We are proud to welcome Dr. Genevieve Becker to Lactation Matters. Dr. Becker is currently serving in Penang, Malaysia as the Chris Mulford World Alliance for Breastfeeding Action (WABA) ILCA Fellow, where she is working with WABA at their headquarters on outreach and advocacy projects. She was recently able to attend the WABA/UNICEF Symposium in Stockholm, Sweden and reflects on her experience here.
By Dr. Genevieve Becker, IBCLC, FILCA
As health workers, ILCA members are important advocates for a supportive environment that protects and promotes breastfeeding as the norm. Maternity protection has improved for some women, though challenges still remain for many mothers, in all parts of the world, to balance their mother-work and paid work.
As part of my Chris Mulford WABA-ILCA Fellowship, I was privileged to be included among the 50 invited participants from 23 countries discussing the challenges and actions to improve maternity protection at the WABA/UNICEF Stockholm Symposium which focused on “Contemporary solutions to an age-old challenge: Breastfeeding and work,” held 26-28 September 2015. At least a dozen IBCLCs and ILCA members participated in this symposium as contributors, presenters, panelists, and rapporteurs, and shared their expertise and commitment to working together with others as advocates for maternity protection.
Three main themes related to Maternity Protection ran through the symposium: Economics and Financing, Gender Equity, and the Informal/Short-Term Contract Sector.
Economics and Financing
Julie Smith, an Australian economist who has spoken at ILCA conferences and published in the JHL, provided numbers and analogies to help us understand how valuable mothers are in the economic system. These vital contributions by women may be lost if they are not widely recognised and protected. Women’s skills and knowledge are valuable to retain in the workplace and their milk ensures their children are well nourished, nurtured, and protected from illness to grow into productive future workers.
Labour policies in the absence of paid maternity protection can have negative effects on health behaviours with resulting decline in the wellbeing of mother and child. The MACHEquity.com database (McMaster University Canada) has data on policies and their effects. States need to commit to women and child rights as an investment in the future. The tools of the World Breastfeeding Trends Initiative (WBTi) and the associated World Breastfeeding Costing Initiative (WBCi) can be used to study costs of not breastfeeding at national level.
If an employer asked you how paying maternity entitlements would benefit his company, could you provide information? Is the value of breastfeeding and costs of not breastfeeding counted in economic data for your country, state or region? Have a look at the World Breastfeeding Trends web site and see how you can become part of gathering data on the costs and gaps in protection.
Gender equitable maternity protection includes recognition of the importance of fathers as nurturers, their need for paid parental leave, and the overall aim of family friendly workplaces. Actions recommended at the symposium towards achieving this included spaces for men to talk to men, highlighting positive role models in media, school books, and antenatal services, as well as providing evidence to employers of the value of paid parental leave.
In your work setting or locality, is workplace childcare equally accessible to men and to women employees? Can a father have his baby at his desk? Is flexible working available to both fathers and mothers?
Look at the images portrayed about men. Are they shown as competent to care for a baby and nurturing? Or are the images of the macho man linked with violence and power?
Review the images in antenatal and new parent information that you use. Are fathers behind the mother who is holding the baby or are parents beside each other as equal?
Women working in the informal or short term contract sector may have no access to maternity protection and many are less visible and hard to reach and organise to seek protection. This is a global issue. We may think of informal workers as migrant fruit pickers, home-based garment workers paid a piece rate, domestic cleaners, or self-employed women. However with the increasing casualization of labour, jobs that were previously formal jobs may now be short term contracts and can include nurses, school teachers, journalists, software programmers, and many more. These women may work in the formal setting of a hospital or office of a multi-national information technology company but have no entitlement to maternity protection (or health care, or job protection if they say they are pregnant) that co-workers may receive who are formally employed.
Look around you – who are formal workers with entitlements and who are informal workers? Are the informal workers counted in labour surveys? Are there organisations advocating for maternity protection for women in the informal sector? What allies in other sectors can you find to advocate with you?
In addition to these three areas for thought, there were additional issues raised that I thought were particularly relevant to lactation consultants such as:
- Concerns were expressed about how many families rely on pumping as the main provision of milk. Challenges can arise if expression/pumping is prioritised over direct breastfeeding. Are we going against human biology?
- We must encourage families to not assume that the short length of paid maternity leave is viewed as the expected length of exclusive breastfeeding.
- Maternity protection on its own may not increase breastfeeding rates. Breastfeeding families need the whole package of support and protection for sustaining breastfeeding.
- It is not enough to have a maternity protection law, the laws need to be strong and to be implemented for ALL women. Worldwide, only 28.4 % of employed women (330 million) are effectively protected.
- We should encourage the use of phrases such as “PAID maternity leave” and “balancing family responsibilities and breastfeeding with PAID work” to emphasize that maternity entitlements means money.
- In addition to generating additional tax income for the state through increased labour participation, maternity protection contributes to improved health and development outcomes and reduce companies’ and nation’s healthcare costs. The value of breastfeeding and the costs of not breastfeeding need to be counted in economic data.
- At all levels, engage in advocacy around the actions from different sectors – nutrition, social protection, labour, anti-poverty, rural development, education, like-minded private sector employers, manpower agencies, reproductive health, child health, men’s initiatives, women and gender programmes, trade unions, financial institutions, religious groups, media and more. We should also aim for universal rights/social protection not linked to particular employment sector.
A draft Framework for Action is being discussed by the symposium participants over the coming weeks aiming for a version with wider distribution early in 2016.
Genevieve Becker is a registered dietitian and an IBCLC who has worked in maternal, infant and young child feeding for over 30 years. Her main interest is the education and performance of health workers. She has earned a Masters of Science (Community Health), a Masters in Education and a PhD, all which examined aspects of assessment of health worker performance in assisting mothers to learn skills related to breastfeeding. She is the lead author for the Cochrane systematic review on methods of milk expression. She was a volunteer counsellor with a mother-to-mother support group for 20 years.
Her business, BEST Services, provides consultancy services related to breastfeeding education, support and training nationally and internationally. Some current contracts include the coordination of the Baby Friendly Health Initiative in Ireland and assisting countries to revitalise their BFHI activities. Genevieve was the lead for the updating and revision of the UNICEF/WHO BFHI global materials in 2006-2009.
Genevieve served for 6 years on the ILCA Board and is currently the only FILCA in Europe. Genevieve lives in Galway city, on the west coast of Ireland with her husband. Their daughter currently works in Boston and their son and two granddaughters live in Ireland.