The Birth Connection: An Examination of the Relationship between her Birth Event and Infant Feeding among African American Mothers

There is an epidemic of maternal and infant death rising in plain sight in the United States. The maternal and infant mortality rate of Black/African-American mothers is three times that of White/European Americans in the US. Current research indicates that breastfeeding lowers both. While African-American mothers had the highest breastfeeding rates through the start of the twentieth century, by close of the century, their rates precipitously declined. Presently, they have the lowest rates of breastfeeding in the United States. In this paper, I examine how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected initiation and duration of breastfeeding. Also, I investigate how mothers’ healthcare providers affect their decision making, as well as how the type of birth that a mother has, e.g., preterm, vaginal, c-section, full term, affects her actual versus idealized infant feeding practice. I present a discussion of how doctors, nurses, breast pumps, etc., affect breastfeeding practice and how the practice impacts mothers’ beliefs about themselves as “good” mothers. In order to understand the interplay of the decision-making process and these constructs, I conducted a qualitative study in which I participated in face-to-face interviews with a diverse group of thirty African-American mothers. They ranged in age from 18 years-old to 50-years-old. At the time of her interview, each mother had at least one child who was three years old or younger. Through our discussions, we explored how pre-pregnancy perceptions, lived experiences as a mother, familial influences, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes and the interaction that the mothers in this study had with resources, human and material, had the highest on the initiation, duration, and attitude toward breastfeeding.