Category Archives: choice

things I have been reading online…

I am trying to write a short review on new materialistic approaches in Geography and the politics of feeding, and as such, have been reading a few articles on this, which as it happens, seems to be a hot debate at the moment…

blue milk, on the ways the message of breastfeeding is conveyed. I love that it particularly pins down the difficulties I find in the notion of ‘choice’, individualism and patricarchy…

A guest post in PhD in parenting on the debate generated recently on breastfeeding in public.  

And then, something that relates to one of my daily struggles at the moment: to-do list vs being present with your child. Since I am mostly a full-time mom, I have to do things with r. around. I have always cooked and done some cleaning and ordering with her, but now it is also phonecall, fixing stuff in the house, clothes shopping (mainly for her!) and so on. We have recently moved houses and the house needs work, and I am in full nesting mode, so I want to do loads of things before the baby comes. So I find that I am itching to do things, to feel I have done ‘productive things’, and sometimes this means I see parenting as a chore more than something enjoyable, and on times like that, there is inevitably trouble, fights, and bad feelings. This post by Sew liberated on chucking the to-do list, really hit the spot for me.

Hope you enjoy these!

Lucila

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old news but good…

I don’t know about you, but I only get to read the papers I buy on Saturday slowly during the week, so here it goes, a bit late…

Guess what everyone is talking about these days, and was the headline of the Guardian this Saturday? New regulations on the sexual commercialisation of children. David Cameron (the UK Prime Minister that is) commisioned research on this, called the Bailey Review, and the report is out this week. Some of the recommendations include:

‘to back a plan to stop retailers selling inappropriate clothes for pre-teens and shield childrenfrom sexualised imagery across all media, including selling “lads magazines” in brown covers and making the watchdog Ofcom more answerable to the views of parents.

Retailers would be required to sign up to a new code preventing the sale of items for pre-teens with suggestive slogans, which the prime minister has repeatedly criticised.’

What it seems like is that more than regulation and legislation the recommendations are  going to be for signing up to voluntary codes of conduct for instance.

What Tanith Carey argues in the the family section is that regulation is a good way of sending a signal, but it is only a starting point, and urges parents to be more vocal and to exert their power as parents too.

I think it is a step forward that this is a matter of debate, of regulation and that it migth open up spaces for parents to feel that they are not isolated in thinking that padded bras and thongs with suggestive slogans are a bit mad for 6 six year olds.

In this debate, there were many opinion pieces which can be found online here and here and here for instance, and luckily the F word made an appearance because I was already starting to worry about siding with the conservatives!

Lucila

Motherhood and nurturing in the age of obesity

Keenan, Julia and Stapleton, Helen, 2010,  Bonny babies? Motherhood and nurturing in the age of obesity, Health, Risk and Society, Vol. 12, No. 4, 369-383

 This article grabbed my attention as I am very interested in issues of feeding and nurturing as core activities of motherhood practice, as well as in body image issues. In this article, Keenan and Stapleton draw on women’s accounts of their interactions with health professional and families to see how the prevalent and powerful biomedical discourse around obesity plays out in practice. The authors describe the importance of this discourse for this study as involving the medicalisation and moralisation of large bodies in pregnancy as ‘obese’ and thus the creation of subjects ‘at risk’ to themselves and their foetus/infant.

This paper is based on findings from a qualitative research project, conducted from 2006-2008 in a city in the north of England, and this paper draws mainly on accounts and experiences told by  participants with large bodies.

First they discuss the World Health Organisation’s definition of obesity as ‘excessive fat accumulation that may impair health’. This definition is operationalised many times through the use of Body Mass Index (BMI), based on a height to weight relationship, which is a simple and cheap tool. A BMI of over 30 is most commonly seen as obese. For children, categories are based on the percentile position on ‘normal’ growth scales. Obese children are considered those which surpass the 95th or 98th percentile.

The authors discuss the different problems that the use of BMI to figure out risks brings, and show how critical studies of obesity question the link between BMI and health, which often are translated into policy in oversimplified ways that create definitions of certain bodies as fat and problematic.

The authors show how biomedical research links appropriate pre-pregnancy weight, weigh gain and nutrition in pregnancy with satisfactory foetal outcomes, and more and more with infant health over the life-course.

In the biomedical literature, a BMI over 30 is linked with

‘increased risks of miscarriage, gestational diabetes,  high blood pressure and pre-eclampsia,  blood clots, haemorrhage following birth, increased risk of induction and instrumental delivery, post-caesarean wound infection, genital and urine infections, giving birth to an infant with an abnormally high birth weight and problems with breastfeeding; obesity is significantly implicated in maternal deaths (CEMACH 2007). Babies born to ‘obese’ mothers are at increased risk from premature birth, still birth and birth abnormalities and are more susceptible to health problems, including obesity and diabetes in later life.’

However, as the authors point out, there is still debate about how much of an increased risk obesity brings, and these risks are not exclusive to women with BMI over 30. And there are contestations to the notion that adult health is predetermined by infant body size.

But this discourse comes strongly through social and cultural norms concerning the right way to prepare for pregnancy, and is framed in the media in this terms. This authors point out how health has increasingly moral connotations, and how being obese, this ‘risky’ bodily state is seen as an individual and moral failure.

However, given this atmosphere, the authors were surprised to find that women in antenatal interviews reported that health workers did not discuss ‘obesity’ with them. Very few were under consultant care due to their weight, and most of them were not aware of any of the risks listed above, apart from those few who were self-informed. In the UK, maternal weight in pregnancy is not monitored. So apart from a one-off measurement of weight and height at the beginning, weight is only informally monitored by midwives.  Women with a family history of diabetes, or with a BMI over 30, where tested for gestational diabetes, and monitored if the results were positive.

The authors argue that it is understandable that health workers were reluctant to broach the subject, as despite the urgency of the obesity debates, there are still no clear policy guidelines, support or resources, and health workers do not want to make women feel guilty, uncomfortable, or encourage them into weight regulation. Although the authors do not go into this in detail, they highlight that negative comments were always given by family, their social circle or the media.

In this way, weight was not made an issue during pregnancy by health workers, and while attempts at discussing this issue by participants were met with reassurance, some women found this helpful, while others found it frustrating, as they would have liked some support and discussion. This was especially the case for women in terms of birth plans. Most of them were led to believe that they could just plan whatever birth they wanted, but they were unaware of the regulations that prohibit certain options for women with BMI over 30, and they felt that, at the last minute, they were snatched of their choices.

Furthermore, the lack of dialogue about the risks for women and their babies meant that when health professionals, especially higher rank ones, mentioned weight as the cause of ‘poor outcomes’, these were dismissed by women. The approaches that higher ranking health professionals used were crude, induced blame and were insensitive, and did not work in terms of the goals of these professionals – raising awareness about the risk of excess adiposity – but made women, quite rightly, discredit their comments.

In terms of infant size, the authors note that across their data as a whole, underweight or premature babies generated much more anxiety around their weight than a baby deemed to be ‘big’. The authors show that the much like the more traditional understandings of ‘bonny’ babies, bigness and a good appetite were seen positively, and not as a problem. The only exception to this unproblematised view of weight gain was done by women who managed diabetes through pregnancy.

The authors end up concluding that while they do not want to contest the studies that relate excess adiposity with increased risks for women and infants, they want to identify the problems that using a measure such as BMI can bring in terms of policy, or in its translation in the treatment of individual women to improve birth outcomes and health. This article shows the disparity between discourses and practices. At the moment, health workers do not encourage women to manage biomedical risks, within pregnancy, but there are many policy and guidelines in the pipeline that are probably going to change this. Moreover, this article underlines how it is not possible to understand the medicalisation and moralisation through the work of one type of actor, such as health workers, but other social actors need to be included.

I liked this article because it tackles a sticky issue: how to understand in a measured way the risks that ‘obesity’ might bring, while problematising deterministic studies and the individualisation and moralisation of this problem. At least I find it tricky. I am worried about what these studies are showing, and scared, frankly, but at the same time, am wary about how this might be translated. If I had to bet, I would say it will probably end up in blaming the mum, and not only for a difficult pregnancy and or birth, but for the health of their children now and forever. Which is not the outcome I would like to see, but it is one that is taking shape in the media for instance. But just because it is sticky does not mean we can ignore it, or act as if nothing happened….It is the same with women’s bodies and fat shaming. We don’t need more of that, and we do not need more women who are not happy in their bodies. In this case, how could there be support for women, without it being medicalising, moralising and individualising the problem? As I say, tricky.

Lucila

Is childcare a love market?

Carol Vincent and Stephen Ball, 2001, A market in love? Choosing pre-school childcare, British Educational Research Journal, 27, 5, 633-651

This is a bit of an old article, and one which is tentative in that it is a first attempt at looking at a small and limited sample of data, but I liked what they were trying to do here, especially in view of my angst in terms of looking for childcare, and also because of comments that this post sparked in terms of the role of the state in childcare provision. This article explores the way that a group of mainly white middle class women made choices on childcare, and how they ‘operated the market’, in the UK. Most of these women paid for childcare, instead or in addition of using informal arrangements.

What Vincent and Ball show us is that in spite of these women being very good at working the market, by searching different providers, looking for information, getting reviews, going to visit the places and so on, these women did not have much control of the market-based relations that developed, and had to negotiate different tensions and trade-offs between their work, childcare and domestic responsibilities.

What struck me about this article is that it underlines a prominent feature here in the UK, which the article describes as an Anglo-American phenomenon: that childcare for children younger than 4 is considered mainly a private matter, not a public responsibility. This is different from other countries, such as Scandinavia, France, Belgium, and Australia. Families have to cope in their own ways, and have to pay for whatever they can afford for care. The state does not provide, or provides minimally, for this age group. Since this article was written, the state has become a bit more involved, at least in terms of inspections, and offering childcare vouchers and so on, but not much in terms of provision of care. But even if, or because of, this area is left to the market, women find they have to compromise on what they would like for childcare, as they haven’t got the ability, or power to really ‘choose’ the care they want to.

A very interesting part of the article deals with the compromises that women make at the moment of making choices for childcare. Cost, geographies of choice (location and distance of travel, places available, times available, etc), women’s type of work hours and flexibility allowed, different types of care arrangements, are all elements in a giant and fuzzy puzzle that women juggle in their everyday lives. These authors show that there are two key issues that relate to this compromise. They show that even if women manage the market well, they still are forced to accept situations that are not ideal. And that the dissatisfaction is fuelled by their unease about negotiating market-based relationships in search of care.

Women did not have much choice of manoeuvre between one provider or another. They show how it was more of a ‘work with what there is, and what it is’, rather than, as other studies suggest, a continuum of care, or co-ordinated care. That is, the situation was more one in which mothers had to compromise their ideals, or to leave. And women compromised more or less than others, and on different things.

The authors argue that because of this unease with market relations, women attempt to personalise, and bring the affective dimension of care to the forefront. As they show, for these women professionalism is not enough and warm relationships are vital. This is a part of the article that bugs me a bit. In their analysis, the authors highlight how this really is about a financial exchange, and how the other elements are part of a ‘necessary fiction’ that women and providers use to cover this core issue.

This bugs me not because I don’t agree that there is an element of market exchange, and that this brings discomfort and a strategy to bring out the affective, but because it feels like they are saying that the women do not understand this and live in fiction, and thus, for me, it feels dismissive.Secondly, I think that market relations are complicated and more than financial exchanges in any case, and more so in this case.

In spite of this matters, I find that this poses interesting questions: would women be more at ease with their childcare decisions were it not a market exchange? Would public provision, for instance, change the forms of childcare at their core? And thus, what role should the state play in childcare provision? Probably the answer to that would be to see what kind of alternative care, public care or cooperative there was, and if the care relationship would be more prominent in this type of care. I would argue that this would probably not be so clear cut, as childcare providers and workers are mostly under-paid, and probably choose this job in some part because it is something they enjoy doing (this does not justify the low pay, which I think should be part of the struggle for better care). Even so, the questions are good ones, especially at this point in time in the UK, where conservatism and forms of privatisation are rampant.

The next thing that struck is how this is an area where women are the main responsables, in two senses, for worrying, juggling and searching, and also in the sense of being responsible for it to work well. Women are the ones juggling, searching, making compromises, and men are in the background, even though these are, as some of them described, involved in many other areas of care and household tasks. This area was theirs.

It is exactly my case too. I do question myself why is it that I am the one that seems to worry most about childcare, searches options, and thinks of the different ways to combine things. Even though my partner comes to visit places, and was there to interview our nanny, and we talk about childcare decisions, I feel this is my responsibility. As the women in the article also state, there are many reasons for that: my flexibility in terms of my work, the relative less pay, the inconvenience in terms of times and distance for ones who those not work from home, etc, but for me the thing at the heart of this is something else: as much I sometimes fume about this being seemingly my burden, I would not like it if it weren’t. Do I care more than him about childcare? Probably not. But somehow it seems like I am the one that is annoyingly picky about it. Why is this? Not sure. Of course he does other things I don’t do, but it seems peculiar that this is something marked not only in our relationship, but is common and has been the most usual way in which it happens: women keep this matter into their hands. It would be interesting to read more about why this is the case: why is it a mother’s matter more than a dad’s matter? Or a shared one? A good feminist question.

Finally, an interesting point is held, when these authors show the ways that women talk about this process. The women in this study compromised somehow in the range between what would be for them ideal and what would be a horror story. These authors show how this middle ground is then maintained through ‘legitimation talk’, that is, narratives that contain very complex justificatory accounts and schemas, which are also underpinned by the rejection of other options. These authors comment how sometimes it is difficult to tell ‘preference’ from ‘necessity’, as there is a lot of emotional work going on, as these women also explain these choices to themselves through this talk.

I find this to be true, and part of the constant questioning that motherhood and parenthood brings: is this the right thing? Is my son/daughter happy? Could it be better? But also, I found, that this is something that many of my friends do, and probably I do too. For instance, sometimes I am a bit taken aback when something that I was told was great, and worked perfectly well, somehow falls apart. It is only then than some start to talk about their doubts, fears and negative experiences. I know it is hard to admit, to oneself first, but also to others, that one is not doing the best thing, but one that is OK, and works for the moment. I think that this area is one in which a bit more insight or openness might do mothers some good. This is what loads of blogs are great for, so there is something brewing definitely, but the competitiveness and tribalism is also rampant, so it is good to keep talking about this.