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1 Recently there has been an explosion of feminist attention to breastfeeding, in addition to increased activity in public health and medical research. Our collected volume, Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, contributes to this diverse field of research, policy, and practice by drawing on women’s voices, feminist theory, public health, and novel interdisciplinary conceptualizations. Our aim is to expand the understanding of women’s experiences of breastfeeding and to provide insight for public health policy and planning. Our title indicates the main elements of our approach. Current public health promotion of breastfeeding per force relies heavily on health messaging and individual behavior change, often failing to take into account the myriad constraints on women’s choices and practices. The result is a perceived pressure on women to breastfeed without necessary social and cultural support. The reality of women’s lives is diverse and constrained by structural factors outside of their personal control. Our volume focuses attention on the multiple contexts that affect women’s behaviors, beliefs, and practices, exploring ways to refocus public debate about infant feeding decisions in the United States and elsewhere. Beyond Health, Beyond Choice is a unique contribution to the burgeoning field of breastfeeding studies. Contributing authors hail from various disciplines and countries, and include social scientists, humanities scholars, health workers, and public health activists and policy makers. We focus attention not only on describing the problem but also on strategies and approaches that inform policy, programming, and practices in health care and public health, Introduction Breastfeeding Constraints and Realities Bernice L. Hausman, Paige Hall Smith, and Miriam Labbok basing our analyses in feminist practice and theory. Our commitments to feminism and to public health define the basic framework of our analysis. Our interest is in developing public health approaches to breastfeeding promotion, advocacy, and support that are embedded within a distinctly feminist perspective. Beyond Choice: Feminist Standpoints and Women’s Experiences Feminism is diverse and changing. Feminism has never been and never will be one thing. As a result, our authors demonstrate varied feminist commitments. However, feminism as a general framework does suggest several basic principles that guide our understanding and inform our research. First and foremost, feminism values women’s experiences and the perspectives that they develop from those experiences. Standpoint feminism is one approach that seeks to honor women’s perspectives on their own experiences. It is a specific version of what Donna Haraway has called situated knowledge.1 Both standpoint feminism and the notion of situated knowledge suggest that because women’s experiences often result from their lower status in society vis-à-vis men, these experiences offer an important window through which everyone can see new truths and possibilities. That does not mean that women’s experiences in and of themselves represent unquestioned sources of knowledge or truth. It does mean, however, that the ideological and material contexts of women’s lives are a critically important part of the reality that needs to be identified and taken seriously in the development of public health polices.2 The experience of breastfeeding seems to engender divergent and contentious responses. Many women express anger at perceived pressure to breastfeed. Contemporary blogs about infant feeding contain emotionally charged discussions about how pressure to breastfeed from medical professionals or breastfeeding supporters can lead to feelings of maternal failure or anger at biological insufficiency. Some women face censure for public breastfeeding, which, when publicized, can motivate widespread “lactivism” in support of breastfeeding women’s rights. U.S. feminist labor activists bemoan medical recommendations to breastfeed that are thought to increase feelings of maternal guilt among working women while seeming to ignore the fact that the United States lags behind the rest of the industrialized world in providing maternity leave. Meanwhile, feminist breastfeeding advocates and supporters identify pitfalls in a health care system that seems to deny mothers accurate information of the contributions that breastfeeding makes to maternal and infant health. These varied responses to breastfeeding, breastfeeding promotion, and perceptions of breastfeeding support or censure offer 2 B. L. Hausman, P. H. Smith, and M. Labbok important openings for feminist analysis of the politics of motherhood and infant feeding. At this point in time, much feminist analysis of breastfeeding has focused on breastfeeding promotion that is unaccompanied by real support, identifying it as a factor contributing to women’s continuing cultural and political subordination . Notably, this is the approach taken by feminist political scientist Joan Wolf in her recent book Is...


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