‘Full pandemic mama’ becomes full spectrum doula

Allysa Singer was, as she describes, a “full pandemic mama.” Singer became pregnant with her first child in the winter of 2019. As she became aware of the threats and the consequences of COVID-19, she started researching her options and her rights in the delivery room she’d find herself in August 2020.

What started as personal preparation– How many support people would she be allowed? Would she be allowed a support person at all? What restrictions would she encounter? How could she advocate for herself? What were her options?–  propelled her into a world of birth support and autonomy advocacy.

“I was just dumbfounded by the disparities that exist in maternal health,” Singer begins.

In 2020, Alabama, where Singer and her family live, had the third-highest Maternal Mortality Rate in the nation, at 36.4 per 100,000 live births.

BIPOC families suffer from massive disparities in maternal and infant deaths. In a recent piece, Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds, Tiffany L. Green, an economist focused on public health and obstetrics at the University of Wisconsin-Madison is quoted: “It’s not race, it’s racism…The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”

Still, unlike so many of her peers, Singer reports having had an amazing birth experience.

Inundated by birth horror stories, she decided to change care at 27 weeks in hopes that she would be better supported in her choices at a different institution.

Here, she was allowed a doula and support person to accompany her during her birth.

“Not a lot of women had that luxury,” Singer comments.

Knowing well that birth support is a right and not a luxury, she started her own doula practice in December 2021. 

Singer shares that she experienced severe postpartum depression, but she was able to divert and ultimately reshape this energy into her doula work.

“My doula training was the lifeboat that saved me from drowning in my PPD,” she says.

And now her practice, Faith to Fruition, has become the lifeboat for many of the birthing people Singer supports.

She shares: “I don’t believe that a birther’s desire to have more children should be dictated by their birthing experience. I have heard so many stories from people who had one kid but say, ‘I would never do this again because my experience was so traumatic.’ One of my biggest missions and goals is to support birthers to feel empowered in their process; not as bystanders of their process.”

Singer also holds a full time position as an industrial psychologist where she channels her advocacy work, pushing for organizational change and understanding of proper maternal support.

In fact, as part of a public speaking course for a training curriculum, Singer presented on why it’s important to support breastfeeding. She reports that her audience of roughly 25 was engaged, especially as she pointed out the absurdities of infant feeding culture in our country: How would you feel if I asked you to eat your meal in the bathroom? How would you like to eat with a blanket tossed over your head? for instance.

Singer also points out the “insanely amazing public health outcomes” breastfeeding affords.

If 90 percent of U.S. babies were exclusively breastfed for six months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). [Bartick, Reinhold, 2010]

“Not only is there a personal investment, there is a public investment and value to understanding the larger implications,” Singer comments. “As a taxpayer, [breastfeeding] impacts you; as someone who utilizes our healthcare system, [breastfeeding] impacts you.”

With the recent passing of the PUMP Act and the Pregnant Workers Fairness Act coming soon, Singer says “We still have a long way to go.”

Organizational policy doesn’t support motherhood; instead it fuels detached parenting which goes against nature, Singer goes on.

“Mothers feel the brunt of that more than ever,” she says.  “[We aren’t] supported to be able to care for our children the way that we want to.”

Singer says she sees it as her mission as an organizational psychologist to encourage change that supports parenthood, so that women don’t feel threatened to care for their children the way that they want to. This means ensuring that women are provided with ample space to pump their milk while away from their babies and empowering them to approach HR when there aren’t appropriate accommodations.

“Outside forces shouldn’t be able to dictate how you care for and feed your child. The end of one’s breastfeeding journey should be a personal decision.”

She continues, “It’s amazing that legislation is catching up. The thing that I fear with any law, there are still people behind those laws that have to enforce them and carry them out. Education and garnishing an understanding of what this looks like is a key component to implementation. The people behind those policies have to make them successful, but this is  moving things into a very good direction, and I hope that more changes to legislation follow suit, especially with paid parental leave. It’s a catalyst for change; I am hopeful but cautiously optimistic.”

Singer says she owes her personal success continuing to breastfeed her two-and-a-half year old to Chocolate Milk Mommies, where she now serves as a board member.

Through Chocolate Milk Mommies, Singer started a subcommittee to focus on education for individuals within the breastfeeder’s support system.

“The people in the village need to be supportive. When you don’t know better, you can’t do better,” she explains.

Singer recently completed the Lactation Counselor Training Course (LCTC) as part of Chocolate Milk Mommies’ mission to best support their constituents and as a way to benefit her doula clients with more well-rounded support.

“I really loved the training because I already thought that our bodies are amazing, but learning more science was great. I would text my friends the ‘Boobie Fact of the Day’,” Singer shares. “[The science] allows me to really appreciate my journey that much more and how impactful I’m being with my daughter.”

You can follow Singer’s work here and here.

Breastfeeding is part of a continuum. 

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is part of a continuum.

It has been hypothesized that starting around nine weeks of fetal development, the pattern and sequence of intrauterine movements of the fetus seem to be a survival mechanism, which is implemented by the newborn’s patterns of movement during the first hour after birth  (described as the 9 stages)  when skin-to-skin with the mother to facilitate breastfeeding.

Photo credit United States Breastfeeding Committee

This very behavior refutes the idea that breastfeeding is “an adjunct to birth” as it is generally viewed in maternity care settings in America.

Not only are human babies hardwired to progress through 9 stages and self attach to the breast, mammalian bodies are hardwired to produce milk too.

Around 16 weeks of pregnancy, the body starts to prepare for breastfeeding. This phase, called Lactogenesis I is when colostrum begins to be created. During Lactogenesis II, the secretion of copious milk follows the hormonal shift triggered by birth and the placenta delivery. After this phase, milk production must be maintained through a supply-and-demand-like system. [Neville 2001]

Even before a pregnancy is achieved, individuals are being influenced by the infant feeding culture that surrounds them, consciously or subconsciously laying a foundation for how they feel about feeding their own babies.

Pat Hoddinott’s, et al study found that women who had seen successful breastfeeding regularly and perceived this as a positive experience were more likely to initiate breastfeeding.

Exposure to prenatal breastfeeding education also affects breastfeeding outcomes. Irene M. Rosen and colleagues found that women who attended prenatal breastfeeding classes had significantly increased breastfeeding at 6 months when compared to controls.

Photo by Luiza Brain

Mode of birth and birth experiences influence infant feeding too, for both members of the dyad.

A growing body of evidence shows that birth by cesarean section is associated with early breastfeeding cessation.

Intrapartum exposure to the drugs fentanyl and synOT is associated with altered newborn infant behavior, including suckling, while in skin-to-skin contact with mother during the first hour after birth. [Brimdyr, et al 2019]

What’s more, the authors of Intrapartum Administration of Synthetic Oxytocin and Downstream Effects on Breastfeeding: Elucidating Physiologic Pathways found “No positive relationships between the administration of synthetic oxytocin and breastfeeding.” They comment, “Practices that could diminish the nearly ubiquitous practice of inducing and accelerating labor with the use of synthetic oxytocin should be considered when evaluating interventions that affect breastfeeding outcomes.”

Photo by Olivia Anne Snyder on Unsplash

In Transdisciplinary breastfeeding support: Creating program and policy synergy across the reproductive continuum, author Miriam Labbok takes a detailed look at “the power and potential of synergy between and among organizations and individuals supporting breastfeeding, the mother-child dyad, and reproductive health to increase sustainable breastfeeding support.”

Labbok points out that a paradigm shift on the issues in the reproductive continuum – family planning, pregnancy and birthing and breastfeeding– is needed.

“These are issues that are intimately, biologically, gender linked in women’s lives, and yet ones that are generally divided up to be addressed by a variety of different professional disciplines,” Labbok begins.  “Despite the impact of child spacing on birthing success, of birthing practices on breastfeeding success, and of breastfeeding on child spacing, we are offered family planning services by a gynecologist, birth attendance by an obstetrician or midwife, and baby care by a pediatrician. Having these ‘silos’ of care, each with its own paradigm and priorities, may lead to conflicting messages, and hence, may undermine the search for mutuality in goals, and collaboration.”

One such initiative looking to deconstruct siloed care is the Baby-Friendly Hospital Initiative which includes standards and goals for birthing practices, for breastfeeding-friendly communities, and guidance for birth spacing, in addition to reconfirming the original Ten Steps to Successful Breastfeeding, in recognition that breastfeeding occurs along a continuum.

Source: United States Breastfeeding Committee

1,000 Days emphasizes how breastfeeding fits within the global picture as a crucial part of a whole.

In the U.S. context, the 1,000 Days initiative recognizes comprehensive health coverage, comprehensive guidelines on nutrition during pregnancy, lactation, and early childhood for women in the first 1,000 days, paid family  and medical leave policy for all workers, and investments to ensure parents and caregivers can access good nutrition as solutions to a well nation and a well world.

 

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, please share with us some or all of your birth stor(ies).

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

‘Our Milky Way’ is 10

It has been 10 years since we authored our first blog post here on Our Milky Way. Ten. Years. This milestone is accompanied by a myriad of emotions!

I’m so proud of our collection of publications, promoting fantastic work by fantastic people.

I am stunned by the elusiveness of time; I first took the Lactation Counselor Training Course (LCTC)– which propelled me into this work– when my first child was only a few months old and now she is 11.

I am deeply grateful for everything I’ve learned from our participants and my colleagues and mentors who have shaped this blog. It’s such a thrill to connect with people across the continent and across the oceans, and I consider it such a privilege to have spent time with all of the beautiful minds featured on this blog.

I am both discouraged and encouraged. Scrolling through a decade’s worth of stories leaves me inspired by maternal child health advocates’ tireless work and triumphs both big and small. Lactation spaces have been carved out and employers have adopted breastfeeding-friendly policies, breastfeeding murals have been painted, generous human milk donations have been made, babies have gone skin-to-skin in the operating room, World Breastfeeding Weeks have been celebrated, important research has been conducted and published, and the accomplishments go on and on!

I’m also disheartened by the darker spaces where negative forces are at play like conflict among care providers, our culture’s disconnect between birth and breastfeeding, systemic racism, no paid parental leave, and the pervasive industry influence in infant feeding and beyond. These, among other forces, leave the United States consistently dangling near the bottom of the WBTi World Ranking list.

Despite our country’s poor performance in supporting healthy beginnings, I still find myself with a sense of wonder and cautious optimism for what the next decade holds for familial, community and global health.

In celebration of Our Milky Way’s 10th birthday, we’re launching a series called “Breastfeeding is…” For ten weeks, we will revisit a topic that describes breastfeeding. This series was inspired specifically by our 2013 piece Breastfeeding is… where Healthy Children Project faculty emeritus Barbara O’Connor, RN, BSN, IBCLC, ANLC discusses what breastfeeding can be and the cultural forces at odds with positive health outcomes.

Join us in celebrating and honoring healthy infant feeding by sharing what breastfeeding means to you. You can post in the comments below, find us on social media @centerforbreastfeeding, or email us at info@ourmilky.org.

What’s more, I am so pleased to announce that we will be giving away an online learning module with contact hours each week of our 10 week celebration. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us what breastfeeding means to you. Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

Happy National Midwifery Week!

October 2 to 8 marks National Midwifery Week. National Midwifery Week was created by the American College of Nurse-Midwives (ACNM) to celebrate and recognize midwives and midwife-led care.

Two of my three births were attended by midwives. My first birth in a hospital attended by an obstetrician might best be described using words like chaos, fear, coercion, and out of my control. Juxtapose that next to my subsequent home births with professional midwives which conjure words like calm, empowerment, grounded, respect and safety.

Midwives aren’t only attending births though, providing personalized, ethical care, but as this year’s Midwifery Week theme embodies– Midwives for Justice– midwives strive for justice on many fronts. You can find out about the North American Registry of Midwives (NARM) national advocacy efforts here.

Midwives also play an integral role in establishing healthy infant feeding practices. Read the Global Breastfeeding Collective’s advocacy brief The Role of Midwives and Nurses in Protecting, Promoting and Supporting Breastfeeding here.

I am proud of and inspired by the work that my midwife Erin does beyond helping catch babies. You can read about her efforts as an ally here.

ACNM has created a beautiful toolkit to help us celebrate the midwives around us and the midwifery model of care this week and beyond. You can access that PDF here. It includes sample social media posts and ways to engage online, suggestions for community gatherings, and ways to celebrate accomplishments like parties, team building events and award ceremonies.  

Check out past celebrations of the midwife for still relevant resources like WHO’s declaration of 2020 as the Year of the Nurse and the Midwife and the International Day of the Midwives.

For further reading on midwifery care, especially indigenous midwifery care, check out Knowledge Keepers: Why We Need Indigenous Midwives and Giving Birth Where the Family IsCommonSense Childbirth and Changing Woman Initiative’s  Power of One Indigenous Midwifery Fellowship program at http://www.changingwomaninitiative.com/power-of-one-indigenous-midwifery-fellowship.html.

Past Our Milky Way coverage on midwives

Honoring midwives during Women’s History Month

Alabama birth worker facilitates holistic, sustainable care for families

Taking ‘if’ out of the equation

Skin-to-skin in the operating room after cesarean birth

High schoolers explore human placenta, learn about physiological birth

Happy Birth Day, a new project by Dr. Kajsa Brimdyr

An opportunity for normal birth

Renaissance Woman

Dr. Soo Downe: International Breastfeeding Conference presenter Sneak Peak

#MidwiferyWeek2022 #MidwivesforJustice

‘Strong. Resilient. Latched.’ Celebrating Native Breastfeeding Week

Just short of a decade ago, the United States Breastfeeding Committee (USBC) declared August National Breastfeeding Month. National Breastfeeding Month kicks off with the World Alliance for Breastfeeding Action’s (WABA) World Breastfeeding Week (WBW) and continues to celebrate each subsequent week:

Week 2 (August 9-15): Native Breastfeeding Week: Strong. Resilient. Latched.  

Week 3 (August 16-24): Spotlight on Infant and Young Child Feeding in Emergencies 

Week 4 (August 25-31): Black Breastfeeding Week: Revive. Restore. Reclaim.

This week, we honor the very diverse experiences of Indigenous families and “address the inequity and injustice of Indigenous parents and their abilities to practice their roles in accordance to the tribal communities they descend from.”  [https://www.facebook.com/NativeBreastfeedingWeek/

There are so many ways to celebrate, to uplift, to support, and as white lactation care providers and maternal child health advocates, ways to learn, humble ourselves, and do better.

The official Native Breastfeeding Week Facebook page actively includes ways to engage in Native Breastfeeding Week. There are sunrise honor prayers, a Virtual 5K Move, Q&A sessions, platforms for sharing personal accounts, and much more.

On Tuesday, the American Indian Cancer Foundation will host an #IndigenousMilkIsMedicine webinar, where Indigenous midwife Hope Mayotte (Bad River Tribe) presents on the importance of Indigenous birth and breastfeeding. 

“For generations, our families have known that breastfeeding nourishes baby’s mind, body, and spirit, and also reduces the risk of cancer and cancer risk factors for birthing people,” American Indian Cancer Foundation’s Communications Specialist Tina MacDonald, BA (Leech Lake Ojibwe) shares.  “During Indigenous Milk Is Medicine, we aim to educate and support Native families across the nation by providing them with culturally-tailored breastfeeding webinars and resources.”

Register here

The Indigenous Birth and Breastfeeding Collective of North Dakota will host the Indigenous Breastfeeding Counselor Training in Standing Rock August 26 to 30. The course is taught by Camie Jae Goldhammer, MSW, LICSW, IBCLC (Sisseton-Wahpeton) and Kimberly Moore-Salas, IBCLC (Navajo) and covers topics like historical trauma, the impact of birth on breastfeeding, water rights and its relation to breastfeeding, food sovereignty, maternal mood disorders and much more. The course is open to those who self-identify as Indigenous. Find more information here

Indigenous Women Rising is facilitating the delivery of Covid-19 care packages, and while the deadline to apply has passed, individuals may still donate to the cause

Bold Futures shared An open letter: Seeking justice and systemic change for Native Families harmed by structural racism, a response to a “secretive policy [at a prominent women’s hospital]…to conduct special coronavirus screenings for pregnant women, based on whether they appeared to be Native American, even if they had no symptoms or were otherwise at low risk for the disease, according to clinicians.” [https://www.propublica.org/article/a-hospitals-secret-coronavirus-policy-separated-native-american-mothers-from-their-newborns

The letter details how maternal child health advocates can help move forward; for example:

* “Centering BIPOC midwives, birth workers and birth advocates in leadership and decision making,” 

* “Significant investment through the state Department of Health and public health funds in out-of-hospital birth models led by Native, Black and People of color,”

* “Defunding and criminalizing of medical institutions and providers that are, or have, engaged in hate crimes under the guise of medical care.”

Last year, four out of 10 Indian Health Service (IHS) hospitals achieved Baby-Friendly re-designation. Baby-Friendly hospitals support exclusive breastfeeding which “protects against obesity and type II diabetes, conditions that American Indians and Alaska Natives are particularly prone,” Tina Tah, IHS Senior Nurse Consultant writes.  

Learn more about IHS and the American Indian and Alaska Native Communities and Hospitals Advancing Maternity Practices (AI/AN CHAMPS) project’s successes here.

 For more on Native American experiences in birth, infant feeding and beyond, read Generational trauma among Native American cultures affects infant feeding and Honoring the diversity of Indigenous breastfeeding experiences.

#NativeBreastfeedingWeek

#StrongResilientLatched

#IndigenousParenting

#IndigenousMilk

#Bodyfeeding