Birth, breastfeeding and biopower

Woman Shouting Using Megaphone to Stressed Woman

Women’s biology has always been used against them and to control them.

For example, although pregnancy requires two people — one male, one female — only women get pregnant, carry babies and give birth. Therefore, women can be coerced and manipulated through government and economic policies around access to birth control and pregnancy termination.

Breastfeeding promotion is the exercise of biopower over new mothers, targeting them as objects to be manipulated and trained.

For what it perceived as legitimate health interests, the government of China enforced a one child policy, forcing women to have abortions they did not want, and punishing women who gave birth to a second or third child.

For what it claims are legitimate health interests, conservative politicians in the US promote ever more burdensome and arcane restrictions on abortion access, forcing women to give birth to children they do not want, risking their lives, health and ambitions for themselves.

Using government and economic policies in this way is an expression of biopower.

As Robyn Lee explains in Ethics and Politics of Breastfeeding: Power, Pleasure, Poetics:

Biopower refers to knowledge and strategies of power that aim at governing a population’s life forces, involving the security of populations, the optimization of their health, and the discipline of their bodies. Governments exert increasing control over variables such as birth and death rates, rates of illness, fertility, rates of sexual activities, life expectancy, migration and nutrition… Through biopower, techniques of population control permeate all levels of life. Under the influence of biopower, the freedom and truth of the individual are defined in economic and biological terms.

It’s easy to understand how China’s one child policy and conservatives’ efforts to restrict abortion access are abuses of biopower. It is perhaps less obvious, but equally true, that contemporary breastfeeding policies are also an abuse of biopower.

As part of the influence of biopower, a technology of population emerged, beginning in the eighteenth century, which had two aspects: (1) the child and the medicalization of the family, and (2) hygiene, and the function of medicine as a form of social control… Breastfeeding became an area of concern because it involved both these aspects…

Contemporary breastfeeding promotion efforts like the Baby Friendly Hospital Initiative are aggressive efforts to exert biopower over women:

The influence of biopower on breastfeeding continues in the contemporary context; it can be seen in ongoing efforts to increase the initiation rates and duration of breastfeeding… [R]ules, norms, and the provision of [breastfeeding] advice represent a form of biopower through control that is exercised over the identity and behavior of women.

Biopower also involves disciplinary power that targets the human body as an object to be manipulated and trained… Conceptions of good mothering as requiring breastfeeding become internalized by individuals who carry out self-policing in relation to these norms.

Biopower is an apparently benevolent, but peculiarly invasive, form of social control.

Biopower relies on process of self-disciplining: individuals are encouraged to become agents of their own subjection through incorporating within themselves external authority structures including dominant cultural ideals and practices.

Though lactation professionals like to bewail the medicalization of infant feeding that occurred with the introduction of formula, they are deeply committed to perpetuating the medicalization of infant feeding. Just as doctors once used the language and authority of science to promote formula feeding as best, lactivists now use the language and authority science to promote breastfeeding as best. The fundamental assumption of lactation professionals everywhere is that science justifies their invasive efforts to control women’s behavior.

By medicalizing infant feeding in this way, they deploy the classic techniques of medicalization: “the expansion of medical jurisdiction and its use as a mechanism of social control through the medical gaze and surveillance.” It’s difficult to come up with a more accurate description of programs like the BFHI than that. It is an expansion of medical jurisdiction (mobilizing medical personnel to achieve its aims); it’s a mechanism of social control of women; and it brings the laser-like focus of the medical gaze on women with its surveillance techniques of constantly measuring rates of exclusive and extended breastfeeding.

The result, ironically, is that infant feeding has never been more medicalized than it has become under the influence of the lactation profession.

Breastfeeding expertise has been transferred away from women as a result of the medicalization of infant feeding, with breastfeeding norms largely determined by expert medical advice to women. Medical researchers assume their recommendations are valuable advice that can significant reduce infant morbidity and mortality… They also assume that they have the right to dispense such advice …

Moreover, while it is easy to understand how making it difficult for women to access to birth control is an unacceptable way of using women’s biology to control them, it is harder for some people to understand that making it difficult for women to access formula is an equally unacceptable way of using women’s biology to control them.

The truth is that current breastfeeding promotion efforts are an abuse of biopower by lactation professionals under the aegis of government and medical authority. It is purportedly justified (as are most uses and abuses of biopower) by the belief that it is “best” for the population of babies and mothers, while simultaneously ignoring the lives experiences of individual babies and mothers.

These breastfeeding promotion efforts are the exercise of disciplinary power over new mothers, targeting them as objects to be manipulated and trained. Women are encouraged by lactation “authorities” to become agents of their own subjugation, surrendering their bodies and lives to a medicalized view of infant feeding. That is unethical, unacceptable and profoundly wrong.

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  • https://manual.jointcommission.org/releases/TJC2017B2/MIF0170.html

    Hoping someone will eventually address the impact of the Joint Commission Perinatal Core Measure efforts to measure breastfeeding exclusivity and data from hospitals being reported regarding “performance”? (any hospital having more than 1500 deliveries in a year is supposed to report) Improvements = increase in percentage of babies who COULD be breastfed and those who leave the hospital as exclusively receiving breast milk. JC feels that 70% is a reasonable percentage to strive for – even with maternal choice involved.
    Can this be addressed as one of your topics, Dr. Amy?

  • Sarah

    People and movements wanting to control women’s bodies and what we do with them invariably have a Very, Very Important Reason.

  • Cartman36

    I just listened to the Econtalk podcast. Preach Dr. Amy Preach. I absolutely loved what the host said that if we could control pain with breathing they would teach it to soldiers. I was in the military and we got a lot of training but never anything about how to breath through pain.

    • Cartman36

      Also, I don’t know how any one could listen to that and think that Dr. Amy hates or bashes or speaks disparagingly about breastfeeding. Yes, she speaks disparagingly about the way breastfeeding is promoted but not at all about breastfeeding itself. I really hate people that don’t listen or read what Dr. Amy says to understand her, they only listen long enough to decide what they are going to reply with such “Dr. Amy hates breastfeeding”.

      I am so glad that Dr. Amy is out there getting the word out to new moms.

      • rational thinker

        Most of those people only hear what they want to hear. They tune other parts of the conversation out.

    • Amy Tuteur, MD
  • LaMont

    This is definitely reminding me of the Duke’s spiel in Dune where he talks about needing “desert power”… does this make men the Harkonnens? 😉

  • fiftyfifty1

    Hmm, biopower. An interesting idea. I wonder, though, whether it is such a broad concept that the idea starts to become meaningless. “Strategies that aim at controlling a population’s life force.” Doesn’t this include almost everything that societies have ever done? Like any law or custom surrounding sex, or food, or hygiene? When we get married and don’t just have sex with whomever whenever, this is a manifestation of biopower, no? Religious or cultural food patterns too since they control eating which is a vital part of our biology/life force. Even when we “self-police” and poop in the toilet rather than the middle of the street.