Last week I reviewed why natural childbirth philosophy is fundamentally and ineradicably racist. I quoted Rachelle Chadwick (Bodies that Birth: Vitalizing Birth Politics) in exploring an imagined racial dichotomy in birth where indigenous women of color are fantasized as “primitive and animal-like and thus primed to give birth (and breastfeed) easily and without pain or the need for medical assistance …”

The philosophy of natural childbirth is also deeply classist. It reflects the cultural preoccupations of privileged Western white women and entirely ignores the ugly, deadly realities of maternity care for poor women.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Privileged women worry they will be subjected to the “medical gaze”: poor women worry they will be invisible.[/perfectpullquote]

Chadwick has a lot to say on this topic, too, and I’m impressed with her framing of this issue, too. Despite being immersed in obstetrics for the past 35 years, this framing is new to me, though it provides an explanation for a widely known phenomenon — the terrible infant and maternal mortality rates of poor women.

Simply put, while the privileged white women of the natural childbirth movement have been obsessing over being subjected to the “medical gaze” of increased monitoring and risk mitigation, poor women (particularly poor women of color) have been suffering from their “invisibility” under the medical gaze.

That’s because, as Chadwick notes:

Problematically, studies of risk and birth have been overwhelmingly based on the perspectives of privileged women … There has been little examination of risk and birth from the perspectives of marginalized women …

Chadwick directly addresses this serious oversight.

Far from being subject to increased monitoring and surveillance, low-income women were often subject to biomedical invisibilization during labor/birth in which they disappeared, were forgotten and disregarded, and fell outside of the medical gaze. Monitoring, machines and interventions were often missing and many women were left to labor alone with no medical assistance or pain relief.

As a result:

…[W]hile the biomedical definition of birth as a risky event requiring medical care/intervention framed women’s experiences and narratives of birth across diverse sociomaterialities, biomedical risk was enacted differently according to positions of privilege/marginalization.

Privileged women worry about “medicalization” of birth, though even those who choose homebirth and freebirth assume that their choice to forgo medicalization is made safe by their easy access to high tech care should they need it.

Therefore:

The enactment of largely middle-class notions of ‘natural birth’ or planned homebirth are thus founded on privileged access to resources and the ready availability of medical care and technocratic interventions on demand.

Poor women — in both high resource as well as low resource settings — have a very different experience of risk.

While privileged women were concerned with the risk of ‘losing control’ and made birth choices accordingly, worries about ‘control’ did not appear in the stories of low-income women… For [low-income] women, entangled within a different set of risk politics, a key concern in relation to birth was not loss of control but lack of care.

Chadwick is writing about South Africa but her observations apply to most industrialized countries:

In public sector [maternity facilities] however, the biomedical risk economy is structured very differently and in some settings is marked by the absence of technological monitoring and machinery, indifferent care and a lack of surveillance. In these contexts, women’s laboring bodies are often rendered invisible and fall outside of biomedical optics.

Privileged women and poor women have very different experiences of maternity care:

While women utilizing the private medical sector are usually highly monitored throughout their pregnancies, poor pregnant women are generally not subject to the same degree of high-tech monitoring and risk management.

It is not surprising then that poor women suffer much higher rates of infant and maternal mortality. They and their babies are dying from a lack of the very technology that privileged women disdain.

For privileged, Western white women:

…[P]regnancy and birth often became an identity-making process in which a range of technologies and practices (3D sonograms, sonograms, acupuncture, pregnancy yoga, amniocentesis, hypno-birthing) were used as ‘technologies of the self’ to craft selves and identities.

Poor women, in contrast, are desperately hoping they and their babies survive.

Natural childbirth advocacy ignores these women. Indeed, to the extent that most midwives, doulas and natural childbirth advocates acknowledge the high infant and maternal mortality rates of poor women, it is purely instrumental. They mobilize these tragedies to argue — grotesquely — that poor women need more midwives and doulas when they really need more perinatologists and ICUs.

Processes whereby black and poor laboring bodies are rendered invisible and left to fall outside of normative modes of biomedical risk management (in some public sector contexts) speak to wider forms of societal power in which some lives are valued (and must be protected) and others are not.

As Chadwick notes:

Both the panoptical [medical] gaze and the absence or withholding of the gaze thus function as potential technologies of power and are embedded in sociomaterial relations of oppression, privilege and marginalization.

The racism of natural childbirth advocacy is usually covert, but back in 2017 Ina May Gaskin inadvertently showed hers.

According to birth workers of color who attended her talk, when asked about the problem of extraordinarily black maternal mortality, Gaskin blamed women of color for their own deaths:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Gaskin appropriated the maneuver from Guatemalan midwives and in the tradition of Columbus “discovering” America, named it for herself.[/perfectpullquote]

Gaskin responded with anecdotal stories about Black women who lost their lives as a result of provider negligence, and blamed the Black women for not being more informed of their life-threatening symptoms. Moreover, Gaskin stated that “drug overdose” and the use of illegal drugs was the cause of the massive amount of Black maternal death rates. She also mentioned that communities “don’t pray as much as we used to” as a reason contributing to maternal death rates.

I’m not sure why people were so surprised. Gaskin has always trafficked in the language and habits of medical colonialism. Colonialism is the practice one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism involves control over black bodies, knowledge and practices and exploiting them for the benefit of the white majority.

Classic examples of medical colonialism come, not surprisingly, from medicine. The Tuskegee experiments, when black men with syphilis were deliberately left untreated, are the most egregious example, but medicine has plenty more including the story of Henrietta Lacks and the use of her HeLa cells for research, and the work of gynecologist J. Marion Simms, who practiced on female slaves to perfect his techniques for repairing obstetric fistulas.

But midwives have enthusiastically embraced medical colonialism, too. And Ina May Gaskin has built her career on it, including:

1. Her embrace of the racist foundational lie that indigenous women have painless labors

2. Her shockingly cynical exploitation of high rates of maternal mortality in general (her Motherhood Quilt), and black maternal mortality in particular, to critique modern obstetrics without doing anything to address it.

3. The profoundly disturbing trend of white homebirth midwives learning their trade (getting “catches”) on the bodies of women of color in developing nations.

4. The Gaskin Maneuver. In a classic example of medical colonialism, Gaskin appropriated a shoulder dystocia maneuver from Guatemalan midwives; then in the tradition of Columbus “discovering” America, she named it for herself.

Natural childbirth is a philosophy of privilege. Political scientist Candace Johnson explores this phenomenon in The Political “Nature” of Pregnancy and Childbirth. Johnson asks:

[W]hy do some women (mostly privileged and in developed countries) demand less medical intervention in pregnancy and childbirth, while others (mostly vulnerable women in both developed and developing countries) demand more …? Why do the former, privileged women, tend to express their resistance to medical intervention in the language of “nature,” “tradition,” and “normalcy”?

And answers:

It is a rejection of privilege that simultaneously confirms it…

The fantasy of Third World women’s natural experiences of childbirth has become iconic among first world women, even if these experiences are more imagined than real. This creates multiple opportunities for exploitation, as the experiences of Third World women are used as a means for first world women to acquire knowledge, experience and perspective on ‘natural’ or ‘traditional’ birthing practices, while denying the importance of medical services that privileged women take for granted.

To be clear, I have seen no evidence that Gaskin herself discriminates against individual women of color, but that does not make her innocent of mobilizing racist stereotypes and practices. It’s not merely that she failed to understand the implied racism of her own comments; it’s that she has made a career of medical colonialism, exploiting the knowledge, practices and racist fantasies about black women for the benefit of privileged white women.

Ironically, one of the most racist examples of breastfeeding advocacy that I’ve ever seen can be found on the website of a bastion of liberalism, National Public Radio.

Entitled Secrets Of Breast-Feeding From Global Moms In The Know, it exploits black African bodies to promote the values of privileged, Western, white women.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Invoking simple, contented black women who function based on instinct not intellect is racism, pure and simple.[/perfectpullquote]

It’s almost like in the U.S. we’ve lost the breast-feeding instinct. That Western society has somehow messed it up. [Evolutionary biologist Brooke] Scelza wanted to figure out why: What are we doing wrong?

So a few years ago, she traveled to a place with some of the best breast-feeders in the world.

In the desert of northern Namibia, there’s an ethnic group that lives largely isolated from modern cities. They’re called Himba, and they live in mud huts and survive off the land…

Moms still give birth in the home. And all moms breast-feed.

“I have yet to encounter a woman who could not breastfeed at all,” Scelza says. “There are women who have supply issues, who wind up supplementing with goat’s milk, which is not uncommon. But there’s basically no use of formula or bottles or anything like that.”

And Himba women make breast-feeding look easy, Scelza says. They even do it while they’re walking around.

See the simple, contented black women who function based on instinct not intellect!

It is a ugly illustration of the casual racism undergirding Western natural childbirth and breastfeeding advocacy described by academic feminist Rachelle Chadwick:

Colonial ideas about indigenous and black women’s bodies as primitive and animal-like and thus primed to give birth (and breastfeed) easily and without pain or the need for medical assistance, are rooted in ideologies of racial difference and Social Darwinism…

[T]he ‘primitive’ woman, “haunts western women’s birth stories” as a romanticized, racist ideal that valorizes the power of the instinctive, pure or ‘natural’ birthing body …

The NPR story checks every box of racist, colonial assumptions.

But that isn’t even the worst part of the casual racism displayed by NPR.

The article utterly IGNORES the fact that the babies of these women die in droves!

According to USAID, the infant mortality rate in Namibia — where all the mothers “instinctually“ breastfeed — is 32.8/1000. In the US, the infant mortality rate is 5.82/1000 — where Western white women have supposedly lost their instincts. The infant mortality rate among the Himba is higher still at an appalling 49.9/1000.

Prof. Scelza did not see fit to mention the fact that the babies of the Himba die in droves. It’s not that she didn’t know about the unusually high Himba infant mortality rate. I found the figure on her research website, a throwback to the casually racist National Geographic photo essays of my youth, complete with happy “primitives” with exposed breasts.

It is reprehensible that the NPR article doesn’t even mention infant mortality, let alone address it. It is a classic example of medical colonialism. Colonialism is the practice of one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism is the practice of exploiting black bodies, knowledge and practices and co-opting them for the benefit of well off white people.

Scelza and NPR actually think the major issue here is how to increase breastfeeding rates in the US (a preoccupation of Western, well off, white women) and ignore the REAL issue here, how to decrease the infant death rate among the Harimba people. But what’s few dead black babies when you are trying to convince white women to breastfeed? Not even important enough to mention, apparently.

“I think that there’s enormous pressure to succeed with breast-feeding in the U.S. and that you feel like if you can’t do it that this is a huge failing as a mother,” Scelza says. But Himba women didn’t seem to think the problems related to breast-feeding were a big deal.

It’s hard to imagine how Scelza and NPR could be more racist if they tried.

Yesterday I wrote about the racist origins of the philosophy of natural childbirth.

The idea that “primitive” women feel no pain in childbirth and that the pain that Western women experience can be attributed to the “fear-tension-pain cycle” originated with obstetrician Grantly Dick-Read. If you doubt that his fabricated claims were based on racism, you only have to read his own words:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Natural childbirth philosophy is fundamentally and ineradicably racist.[/perfectpullquote]

The primitive knows that she will have little trouble when her child is born… Natural birth is all that she looks for; there are no fears in her mind; …she has no knowledge of the tragedies of sepsis, infection and hemorrhage. To have conceived is her joy; the ultimate result of her conception is her ambition…

…Two, three or four percent of some tribes [died] without any sadness . . . realizing if they were not competent to produce children for the spirits of their fathers and for the tribe, they had no place in the tribe.

While contemporary natural childbirth advocates are either ignorant of or choose to ignore the racist origins of their philosophy, academic feminists have been studying how the racialization of pregnant bodies lies at the heart of natural childbirth philosophy, from its beginnings to the present day.

Rachelle Chadwick explores the racist and classist assumptions in her book Bodies that Birth: Vitalizing Birth Politics.

In the present day, racist and imperialist prejudices about women’s birthing bodies continue to underpin contemporary rhetoric about biomedicalization, ‘natural childbirth’ and rights-based discourse advocating for women’s right to choice and control. These underlying assumptions are rarely recognized or acknowledged. Colonial ideas about indigenous and black women’s bodies as primitive and animal-like and thus primed to give birth (and breastfeed) easily and without pain or the need for medical assistance, are rooted in ideologies of racial difference and Social Darwinism

Grantly Dick-Read’s racist beliefs persist among leaders and laypeople in the natural childbirth movement:

Colonial myths about easy and painless birth for so-called ‘primitive’ women also continue to frame and are used to legitimize the (largely middle-class and Euro-American) ‘natural birth’ movement and meta-narrative…

These racist myths play an outsize role in homebirth and freebirths:

These racist assumptions continue to resonate in contemporary discourse about homebirth, natural birth and unassisted birth or what has become known as ‘free birth’ in the form of the caricature of the ‘Third World,’ rural or ‘primitive’ woman who does not require biomedical assistance but gives birth alone and without medical intervention… [T]he ‘primitive’ woman, “haunts western women’s birth stories” as a romanticized, racist ideal that valorizes the power of the instinctive, pure or ‘natural’ birthing body …

The trope of the primitive woman who approaches the birth of her baby in an ‘uncomplicated’ fashion, with a “built-in knowledge of childbirth” and “without fear” has been found to inspire and embolden women’s decisions to birth outside the medical system (i.e. homebirth or unassisted birth) and pervade the talk of women planning homebirths.

Chadwick argues that the philosophy of natural childbirth continues to be fundamentally racist:

The call to return to ‘authentic’ birth and “natural selves” while ostensibly neutral, is actually an implicitly racially marked project aimed at predominantly white and privileged women.

This ongoing racism has real and deadly consequences for black women in industrialized countries. The natural childbirth movement, having conjured a racialized pregnant body as inherently “perfectly designed” for birth, elides the fact that black women are much more likely to die in childbirth than white women. To the extent that the tragedies of black pregnant women have been recognized by white women, it is to exploit those tragedies to argue – falsely and disingenuously – that black women need more of what white women want: intervention-free unmedicated vaginal birth, midwives and doulas.

But black women in industrialized countries are not dying because of too many interventions. They are dying because they don’t have access to the very interventions that white natural childbirth advocates deride. Black women die preventable deaths during pregnancy and childbirth because they need more high tech care — medical specialists, perinatologists, ICUs — not less.

The bottom line is that the contemporary philosophy of natural childbirth is fundamentally and ineradicably racist. It is long past time that the natural childbirth movement acknowledge its racist underpinnings and excise its racist assumptions about “unhindered,” “instinctual”, “natural” birth.

I’m not holding my breath. The racist trope of “the primitive woman who approaches the birth of her baby … without fear” is central to natural childbirth and beloved of privileged white natural childbirth advocates; racism be damned.

Sadly, there is an ugly history of racism in medicine. What’s less well known is the history of racism in natural childbirth advocacy and breastfeeding promotion.

As Alison Phipps explains in‘The New Reproductive Regimes of Truth,’ a chapter in the book The Politics of the Body: Gender in a Neoliberal and Neoconservative Age, natural childbirth advocates and lactivists promote an exoticized view the poor indigenous mothers of color while portraying mothers of color from their own societies as “uneducated” and lazy.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]NCB and lactivism promote exoticized views of indigenous mothers of color while portraying mothers of color from their own societies as “uneducated” and lazy.[/perfectpullquote]

Complementing this focus on the ‘natural’, there is a tendency to search for authenticity and origins in the discussion of alternative birth practices. This … often involves the Orientalizing of ‘traditional’ cultures, whether prehistoric or from developing countries. American childbirth educator Judith Lothian describes her Lamaze class as modelling ‘traditional ways of passing information about birth from generation to generation’, and advice to mothers to pursue on-demand or extended breastfeeding often makes reference to the fact that these practices are common outside the West, but without highlighting pertinent differences in culture and lifestyle.

In other words, both natural childbirth and breastfeeding advocates mobilize the myth of the “noble savage.”

According to Rational Wiki:

The noble savage stereotype is generally considered racist, ethnocentric, or culturally insensitive at the very least due to its association with a long history of imperialism, colonialism, and scientific racism …

A good deal of colonial histories and perceptions of indigenous people were based on myths, legends, and pseudohistory…

The racist myth of the “noble savage” is often used to promote pseudoscience:

Noble savage stereotypes are often used to sell woo, especially nature woo due to the perception that indigenous people are more “in tune” with nature or have some ancient and secret knowledge.

Natural childbirth and breastfeeding advocates often channel Grantly Dick-Read’s racist, sexist notions of “primitive” women. According to Dick-Read, “primitive” women have painless childbirth because they are content with their lot of being restricted to childbearing and childrearing. Of course, Dick-Read made it up and his invocation of a tension-fear-pain cycle was the result of his racist assumptions.

As Phipps notes:

… Like the claims of many contemporary activists, however, Dick-Read’s points were made despite the fact that he had not spent extensive time in non-western countries. The lack of an evidence base to corroborate such assertions is particularly problematic when non-western birthing practices are appropriated in the service of authenticity rather than effectiveness.

Contrast that with the view of poor, non-white women in their own countries:

… [W]omen who choose childbirth interventions or formula feed (who are largely from working-class and minority ethnic groups) [are] presented as ignorant and lazy or at best in need of education (which feeds racist and classist stereotypes). A generous formulation is that women lack the confidence to give birth without technology and need to be educated to trust themselves …

The surprising paradox is that natural childbirth and breastfeeding advocates claim to emulate indigenous mothers of color, whom they view as authentic and close to nature, while simultaneously demonizing mothers of color in their own countries whom they view as too ignorant to recognize the birth and breastfeeding “regimes of truth,” and too lazy to employ them when they learn of them.

The notion that women who have different preferences in childbirth and infant feeding are both ignorant and slothful justifies the beloved preoccupation of natural childbirth and breastfeeding advocates with the coercion of “informed choice.”

Within this framework of compulsory empowerment through ‘informed choice’, deviant behaviours are positioned as being a product of ignorance or weak-mindedness, rather than affirmative choices in favour of an alternative. This is clear in Lothian’s question: ‘why are women seemingly uninterested in choosing normal birth, in spite of our best efforts?’

Phipps concludes:

… [A]lthough birth and breastfeeding activists have a tendency to present themselves as counter-cultural, and identify themselves with global Others in their appropriation of ‘traditional’ practices, there is little attention paid to the stigmatizing effect this might have upon our own social Others, the working-class and minority ethnic women who may choose birth interventions or infant formula for a variety of structural reasons.

It makes you wonder: where would natural childbirth and breastfeeding advocates be without racist portrayals of mothers of color.

Imagine a study that compared in hospital blood transfusion rates to death rates. What would you conclude if that study found that people who received blood transfusions were more likely to die than those who did not?

Would you postulate that blood transfusions caused deaths? Would you recommend that blood transfusions be withheld? Of course not!

You would almost certainly recognize the obvious: people who received blood transfusions are likely sicker those who did not and therefore the two groups can’t be compared directly. You would understand that withholding blood transfusions from those who need them would lead to more deaths not fewer.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]A new study claiming to show that in hospital formula supplementation reduces breastfeeding duration is a joke.[/perfectpullquote]

That’s why a new study that claims to show that in hospital formula supplementation reduces breastfeeding duration is such a joke. It’s yet another example that breastfeeding research sucks.

The paper is In-Hospital Formula Feeding and Breastfeeding Duration by Marcia Burton McCoy, MPH, IBCLC, Pamela Heggie, MD, IBCLC.

Here’s what the authors think they found:

Hazard ratios (HR) for weaning increased across time. In the first analysis, the HR across the first year was 6.1 (95% confidence interval [CI] 4.9–7.5), with HRs increasing with age (first month: HR = 4.1 [95% CI 3.5–4.7]; 1–6 months: HR = 8.2 [95% CI 5.6–12.1]; .6 months: HR = 14.6 [95% CI 8.9–24.0]). The second, more conservative analysis revealed that infants exposed to IHFF had 2.5 times the hazard of weaning compared with infants who were exclusively breastfed (HR = 2.5; 95% CI 1.9–3.4).

CONCLUSIONS: IHFF was associated with earlier weaning, with infants exposed to IHFF at 2.5 to 6 times higher risk in the first year than infants exclusively breastfed. Strategies to reduce IHFF include prenatal education, peer counseling, hospital staff and physician education, and skin-to-skin contact.

Here’s what they actually found: absolutely NOTHING!

Why is the study a joke? Because it fails to fully account for the fact that mothers whose babies need in hospital supplementation may have insufficient breastmilk. The two groups of infants being compared are not comparable and therefore no conclusions can be drawn.

The authors did recognize that — contrary to the beliefs of many lactation professionals — insufficient breastmilk is both real and common. But they did not adequately take that reality into account.

The authors made four assumptions:

1. On the basis of early weight loss nomograms for exclusively breastfed newborns, a maximum of 5% of infants experienced weight loss ≥ 10% because of primary lactation failure.

2. All cases of primary lactation failure were detected by excess weight loss.

3. All infants with excess weight loss were given formula rather than the mother’s expressed milk or pasteurized donor human milk.

4. Those with excess weight loss had the shortest durations of breastfeeding of all infants exposed to IHFF.

Therefore:

In this analysis, we excluded the 5% of IHFF infants with the shortest breastfeeding durations before matching.

Using those assumptions, the “risk” of in hospital formula supplementation leading to weaning was cut dramatically from 6.1 to 2.5.

But most cases of insufficient breastmilk are NOT diagnosed immediately. It can take days or even weeks for insufficient breastmilk to become apparent.

Furthermore, the incidence of insufficient breastmilk in the first week or so after birth is up to 15%, much higher than the 5% that the authors assumed. As a result, they failed to fully account for breastfeeding complications. Therefore, their results are worse than meaningless.

That’s hardly surprising because most breastfeeding research is like bad drug company research; it is impaired by conflicts of interest. It uses statistically illiterate methods to demonstrate meaningless ”benefits” and reach the predetermined conclusion that we should be buying more of whatever the breastfeeding industry is currently selling.

At first it seems confusing and out of place; they weren’t celebrating their heritage, real or imagined. So why did protesters in Michigan — as far north from the Deep South as you can possibly be and still be in the US — wear Confederate garb and carry Confederate flags?

Because COVID denialism is primarily an expression of white identity. It is partly wishful thinking that white, rural people are immune, but it also includes a willingness to die to conserve a superior “place” in a purported racial hierarchy.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Many poor white people are willing to die to conserve their “place” in a purported racial hierarchy.[/perfectpullquote]

When these protestors die, and too many of them will, they will be dying of whiteness.

How did we get here?

It’s just an extension of the politics of racial resentment that have been roiling the country for a generation.

COVID-19 started in China and brought massive suffering to Italy, literally shutting the country down. But the first major flares in the US occurred in cities known for liberalism, tolerance and population density. And because it disproportionately kills people of color, many white people erroneously believe that they are immune.

But even as they find they are not immune — consider the stories circulating about COVID deniers who dropped their denialism when they became desperately ill — denialism is growing as a political force.

Homemade placards reading ‘give me liberty or give me covid’, and ‘live free or die’, feel frighteningly close to the truth, as protestors defy crucial social distancing guidelines, and demand the lifting of necessary measures which would see a sharp spike in fatalities…

As physician Jonathan Metzl explained in Dying of Whiteness: How the Politics of Racial Resentment is Killing America’s Heartland, poor, rural white people often favor beliefs and policies that literally kill them.

As Metzl noted in an interview last year:

…What I was trying to do was first explore how racial tensions shaped policies in particular states. And I found very clear evidence of the ways that fears of immigrants, fears that minority people were usurping resources, were shaping policy agendas in these regions.

In Kansas [where voters have supported massive cuts to public services], for example, a number of very far-right people told me that they felt like minority school districts were taking all the state taxpayer money and buying party buses and having parties. And those tensions shaped policies that defunded schools or blocked immigration or cut health care services. So were the individual people racist? I don’t know. But the policy itself was shaped by racial tensions, and that, ultimately, dictated health outcomes across the board.

This isn’t merely people failing to understand how the policies they support will hurt them. It’s people willing to be hurt in order to preserve racial hierarchies. When COVID deniers declare they want to live free or die, they mean that they don’t want to live if they have to live in a world where people of color are accepted as equal.

But what about COVID deniers on the Left, the anti-vaxxers and purveyors of the nonsense “documentary” Plandemic? Although they will deny it vigorously, their views rest on racism, too.

Anti-vax has long been an expression of white privilege. As sociologist Jennifer Reich writes in the paper Neoliberal Mothering and Vaccine Refusal: Imagined Gated Communities and the Privilege of Choice:

[Anti-vax mothers] … envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable …

Anti-vaxxers claim to be empowered by their decisions:

Yet, they do so by claiming their power through dominant feminine tropes of maternal expertise over the family and by mobilizing their privilege in the symbolic gated communities in which they live and parent…

At its heart — both on the Right and the Left — COVID denialism is an expression of racism. It is the belief that white people, by virtue of being superior, are immune to the scourge. And if it doesn’t actually make them immune, they will settle for displaying their supposed superiority by campaigning against measures they view as benefiting poor people of color.

It’s not difficult to recognize that this husband is abusive:

My daughter, 10 months old has recently started biting during breastfeeding… [M]y breasts kind of look like a war zone- I’m bleeding and sore because of the biting and simply cannot take it anymore.

… My husband does not like this. He was okay with me pumping and feeding our daughter until I started supplementing with formula. He believes that breastmilk is best and formula is the devil because it’s not “natural” or something…

It reached the tipping point yesterday when he hid the formula so I’d have “no choice” but to breastfeed our daughter.

I ask him why he’s doing this, and he simply says he doesn’t think I’m not trying hard enough because I stopped simply because she’s biting me, and that a good mother wouldn’t stop doing what’s best for her child simply because she’s in pain.

Most of the comments on the Reddit thread are supportive of the mother. For example:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]What’s the difference between this abusive behavior and the typical behavior of many lactivists?[/perfectpullquote]

… How fucking dare he. I am filled with righteous indignation on your behalf. A good husband wouldn’t gaslight his wife into thinking that she is somehow doing her child wrong by making certain her child gets the nutrients she needs while make certain that her own body isn’t relegated to the status of a chew toy… [I]f my husband did this to me (hid formula to try to force me to breast feed; doubled down by accusing me of being a bad mother if I didn’t follow his command) I would tell him I’d see the formula back immediately, or I’d see him in court.

So here’s my question: is there any difference between this abusive behavior and the typical behavior of many lactivists* and lactation professionals?

A foundational document of contemporary lactivism, Diane Weissinger’s Watch Your Language, is a veritable primer on emotional abuse. It explains in detail how to use fear, obligation and guilt to force women to breastfeed.

What are the tactics employed by both the abusive husband and by lactivists?

1. Thought policing:

This is the key tactic:

When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding… Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.

What better way to ensure fear, obligation and guilt than to insist that infant formula is “deficient, incomplete, and inferior”? The abusive husband employs the same tactic when he tells his wife that breastfeeding is “what good mothers do.”

2. Lying: Lactivists lie routinely in promoting breastfeeding. Yes, breastfeeding can be beneficial, but in first world countries with access to clean water the benefits for term babies are trivial. Honesty is unlikely to promote the fear, obligation and guilt desired by lactivists so they lie instead. This deprives women of the opportunity to make informed decisions about breastfeeding since the information they are given is proganda, not scientific evidence. The abusive husband employs the same tactic when he implies that the baby will suffer by being weaned at 10 months of age.

3. Invalidation: In the world of lactivism, women’s thoughts, needs and values are dismissed out of hand. Maternal exhaustion? Who cares. Maternal need to return to work? Just pump. A history of maternal sexual abuse that leads a woman to avoid anyone touching her breasts? She should just get over it. Mothers’ feelings aren’t simply irrelevant; they are invalid.

4. Gaslighting: This is a specialized form of invalidation that involves denying reality. A mother says her baby is hungry? Tell her all babies scream like that. A mother finds breastfeeding agonizing? Tell her her pain doesn’t matter. A mother needs medication incompatible with breastfeeding? Tell her she doesn’t really need it. In other words, lactivists — like the abusive husband — refuse to accept the lived reality of breastfeeding for many women, substituting preferred beliefs instead.

These are not the only emotionally abusive tactics used to promote breastfeeding, but they are among the most prominent. Rather then treating women respectfully as individuals with their own needs and desires, emotional abusers treat women as existing merely to be manipulated to satisfy the abuser’s needs. This husband “needs” his wife to breastfeed their child so he abuses her in an attempt to force the issue. Lactivists “need” other women to breastfeed so they abuse women in an attempt to force the issue.

Like this husband, lactivists deploy thought control, lying, invalidating and gaslighting to exert control. If it’s abusive behavior when a husband does it, it’s abusive behavior when lactivists and lactation professionals do it. In both cases, it must stop!

* I am not suggesting that the emotional abuse meted out by lactivists has anywhere near the destructive effects of the emotional abuse that can occur within personal relationships.

The lactivist community is obsessed with the idea that breastmilk might contain antibodies against the virus that causes COVID-19.

[Rebecca] Powell is an assistant professor of medicine and infectious diseases at Mount Sinai’s Icahn School of Medicine who studies the immune properties of human breast milk.

Her lab is hoping to pin down whether breast milk has antibodies specific to COVID-19, whether they might protect babies from COVID-19, and ultimately, whether they can be spun into a therapy against the illness for adults.

They’ve released their results as a pre-print, Evidence of a significant secretory-IgA-dominant SARS-CoV-2 immune response in human milk following recovery from COVID-19, a paper that has NOT been reviewed by other scientists:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]There’s not much practical significance to a breastmilk antibody that reduces the risk of an already rare disease by only 8%.[/perfectpullquote]

In this preliminary report, 15 milk samples obtained from donors previously-infected with SARS-CoV-2 as well as 10 negative control samples obtained prior to December 2019 were tested for reactivity to the Receptor Binding Domain (RBD) of the SARS-CoV-2 Spike protein by ELISAs measuring IgA, IgG, IgM, and secretory Ab. Eighty percent of samples obtained post-COVID-19 exhibited IgA reactivity, and all these samples were also positive for secretory Ab reactivity, suggesting the IgA is predominantly sIgA. COVID-19 group mean OD values of undiluted milk were significantly greater for IgA (p<0.0001), secretory-type Abs (p<0.0001), and IgG (p=0.017), but not for IgM, compared to pre-pandemic group mean values. Overall, these data indicate that there is strong sIgA-dominant SARS-CoV-2 immune response in human milk after infection in the majority of individuals, and that a comprehensive study of this response is highly warranted.

Or as a pediatrician opined on Facebook:

Not only does the act of breastfeeding likely protect baby, but a potent antibody response within the breast milk could be even more effective than plasma or immunoglobulin infusions as a therapy for active COVID-19 infection!

Let’s assume for the moment that the results are true and breastmilk contains secretory IgA against COVID-19. What does it really mean? Not much!

We already know that breastmilk contains secretory IgA against respiratory and diarrheal illnesses. And we know that the secretory IgA reduces those illnesses by a — wait for it — only 8%! That’s not especially meaningful for the common cold; the antibodies DON’T prevent babies from getting the common cold (as any breastfeeding mother could tell you). They simply reduce the incidence by only 8%.

For an illness like COVID-19, where the incidence among infants is already low, the impact is likely to be negligible or even unmeasurable.

Why?

Because IgA is a subtype of antibody and not a particularly effective one. It is very different from what most people think about when they think about antibodies.

The most powerful antibodies against disease — the antibodies that you make if you are infected or vaccinated against the majority of childhood diseases — are IgM and IgG. IgM and IgG circulate in the bloodstream and seek out a specific virus or bacterium to tag it for destruction by white blood cells. These antibodies are so effective that they can be harvested in the plasma of people who have recovered from a disease in order to passively protect people who can’t make enough antibody on their own.

Secretory IgA, in contrast, acts on internal surfaces of the body like the respiratory and gastrointestinal tracts.

Secretory IgA (SIgA) plays an important role in the protection and homeostatic regulation of intestinal, respiratory, and urogenital mucosal epithelia separating the outside environment from the inside of the body. This primary function of SIgA is referred to as immune exclusion, a process that limits the access of numerous microorganisms and mucosal antigens to these thin and vulnerable mucosal barriers.

Secretory IgA reduces the risk that a virus or bacterium will gain entry to the body, but doesn’t act in the bloodstream where the organism wreaks its havoc. To use an analogy, if IgG and IgM are guns then secretory IgA is a fence. Fences are useful but they don’t do much to protect you once the invader has scaled the fence and dropped over the other side. Only a weapon could possibly protect you then.

That’s also why breastmilk is not protective against the majority of childhood diseases. While IgG can be transferred to a baby across the placenta, (hence vaccinations for mothers in the last trimester of pregnancy) it can’t be effectively transmitted in breastmilk because it will be digested in the baby’s stomach.

Moreover, to my knowledge, unlike IgM and IgG — which can be used to provide passive immunity in someone who can’t make or hasn’t yet made their own antibodies — IgA has NEVER been used effectively to provide passive immunity to anyone for anything. To put it another way, if secretory IgA were a useful therapy, we already would have used it to prevent the common cold and that hasn’t happened.

The bottom line is this: even if breastmilk contains antibodies to COVID-19, the practical significance is likely to be low and the possibility of using it as a therapy is vanishingly small. It’s just another example of breastfeeding researchers touting ever more arcane theoretical benefits of breastfeeding that make no difference in reality.

When the Japanese bombed Pearl Harbor on December 7, 1941, killing thousands of Americans, the “Greatest Generation” recognized we had been attacked, rallied to enlist in the defense of our country, willingly accepted privation and worked tirelessly for victory.

Can you imagine what would have happened if the Left denied we were attacked or if the Right insisted that Hawaii wasn’t really part of the US so there was no need to respond? We would have been invaded and conquered and we would have deserved the destruction that followed.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Instead of the “Greatest Generation,” we are the Gullible Generation. [/perfectpullquote]

Faced with our Pearl Harbor, a pandemic that has already killed tens of thousands of Americans, many in our generation — the Gullible Generation — deny that there is a deadly threat, refuse to participate in the defense of our country, won’t even tolerate wearing masks in public and refuse to believe in the existence of the enemy let alone work to defeat it.

And they’re proud of their gullibility!

They tell themselves that they’re the ones who see the lies, and the rest of us are sheep. But believing that everybody’s lying is just another kind of gullibility.

Slate writer William Saletan was talking about JFK assassination conspiracists, but he could just as easily have been talking about coronavirus conspiracists. They, too, are absolutely sure that there is giant conspiracy, a conspiracy that encompasses the entire world, designed to falsely convince people that we are in the midst of a pandemic. Ironically, instead of being the only people who see the conspiracy, they are the the very “sheeple” that they purport to despise.

From the alt-right to the loony left, thousands of people have created and then clung to conspiracy theories that feel to their believers like a child’s fuzzy blanket — offering comfort from the big, scary world. They are so psychologically immature that they are incapable of dealing with reality, a pandemic that could kill them and their family members, so they escape into fantasy.

Why?

Unlike the “Greatest Generation” that came to maturity in the 1930s and 1940s forced to endure the reality of the Depression and World War II, the current generation of conspiracy sheeple came to maturity in the age of social media, able to recuse themselves from reality.

Social media allows us to:

… customize our surroundings, and accustom us to regulating and controlling the information that comes our way. This has several effects: an expanded sense of what falls under our personal social domain, an increased expectation of control over that domain, and a greater sensitivity to input that deviates from our preferences.

If reality is too hard or too frightening, we don’t work harder or mature to handle our difficulties. Instead, we seek out like minded sheeple on Facebook and Twitter to bond around fables that leave us simultaneously victims of malevolent forces AND heroes who recognize the true source of our peril. The sheeple on the Left soothe themselves by pretending that the pandemic was planned by the government and corporations; the sheeple on the Right soothe themselves by pretending that it doesn’t even exist.

The Greatest Generation was blessed with extraordinary leaders like Franklin Roosevelt and Winston Churchill. The Gullible Generation is cursed by Donald Trump, the apotheosis of recusing yourself from reality. He constantly vomits forth a barrage of lies, nearly all of which involve simple, but wrong explanations for complex problems and advocate simple, but wrong solutions that never work.

Both the alt-right and the looney left may cling to their conspiracy theories, but they cannot recuse themselves from reality for long. Countries like Germany, which relied on scientists and epidemiologists, quickly brought the pandemic under control, have experienced far less economic and social disruption (not to mention far fewer cases of illness and deaths), while countries like the US, which ignored (and continues to ignore) scientists and epidemiologists has seen the pandemic accelerate with no end in sight. The massive economic and social disruption we have experienced will continue because we don’t have the disease under control.

The COVID-19 pandemic is another national Pearl Harbor and unlike the Greatest Generation, we are not rising to the challenge. The Gullible Generation, in the grip of conspiracy theories, is failing spectacularly.