CIMS/Breastfeeding & Feminism Conference!

Ok I am FINALLY getting down to blogging about the Coalition for Improving Maternity Services/Breastfeeding and Feminism Conference that I attended...  two whole weeks ago now!

"Reframing Birth and Breastfeeding: Moving Forward" Conference, co-hosted by CIMS, the Carolina Global Breastfeeding Institute at UNC Chapel Hill, and the Center for Women's Health & Wellness at UNC Greensboro.

This was the very first time that the two organizations joined together to present together at one conference. Essentially, there was a Mother-Friendly Childbirth track and a Breastfeeding and Feminism track going on concurrently, with a few joint sessions at the beginning and end of the conference.

At times it was very tough to decide which track's talks to attend! Everything was so interesting. To get an idea of what the days looked like and who the speakers were, check out the pdf of the schedule.

The keynote session was by Eugene Declerq of Boston University School of Public Health, one of the "big names" in the birth world, and very big into "the numbers."

Some things I took notes on:

• Home births increased in 2008 by 6.9%, especially in white mothers (88% of all home births). Among other races, home births tend to be "unplanned" (the oops! baby came too fast! births)
• Home births are a rural state phenomenon 
• Closing Certified Nurse Midwife groups in hospitals made the C-section rate increase more and faster than hospitals that opened CNM services
• The gestational age in the USA has shifted down from 1990-2008 without better outcomes
• Planned home birth has a normal gestational age curve (majority at 40 weeks, with about 2 weeks on either side) 
• VBAC rates might be better than we think they are because of frequent documentation errors
• Florida has the second lowest VBAC rate (2.8%). the highest is Alaska (18%)
• Its not about the mothers, its about Practice, Culture, and Institutions!
• Half of mothers have no interest in VBAC at all
• Who is the patient? the fetus or the mom?
• A lot of women and OB's don't see that there is a problem with maternity care
• Decisions are not based on evidence, they are based on CULTURE
• we can gather as much evidence as we want, people are still going to make choices based on cultural beliefs

A big thing that kept coming up in many of the talks was the idea that we can't just keep focusing on women at the individual level - we have to make society and policy level changes. That we have to get the attention of the policy makers, which is frequently achieved through the media.

This is where Danielle Rigg and Bettina Lauf Forbes from Best for Babes stepped in and talked about giving breastfeeding an image make-over. If you don't already know about the breastfeeding booby traps, take a look.

• They argued that we need a complete culture change. 
• Women "know more about which stroller to buy than how to feed their baby." 
• More money needs to be spent on breastfeeding marketing in order to promote a positive message. 
• "cultural squeamishness--> social disapproval (esp. of nursing in public) --> condemnation"
• Pressure on moms to breast feed and hidden booby traps = a negative personal experience which leads to a backlash against breastfeeding -- a vicious cycle! 
• This is a human rights issue, not a freedom of choice issue
• Trying to market breastfeeding the way that other products have images have been successfully branded by logos, ads, etc in order to make breastfeeding desirable.
• use of shock value and media combo

The Best for Babes talk was one of the most talked about of the whole conference. Many people had a problem with their using sex imagery to sell breastfeeding, saying it perpetuated the idea that breasts and women's bodies are sexualized, so breastfeeding is a sexual act. Also the use of "babes," which has a certain connotation about women. On the other hand, you could understand their argument - branding does work in our culture and it can contribute to some changes in regards to attitudes toward breastfeeding. Whether that helps beat the booby traps, I don't know, and whether it will actually change the culture rather than perpetuating the current gender power divisions, we shall see. 


Some good quotes from the conference:

"If every woman knew she was as powerful as the ocean, the world would be a better place" - Danielle Rigg
"I don't like the term 'pro-breastfeeding.' Are you pro-breathing?" - Keren Epstein-Gilboa
"2/3 of VBACs end in vaginal birth, but keep in mind 2/3 of all births end in vaginal birth these days!" - didn't write name down
Feminism's issue with breastfeeding - "do we want to think about women as the same or different as men?" - Bernice Hausman
"When breastfeeding was the societal norm, women had fewer problems breastfeeding." - again, I forget! But this is such an important idea... its not your body, its your social environment that is causing breastfeeding failures.
"Doula support has always been evidence-based. Not so for Electronic Fetal Monitoring, which is more prevalent... EFM or Doulas?" - Penny Simkin


There was a fascinating panel discussion on the breast pump and the role of consumer goods in breastfeeding support. One of the things that I was really interested to learn was the results of a study that took a look at Formula Samples vs. a Manual Breast Pump being given in Hospital Discharge bags (formula samples in bags are currently the hospital norm, which is also in violation of the WHO Code of Marketing Breast-Milk Substitutes, and undermines breastfeeding). The study methods assigned mothers to a formula sample bag group, a breastfeeding information bag group, or a manual pump plus breastfeeding information bag group. Infant feeding methods were measured at 2, 4, and 12 weeks postpartum.

Women who received the information bag and the pump bag had the same mean duration of breastfeeding, which was about 2 weeks longer than the routine formula sample bag women. Meaning, as long as there was no formula, women breastfed longer! Women who were given a pump and breastfeeding info were more likely to be engaged in any breastfeeding at 3 months than the info bag alone, and both were more than the routine bag. Exclusive breastfeeding from 2 weeks to 12 weeks was sustained more in the two breastfeeding bags than the formula bags, with the women who received pumps having a much smaller drop in exclusive breastfeeding than both the other groups - most consistent. How interesting! The idea that pumps might make a significant difference is an important one, but most of all this study reinforced the fact that routine discharge bags with formula samples given to women every single day all over the country and the world have clear negative effects on breastfeeding success.



Other fabulous moments of the conference included Robbie Davis-Floyd's talk on the 10 Steps to Optimal MotherBaby Maternity Services, and an update on the International MotherBaby Childbirth Initiative at various hospitals all over the world. I also got to sign up to go out to dinner with her, which was awesome! Such an academic/birth nerd moment when I asked her to take a picture with me :)

Also incredible for me as a birth junkie and a doula was seeing Penny Simkin speak and also getting a photo with her! She talked about Birth Doulas Today: History, Status, Successes and Challenges. She talked about how rogue doulas, doulas who go beyond what she believes is the appropriate scope of practice for doulas, are a huge problem for advancing doula leadership.


Click here to watch a great 20 minute video RISK: Consequences of a Near Term Birth - very powerful!

Overall I had a great time at the CIMS/Breastfeeding & Feminism Conference. I am so glad the two conferences came together to offer both tracks at the same time - it is really what motivated me to attend. I learned a lot for my doula practice use and for my academic use. Definitely worth it!


For more photos, check out the Coalition for Improving Maternity Services facebook page album.


EDIT: I've just noticed that Public Health Doula attended the conference as well and blogged a little bit about it! To read her summaries and opinions on some of the talks, here is Breastfeeding and Feminism Day 1 and  Breastfeeding and Feminism Day 2.