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Chapter 1 157 Amanda Marie Lubold and Louise Marie Roth Chapter 13 Since a majority of mothers of infants are in the labor force, work organizations play an important role in facilitating women’s ability to breastfeed.1 In most workplaces ideal worker notions assume male career patterns and treat women’s reproductive activities as deviant.2 Workplace “accommodations” of breastfeeding mothers are then based on deviations from a male standard.3 Until passage of the 2010 Affordable Care Act, American law and policy did little to promote breastfeeding-friendly workplaces, thereby leaving it up to the workplace to decide whether it wanted to accommodate workers’ reproductive activities, placing the burden on the employees to advocate for themselves or navigate breastfeeding-unfriendly environments.4 As described by Jennifer Lucas and Deborah McCarter-Spaulding in this volume, differences in workplace flexibility and accommodation for pregnancy and breastfeeding have contributed to well-known racial, ethnic, and socioeconomic disparities in breastfeeding, whereby affluent white women are more likely to breastfeed and tend to do so longer than lower-income women and women of color.5 The ways that organizations responded to public health’s call for “more breastfeeding” before the 2010 law thus helped some women and not others. In effect, organizational strategies for accommodating breastfeeding workers affect the distribution of breastfeeding and disparities in breastfeeding rates. The theory of gendered organizations argues that organizations themselves are gendered and typically assume an abstract male worker requiring no accommodations for reproduction or child rearing.6 The implications of this ideal for workers who breastfeed are considerable. Breastfeeding mothers are a significant aberration from the expected behavior, which assumes a nonlactating The Impact of Workplace Practices on Breastfeeding Experiences and Disparities among Women 158 A. M. Lubold and L. M. Roth male body.7 Because the male body is the unstated norm for the ideal worker, and the law has required no accommodation for breastfeeding, employers, managers, and coworkers often resent having to allow time and space for expressing milk at work.8 In addition, many managers and coworkers feel uncomfortable with lactating bodies in the workplace and make breastfeeding mothers feel unwelcome. This is partly because the “female body threatens the conventional (male) social order of things due to its metaphorical and material tendency to ‘leak.’”9 Without legal mandates, employers have had little incentive to accommodate the needs of workers who have deviated from the unstated male norm, and organizations have displayed, at best, ambivalence toward breastfeeding mothers.10 Many women report that they are unable to continue breastfeeding upon returning to work due to a lack of institutional support.11 Organizational policy and support has an important influence on mothers’ ability to breastfeed that is independent of her desire to nurse or her ability to produce a milk supply, and thus constrains any genuine vision of choice. There are also racial differences in working women’s likelihood of breastfeeding that are related to organizational influences that undermine the ability of women of color to breastfeed, resulting in black mothers being much more likely to stop breastfeeding after they return to work than nonblack mothers.12 White women are more likely to work in jobs where they have private space, scheduling flexibility , and storage facilities that accommodate breastfeeding, thus potentially contributing to known racial differences in breastfeeding. Prior to 2010 there was no legal mandate for workplaces to accommodate breastfeeding. This situation stems from the legal doctrines governing equal employment opportunity that require gender-neutral, equal treatment of employees, even with respect to reproductive activities where women and men are clearly not the same, and has limited women’s opportunities to combine breastfeeding with paid employment.13 Under these doctrines, breastfeeding accommodations only address women and are therefore not mandated.14 Breastfeeding is also something that not all women do, as substitutes (formula) are readily available and culturally accepted. As a result, there is a view of breastfeeding versus formula-feeding as just another consumer option rather than an issue of reproductive justice. In this regard, organizational and social policies that assume or require gender neutrality create reproductive injustice and contribute to reproductive inequalities among women. The 1993 FMLA requires organizations with over fifty employees to provide twelve weeks of unpaid leave, but many women work for smaller organizations or simply cannot afford to take unpaid leave. The lack of paid maternity leave can make it difficult to establish breastfeeding before resuming employment and many women do not...


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