Category Archives: difference

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

Starting point

Each week I will examine one chapter of Orenstein’s book. The first one basically states her starting point, and I put it out here so we can all start in the same page. For those of you who are new to here and wonder what I am talking about, the general review of her book is here.

So, how important is that girls play as princesses? Does it really matter if their clothes and toys are pink and if they have mainly flowers and butterflies? Orenstein thinks about this, and acknowledges the temptation to give this a pass, to think that ‘it is just a phase’, but ends up arguing that it matters, a lot.

In the first chapter of Orenstein’s book, she sets out her aim. She wants to understand the impact of images and ideas that girls absorb as to what they should be, and what roles should they play, and what made them girls, in this mainstream girlie-girl culture. And she asks, what is the first thing she learnt in her ventures into mainstream culture?

‘Not that she is competent, strong, creative, or smart but that every little girl wants  – or should want- to be the Fairest of them All’

She shows how studies done by the American Psychological Association show how

‘the emphasis on beauty and play sexiness can increase girls’ vulnerability to the pitfalls that most concern parents: depression, eating disorders, distorted body image, risky sexual behaviour’

Well, those are things I do fear.

She points out to some confusing signals: while there are more and more examples of girls’ successes, the push to make their appearance the centre of their identities , did not seem to have diminished, on the contrary, it seems to have intensified, and extended (to younger, and also older ages). And I have read many studies how teenage girls seem under so much pressure these days, much more than boys. Duties have piled up, and intensified.

(Does it not ring a bell with how the role of parents -and the invention of the verb to parent-, and especially mothers, has seemed to intensify in the last decades, just when women have more and more taken other roles?)

And this triggered in her questions about how to help our daughters navigate the contradictions they will inevitably face as girls. Her question is one I worry a lot about:

‘How do you instil pride and resilience in her?’

She gives examples of myriad moments in which we have to navigate the land of toys, clothes, of things. And she argues that answering this question, and navigating this world, is harder now, since the mid-1990s, than it was before. She explains that this is the moment where the Girl Power movement which celebrated ability over body, has its message turned around. Somehow, the body, the pursuit of physical perfection, became the source of empowerment.

This is her starting point. And in one way, much of mine too.

Lucila

Education crushing creativity in children

Just when I was thinking about finding ways of not interfering and allowing children to make mistakes and what critical thinking is, I came across this amazing video. Please please watch this amazing video talk on children’s creativity and education by Sir Ken Robinson, I found via simply montessori. It will make you think, laugh out loud, and if you are softy as me, even cry.

And if you get carried away, also watch this one, by the same guy.

Lucila

The materials of mothering

Boyer, Kate and Boswell-Penc-, Maia, 2010, Breast pumps. A feminist technology, or (yet) “More Work for Mother”? In Layne, Linda, Vostral, Sharra and Boyer, Kate (eds.) Feminist Technology, University of Ilinois Press, 119-135. (Women, Gender, and Technology)

Boyer and Boswell-Penc enquire in this chapter whether breast pumps can be considered a feminist technology. I find this article interesting in that it focuses on one example of the stuff, that is,  the materiality, which makes up modern motherhood and examines what roles this technology play, what does it enable, and what are the risks that it brings, through analysing  the cultural context of its emergence but also by analysing its use in practice.

Their work focuses on the use of breast pumps in the waged workforce in the US, one of the countries where women have less maternity leave in the world. One of the questions which frames this study is understanding if the breast pump is a feminist technology or if it is it another device which, as Ruth Schwartz Cowan (1983) argues, creates ‘more work for mother’, as many other so-called labour-saving devices.

In this chapter they look at the cultural context in which the breast pump emerged – a time (60s-70s) where there was growing awareness and advocacy for the benefits of breast milk over formula, and a moment when higher number of women were returning to the waged workforce. The latter practice was due to different reasons ranging from economic restructuring, the need for double wages, and the fact that women were occupying better managerial positions. They describe how, in the 1990s, the technology evolved to be lighter, portable and cheaper, and jumped from being mainly hospital-based, to being available for retail.  

The argument for it being a feminist technology stems from the way that using this technology allows more mobility, more temporal and spatial freedom to the mother. The breast pump can bring a much needed break for mothers and it allows for mothers to break the cyclic time loop that new mothers who breastfeed are in – the two hour window to do things!- as well as the necessary proximity to the child. It also expands the choices that women have in terms of infant nutrition, as well as serve other important purposes, such as relieve engorgement in mothers who choose not to breastfeed, and help initiate breastfeeding for mothers who adopted an infant. Moreover, its use in waged workplaces could help push the boundaries of the private/public, by bringing to work an activity normally done in the privacy of the home.

However, these authors point out that much of its liberatory potential in terms of waged work is constrained by attitudes about pumping (and general lactation), issues about the technology, workplace design and the politics around actual pumping. Breast pumps, thus, have to be understood within its actual use, which is something that these authors delve into. They show how attitudes to pumping at work make women who pump, as well as the breast milk itself, feel ‘out of place’. The strong feelings that breast milk brings out is seen, for example,  in the case where women were fired for leaving their breast milk stored in the communal fridge. For women who pumped at work, the search for privacy and the sense of embarrassment around pumping, made them look for different strategies that would allow them not to be seen or heard (electric breasts pumps can be very noisy!), such as going to feed to the car, in the medical centre, in an unused office/conference room. Other constrains also include finding the time for it, as often employers do not structure extra breaks for this. What this shows is that the responsibility of finding a place and a time for this activity is down to the individual. Moreover, it highlights the reasons for the uneven distribution of its use, in terms of class especially, as the possibility of having this extra space and time is most likely to be in middle income jobs, rather than low income ones.

Furthermore, these authors also highlight some of the risks that this technology can bring to feminist struggles. By providing a technical and individualised fix to the question of how to combine lactation with work, it might keep employers off the hook in terms of providing other, and maybe better, alternatives. In addition, as these authors show, this technology has something in common with other technologies, such as communication technologies, in that they give more mobility, more spatial and temporal freedom, but it also raises the expectations of what can be done. The authors show that as much as this technology increases choices and provides flexibility, there is a risk that it could be used against efforts for longer maternity leave or on-site care, for instance.

What I found fascinating is that this article makes me think about the different things that make up the practices of mothering, and how each of these things are performative in more than their utilitarian sense. They work to highlight questions of race and class, as it has been shown in this article. I would say that things and technologies also play a role in identity formation, as they act as markers of inclusion in certain groups. In a sense, I think that they are also part of the ways of evaluating a mother’s performance – I am thinking here of the pressure I felt the first times I tried to put up or down the buggy in public, for instance!

We are surrounded by stuff in our practices as mothers: buggies, breasts pads, sterilisers, cots, nappies, dummies, bottles, special clothes for breastfeeding, high chairs, car seats. And the list can go on and on. Leaving out the stuff of motherhood would impoverish our understanding of the politics of motherhood/parenthood, which is why I find what these authors do, that is, questioning the theoretical possibilities but also the complexities that seeing and thinking these technologies and things in practice bring about, is a crucial exercise.

What is feminist mothering for me? What needs to be done?

One of the things that inspired this post was Blue Milk’s questions on feminist mothering. The answers to these questions by different people are incredibly inspiriring, and thought-provoking, so go have a peak. These questions resonated with ones I have had in my head since well before r. was born, but which acquired a different intensity and importance since she’s been with us.

Beware: it is long!

I am a feminist, and I am a mother. Inevitably, my feminism is formed by my motherhood, and my motherhood by my feminism. But, if pressed, I find it quite hard to define what my feminism is about, just as I find impossible to define my motherhood. My feminism gets done and thought through differently, in different practices, events and experiences. The same goes for my motherhood. I can easily say that I have always supported the basic tenets of feminist struggles for equal rights and opportunities for women in different areas. This slowly evolved from a position of not much aware of this as feminism, to identifying comfortably with the term feminism. In terms of mothering, being aware, for instance, of gender constructions/constrictions and its practice in the gendering of clothes, toys and activities; the sexualisation of children, especially little girls; body image and food issues; corporate practices in terms of marketing of formula milk, or advertising, all make me think carefully about the ways in which I/we parent. Being a feminist mother means for me thinking and picking at these issues, trying to find ways of working through them, more than having a clear solution, or blueprint for raising feminist children, and for being a feminist mother. It also informs the different forms of political practices that I get involved in.

Before I had my daughter, I knew that her arrival will change everything, that we will be affected in different ways; that our lives would change. In this sense, I was somehow prepared. I just did not know how, where, what, and especially I did not know how strongly it would feel. Little things, right? One of the things that most struck me as I became a mother is the force, the sheer strength of the feelings, of the ways that motherhood affected me, affected my priorities, my views, my fights, as well as the sense of satisfaction and joy I got out of it (which obviously does not mean that things are always lovely and rosy – the levels of tiredness my body resists amaze me, as well as the levels of patience required, which are not always forthcoming). I embraced motherhood, and allowed myself the time and space to enjoy it, and was lucky enough to be able to do it, and to be supported in the process. But it is here that I feel more work needs to be done, and a different vocabulary created.

Becoming a mother is done through a particularly powerful relation, which deeply affects our relations to others, but also to ourselves. This particular relationship is demanding in many ways, from a person that is totally dependent on others, especially the mother. OK, so my needs at times, many times, took the backstage, my time was interrupted and my presence and nurturing needed. I did not have time for anything. But I think that this, though very hard at times, is not a model for a lifetime. Motherhood is a trajectory. The first years necessarily mean for me, a more intense, time-consuming, relation with my child, where I was indispensable. Breastfeeding a baby, for instance, means that it is inevitably the mother who is needed, who needs to be present (though pumping has complicated and extended the ways of being present), who needs to put the body, who find her time interrupted by other’s needs and timings. I personally felt this was a challenge, but also felt I wanted to do this. Not to listen to this desire, not to let go and follow the flow, not to allow the different temporality, and forms of (not very well recognised) ‘productivity’ of this time, especially the first months, and even year, demanded for me, would have been a struggle. I allowed myself (and was lucky enough to be able to) to do this. I think that this did not mean I was submissive, or a traitor to feminist values. But many times it is framed in this terms, or felt this way. This, for me, is a crucial aspect of mothering which has been in conflict with much feminist thought.I think this has to do with independency being such a fight for women, for the conditions that women had to live in/with for so long (and still are). However, I think that this focus can be damaging too, especially in terms of mothering. Why are we so afraid of dependency? Or more to the point, why can’t we find ways of nurturing and supporting our interdependence in ways that do not push us towards a binary? 

The problem for me was the lack of support from wider society for this task. For me, in this sense, this difference is one to be valued, and of course, this means to create support networks to make this possible. This obviously is not what is out there now. Because of this, motherhood can be isolating and also it turns into a great burden and demand for individual women. The wider societal responsibility for children, has swiftly been turned into an individual problem. Here it is where I think that the personal is political can be important, realising that this is not only an individual problem, your failing that ‘balance’ never seems to be achieved. Many times, this is felt this way, framed this way – hello mother bashing, I’m talking to you. Also the whole constructions of parenting tribes – the media frenzy, but also the practices – is part of this wider individualisation of the problem, and the understanding of parenting in terms of choice. As individuals we are not the problem and cannot change the problem. So I think there is a feminist fight here, to work to do for mothers to feel valuable, respected and for looking after the children to be though as important, and worthy, for its difference to be part of a richer society and richer notion and experience of public space. The fight for this is for me part of my feminist mothering.

One of the issues that complicate this is that feminist struggles for equality sometimes leave out the need for fighting for spaces for difference. Feminism struggles have concentrated a lot on achieving equality, but sometimes this has meant accepting traditionally ‘male’ terms of success and of value. In a way, the female experience of motherhood disrupts this and is many times in friction with these imperatives. To think of feminist mothering has meant a lot of the times the fight for women to be able to work, to return to work, maternity leave, which are all amazing results of feminist struggles. However, I feel more work needs to be done in terms of valuing the work of mothering – and thus putting money, policies, and translating these into actual practices, which means changing very stubborn values and the relations that support them. Though much feminist thinking has been done in terms of trying to tackle this sticky issue, a lot of it uses approaches that I think are limiting. Many of the things I read resonate in one way or the other, but I feel much of it still uses binary thinking, for instance in terms of mother needs vs baby’s needs, power vs submission, production and reproduction, dialectical thinking. I think this way of thinking about mothering produces and frames issues in ways that can be useful for certain strategic political struggles, but that leave too much out for it to be valuable to create other, alternative types of politics. I would like to see different approaches that reflect more on the ambiguities, the non-coherence, on spaces for difference, than what these framings allow. Furthermore, I would love feminism to tackle full-on the issue of motherhood, as a female experience. This is tricky because of the long history of different forms of oppressive types of motherhood, and also of falling into essentialism. But can we find ways of thinking this particular and powerful relation that is motherhood? Can we find ways of valuing this particular female experience without falling into essentialism or oppressive and moralising notion of motherhood? Can we find spaces for difference? I think this is something that is taking place in different ways, and one which as a feminist mother, I would like to contribute.

Lucila