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I confess, I love Louis Vuitton bags and Christian Louboutin shoes. I love following and supporting Black
fashion designers in the U.S and across the diaspora and I’ve been known to rock a Gucci belt. I am also
a birth and breastfeeding advocate and strategist—this is my passion. I just had no idea and was wholly
unprepared for how these two loves would collide.
The “look” of birth and breastfeeding advocacy, as I learned, was dominated by so-called (and with all due
respect) the stereotypical tree-huggers, crunchy folks, and natural hair wearers. Committed folks wore
Birkenstocks, flowing skirts, and natural hair, it seems. I don’t do any of that. So when I showed up as my
authentic self in high-heeled pumps, a stylish outfit, and a designer bag to speak at conferences, many
people gave me the side-eye. Did I have the “look” of a serious birth and breastfeeding advocate? And
why was I being judged by my clothes and accessories versus my words and my work?
To be clear, my sense of style is a part of my identity. It is just who I am. I spent years in senior
management at the largest Black woman’s lifestyle magazine in the world. My mother went to a special high
school in New York City to study fashion and then went on to hand make about 40% of my childhood
wardrobe, so to paraphrase Beyonce’—I got this isht from my mama.
I am comfortable in my heels—in all meanings of the word comfort and I’m not sure why everyone is
worried about it. Please stop asking me.
This typecasting also has dangerous consequences for equity. I will never forget visiting a childbirth
center in the South east, several years ago, with great potential for impact on Black birth outcomes. The
white female owner talked about attempting to hire a Black midwife, who showed up for a job interview
with heels—the white midwife was taken aback as she shared this experience with me. “How will she do
the job in heels?,” she said with a scoff and a laugh, dismissive of the midwife’s attire, as if the midwife’s
“look” were analogous with her skills. As if her clothes were a leading indicator of her effectiveness to
safely catch babies. Why was she being judged on her attire? This gave me great pause, on many levels.
First of all, a job interview is a job interview. Back in the day, dressing “properly” was how we had to prove
ourselves as credible and upstanding citizens. Black people dressed up just to go to the post office or run
every day errands, so they could be viewed as respectable by white society and hopefully increase their
chances of being treated like a whole human. We have never had the luxury of showing up “any ole kind
of way” (as my mother would say) regardless of our credentials.
Now, the same white people who created that dynamic were judging us for it? This was a culture clash of
white privilege proportions.
Meanwhile, this focus on the look of a “birth advocate,” has also perpetuated a dangerous myth that
birthing with a doula or at a childbirth center is a fringe culture, indeed for a certain type of person. Or to
be a doula or midwife, you have to look a certain way or subscribe to a certain lifestyle.
I would argue that this historic “look” of birth and breastfeeding has limited the scope and impact of
equitable birth and breastfeeding outcomes. People thinking doulas, midwives or lactation consultants
aren’t for them because they don’t see any that look like them.
My message is clear. You do not have to be an Erykah Badu-type to have a doula. You do not need to
subscribe to a natural lifestyle, have natural hair, wear African print head wraps, be a vegetarian or
vegan, compost, or even recycle to have a doula or be a doula. Bring your lace fronts, your weaves, your
relaxed hair, or braids (knotted or unknotted) or your Gucci and Louis Vuitton bags to the movement.
Grab your wig or your bonnet and let’s get over to this childbirth center and breastfeeding support class.
You want to be a midwife but you wear wigs, eyelash extensions, and are comfortable in heels?? So
what! However, you come, we are here for you.
I love traveling the country for The Big LetDown and now for Irth work, and having young Black women
say, “I’ve never seen a breastfeeding advocate that looks like you,” — or my other personal favorite, “You
must be from New York City!” and then we talk shoes, handbags, breastfeeding, Essence magazine,
doulas, and midwives. I’m extremely proud of this.
The more people see themselves in us, the more we can attract to the message and the movement.
This gatekeeping around people needing to look a certain way to be accepted in the birth and
breastfeeding movement is dangerous. So as Fashion Week season is in high gear and we celebrate Black History Month, it’s an important time to examine how the “look” of birth and breastfeeding advocacy has caused harm and at times, perpetuated dangerous stereotypes that get in the way of equity.
It’s time for a mindset makeover.
Now to the other elephant in the room—especially, I feel, when I enter it. The second part of this issue is
the cost—how does she afford that bag or the shoes and outfits? I can see the look on many faces. Birth
and breastfeeding advocacy has always been associated with meager earnings and a life of service not
income. To be clear, I unequivocally reject that notion as well. I believe people can do good and do well. I
believe in getting paid what I’m worth for my books, speaking, and consulting work and I have worked
hard to build a business around my passion and earn what I’m worth. I also believe all Black people
deserve luxury, when and how they can afford it. And however they define luxury or “nice things” to be.
As we think of inclusivity—beyond skin color, gender, and language, let’s also consider the “look” of our
work. So that nobody will be judged by their attire but by their passion, their commitment, and their
impact. So that we widen the lens of who can work in this field or access the lifesaving and joy-bringing
services it provides.
So that birth and breastfeeding is forever fashionable and always in style in the ways that matter the
most.
In The Picture of Dorian Gray, Oscar Wilde wrote, “Nowadays people know the price of everything and the value of nothing.” In our society, items are priced but value remains an abstract and often misunderstood concept. When it comes to breastfeeding, the valuations get even trickier. Our idea of value is based on what somebody is willing to pay for something, and that leaves the modern valuation of breastfeeding steeped in confusion. There is the actual cost of breastfeeding-related products and then there is the priceless value of the preventive health benefits and the monetary value of the time it takes a mother to provide it. How we value the huge time commitment for breastfeeding is directly related to the broader issue of valuing mothering in general.
As a society, we talk endlessly about the importance of family, yet the time and work it takes to nurture and manage a family is utterly disregarded. Pressed for time and money, unable to find decent affordable day care, racked with guilt at falling short of the mythic supermom ideal—working and nonworking American mothers alike have it harder today than they have in decades, and they are worse off by almost every measure than many of their peers around the world. Capitalist models would tell you that when you “corner the market” on a certain product or service, then by definition your value should increase—but the exact opposite has occurred for women, who have been actually devalued by their ability to bear children and exclusively feed them. Witness the ever-persistent gender gap. Women are paid 23 percent less than men even when we are doing the exact same work as a man. So how could we be properly valued for doing work, such as birthing and breastfeeding, that men cannot do? It is universally accepted that no one would work for free except mothers, yet no one has enough money to hire a good mom, which, in that framework, actually makes mothers priceless. This does not include Mother’s Day—when the commercial interest in celebrating mothers reaches a fever pitch. Beyond that, mothering is mostly considered thankless work. In some places, it can even be a penalty. A 2008 study documented the motherhood penalty showing that the bias toward mothers, the so-called “maternal wall,” is more of a problem than the glass ceiling is for all women. The study found that when female subjects were given identical resumes, one but not the other a mother, the mother was 79 percent less likely to be hired, 100 percent less likely to be promoted, offered an average of $11,000 less in salary, and held to higher performance and punctuality standards. Mothers are under stress coping with an outdated system built around the idea that families can afford for women not to work, yet mothers are being underpaid and undermined for their secular work and their maternal work. The contradictions are complex. So are the implications. The psychological impact of generations of undervalued mothers is hard to ignore.
• • • • • •
Excerpted from The Big Letdown: How Medicine, Big Business, and Feminism Undermine Breastfeeding (St. Martin’s Press, 2017) by Kimberly Seals Allers
At times, the language of feminism has led to the undermining of breastfeeding, starting with the word “choice.” The mere word conjures up thoughts of women’s liberation and reproductive justice and hard-won rights and freedoms earned by the feminist movement. In fact, the very essence of women’s liberation was the liberation to make individual choices, whether it be about work, family, or lifestyle. This was most strikingly the case after Roe v. Wade, when reproductive politics made the language of choice synonymous with women’s liberation. As the feminist writer, Summer Wood wrote of “choice” in Bitch magazine, “The word’s primacy in the arena of reproductive rights has slowly caused the phrase, ‘It’s my choice’ to become synonymous with ‘It’s a feminist thing to do’—or perhaps more precisely, ‘It is anti-feminist to criticize my decision.’” In the so-called mommy wars and specifically in the milk wars, we see the most perverse form of individualism, where individualizing and privatizing choices around motherhood and breastfeeding has created a dangerous environment. What was once the trademark for women’s rights has become a consumerist tool being used against women. What began as a highly politicized term, in the context of a right to decide to terminate a pregnancy, has now been depoliticized and used for consumer imperatives, as in the “right” to buy all sorts of products marketed to women, from antidepressants, moisturizers, and diet frozen pizzas to infant formula. Implicit in this tactic is that exercising your choice in these matters is in itself a feminist act. We see this tactic often in pop culture, such as an episode of the fan-favorite Sex and the City, where liberated consumer Carrie Bradshaw (in an episode fittingly titled, “A Woman’s Right to Shoes”) proudly justifies purchasing expensive footwear.
The problem with “choice” today is that it has been taken out of the context of women’s rights and misconstrued.
In its most disgusting reiteration it is being marketed to women and girls by corporate interests. We are being sold on the idea of choice. The combination of aggressive advertising, medical backing, and a love of consumer freedom has led to a free-market paradise where a host of instant foods are readily available and women have been led to believe that the choice between formula feeding and breastfeeding is merely a matter of personal inclination—a feather in the cap of the quest for liberation. And since choices are individual, they have no social consequences; women are therefore relieved of the responsibility of considering the broader implications of their decisions. And once I make my choice, no one is to challenge me.
Lately, choice has taken on a concerning meaning in third-wave feminist circles. One of the new iterations of feminism is called “choice feminism.” In contrast to political philosophies that explore the ways in which structural inequality limits freedom, choice feminism tells us that every individual is free to choose and that choice is empowering, no matter what the choice actually is. The result is that the term “choice” is now employed in feminist debates about everything from the sex industry to marriage and makeup to breastfeeding versus formula feeding. Choice feminism dictates that anytime a woman makes a choice, even if it’s to engage in prostitution or pole dancing, it is an act of feminism. This is dangerous thinking when the reality is that our “choice” has more limitations than many think and choices based on uninformed decisions founded on marketing propaganda is not true choice at all. It’s particularly dangerous because we fail to differentiate between those who have the privilege of choosing and those who do not, and it avoids any analysis of how race, class, and power actually affect a woman’s choice.
For one, choice should be based on equal options. Is having the option of breastfeeding versus formula feeding really a choice when the options are not equal? They are so incongruous that it has taken billions of dollars in research and insidious marketing tactics to build the notion that infant formula is just as good. When one option gives your baby preventive health benefits and the other increases your baby’s risk for health problems, then that’s not an actual choice. The options are not equal. The options are not equal when the reasons people give for not breastfeeding include returning to work, perceiving formula as more convenient, and fear-based ideas such as it will hurt or that their breasts won’t produce enough milk. This is not the choice women need.
It’s easy to see why framing breastfeeding versus formula feeding around individualism is a win-win for the formula companies. Doing so means that the idea can’t be challenged. So, for example, when breastfeeding or formula feeding is framed as an individual choice, the economic interests of selling formula can be disassociated from the conversation. The billions spent on marketing to create doubt among mothers who are undermined from the day they leave the hospital with a free infant formula bag can be removed from the discussion. If breastfeeding is purely a personal choice, it need not have anything to do with greedy corporations, body politics, or a marketing industry that has sold women damaging messages. If breastfeeding is purely a personal choice, then we don’t have to connect the dots between the paltry breastfeeding rates in this country and high levels of childhood allergies, asthma, type 2 diabetes, and obesity.
Think back to reproductive rights. At this point many women see those rights as accessible, but the right to have an abortion is greater than access.
It touches on issues such as the wage gap, health care, education—issues that have as much if not greater impact on the real-life choices of women. Similarly, breastfeeding is far greater than a matter of choice when issues such as employer practices, child care, and the lack of federal maternity leave play such a large part in how a mother decides to feed her baby. But continuing to frame the issue around choice allows these greater, more influential factors to remain unmentionables. Most significantly, keeping breastfeeding as a private choice rather than a public health issue hampers momentum. After all, private choices do not provide the basis for a movement. In fact, framing breastfeeding as a personal choice erases the context of corporate interests and deep-pocketed marketing machines in which it typically occurs. In this context, choice is not liberation. It is suffocation.
• • • • • •
Excerpted from The Big Letdown: How Medicine, Big Business, and Feminism Undermine Breastfeeding (St. Martin’s Press, 2017) by Kimberly Seals Allers
The ultimate connection between breastfeeding and feminism is that in a truly equitable society, women would have the capacity to pursue both their productive and reproductive work without penalty. In that vein, breastfeeding becomes the perfect lens to see the misogyny of our culture as it impacts mothers: women are harassed and shamed and illegally evicted from public spaces for breastfeeding; women are threatened with losing custody of their children for breastfeeding for “too long”; women are ridiculed and bullied for trying to pump milk at work; women are described as freak shows for breastfeeding twins or tandem feeding; women are called names for breastfeeding; women are told they are sexually abusing their children for breastfeeding; women are told they’re not allowed to keep breast milk in communal fridges because it’s viewed as a bodily secretion and not as food; women are bullied into stopping breastfeeding because breasts are the sexual objects of men; women are told that it is obscene to breastfeed in front of other people’s children or other people’s husbands; women are told their bodies are too fat and too saggy and too veiny to be exposed while breastfeeding; women are told to stay at home with their babies until they are no longer breastfeeding; women are instructed to throw blankets over themselves and their babies if they wish to breastfeed outside the home. The list goes on. This is not the result of some peculiar sensitivity toward babies and small children eating; this does not happen with bottle feeding. This is unique to breastfeeding, and it is about policing women’s bodies and lives. You know, exactly the kinds of things feminists used to get riled up about. The fact that women are harassed and shamed for doing something that women’s bodies do as a routine part of bearing children is a severe societal flaw that should trouble all feminists.
• • • • • •
Excerpted from The Big Letdown: How Medicine, Big Business, and Feminism Undermine Breastfeeding (St. Martin’s Press, 2017) by Kimberly Seals Allers
It was the longest walk ever. Entering the double doors to the operating rooms and walking slowly down the cold hallway, the tears just streamed down my place. I had flashbacks of my pregnancy belly, my womb swelling with life. I was walking toward the end of my fertility and the sadness was overwhelming. The very kind nurse, a young woman, said her mother also had to have a hysterectomy and she cried on this same walk too.
I wondered how many women were carrying grief over having their wombs removed but were suffering in silence. As I climbed onto the surgical platform, and looked up into the bright lights, the last thing I remember was saying a prayer to God and a thank you to my uterus for giving me the two best things I’ve ever known—my children.
For the past 2 1/2 years I have been fighting to keep my womb, to avoid this exact walk to the operating room, the lights, the coldness—all of it— trying everything from Eastern medicine, restrictive diets, an IUD and having multiple surgical procedures to deal with the fibroids that just kept growing inside of me.
What’s worse as friends and loved ones saw me trying all sorts of things and still suffering, they just couldn’t understand why I didn’t just have the hysterectomy already.
“Well, it’s not like you want more children?” (Correct, I do not.)
“You have two children and some women don’t get to have that.” (I understand I am blessed.)
“You’re lucky you didn’t get fibroids until your late 40s.” (Black women have higher rates in their 20s and 30s.)
“Just get rid of it,” I was told.
It came to a point where I just stopped talking about it so I would not be judged. Was I crazy to care so much?
Hospital physician residents threatened me and fear mongering was a common tool whenever I had to be admitted into the hospital. I was scolded that I needed “definitive management”—which was callous-speak for removing my uterus. Definitive management??? Is that the best language modern medicine has to offer?
It was like removing a uterus was akin to removing a finger or a wisdom tooth. You can manage just fine without it. Yes, I may function just fine, but what about my feelings. The devaluation of women’s bodies and the medical establishment’s control over our reproductive organs has left little space for how women actually feel about these things. In fact, many women have adopted this normalization, perhaps as a survival mechanism but certainly as part of social conditioning.
Women are too often told what should matter to them. Whether we are grieving over a loss of a breastfeeding relationship, a pregnancy loss or the loss of our wombs, there is a “remove and replace” or “just get over it” mentality that is dangerous to our bodies, our psyches and our souls. Our grief is not validated. We are silenced into sadness. This is happening across the reproductive spectrum.
But the truth is, keeping my uterus mattered to me. For me, it was connected to my identity as a woman. I grew and nurtured my beautiful children there. I saw my womb as a source of creativity and life energy. And as a Black woman, it was a form of resistance to a medical system that has disproportionately controlled and unnecessarily exterminated Black women’s reproductive organs with no regard. (Black women are three times more likely to have a hysterectomy than white women)
I know the history of eugenics in this country. You will not take mine without a fight.
For me that fight looked like trying everything else first and making sure hysterectomy was the last resort. I tried Eastern medicine and acupuncture—at one point flying out to San Francisco frequently to see a highly recommended reproductive specialist. I had an IUD inserted. I tried restrictive diets. I’ve had a few surgical procedures including embolization and endometrial ablation. But my fibroids were mostly submucosal—which means they were literally embedded in the lining of the uterus and it seemed like nothing helped.
Though fibroids themselves are benign growths, they cause excessive bleeding and for me, 10-12 day periods every month that led to severe anemia. Many times, my period would come twice a month. One day, I remember driving my children to school and being so weak, my head was leaning against the driver side door window and I asked my 16-year old (who had a learners permit and was in Drivers Ed at the time) to help me steer. I dropped them off, drove to the closest ER and ended up being admitted. My hemoglobin count was at 5. A low hemoglobin count is generally defined as less than 13.5.
Later, the ongoing anemia meant rounds of weekly iron infusions, sitting in a room with mostly cancer patients receiving intravenous treatments. It was becoming too much. Balancing my wellness and my perceptions of womanhood, became too much.
And even though I could rationalize that this was the right decision for me. I was still sad. Even though I can look back and feel comfortable that I had tried every other pathway, I am still sad. Losing something that matters to you, even after a fight to save it, is still a loss.
It mattered to me. And right now, I am grieving.
Right now, there is an empty space inside of me literally and emotionally and I am working through it.
I hope one day soon we can have a more meaningful and nuanced conversations about how grief shows up across the reproductive spectrum. So that women don’t feel silenced or shame. Nor should they think that only other women who have had the experience will show up in word and deed to support them. We all need a new language for the losses across the reproductive spectrum. We deserve a medical system and physicians who value our reproductive organs even when they are not being used to do so.
And we all could use more honest discussions about womanhood and what that really, truly means.