From inquiry to impact to action: The Inequity in Breastfeeding Support Summit
Inquiry: What is inequity in breastfeeding support and why does it matter?
Breastfeeding is a cornerstone of public health. Mothers know breastfeeding is important, yet the care and support provided to all women is not the same (like educational opportunities or job access), setting some mothers up for success and creating barriers for others. In short, white women tend to experience a more supportive mainstream healthcare system, with greater breastfeeding resources made available to them, than women of color. This inequity in support leads to long-term disparities in care and health. Breastfeeding significantly predicts health outcomes for mothers and babies for things like Sudden Infant Death Syndrome, breast and ovarian cancer, diabetes, asthma and more- all things experienced disproportionately by people of color. This is a huge gap in care, and entities ranging from community grassroots organizations up to the Surgeon General are increasingly acknowledging and working to address this.
While disparities in breastfeeding rates are often cited by medical organizations and in the media, rarely do we discuss the root causes of these differential health outcomes born by women and their families. Dr. James Collins and colleagues have shown the impact of racism on maternal child health outcomes, specifically low-birth weight and pre-term babies in the African American community. Institutional racism and white privilege impact the breastfeeding care that women and their babies receive as well. Institutional racism is a term first coined by Stokely Carmichael to refer to the “collective failure of an organization or system to provide an appropriate and professional service to people because of their color, culture, or ethnic origin.” Solid Ground, one of WithinReach’s community partners, defines institutional racism as:
The systematic distribution of resources, power and opportunity in our
society to the benefit of people who are white and the exclusion of people
of color. Present-day racism was built on a long history of racially distributed
resources and ideas that shape our view of ourselves and others. It is a
hierarchical system that comes with a broad range of policies and institutions
that keep it in place.
White privilege refers to the [perhaps unspoken or unacknowledged] privileges that white people have in a racist society that affords more value to white people than people of color- it is the flip side of racism. While we often hear about ‘underserved’, ‘underprivileged’ or ‘disadvantaged’ communities, the flipside is rarely acknowledged: that other communities (namely white, middle and upper class) are over-served, over-privileged and over-advantaged.
Impact: The 2013 Inequity in Breastfeeding Support Summit
In 2012, community breastfeeding activists, including representatives from the Native American Breastfeeding Coalition of Washington, Mahogany Moms Breastfeeding Coalition and WithinReach’s Breastfeeding Coalition of Washington, got together in an effort to address the institutional barriers faced by women of color seeking breastfeeding support. Out of these conversations, the Inequity in Breastfeeding Support Summit was born. The purpose of this Summit was threefold: to collaborate, educate and act together as a community of breastfeeding supporters to counter institutional racism in support services for new families, that are significantly centered on the needs and experiences of white women. Our long-term aims as a result of this Summit are to increase the cultural competence of breastfeeding supporters, increase the proportion of breastfeeding counselors who are women of color, and increase the organizations that provide culturally relevant breastfeeding support to women of color.
Cynthia Good-Mojab, a Summit planning committee member and speaker, acknowledged that “this Summit has been a yearlong, collaborative labor of love. We stand on the shoulders of giants. Long before and concurrent with our efforts to create this Summit, others have made far more significant contributions to the ongoing movement to dismantle racism and other forms of oppression.”
On June 21-22, over 200 people came together from across Washington State and the country- mothers and babies, community members, breastfeeding peer counselors, public health professionals, health care providers and more. The day started out with a blessing from Emma Medicine White Crow honoring the Duwamish people for their land that the city of Seattle and the Summit were held on. Day one was focused on what systemic racism looks like and how it impacts families. Leaders in maternal child health such as Dr. Maxine Hayes, Kathi Barber and Sheila Capestany, laid the historical groundwork for disparities in breastfeeding rates and the access to breastfeeding support that mothers have. Kathi Barber led us through a history of the African American experience starting with women’s treatment during slavery, how many women were removed from their children and unable to nurse them and bringing us to present day, showing how this collective history has contributed to where our society is today with regard to breastfeeding.
Day two was focused on solutions that prioritize supporting moms and babies of color. Six breakout sessions focused on topics ranging from grassroots community breastfeeding support programs to heterosexist language in breastfeeding support to the role of social media in creating ally communities. A three-hour action planning session got participants discussing solutions and the role they can play in ensuring all mothers and babies are receiving quality care. The end result: the synopsis of dozens and dozens of voices answering one question: What key actions can we take to advance racial equity in breastfeeding support at the individual, family, community and societal level? The two days ended with each participant, speaker and planning committee member saying just one word about how they were feeling or what they were left with. Comments ranged from uplifted, humbled and doubtful to motivated, skeptical and inspired. The Summit likely didn’t meet the needs of all participants, but it did build upon the groundswell of work happening around the country to name and address institutional factors that create unequal care for mothers and children. To read one student midwife’s reflection of her experience at the Summit, visit Robin Gray-Reed’s post from her blog The Mindful [Student] Midwife.
Action: Next steps in moving forward
This Summer, WithinReach intern Rebecca Allen and the Summit planning committee will drive the development of a Community Action Report. We hope this document will serve as a blueprint of steps to take for all communities interested to work in achieving equity in breastfeeding support and maternal child health outcomes. To learn more or get involved visit the Inequity in Breastfeeding Support Summit Facebook page.