6.17.2006

Linda Hirshman on how to lead your life

I want to comment briefly on latest article (Unleashing the Wrath of Stay-at-Home Moms, Washington Post, June 18, 2006), and it’s complaint about the ‘backlash’ she has received from stay-at-home moms, and particularly bloggers.

Two examples from her article are enough to illustrate why she has not earned much support from the majority of women:

“[I said]...women who quit their jobs to stay home with their children were making a mistake. Worse, I said that the tasks of housekeeping and child rearing were not worthy of the full time and talents of intelligent and educated human beings. They do not require a great intellect, they are not honored and they do not involve risks and the rewards that risk brings.”

First of all, believing that you are in a position to judge the choices of others is at the very least patronizing, not to mention delusional. Her job versus children view of the world lines up nicely with patriarchal thought in its devaluation of child rearing. Child rearing is for dumb, uneducated human beings who can waste their useless time on it, which is why we don’t honor it, and why, if you are a worthy human being, you should be out in the world taking risks (that are socially recognized and approved, of course). Still wonder why Hirshman isn’t getting the respect she feels she deserves?

I have followed Hirshman’s articles in various forums, and the negative reaction she elicits comes not only from stay-at-home-mothers, but also from working mothers, fathers, and even her academic peers. The reaction is not, as she states, “because standing up for staying at work is the big taboo”. It is due to her arrogance at dictating what women should do, how they should do it, and how they should feel about their choices. It is because of her narrow-mindedness in believing that there is one definition for everything in life, and that conveniently she is the author of that universal dictionary. In fact, I’m not surprised that she considers that “a philosopher's job [is] to tell people how they should lead their lives”. (Philosophers take note: Hirshman has just ended centuries of debate concerning your role in the world.) Though she may deride and criticize anyone who disagrees with her opinion, it is her mandate to impose her view of life on you. How philosophical of her.

Finally, Hirshman’s feigned shock at the responses she has garnered is a poor excuse for an article. But hey, we all know that to sell books, even bad ones, you need to create media buzz. And like Ann Coulter, what better way than by using aggressive, reductive and insulting language? With statements such as this, is it any wonder people get upset?

“Much worse than the roofing-and-barfing and salvation crowds, though, were the relativists, who criticized me for trying to give feminism some context and boundaries. My favorite was the woman who dissed me for defining feminism and then said, "Supporting other women's choices is the very essence of feminism, at least as I define it."”

Really Hirshman, such writing “is not worthy of the full time and talents of intelligent and educated human beings.” And by the way, though you say little about the relativists' arguments (just enough to scoff at them), I think they may be on to something. Try listening. It's worth the risk.

Want a little support with that breast milk?

According to the latest New York Times article (Breast Feed or Else, by Roni Rabin, June 13, 2006), it seems that the tide has finally turned. The medical establishment has fully and officially endorsed breast-feeding. The same medical establishment, by the way, that for years has allowed baby formula companies to pitch their products to mothers who have just delivered and provide them with baby welcome bags full of free samples.

This happened to me as recently as January of 2005, even though it was already a prohibited practice where I lived. After an emergency c-section the day before and countless fights over outdated hospital protocols, I was awakened at 7 am by a chirpy representative who passed herself off as hospital staff and started asking me questions, including my contact information and income. She left quickly when I told her I was going to report her company, but it was clear she did this daily with every new mother in that hospital. So much for following all the rules.

But now that science supports what breast-feeding advocates have been saying all along, it seems women have been given a new ultimatum: breast-feed or else.

Don’t get me wrong, I fully support breast-feeding, and continue to breast-feed my 17 month old. In that sense, I am part of the success stories. However, I’m also in that group of mothers who has to supplement with formula for a very simple reason: at age 18 I had breast reduction surgery. The fact that I’ve partially breastfed is another success story of a different kind. (For more information on that, see this link.)

I don’t regret my surgery, even if it meant a lot of hard work to establish breast-feeding with my child. I had excellent coaches and a great support team, yet it was still emotionally draining to keep trying without being able to forego supplementation. I was afraid that my son would come to prefer the bottle and wean himself, and frantically tried every available means to increase my supply. At a certain point, this frenzy took its toll on breast-feeding itself, and that’s when I realized that it wasn’t just about milk, but also about our relationship. It wasn’t healthy to feel inadequate every time I fed my child, and I decided to just relax and enjoy it for as long as it lasted, without pressuring either of us. And that’s when our breast-feeding relationship truly developed, and it became about us and not just the milk.

This is important, because the benefits of breast milk are only part of a complex equation that also involves the emotions of both mother and child. If a mother is unhappy with breastfeeding, for whatever reason, she should be able to do otherwise without becoming the target of criticism of either the medical establishment or society. Yet there is another part to the breastfeeding equation that has yet to be adequately addressed, and that is the lack of a social structure to foster and sustain it, both in the workplace and at large.

In fact, we should think about why women become disenchanted with breastfeeding. For example, how do you deal with the still prevalent discomfort of others with nursing in public? (It’s not a coincidence that breast-feeding and pumping are relegated to public bathrooms, since they are deemed unseemly bodily functions. Would it feel nice to eat your lunch in a public bathroom?) How do you educate a public that was brought up on the ‘practicality’ of formula, or that feels free to remark with disapproval that your child is too old to nurse?

More importantly, how do you maintain a breastfeeding relationship when you have to go to work? The article clearly summarizes the difficulties of breastfeeding and work:

“Moreover, urging women to breast-feed exclusively is a tall order in a country where more than 60 percent of mothers of very young children work, federal law requires large companies to provide only 12 weeks' unpaid maternity leave and lactation leave is unheard of. Only a third of large companies provide a private, secure area where women can express breast milk during the workday, and only 7 percent offer on-site or near-site child care, according to a 2005 national study of employers by the nonprofit Families and Work Institute.”

If we really care about promoting breastfeeding, then we need to address the obstacles faced by women in order to successfully do so. It would be infinitely wiser to allocate funds for better maternity leaves on a nationwide scale, access to healthcare and childcare, and flexible work options for women, rather than spend it on campaigns that play to women’s guilt and fear. The use of sensationalist TV ads, portraying heavily pregnant women in a log rolling competition or riding a mechanical bull, trivializes the unique and complex circumstances of each woman and endorses a judgmental public attitude towards non-breastfeeding women. In fact, it’s disturbing that this new government initiative to promote breastfeeding, known as Healthy People 2010 is part of the same initiative that brought about the CDC’s report on preconception health. (See my previous entry on that report.) While I am not against the goals of better health for women or of the promotion of breastfeeding, I balk at the way it is overriding women’s personal choices to mandate certain behaviors.

As I write this, I realize that this entry shares more personal information than I expected. In that sense, breast-feeding is, like pregnancy, a unique experience for every woman. It is affected by her circumstances and differs in accordance with the needs and temperament of each mother and child. And because of that, we need to provide not only the structural support needed for women to successfully breast-feed, but also our respect to those who, for many reasons, do not.

6.16.2006

The CDC report on preconception health

On April 21, 2006 the Centers for Disease Control and Prevention issued a series of Recommendations to Improve Preconception Health and Health Care in their Report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. (You can read the report here.) The report was covered in major newspapers and received attention because of its definition of preconception health patients, which includes all women between the moment of their first period and menopause. Intrigued, I decided to take a close look at the document.

The report is 16 pages and tailored to the stated goals and recommendations: in that sense, it is more vague and repetitive than informative. While it talks about ‘improving the health of women and couples’ and promoting ‘optimal health for women, children, and families’, you eventually discover its focus. Predictably, buried on page 9 of a 16 page report it says: “The target population for preconception health promotion is women, from menarche to menopause, who are capable of having children, even if they do not intend to conceive.” (Emphasis mine.) And in fact, leaving aside the repeated invocations of benefits to others, the recommended actions are aimed at women.

For example, the first goal is to “improve the knowledge and attitudes and behaviors of men and women related to preconception care,” (p. 1) yet the bulk of the report focuses specifically on women’s preconception health and how to facilitate ‘assessment’ of risk factors and intervention. Aside from general public outreach programs, there isn’t a single recommendation that is geared specifically towards men. It has been established that male fertility is adversely affected by alcohol and smoking and by chronic health conditions such as diabetes. This means that to improve reproductive health men must be participants and not just sideline supporters. Here, however, only women are responsible for fertility or the health of offspring.

Another issue is the definition’s clear dismissal of women’s agency: “even if they do not intend to conceive”. While I am aware that one goal is to improve pregnancy outcomes, including for unintended pregnancies, I worry about the consequences of guidelines that ignore women’s intentions and give precedence to a potential pregnancy. The idea of a life now dictates the healthcare of real, living women.

This may not seem like much when it comes to daily folic acid or even screening for STDs and HIV (though some may object). The emphasis on ‘lifestyle’ risks such as alcohol consumption and smoking becomes problematic when you read “risks and behavior should be addressed during any encounter with the health-care system because approximately half of all pregnancies in the United States are unintended” (p. 5). That means that a woman’s lifestyle may be scrutinized every time she sees a health care practitioner (even her child’s pediatrician, as suggested) because of a possible pregnancy. It’s more disturbing to realize the socioeconomic and therefore racial issues at play, as it is acknowledged that “a small number of women experience the majority of the pregnancy-related morbidity and mortality” (p. 8), and that the intervention is aimed primarily at those women.

If this report meant guaranteed health care for all who are currently without, I might support it. But shouldn’t this be available to all women, regardless of their capacity to conceive? What happens to infertile women? Are they less worthy of care or concern? Are they a lesser benefit to their families or society? Though the report’s goals may be well intended, their linkage to reproduction is unnecessary and troublesome.

Finally, the report’s glaring silence on contraceptive education as part of preconception health makes me wonder about a hidden political agenda. Given the heated debate on the issue of abortion, it seems unusual that the report would mention that “[the] health plan might increase the number of planned pregnancies” (p. 2) without once addressing how unwanted pregnancies may be avoided or reduced. The goal then is not to maximize women’s health, knowledge, or choices with respect to fertility and pregnancy, but to turn women into healthier vessels for a possible life.

I guess it’s time to dust off my copy of The Handmaid’s Tale.