The Mothers of Men

by Leslie Lytle on January 17, 2012

This past weekend my sister and I walked from my Fan home on Grace Street over to the Japanese Gardens in Maymont and back. Crossing Byrd Park, we happened upon a fountain built as a monument to the success of local Prohibition activists in achieving their goals in the early 20th century. We chuckled at the quaint and righteous aspirations of the female led initiative described on the monument. But then the quotation at the bottom of the monument caught my eye:

“The bravest battle that ever was fought;
Shall I tell you where and when?
On the maps of the world you will find it not,
‘Twas fought by the mothers of men.”

There’s some truth in that, I thought, and we walked on.

Yesterday, one of the women’s health email lists I’m on sent me an article about a proposal to dismantle the midwifery program offered through the School of Nursing at the University of Washington. That recommendation was based in part because the program “did not meet a societal need”, and doesn’t bring in the high dollars that research based programs generate. Though the midwifery model of care has a proven track record of being a safe, cost-effective, highly satisfying form of care that leads to better outcomes, it is expendable. It doesn’t make money for the system (though it saves money in both the short and long term). And so it is not valued. Instead, our health care system places priority on high-tech, highly medicalized approaches to a normal life process that results in greater costs and poorer outcomes (the US cannot brag about any of its maternal/child outcomes – we lag behind many other countries in the industrialized world in terms of infant and maternal mortality and morbidity. And we’re paying more money for those lousy outcomes than any other country in the world).

The Richmond Times-Dispatch recently published an article about Richmond area hospitals’ efforts to comply with internationally recognized “baby-friendly” standards with regard to breastfeeding. One of the major difficulties in obtaining this status is doing away with the goody bags supplied by formula companies that go home with new mothers. A long history of research indicates that when moms go home with free formula, breastfeeding rates go down. Women are handicapped from the get-go. Instead of getting the support they need for breastfeeding, which many women have never seen close-up and personal, they’re given subtle and not so subtle hints that formula might be an easier way – right when the breastfeeding relationship is first getting established. Women struggle, babies lose. But you can bet that the formula companies are benefitting, otherwise they would not be giving away those marketing kits to the hospitals. And that is the challenge for the hospitals – to move away from their economic dependence on the free supplies that undermine women’s breastfeeding success.

I serve on the Mayor’s Breastfeeding Taskforce, along with the hospital representatives who are leading the Baby-Friendly initiatives within their institutions. Organized last summer, the Taskforce is peopled by many dedicated, talented, and passionate women working  to improve breastfeeding rates in the City of Richmond. Why a taskforce for breastfeeding? Because Richmond has very high infant mortality and morbidity rates. Breastfeeding is one simple, cost-effective method of improving the health of moms and babies now and over the trajectory of their lives. But while I love the women I’m meeting and the discussions we’re having as part of this Taskforce, I worry about whether the recommendations that come out of it will have any teeth. How do you get hospital administrators, local health care providers and funders, and the general public to focus on an issue that ultimately affects 100% of the population. There’s got to be pressure on the system to nudge it toward positive change.

From my experience working with pregnant and postpartum women, I have found that one grossly undervalued factor in good outcomes is how well-educated and prepared mothers are to take on the challenges of birth and early parenting (And that is a challenge that can whip your ass, let me tell you.) Many former OmMama students tell me their lives were transformed by the information about evidence-based practices and the social support they received in our classes. Yet there is little financial support for this kind of low-tech, high-touch, face-to-face programming. Without economic support, high quality, evidence-based childbirth preparation classes, lactation and postpartum support services are not cheap to develop or deliver. Though these are the very kinds of programs that could help lead to better outcomes (i.e. physically active mamas, armed with accurate information, and the support they need to help them achieve their goals), Virginia insurance companies don’t reimburse for them, and their cost may be out of reach for many families.

And that’s where that line about battles fought by “the mothers of men,” keeps coming back to me. The Mayor’s Taskforce is a wonderful initiative. The recommendations we identify will hopefully help guide efforts toward creating a local culture that supports breastfeeding. But it is going to be the informed, empowered “mothers of children” (and the men who love them) who are going to move this battle forward, one step at a time. Who are going to step in and say that yes, we want this community to be breastfeeding friendly. Yes, we want to improve maternal and infant outcomes in our city. Yes, we value healthcare approaches that are safe, satisfying, and cost effective for our community  – even if they don’t generate big profits for corporate interests. Yes, we want there to be support for women in the alternately vulnerable and empowering but always life-changing passage of bringing forth the next generation. And yes, we are willing to help steward that change.

Ways to help:

  1. Contact your local hospital administrators and let them know you support evidence-based childbirth and breastfeeding practices. Applaud their efforts to obtain “Baby-Friendly Status. In Richmond, Virginia they are:

Bon Secours Richmond Hospital (St. Francis, St. Mary’s, and Memorial Regional Hospitals)
Peter J Bernard
Chief Executive Officer
Bon Secours Virginia
5801 Bremo Road
Richmond, VA 23226
Virginia Commonwealth University Hospital System
Michael Rao
Virginia Commonwealth University/Office of the President
P.O. Box 842512 | Richmond, Virginia 23284-2512
Phone: (804) 828-1200
E-mail: president@vcu.edu

HCA Hospitals of Richmond (Henrico Doctors’ and CJW Hospitals)
Patrick Farrell
Central Virginia Market Lead
HCA Virginia Health System
7300 Beaufont Springs Drive
Phone:
Richmond, VA 23225
Ask your health care providers what they are doing to support evidence-based maternity and infant care in our community. Tell them this is important to you. Ask them to put it on the top burner.

Join the discussion! 
Share your thoughts with the community.
To read and comment on the TD article, click here:
Your feedback, thoughts, ideas are always welcome on this blog and on the OmMama Facebook page.

Here’s to a healthy, happy, and productive 2012 for all of us here in the River City.

Leslie

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