Category Archives: Laurie and Debbie’s blog

Barriers to Breastfeeding: Disappointing but Not Surprising

Debbie says:

I was born in 1951. My mother wanted to breastfeed me, but breastfeeding was completely out of fashion among affluent white people. Her doctor said, “Well, go ahead, I guess, but I can’t help you. I don’t know anything about it.” So when she ran into issues, she asked the the Black women at the bus stop, waiting to go home from their jobs as cleaning ladies and maids in the Jewish neighborhood of Baltimore where I was born. They apparently thought she was kind of dumb, but were very helpful. (I never asked her why she didn’t ask her mother …)

Breastfeeding_paolopatruno9Photo by Paolo Patruno.

Things change. Now breastfeeding is what affluent White mothers do, and harder for working, unemployed, or impoverished Black mothers. And bearing in mind that not every mother can breastfeed, and not every  mother wants to breastfeed, there’s no doubt that parents and babies are well served by having breastfeeding as an option.

According to the United States Breastfeeding Committee, one of the leading experts
on the current state of breastfeeding in the U.S., breastfeeding is the “most effective
global public health intervention for child survival.” Breast milk provides critical
nutrients to babies when they need them the most, supporting a variety of early
developments in the body, including brain development. It also transfers necessary
antibodies from mother to child that protect against disease, and wards off other early
childhood dangers such as SIDS and asthma.
The Center for Social Inclusion has released a long, detailed report in .pdf form, detailing the issues that contribute to making breastfeeding challenging. Two things make this report especially important: first, the focus on structural racism:
Often, when we think about racism, we focus on individual attitudes or behaviors,
which is important. Sometimes, we look at how particular institutions treat people of
different races differently, which is also important. But to truly understand the root
causes of racial inequity and thereby produce solutions that work for everyone, we
need to take a structural race approach. That means looking at the First Food system
through the lens of policies, institutions, and people—together.
and second, the storytelling style, focusing on three fictional mothers:
Sarah is White and lives in a suburb of Detroit. Her husband is a doctor at the nearby
hospital, and she volunteers full-time for a local nonprofit. Nicole is Black and lives in a
small town in Alabama. She is a teacher at the middle school and her husband is earning
his MSW through online classes at the University of Alabama. Lara is Latina and lives in
Los Angeles with her husband and mother. She and her husband both work for (and met
through) the city’s transit agency; her mother runs the home and receives Social Security.
The report follows all three women through their breastfeeding journey, interlacing their stories with statistics and information about breastfeeding in their various communities. The information is detailed, clear, and excellent, and the conclusions are convincing.
At each stage, smart policy interventions with robust implementation can make it easier
for all women to choose to breastfeed if they want to.
We seek policy interventions that truly address the root causes that are linked to
breastfeeding outcomes, especially lower rates for women of color. We know that
no single policy alone can dismantle structural inequity. This takes reform, including
diversification of the medical sector and those providing services, as well as changes to
and better implementation and promotion of existing policies like the ACA breastfeeding
provisions. But it also takes transformation, including directing funding streams to
challenge all barriers at the neighborhood level. We therefore need a variety of policy
and practice interventions that support women and communities of color to truly achieve
higher breastfeeding rates for all mothers.
The report goes on to detail these interventions; read the whole thing.
Why is breastfeeding a body image issue? For me, it’s because breasts have been fetishized, banned, turned into objects of the male gaze, commodified, judged, and generally objectified, often at the expense of remembering their biological function. So it’s important to me to remember what breasts do and more important that anyone who wants to be able to provide food for their babies from their breasts should be supported in doing so.

Sex-Linked Links

Debbie says:

Last time I set out to do a links round-up, I wound up with a themed post on penises. This time, I’m finding a set of themed links on human sexuality. One day, we’ll have a real wide-ranging links round-up … but not today.

299px-Sperm-egg

Diane Kelly at Throb shares an interesting insight into why more babies are boys than girls … and why what we’ve always believed about that is wrong.

For nearly two centuries, experts have assumed that the skew came from a higher rate of male conceptions. In an article at Nautilus, David Steinsaltz, J. W. Stubblefield, and J. E. Zuckerman explain that an early, 19th-century guess that more males were conceived to compensate for greater losses in utero–the so-called “fragile male” hypothesis–snowballed into a rarely-questioned “truth. …

In fact, new methods of looking at the sex ratio during development have shown that … X and Y sperm are equally likely to fertilize any given egg. The skew comes instead from differences in survival rates during embryonic development. There’s a complex shift in miscarriage ratios over time, from more males to more females at different moments in gestation. In the end, more female embryos are lost to miscarriage, skewing the birth ratio slightly to males.

I will forbear from making jokes about the “fragile male” hypothesis. Really I will.

***

In other news, the FDA has approved Addyi, a libido-enhancing drug for women. This sounds like good news, but Sarah Boseley at The Guardian is viewing it with alarm, and I think she makes sense.

[Cynthia] Graham, [professor in sexual and reproductive health at the University of Southampton] and other critics believe the FDA was pressured and half-shamed into approving Addyi (generic name flibanserin) by a campaign headed by a vocal group called Even the Score, which pitched the absence of drugs to help women with low libido as a gender inequality issue. It describes itself as a campaign for women’s sexual health equality which was “created to serve as a voice for American women who believe that it’s time to level the playing field when it comes to the treatment of women’s sexual dysfunction”. On the front page of its website now runs a banner saying “Thank you, FDA”. Sprout Pharmaceuticals, which owns Addyi, is one of the funders, as is Trimel, another company in the same field.

Nothing makes me more nervous than “grassroots” political groups which turn out to be funded by corporations with a financial interest in their activism. And learning that Addyi is “only moderately effective, should not be taken with alcohol, and has potentially serious side-effects” doesn’t calm my nerves.  I also appreciate the comments by Dr. Petra Boynton, an extremely smart and sensible analyst of sexual issues, who said:

“People have a perception that everybody else is having fantastic sex all the time with exotic positions.” There is, Boynton said, “anxiety brought about by misinformation about sex”, which is perpetuated by the media and especially men’s and women’s magazines. “The cultural wallpaper is telling you that to keep someone and be desirable and not left alone, which is a huge fear, you must be having and providing frequent sex.”

***

In a related vein, Mona Chalabi at 538 is talking about “the gender orgasm gap” from her point of view as a data analyst:

In 2009, the National Survey of Sexual Health and Behavior (NSSHB) asked 1,931 U.S. adults ages 18 to 59 about their most recent sexual experience. The topline findings show that men are more likely to orgasm than women — 91 percent of men said they climaxed during their last sexual encounter, compared with 64 percent of women.

But there seems to be a perception gap, too — at least among men. Eighty-five percent of men said their partners in that recent sexual encounter had reached climax, far higher than the percentage of women who said they orgasmed. That can’t simply be explained away by saying that the men were referring to different sexual partners. Most of these sexual encounters were heterosexual — 92 percent of men and 98 percent of women said their last sexual encounter was with someone of the opposite sex. So it seems like some of those men were wrong when they said their partners had orgasmed — either their egos are causing them to overestimate, or some of those women are faking it.

Nothing surprising here (and it’s six-year-old data); nonetheless, 538 is always refreshing because of its focus on data. Chalabi has a lot more to say about which sexual acts, done with whom (including alone), etc.  And who can resist a chart about what acts lead to orgasm entitled “How Come?”

***

Finally, Liz Prato at Hippocampus has a rich, nuanced article about female masseuses, male clients, and erections.

Massage school was the first to teach me that there were two types of erections: hostile and benign. My instructors taught me how to deal with each erectile happenstance, ranging from saying nothing at all, to having a clinical discussion with the engorged client about what’s appropriate behavior during a massage. I was confident that, by the time I graduated from massage school, I would have no problems dealing with erections, hostile or otherwise. After all, I’d seen a few in my private life without eliciting trauma, and (thought) I had a clear concept of professional boundaries. This would be no big deal.

My first encounter with a hostile erection popped up a lot sooner than I expected. … My school was a blond brick office building with bleached linoleum floors and industrial-grade carpet (in other words, not a bordello), and my student uniform was khaki pants and a green polo shirt (not a mini skirt and knee-high fuck me boots). My client was in his mid-twenties, with dark hair and a cheesy mustache. The massage began with him lying on his stomach, so if there was an erection, I didn’t see it. Sure, he moaned and groaned a little, but, Hey, some people are expressive, I reasoned. But when he turned over, there it was, pitching a tent under the thin white sheet.

Okay, ignore it, was my tactic. I figured bringing attention to the erection was always the wrong way to go, and just massaged his shoulders. That’s when his moaning turning into loud groaning. “Oh, God, oh, yes! It feels so good!”

Prato goes on to discuss the relationship between massage and sexuality, between touch and sexuality, and the complexities this entails. She looks at the issues with directness and compassion:

I used to have a forty-something client named Tom who saw me weekly. He was referred by a psychotherapist who treats sex addicts. It’s not as creepy as it sounds. I’ve worked with several recovering sex addicts, and they’re no more interested in a Happy Ending than anyone else who lies on my table. These folks have a pretty good idea of where to go for sex and don’t want to waste my time and theirs if that’s what they’re looking for. What they are looking for is touch that’s not a futile attempt to mask their emotional pain. See, for them, sex isn’t about pleasure, and it sure as hell isn’t about intimacy. It’s usually about trying to cover up some horrible wound inside of them, but that’s like trying to douse a flame with kerosene. All it does is create a firestorm of emptiness and shame. When they come to me they want touch that isn’t sexual. They want intimacy with boundaries. They want – and they get – no self-hatred.

When I lay my hands against their skin, it might very well be the first time that touch hasn’t been manipulative or degrading. So they come back. Each time I touch them, they relax a bit more. They feel a little more pleasure. They get a little less scared. It reminds me of how we all walk around carrying fear and self-doubt and weeping wounds, and we’re just doing the best we can to dance around all that pain. I wish I didn’t need to be reminded of that, but I’m so glad I am.

Read the rest; Prato is a fascinating writer.

Thanks to oursin for the Addyi link; the others are from my regular reading