost invisible scar), it took I think all together 1 hour, and I was back in my room, 2 days later I left the hospital, had some pains for about a week, but my daughter and I had a calm first encounter, I enjoyed the c-section because it was fast, I had no pains and no tensions to deal with. Perfect. I breastfed for only 3 and a half months because I didn’t have enough milk. I was oriented to avoid formula, but my baby, even after hours of breastfeeding, was always hungry, always crying, I preferred to give formula all along than see her crying in hunger. When my milk was over she was already on formula too. I have no regrets whatsoever. Once I read the interview with a brazilian ob about this whole fuss, and he said (anonymously by the way) “People choose c-sections because it’s safer. Birth happens only once, if it goes wrong it’s forever, there’s no second chance”. All this moral crap surrounding something so risky as a birth is really scaring, My opinion about natural birth is that a woman doesn’t have a lot of room for plans regarding it since it is very difficult if not impossible to predict how it will unfold, so many things can happen, and it is extremely cruel to make them believe they have this “power” when in fact nobody can guarantee anything. But of course if you believe it depends entirely on you and things go wrong you will feel guilty when it doesn’t go “as planned”. I wouldn’t choose a natural birth but I think woman who want it should be well informed about the risks. And to finish: all my life I never heard, in my country, of a planned c-section gone wrong. Never. In fact I laugh when people in Brazil talk about the terrible “risks” of c-sections, influenced by the WHO or by trends. I know so many woman that have been through it, so many, never heard of a problem in my entire life.

  • Who?
  • Mimc

    I ran into an infographic listing the “false” signs of undersupply. It included the baby appearing hungry right after nursing, not getting much when pumping, and not gaining weight. It makes me wonder if they will accept any sign that a baby needs supplementation at all.

    • Sarah

      No.

  • namaste

    In response to the meme above, Who wants to be “Normal?” “Normal” is just another word for “Boring.”

    • Mari

      In this particular instance, a boring birth is exactly what most women would want. Boring means nothing has gone disastrously wrong or looked like it might go pear-shaped. Some people do seek drama in it, but they are the problem…

    • Kelly

      My last one was so boring I watched t.v. throughout the entire labor. It was glorious.

  • an indoor ficus tree

    Finally, there is some effort to hold Dr. Bob Sears accountable for his actions

    https://arstechnica.com/science/2018/06/doctor-with-dangerous-vaccine-views-gets-probation-for-gross-negligence/

    • HailieJade

      I have to wonder how desperate is California for pediatricians if that tosspot is still practicing medicine?!

  • fiftyfifty1

    “But the truth is that natural childbirth advocates and lactivists are not the peers of most women.”
    Yes, they are not our in-real-life peers, and more important that are not our FRIENDS. Real friends don’t bully you.

  • Cartman36

    This has always been my thought. The things that lactivists and birth junkies say don’t align with what women have experienced in our lives. We all known people who had epidurals and formula with great results.

    OT: I just had baby # 3 at a BFHI. I insisted on combo-feeding from the beginning and I was surprised at how accepting they were (after the initial attempt to dissuade me). I still saw the lactation consultant on day 2 and she warned me that my baby would likely cluster feeding that night and to be prepared to not get much sleep. I feel like I was looking at her like she had two heads. My baby sleep peacefully for 2 hour stretches at a time in his bassinet because he had a fully tummy (and we brought a swaddle and a pacifier). I could hear other babies on the maternity crying and I felt so bad for them and their parents.

    My husband and I laughed and laughed at the recommendation to not use a pacifier because, according to the sign in our room, we might miss important feeding cues. I feel like, they eat all the damn time, how do you miss that. All my babies spit the pacifier right out when they are hungry.

    • Jessica

      Yeah, if you try to give my son a pacifier when he wants a bottle (or the breast, when we were doing that), he’ll spit it right out and scream LOUDLY at you until you get it right…..

      • Merrie

        Yup. My firstborn was a total pacifier addict, but there were times when she wanted it and times when she wanted me! One time I was at a babywearing group and she flipped out wanting her paci. I couldn’t find one so I packed her up to leave and told the group leader why we were leaving (lack of pacifier). Her response was “You know, you have two of those attached to your body”. Ugh! Never went back.

        • PeggySue

          I would *want* to say, “No, she wants a REAL pacifier, not a substitute.” I don’t know that I would say that though.

          • Merrie

            I don’t mind a certain amount of comfort nursing, but I couldn’t blame the kid for not wanting to, because I always had ample supply and so comfort nursing really was not much of a thing for us. But I knew if I tried to explain it to this lady she’d just write it off as my fault for having let the kid have a pacifier in the first place. And I’m sure she’d also have had a field day with my middle one, who we deliberately got hooked on a paci because otherwise he sucked and chewed his hands until they were raw. Having a piece of rubber to suck on seemed preferable to macerating his own flesh. My youngest was the only one who never seemed interested in a paci, though he’s tried to swipe them from other babies.

        • Who?

          That is feral. ‘Attached’ indeed. Do not get me started.

        • Resident

          You wouldn’t want to give her pacifier confusion by offering a nipple anyways

        • Cartman36

          ewww! our first pediatrician, who I LOVED and we would still be seeing if we didn’t move, told me i was not a pacifier.

    • crazy mama, PhD

      Pardon me while I build on your comment and go off on a rant about cluster feeding, because I think it’s a concept that’s massively misused by LCs and lactivists.

      Cluster feeding is when a baby feeds more frequently at certain times of day, usually in the evening when mom’s milk supply is lower. e.g., you have a baby who’s going 2.5–3 hours between feeds during the day but eats three times in the last three hours before bed. That kind of thing is normal when they’re little.

      Cluster feeding is NOT a baby who wants to eat constantly all night or all day with little break. That’s a baby who isn’t getting enough to eat.

      • Mel

        Right? My son – who was always bottle fed or NG tube fed regardless of what was in the bottle – had cluster-feeding episodes at an adjusted age of around 1 week, 2 weeks, 4 weeks and 6 weeks. He still took around 24 oz of liquid a day but instead of 2 feeds of three oz in the evening, he decided his evening feeds should be 1.5oz every hour….

      • yentavegan

        ^^^^ Thank you …. the term cluster feeding has been mis used for so long in the lactation promotion/support community.

        • PeggySue

          Yeah, I’ve seen it used in the “take off your top, take the baby into your bed, and keep the baby on your breast all day and night” kind of advice.

      • Megan

        Yes! And EFF babies do it too. My 7 week old does this in the morning right after waking and in the evening right before bed. During the middle of the day he eats less and he is starting to sleep longer and eat less at night.

    • aurora

      I formula fed from birth and my son slept well and didn’t cry. Some of the nurses kept saying “oooo he is sleeping nice stretches, but don’t get used to it, it’s just random” The whole 3 days in the hospital my son was on a happy, diaper, eat sleep schedule. I fully believe it was because he was happily fed since the moment he was born.

      • Amazed

        My cousin’s first was a crier. At least this was the explanation. He cried. Day and night. Whenever we taked by the phone, he’d interfere. One day, my mom asked, “Is he eating enough?” My aunt replied, “Hmm, he’s constantly on the breast.” My mom, “Yes, but is he EATING?” Oh joy, Two days later little crier stopped being a crier. Another week, and he stopped being so little. In fact, his mom started over-formula-feeding him for a while because she realized he had been starving. About a month later, she was able to put an end to her “guilty overfeeding”.

        Her second? Formula-fed from day one, supplemented with what little breastmilk she has. Mom? Sleeping well since day one (and mind you, unlike her first MRCS, this one wasn’t a breeze). Baby? Sleeping well. Older kid? Singing, “She isn’t cryiiiiiing, she never cries, what a good baby we have.”

        Of course, first one’s pediatrician was a breastfeeding always works lady.

    • AnnaPDE

      WTF, miss feeding cues? Like when they cry and cry and don’t get anything out of the boob and you ask for formula and the nurse (who happens to be a trained midwife and IBCLC) starts explaining that this headbanging crazed little monkey isn’t hungry, just asking for a bit of a walk around the room on dad’s shoulder?
      Yeah, I guess that feeding cue was missed.

    • Megan

      We just had our third too and I EFF from the get go. Other than a lecture about formula powder not being sterile (um, neither are my boobs!?) I got no push back and it was great. He slept 2-3 hours at a time and didn’t cry as much as my first two whom I tried to breastfeed unsuccessfully. We also brought a paci and swaddle and I agree with you that it’s so obvious when they are really hungry. He still spits out whichever he doesn’t want, paci or bottle. It’s pretty easy to tell. I never understood the fear mongering about over feeding with a bottle for the same reason. They spit it out when they’re done! It’s pretty obvious!