Demanding More For The Future Black History Makers And The Mothers Who Birth Them

As Black History Month comes to a close I've been reflecting on the history of black women as mothers. Thinking about our legacy as the women who tirelessly carried our families and communities. Mothers who didn't listen when the world said we were thoughtless breeders and our children were mere commodities to be bought or sold. In more recent history, black mothers have been publicly shamed as crack mothers, welfare queens and the face of "baby mama drama." Black single motherhood is blamed for all sorts of social ills from crime to drugs to "wilding" teens. And black mothers are often represented in popular culture as neck-rolling domineering household managers who run circles around our men.

Let's face it. The historical misperception of who we are has not been very flattering.

But I'm asking you to stay true to what you know: These stereotypes are very far from the truth. In truth, black women today have redefined black history and created a new conversation about our roles as mothers. For example, when I watched the Brady Bunch and Happy Days and reruns of Leave It To Beaver, the subtle messaging was that being a stay at home mom and catering to your child's every need was a white woman's pleasure. Black women have always worked--as slaves, as cleaners, as teachers, as doctors, as lawyers. Even our TV mamas (Claire Huxtable included) always worked outside the home.

Today more and more black women are stay at home or work at home moms (myself included), we have robust national organizations like Mocha Moms http://mochamoms.org/ to support women who are making motherhood their career (even if just for a few years or so).

We have a First Lady who epitomizes everything modern black motherhood is about, career success, loving partnership and commitment to being the mom-in-chief of your own family command center.

This shift in our motherhood experience may seem subtle, but in the framework of our history, it is groundbreaking. And thrilling. It not only speaks to how far we have come as a people, but how far we have come as black mothers, who went from having no control over our children to taking control of our children, our lives, and our families' financial future. We now have varied and different motherhood experiences yet we still know we are doing important work that goes well beyond our home.

Yet, there is much work to do. We still need to increase our breastfeeding rates, to give our babies the healthiest start in life and improve our own health as mothers. We need to demand answers to why our maternal death rate is double and is some urban cities seven-times that of our white peers, and start questioning the quality of care we receive.

As we celebrate our history as black Americans, we must protect the next generation of black history-makers currently growing in wombs across the nation. And we must demand better care for the mothers who bring them into the world.

Talking Midwives in Midtown: an Aha! Moment

Yesterday, I met an old friend for breakfast. We met at Norma's in Le Parker Meridien hotel. As we noshed on a delicious breakfast, pondered who has actually ordered the $1,000 caviar breakfast item, we had a ground shaking conversation about the role of midwives in changing the landscape for maternal health.

My fellow diner was my good friend Shirley McAlpine, a beautifully statuesque British woman. She became my friend when I lived in London and is now doing some amazing work in the U.K and U.S. about prenatal education and natural childbirth through her popular Birthwise DVD http://birthwisedvd.com/us/ and consulting work. The tagline for Birthwise is "Your Creation. Your Choice." I love that.

Shirley had just returned from the Midwives Alliance of North American conference in the Nashville, Tenn., area and she was buzzing. Her energy was infectious. And while we are both involved with maternal health issues across the board, as two black women we are also particularly concerned about the issues in our community. So the questions began to roll. Could midwives be key to helping reduce the high pre-term birth and low birth-weight baby rate that continue to plague black women of all socioeconomic levels? Could midwives help reverse the high exceptionally C-section rates among black women and reduce the shamefully rising maternal mortality rates among black women?

Shirley and I are convinced, yes. And birth center models like The Birth Place, http://thebirthplace.org an unique midwifery and women's health center in Winter Garden, Florida run by Jenni Joseph, show impressive results in reducing pre –term births.

But, why? The answer, as it unfolded before us, was in the education that midwives provide. Expecting moms who work with midwives are more informed about the birth process than women who work with doctors only. We all know that most doctors prefer that you know less, and trust them more, so that they can do what works best for them and not deal with any pesky little questions about your own life that you may have.

After all knowledge is power.

So when a woman who has had a midwife is told she needs to be induced. She knows she can ask why, if the baby's heart rate is fine and other measures she's been educated on are still ok.

When a woman whose water has broken is told that she must be induced, a woman with a midwife may have been taught that actually unless other indicators show otherwise a baby can be fine for up to 24 hours after the water breaks. It is Hollywood that has told us otherwise, and turned the water breaking into the mad dash to the hospital event that makes for great cinema but woefully misinformed moms to be.

And when a woman has a true (not Hollywood or doctor-friendly) understanding of how long the labor process can be, she won't stand for being told that a C section is necessary because it's been five hours and she hasn't dilated. She will also have been educated on the real signs of labor, so she won't go the hospital too soon where labor can be stunted by laying in a bed and you are more likely to be given unnecessary medical interventions.

These are key pieces to the puzzle. As we know, the answer is not in the prenatal care. Women are getting that. But that hasn't improved matters. The key is in the education--an education that often does not happen in its full measure at a traditional doctor's office. And that midwives can provide.

And that nuanced understanding of how black women end up on the operating table more and remain six times more likely to die from pregnancy-related complication is worth more the $1,000 caviar.

The Importance of World Breastfeeding Week In My Piece of the World

August 1-7 marks World Breastfeeding Week. The annual campaign, organized by the World Alliance for Breastfeeding Action, is the one week where over 170 countries worldwide pay attention to our breasts and their power to help our children.

It's no secret that I'm a huge advocate of breastfeeding as one of the most important things a woman can do to give her baby the best start in life and give herself some unparalleled health benefits. And the Black Maternal Health Project proudly supports breastfeeding and is deeply committed to understanding how we can increase breastfeeding rates among black women.

So while the campaign, now in its 19th year, speaks to the entire world, I'm speaking directly to my part of the world. The African American women who historically have had the lowest rates of breastfeeding for the recommended time periods or don't breastfeed at all.

For over 30 years, African American women have had the lowest breastfeeding rates, and though the numbers have greatly increased in recent years, black moms still have the lowest breastfeeding rates of all ethnicities. And when it comes to the gold standard of infant nutrition--six months of exclusive breastfeeding, among African Americans the rate is only 20% compared to 40% among whites.

Some of these forces have been brewing for decades. A long time ago, black women were notorious for nursing. In fact, slave owners used and purchased black women as wet nurses for their own children, often forcing these mothers to stop nursing their own infants to care for others. "On the one hand, wet nursing claimed the benefits of breastfeeding for the offspring of white masters while denying or limiting those health advantages to slave infants. On the other hand, wet nursing required slave mothers to transfer to white offspring the nurturing and affection they should have been able to allocate to their own children," writes historian Wilma A. Dunaway, in the book The African American Family in Slavery and Emancipation, published by Cambridge University Press. And since breastfeeding reduces fertility, slave owners forced black women to stop breastfeeding early so that they could continue breeding, often to health detriment of their infants, Dunaway writes.

But there's more to our story than a stunted and complex breastfeeding experience at the hands of slave owners hundreds of years ago, though many may argue that some vestiges of slavery still exist in the mindset of the black community. Aggressive marketing by the formula companies in the 1930s and 40s made formula feeding the choice of the elite, "the substance for sophisticates" --white or black. And who doesn't want to be like the rich and famous. That marketing continues to this day, down to the formula company-sponsored bag of goodies you probably received on the way out of the hospital. Then there's something I call the National Geographic factor--that is, most of the images we see of black women breastfeeding are semi-naked women in Africa whose lives seem so far away from the African American lifestyle and experience.

To help remedy the global situation BAWA takes aim at hospitals and other maternity care providers. This year the campaign focuses on "Just 10 Steps--the Baby Friendly Way" showcasing the 10 steps hospitals need to do to encourage breastfeeding. Those ten points include:

• Have a written breastfeeding policy that is routinely communicated to all health care staff.




• Help mothers initiate breastfeeding within a half-hour of birth.




• Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.




• Give newborn infants no food or drink other than breastmilk unless medically indicated.




• Practice rooming-in -- allow mothers and infants to remain together -- 24 hours a day.




• Encourage breastfeeding on demand.




• Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants. (read all 10 points at www.worldbreastfeedingweek.org)

In our community, we need to talk and encourage each other more. And speak out. We still long for an African American role model in breastfeeding, like a Michelle Obama. In the meantime, if you are already on the breastfeeding bandwagon, tell others. Check out the "I Breastfeed Because . . . " campaign sponsored by Ameda, a leading breast pump maker. Mothers who are currently breastfeeding and or have in the past can log onto www.ibreastfeedbecause.com to upload 20-second videos that share the reasons why they chose to breastfeed.

Black women are dying! Enough scaremongering, it's time for solutions!

Lately, I've been extremely frustrated by all the news reporting about maternal mortality. Yes, it is a terribly frightening and frighteningly embarrassing issue. Women are dying during childbirth for preventable reasons, and African American women at even more shocking rates and something must be done. Like now.

A recent study by Amnesty International, entitled "Deadly Delivery", reports that deaths from pregnancy and childbirth in the United States have doubled in the past 20 years--from 6.6 per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006. Pregnant women and new mothers are dying because of "systemic failures" in the current health system, the Amnesty report said.

The alarming data on maternal mortality is even more shocking for African- American women. We are three to four times more likely to die during childbirth than white American women. And even wealthy black American women have a higher rate of mortality during childbirth than wealthy white women.

Yeah. It's serious.

Now I understand the power of fear as a coercive tool in the media world and in political circles, but my personal fear is that all the negative reports and doom and gloom coverage makes the situation seem hopeless. It makes women, particularly Black women, feel powerless to a force that no one can succinctly explain or otherwise tell them how to prevent.

People don't get behind hopeless. Research money doesn't come to hopeless. And the right kind of awareness that actually empowers women to have healthy childbirths and live healthier lives overall doesn't come from hopeless. It comes from hope.

That's why I'm so excited about the work of Dr. Michael Lu, an associate professor in both the UCLA School of Public Health and the David Geffen School of Medicine at UCLA, and one of the influential thought leaders who's talking about new solutions to the maternal health problem. It's pretty clear the old ones aren't working.

Dr. Lu's work focuses on the "life course perspective," a simple yet groundbreaking premise that rests on one simple truth: you cannot correct the outcomes of childbirth simply by looking at the 40 week gestational period. Saying that black women need better prenatal care is a start but not the complete answer. We need a longer term "life course perspective" to address the issue, which includes rethinking how healthcare is delivered, how we look at life stressors and how we get back to focusing on mothers and communities.

I've been a fan of Dr. Lu for some time. In fact, his work was one of the research inspirations for writing my first book, The Mocha Manual to a Fabulous Pregnancy (Amistad/HarperCollins). At the time, it was the first-of-its-kind book for African American women that looked beyond the nine months of pregnancy to offer advice on all areas of life that could affect a woman's pregnancy outcome from her finances, relationships, life stressors, cultural taboos and her medical history. It was the "all you" approach to pregnancy for black women, and I'm grateful to Dr. Lu's work for inspiring me to develop that concept.

I'm also very grateful and excited that Dr. Lu will be speaking this week at our Black Maternal Health conference and sharing his insights and answering your questions on what we need to do now to close the gap in maternal and infant health disparities for African American women.

Please join us on April 28th at our NYC offices at 12:30 p.m.(simply rsvp with your name and affiliation to rosemary@womensenews.org) or click here http://www.ustream.tv/channel/wenews to watch live via our webcast.

We've read the depressing headlines. It's time we start talking about solutions. Please be a part of the conversation.

We Need Our Village Back

For some time now, I've been lamenting the demise of our "village."

When our parents grew up the whole neighborhood helped raise them (and probably had spanking privileges). And when I grew up you could best believe that any neighbor would quickly tell my mother or father if I was ever seen someplace I wasn't supposed to be. There was an "we're all in this together" mentality and a thinking that my child is my responsibility and your child is my responsibility because at the end of the day, we are all in this community together and one success is our collective success and one failure is our collective failure and affects us all.

Somewhere along the way, we lost this village mentality. The changing economic climate has dictated that we move away from relatives or that we move often because of job opportunities. As a result, we never really grow roots in our communities anymore. We don't have our extended family of aunties, uncles and grandparents nearby anymore.

This week Women's eNews hosted a screening of Tonya Lewis Lee's powerful documentary on reducing infant mortality and improving maternal health, in celebration of the second year of The Black Maternal Health Project. It was a full house. The film, Crisis in the Crib--Saving Our Nation's Babies (view the trailer here) speaks directly to preconception health, mobilizing young people as peer educators in the movement and putting a face and voice to the infant mortality issue. The conversation afterward with Tonya and our fabulous guests was even more empowering.

We couldn't understand while infant mortality remains a taboo topic in our country's agenda. Even when you remove African American statistics from the equation, the United States still had an embarrassing ranking as far as infant mortality is concerned. We couldn't understand why maternal health is absent from the current debate about healthcare reform. And we certainly couldn't understand why very little is being done to save our most vulnerable population. There was so much that didn't make sense.

But here's what was crystal clear. We can't wait for the government to solve this crisis. Yes, we have to push for laws. But we also have to advocate in our communities to remove some of the social barriers to our health issues. We need to advocate for safe places to exercise, removing toxins from our communities, having fresh fruit and vegetables available in our communities and more.

It was clear that we need our village of womenfolk. And then some.

In Crisis in the Crib, the 'Healthy Baby Begins With You' Campaign,  takes on a peer education model. It uses college students to go into their own communities and also speak to high school students about preconception health. It goes back to that "village" mentality.

That night of the screening we deployed our own village, a room full of women of all races with personal and professional interests in embracing mothers and producing healthy babies. We thought of ways we could let our own network know about the OMH campaign, spread more awareness about the problem, or help be a part of the solution.

We saw the powerful ripple effect that could be sparked just from those in the room doing one thing. For that evening, we brought our village back. And it felt oh so good.

What can you do to help bring our village back to our babies? What more can we be doing? I'd love to hear from you. Please post a comment here.

Bruce Jenner, Breastfeeding and Keeping it Real with the Kardashians

Earlier this week, after a long day of deadlines and meetings, I was desperately in need of a mindless television moment and channel surfed my way to the "Keeping up with the Kardashians" reality TV show.

 

Have you seen this quality production?

 

Three sisters on an unclear mission. One became famous for having a big booty (an apparent first for a non-black or Latina person), another recently married an NBA superstar after two months of dating, and alas, the third, Courtney, is very pregnant. At least in this episode she was. (I know from a recent trip to the supermarket checkout line that she has already had her baby and sold all the pictures.) But I digress.

 

In this particular episode, the often reviled baby daddy, Scott, did the unthinkable. He didn't show up for a breastfeeding class. O.M.G! Courtney returns home in a huff. Scott says, he didn't think he needed to go to a breastfeeding class because it has nothing to do with him. Courtney lets him know with a few well-timed F-bombs that it absolutely does have something to do with him and if he doesn't "get on her team" immediately then the relationship is over. Drama!!

 

Scott, feeling like he just received an unwarranted tongue lashing from a hormone charged pregnant woman, heads over to talk to Courtney's step father, Olympic great Bruce Jenner. Scott tells Bruce his story. "Breastfeeding is not about me," he says, looking for manly sympathy. Bruce, in his infinite wisdom and having scaled a few hurdles in his own life, sets him straight. "It is about you. It's about support."

 

Ahhhh, a teachable moment in reality TV. I feel like notifying some authorities.

 

But yes, men, breastfeeding is about you. And you don't have to have graced a Corn Flakes box to know it. In fact, many moms say their partners' attitude and support played a major role in whether or not they continued breastfeeding. This is particularly true in the black community.

 

Consider these striking findings from a recent survey by the Bravado Breastfeeding Information Council, or BBIC. (Full disclosure: I'm an advisory board member).

 

When asked to choose the person who had the most important influence in her life as a nursing mom, almost three times as many women selected their partner (54%) over their mothers (21%), even if their mother had breastfeeding experience.

 

Approximately 70% of mothers consider their partners support to be extremely important to their overall confidence as a new mom, and their overall well-being as a nursing mother.

 

With our historically low breastfeeding rates and our woefully high infant mortality rates, it is really important to get our men on board. They are an important part of our "village."

 

If you or your partner don't know what he can do, I found these great tips for Dads.  Share them with your man.

 

1. The first thing a father can do to promote success is to create a positive family atmosphere toward breastfeeding. As a practical matter, breastfed babies need to accompany their mothers whenever possible. A father who views a baby's continual presence as intrusive will subtly undermine breastfeeding. The father who naturally assumes that his baby will accompany the couple to restaurants, movies, dinner parties, and meetings has given breastfeeding his strong endorsement. There's a big difference between a man who agrees to let his partner breastfeed and one who deliberately creates an atmosphere of success.

 

2. Fathers can play a key role in bolstering their breastfeeding partner's confidence by showering them with compliments, praising their efforts, and offering words of encouragement. When a woman is under extreme stress, a man may not know how best to support his mate. He may be uncertain whether she wants to hear, "Don't give up; you can do it!" or "You've done your best. It's okay to switch to bottle-feeding." If you are not sure how to respond to your partner, try explaining that you don't know exactly what to say, but you want to support her in any way you can. Just being a sounding board might be all she needs on a specific day.

 

3. A father can help in so many ways that it's hard to imagine why many men feel left out when their wives breastfeed. A father can go to the baby when he or she awakens and bring the hungry infant to his wife. While the mother is nursing, he can pour her a nutritious beverage, massage her shoulders, compliment her, and lovingly admire his nursing baby. After the first breast, he can burp the baby and help arouse the infant for the second side. When the feeding is complete, the father can change the infant and put him or her down to sleep.

 

In the BBIC survey, moms said, partners could best help by changing diapers, listening to them, praising them, supporting them with family and friends, and burping the baby as key examples of support. 45% of moms would like more help with chores and 36% would like their partners to get up with them at night.

 

So you see Scott, and thousands of other Scott-like men, we do need you. There is much for you to do. It is about the support. Thank you Bruce Jenner.

 

Watch this video to see the webcast of the full release of the BBIC's findings on women and breastfeeding.

 

Kudos to New Moms. Taking Care of Baby Is Not Like Riding a Bike.

A few weeks ago I happily agreed to watch my girlfriend's one year old son for about two days so she could take a work trip.

"I got this", I thought. Auntie Kim is on it! After all, it was only four years ago that I had a one year old. I figured getting back into the baby mode would be like riding a bike. It was more like getting hit by a bus!

Apparently four years is more than enough time to fall off your mommy game. It's amazing how quickly we can forget the work, the juggling (literally), the organization, the patience, the lack of sleep and all the "stuff" that baby's actually require. Because every phase of childhood brings its own stresses, I had nearly forgotten about this phase.

I didn't even mention that my girlfriend still breastfeeds him (Whoo Hoo!), so putting him to bed was going to require some serious creativity and a lot of patience. I haven't rocked and walked and sang that much in years!

Truth be told, on one of the days, I had a little help. My girlfriend from London was in town--and though childless, she is a highly capable Auntie to even my own kids. As two highly educated, savvy women we set out to run errands and take care of some business with my two kids and the baby in tow.

This was my moment to shine. I felt like I was back in the zone. I dutifully packed the diaper bag, refilling his water cup, adding snacks and checking for diapers and wipes. Meanwhile, my girlfriend got my children out the door and into the car. Everybody was belted, buckled and ready to go.

We pulled out the driveway proudly, slapping high fives at our teamwork!

We were halfway to our destination before I realized I left the superbly packed diaper bag in the house!

So there we were out for a long day with a one year old, with no diapers, no snacks, no nothing! Oy!

Watching (and laughing at) my own mommy blunders reminded me how tough parenting can be in the early years. Now I remember why we rejoice at the end of our diaper days, the end of our dependence on wipes, butt creams, changing pads and more baby gear than one human being can manage. I am very happy to be past those years.

On the other hand, there's a specialness of those early years that can never be duplicated. I miss the amazing bond and comfort I enjoyed while breastfeeding--I could totally understand why that little man did not want to go to sleep without it.

But when he did finally doze off, and I watched him sleeping peacefully, I was reminded of the calm that only a baby can bring over you. The joy of motherhood. I saw my own son, little Michael, just four years ago, when I used to stare in wonderment as he slept. I saw this baby as a future strong black man, and myself as part of his "village" that will help mold and shape him. (His mom is certainly part of the village that raises my children).

I saw everything that is beautiful about motherhood.

Hope.

Promise.

And endless possibilities.