Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities

Chapter 1 Feminism and Breastfeeding: Rhetoric, Ideology, and the Material Realities of Women’s Lives

Chapter 1 15 The current popular feminist critique of breastfeeding advocacy and promotion is unhelpful at best and destructive at worst. Its overall effect is to anger breastfeeding supporters rather than to encourage them to different approaches, and it puts feminism in an antagonistic, rather than collaborative, relation with public health. Yet feminism has much to contribute to an improved and more effective public health approach to breastfeeding.1 My aim in this chapter is to demonstrate how feminist analysis could be used to improve public health approaches to breastfeeding, infant health, and maternal health, by focusing on three core feminist issues that, with respect to breastfeeding, translate as the importance of a rights framework for conceptualizing breastfeeding as a maternal practice; an emphasis on social constraints, rather than biological inadequacies, as contributors to breastfeeding failure or cessation; and an analysis of the ideology of the good mother as a primary strategy to promote breastfeeding. Attention to breastfeeding as a woman’s right and to structural and ideological constraints on breastfeeding as maternal practice constitute mechanisms to reframe public health policy and action in this area. Feminist Rhetoric and Medical Evidence Feminist criticism of breastfeeding promotion efforts—most recently exemplified by Joan Wolf’s Is Breast Best?, Hanna Rosin’s “The Case Against Breastfeeding,” and Julie Artis’s “Breastfeed at Your Own Risk”—argues that such efforts ignore the material realities of women’s lives. These critics also challenge the scientific evidence supporting public health measures to increase Feminism and Breastfeeding Rhetoric, Ideology, and the Material Realities of Women’s Lives Bernice L. Hausman rates of maternal nursing. This trend has been evident in feminist writing since the mid-1990s. Pam Carter’s Feminism, Breasts, and Breast-Feeding, Jules Law’s “The Politics of Breastfeeding,” and Linda Blum’s At the Breast all hedge their arguments about the relative benefits of breastfeeding over formula-feeding, suggesting that existing evidence—while perhaps valid in poorer areas of the world—is just not strong enough to support vigorous public health campaigns in the United States to improve rates of breastfeeding initiation and duration.2 The argument that breastfeeding promotion is based on ambiguous scientific evidence only motivates health care professionals and public health policy makers to reaffirm the health benefits of breastfeeding. This response, in turn, further angers feminist critics, because the argument for the evidence suggests that health benefits outweigh material difficulties and social circumstances—in other words, that women’s experiences are beside the point. Thus, the continuing public debate between breastfeeding advocates and promoters and feminists has produced a stalemate that continues to emphasize medical evidence yet is divided over its meanings. The debate fails to address feminist concerns about women’s experiences, as the focus on the value of the medical evidence hinders productive exchange about the other potent issues raised by feminist scholars and popular writers: how breastfeeding affects the sexual division of labor at home, whether breastfeeding is a drag on women’s professional success, and how not breastfeeding might be a strategic response to current and historical social circumstances.3 Addressing this stalemated situation as rhetorical—that is, as an effect of the particular staging of the debate—offers a salutary opportunity to engage other, more productive questions raised by feminist analysis—namely, attention to social constraints, women’s rights, and the power of ideology to enforce behavioral norms.4 A rhetorical analysis of public debate over infant feeding may feel uncomfortable to those who believe that medical evidence should be the last word. Yet from feminist perspectives, scientific evidence has long been used to circumscribe women’s freedom. In the nineteenth century, this came in the form of recommendations that women not pursue higher education on the theory that intense intellectual endeavors during late adolescence would cause atrophy of their reproductive organs.5 Because feminists are sensitive to the ways that medical advice and information continues to implicitly limit women’s life choices—by suggesting that nonparturient women over thirty have a higher risk of breast cancer, for example—perceived pressure to breastfeed in order to ensure infant health can be identified as part of a larger cultural project to maintain patterns of female domesticity and subjugation. 16 Bernice L. Hausman Breastfeeding promotion campaigns like the National Breastfeeding Awareness Campaign (NBAC) explicitly use rhetorical tools to persuade women of the risks of...