Friday, March 23, 2012

Weekend Movie: A Little 9 Month Project

This is just TOO CUTE!

I love these time-lapse pregnancy videos. People are so creative! I definitely want to do this in the future!

"Our Little 9 Month Project"

Monday, March 19, 2012

Breastfeeding and Human Evolution

Recently a biological anthropologist who studied breastfeeding and immunity among a community in Kenya came to speak at my university. After her presentation I searched for her research online and found her dissertation. I found her literature review section on breastfeeding and human evolution to be interesting and useful for my own research, so I thought I'd share this short section here.


Breastfeeding and Human Evolution
by Elizabeth Miller
 
Breastfeeding is one of the defining characteristics of the class Mammalia – so named because all female members develop mammary glands that feed their offspring. The evolutionary origins of the mammary gland is lost in time, but it may have evolved from a sweat gland that was used to keep egg shells moist (Oftedal 2002). The length of time mammals breastfeed their infants depends on each species’ life history. The life history of an organism is the collection of phenotypes that impact the survival and reproduction of an organism (Stearns 1992). Life history characteristics are driven by variation in extrinsic mortality and tend to correlate highly with one another (Charnov 1993). Life history characteristics include adult body and brain size, age at weaning, puberty, and first birth, age specific mortality and fertility, interbirth interval, litter size, and duration of gestation. In general, small-bodied mammals have shorter lifespans and therefore earlier occurrence of life stages. Members of the order Primates have longer lifespans relative to their body size compared to other orders of placental mammals, which extends many life stages, including breastfeeding duration.

Within the order Primates, every segment of the lifespan increases with increasing body size. Large-bodied primates such as the great apes generally tend to wean their offspring later than do smaller primates such as strepsirrhines. Chimpanzees wean around 5 years of age (Watts and Pusey 1993), gorillas between 3 to 4 years (Watts and Pusey 1993), and orangutans between 5-7 years (van Noordwijk et al. 2009). Dettwyler (2004) used several lines of evidence from primate life history characteristics to predict the expected age at complete weaning for humans. She used five primate traits that have been proposed to predict age at weaning: 1) tripling or quadrupling birth weight, 2) reaching one-third of adult body weight, 3) adult female body weight, 4) gestation length, and 5) age at 1st molar eruption. Based on the allometric relationships between these characteristics and age at weaning, she predicted that the “natural” age at weaning for human infants is between 2.5 and 7 years of age. Most values appear to center around 6 years of age (Dettwyler 1995).

However, cross-cultural evidence indicates that most non-industrial societies have an average age of complete weaning of less than 2.5 years (Sellen and Smay 2001). There are few, difficult-to-test hypotheses that explain this shorter breastfeeding period. Kennedy (2005) proposed that when early members of the genus Homo shifted to consumption of energy-dense meat, infants were given this food at younger ages to facilitate brain growth. However, this hypothesis does not consider that a long weaning process, in which infants are breastfed for long periods of time while eating high-calorie food, would provide more calories while offering protection from pathogens that may be introduced through food. It is also possible that human evolution selected for shorter interbirth intervals, requiring earlier weaning times (Wells and Stock 2007). Human infants have a higher percentage of fat than
other mammals, helping buffer infants through malnutrition and poor health associated with early weaning and helping alleviate the heavy energetic demands of brain growth (Kuzawa 1998). In contrast to adaptive hypotheses, Dettwyler posits that shorter breastfeeding duration is a maladaptive artifact of cultural expectations (Dettwyler 1995). The cultural ecologies that contribute to individual and population variation will be discussed further below.

Although the evolution of a shorter human breastfeeding period is unclear, patterns of breastfeeding in living human populations can also be examined from an evolutionary perspective. Life history theory generates predictions that can also be used to examine physiological and reproductive phenotypes at the population and individual level. Variations in life history characteristics are based on the allocation of energy to different bodily functions. Adaptive life history strategies seek to allocate limited energy to growth, maintenance and reproductive efforts in a way that maximizes individual fitness (Stearns 1992). Immune function, along with cellular repair and organ function, is generally considered as part of the maintenance effort of an individual. Immune function, particularly adaptive immune function, is thought to compete with growth and reproductive efforts for available energy. There is evidence in the animal kingdom that this is the case (reviews in Sheldon and Verhulst 1996; Lochmiller and Deerenberg 2000). It is reasonable to assume that humans allocate energy in similar ways. In one of the few examples of trade-offs between growth and immunity, McDade et al. (McDade et al. 2008) found that acute inflammation predicted smaller gains in height after three months. In addition, I found that pregnant women have different immune profiles than non-pregnant women, down-regulating more energetically costly adaptive immunity while up-regulating less costly innate immunity (Miller 2009). Both results hint at energetic or immune life history trade-offs in humans.

Because breastfeeding is so energetically costly, it is an ideal system to investigate life history trade-offs in humans. Parent-offspring conflict, a hypothesis driven by competing reproductive, growth, and maintenance strategies, has been used to explain patterns of behavior in breastfeeding mammals. Trivers (1974) made several general predictions about the evolutionary patterning of transfer of resources between parents and children. Parent offspring conflict theory predicts that mothers will decrease their investment in offspring relative to trade-offs they make between current offspring and future reproduction. This resource patterning is time-sensitive relative to the reproductive interests of the mother and the age-specific mortality probabilities of the offspring (Hill and Kaplan 1999). Often the maternal decrease in investment occurs before it is in the infant’s best reproductive interests, leading to conflict between the two. This conflict can be evident in behavioral observations (Fouts et al. 2005) or allocation of resources during fetal growth (Haig 1993).

 

Tuesday, March 13, 2012

Health Policy and Obstetric Violence in Mexico

Inecesárea: The violence of Childbirth in Mexico by Jenna Murray de Lόpez PhD Candidate, Social Anthropology, University of Manchester


This paper is focused on the violence of childbirth in Mexico as a direct result of social, economic and political mechanisms that impinge on the female body. The subtlety of medical discourse and practice as violence needs to be understood within the wider context of Mexican society. In order to see how violation of women’s reproducing bodies and legitimisation of surgical interventions becomes part of an accepted everyday practice it is essential to examination the political realms of the health economy and the discourse of human rights. This paper was presented at the International Conference on Gendered Violence in 2011.


If we hope to create a non-violent world where respect and kindness replace fear and hatred, we must begin with how we treat each other at the beginning of life. For that is where our deepest patterns are set. From these roots grow fear and alienation,—or love and trust.
Suzanne Arms – A Handful of Hope (poem)

In 2010 the levels of caesarean section reached a global high in Mexico where they have now become only second to the surgical birth practices of Brasil. Along with other Latin American countries Mexico is committed to achieving the World Health Organisation (WHO) Millennium Development Goal (MDG) 5 which aims to reduce maternal mortality and achieve universal access to reproductive health care. This initiative has now entered its final stages with the MDG deadline being 2015, and this is represented in the activity on a national level towards implementing programmes and new welfare policies. 

Increased access to institutions, particularly in urban areas has resulted in a figure of 93% of recorded live births taking place in hospital (WHO 2008). Under the philosophy of development this is taken as an indication that Mexican women are receiving assistance at birth. OECD indicators using data from 2007 estimate that 40% of all recorded live births in hospital are by caesarean section[1]. Whilst this percentage does provide evidence of increased access to skilled birth attendants and antenatal care, the overall improvement of maternal mortality figures that health policy and practice has as its target fails to decrease at a rate anywhere near as significant. In this paper I aim to set the maternal mortality argument and policy smokescreen aside and view effective reproductive health in relation to a woman’s experience and her emotional and physical wellbeing, we can perhaps read the quantitative data in a much more alarming way than the current analysis suggest. An alternative reading, which also supports the need for more qualitative studies, shows that the 40% of pregnant women who enter a hospital are met by a birth attendant who will cut open her abdomen and uterus, while the remaining 60% who undergo a vaginal birth will have their perineum cut as part of routine episiotomy practice. This is done without aesthetic; and often either intervention is made without the woman’s direct consent.

Using obstetric violence in Mexico as a focus, this paper argues that the ways in which a society defines women and values them is reflected in the local treatment of birth. In this paper I attempt to use my research in Mexico to connect isolated works that have questioned gendered violence in hospital settings (Castro 1999: 209Castro and Erviti 2003Diniz and Chacham 2004Kendall 2009) to the more recent quantitative work that analyses the rise in caesarean section (CS) in Latin American countries (Gonzalez-Perez, Vega-Lopez et al. 2001Nazar A B, Salvatierra BI et al. 2007Urquieta, Angeles et al. 2009WHO 2009Barber 2010). I will use existing publications together with my own research as a basis from which to build a more detailed picture of how violent practices are sustained and legitimated by neoliberal policy and human rights discourse. The voices of women, partners and medical professionals collected during periods (18 months 2007-2009 and 8 weeks 2011) spent in two urban locations in Chiapas, Mexico are also presented. Although recognised as a symptom of increased access to medical services, there has been little attention paid to the practice of unnecessary surgical interventions during pregnancy and birth in terms of acts of violence against women. Despite the development approach to public health aiming to empower women via financial control and equal access to services, the intention of neoliberal informed policy to control populations (Harvey 2005Qadeer 2005) and individual bodies means that women continue to be subjected to physical, psychological and symbolic violence as part of daily gyno-obstetric practices in both private and public spaces.

By physical violence I refer to the performance of unnecessary caesarean sections, episiotomies and surgical procedures related to birth control.   
By psychological violence I refer to the aforementioned actions and their affect on a woman’s bodily subjectivity.
And by symbolic violence I refer to the way a woman is scarred by unnecessary surgical procedures and how this reflects an acceptance of violence towards female bodies in Mexican society as a whole. Within this symbolic violence is also a notion of class distinction in regards to the practice of classical incisions in public hospitals.


For reasons of simplification in terms of my discussion in this paper I will encompass all three definitions under an umbrella of Obstetric Violence.

Open-ended interviews were carried out with women and medical staff alongside observations in various environments, including antenatal classes, welfare programmeplaticas (obligatory information sessions), baby showers, other social events and gendered spaces. Initial analysis has identified three different circumstances that can result in caesarean section delivery which I identify as the following three categories: legitimate; Systemic; and Elective. As the latter two denote I shall consider the nature of political economy and private healthcare however due to a distinct lack of data available in regards to Mexico and private health practices, Elective remains for the time being outside of the realms of this particular discussion. The disproportionate levels of caesarean section (CS) in Mexico have many complex political, social and economic causes that ultimately represent the violence in its society as a whole. This paper focuses particularly on the antecedents to disproportionate CS practice as being fostered and maintained within macro public health policy.

I wish to spend a few moments describing the Human Development Programme and health services in Mexico and then discuss the data relating to Chiapas. This region is chosen for its political, economic and social position in the country as a whole (Brentlinger, Javier Sánchez-Pérez et al. 2005Secrateria de Salud 2007Tinoco-Ojanguren, Glantz et al. 2008). There is not the time to go into much detail on the political economic situation in Mexico, so I will state briefly now that public health policy has as an economic model founded in the structural adjustment programmes and neoliberal reforms imposed since the mid 1980’s.

MDGs, Cash Transference Welfare and impact on behaviours
‘…many of the women that arrived [in labour] had to give birth in a hospital so that they could get benefits for the baby, they had to get a medical certifícate, it’s an important document they need in order to apply for Oportunidades
Ricardo , 26yrs, Mestizo, Medic

“Many things have changed many people are going to hospital because of theOportunidades programme. They have to go to be seen or they will take their money from them...That’s why the midwives don’t practice the same, they have no business...”
(Carlos, Rural Community Health Promoter , 38yrs, Chol 9 children all home birth attended by traditional midwife)  

In both developed and developing countries for many decades, the search to improve maternal health and birth outcomes has led to an almost complete medicalisation of pregnancy and birth based on a dominant interventionist model (Barber 2010). I have found that in existing literature and in my own qualitative data I am met with a wall of policy that legitimates the appropriation of birth experience from thousands of women and acts as the catalyst for violence of varying kinds. In text analysis from women in both social and private spaces, and with health professionals the theme of access to welfare is a constant. It appears to affect every aspect of the pregnancy and birth outcome and illustrates the complexities of a pregnant body in a political economic world. The pregnant body is in a state of flux, it is neither a solitary life nor two lives, it is at every stage a social product. It is important to consider the contribution of macro health policy and micro gyno-obstetric practices in local, cultural systems. The creation of universal medical norms in order to deal with the global management of populations produces mechanisms by which political economic forces impinge on the body. Foucault wrote ‘In a sense, the power of normalisation imposes homogeneity, but it individualises by making it possible to measure gaps’(1977) . In other words in measuring the normal, an abnormal is identified. Pregnant women must fit into measurable categories that are defined by medical discourse and aimed at efficiency. If they do not respond well they are become deviants to a system and can be manipulated to conform. When one thinks in terms of a universal public health policy and medical practice this is likely to have profound effects on those accessing health services on local levels in any cultural context. 

Oportunidades (previously known as PROGRESA) is a conditional cash transfer program that started in rural areas in 1997. Its aim is to improve the education, health, nutrition, and living conditions of population groups in extreme poverty and to break the intergenerational cycle of poverty.  In the area of health, the programme offers an essential health care package that includes pregnancy and delivery care for women enrolled in the program. In the case of delivery attendance, health institutions are responsible for providing delivery attendance in their facilities. Attendance at the health promotion talks and medical checkups are a requirement for being registered on the programme and receiving financial benefits. The coercive nature of cash transference programmes impact dramatically in terms of behavioural and cultural change. Although they propagate a firm belief in empowering women by recognising them as responsible financial heads of the household – any financial benefits are given directly to the women.
The Oportunidades programme with its strict compliance to medical attention and training programmes and its payments in terms of vouchers does not translate to women gaining some sort of independence or financial control over their lives. In line with the critique of neoliberal welfare policy, theOportunidades programme reinforces the notion of women’s independence on a patriarchal state and their status as passive and docile agents. This use of coercive welfare programmes results in a continuing cycle that legitimates control of women’s bodies, affecting their social and economic productivity in a negative way that ultimately increases further their dependence on the patriarchal state. 

Chiapas as a case in point
An explorative investigation into medical attention in childbirth affecting indigenous migrants to urban areas of Chiapas was carried out in 2007 (by Nazar et al)This study also makes comparison with mestiza women living in areas of social exclusion who are likely to be using the same health services. In the period of the study, alongside an increase in births attended by institutional medics, a decent in the frequency of vaginal births was registered in both the mestiza and indigenous population. Nazar et al state that in these two cities in Chiapas alone from the period 1979 - 2003 the practice of caesarean section has increased almost nine times (870.0%) in the mestiza population and almost four times (394.1%) in the indigenous population.

Chiapas has been heavily targeted by the Oportunidades programme due to its socio-economic status and large rural populations and this has had a direct impact on cultural practices, traditional midwifery and woman centred health care. Participation in educationalplaticas promote a woman’s responsibility to her gestating foetus and newborn, but they do not discuss the right of a woman to birth where and with who she most feels comfortable with.

Obstetric Violence
“I had a good pregnancy, no cravings, no tiredness, no problems you could hardly tell I was pregnant. I was tiny...I worked and studied up until the baby was born...I felt very healthy”
(Rosie, 25yrs, Tzeltal, Birth Outcome: CS Public Hospital)

‘...first they take you to a place to try a normal birth, but if the [umbilical] cord is wrapped around the baby’s neck they have to do a c-section’
(Bety, 40yrs, Tzeltal, Birth Outcome: CS Public Hospital)

‘…for example if they arrived around 2 or 3 in the morning in labour, and if they were a primagravida[2] ….if it was 2 or 3 in the morning, the gyno-obstetrician would say “lets operate”, he would say that because we wanted to sleep, we had to wake up [in the morning]’
Ricardo , 26yrs, Mestizo Newly Qualified Medic

Anthropologist Bridgette Jordan wrote that the power of authoritative knowledge is not that it is correct but that it counts (Jordan 1993:154). The consultant room and labour ward provide a space for intra-cultural practices and violent tendencies resident in the wider Mexican society. Medical practices and education are from European/American allopathic model of medicine. A model of medicine that not only pathologizes pregnancy and birth but that is often outmoded in the very place it was originated (Jordan 1993:185). The objective of reproductive health and clinical services on a local level place an emphasis on the early detection of complications through the use of technology. A technopolitical economy in obstetrics has specific consequences for women and their bodies throughout pregnancy and beyond. The technological model of birth encompasses notions that a woman’s subjective bodily knowledge has been disproved, and therefore displaced by technology as producer of authoritative knowledge (Davis-Floyd 1987Davis-Floyd 2001). This means for instance that the skilled birth attendant will interpret a pregnancy, labour and birth process via technology as dominant over anything the woman may say she feels. Yet, in the medical space at the same time that medical knowledge dominates actors are embodied by their own historical, cultural and gendered knowledge upon which they also use as a basis for assumptions and decision making. It is at this point where it is possible to indentify the social attitudes towards women based on gender, ethnicity and social class and how they are reflected in medical practices. The reasons stated by healthcare professionals for performing CS, CS with a classical vertical incision, episiotomies, tubal ligation and internal examinations during contractions, though they are legitimised through medical discourse are rooted in cultural and gendered attitudes to women and women’s bodies. The more subtle forms of coercion that take place, as documented in my own research as well as existing literature are harder to explain or mask with medicalized language. Women whom I spoke to who had experienced antenatal care provided by either State or Private healthcare had been offered a CS from the first trimester of pregnancy, many were also challenged by medical actors if they expressed a preference for a normal birth. Forms of resistance to undergoing ultrasounds, taking medication or vaccines or insisting on low interventionist methods are met with subtle threats of mortality in relation to mother or baby. I certainly do not wish to argue that this form of violation if specific only to Mexican medical models of pregnancy, but qualitative analysis does demonstrate that certain violations may persist more than others due to the fact that women’s responses are informed by their status in the wider society – in which in many arenas politically and economically is generalised as subservient and suffering. The data provided by women and health professionals in terms of antenatal care suggests that CS as a birth outcome is built into the apparatus of the healthcare system long before the women enters into her third trimester. Offering the counterargument that current reproductive health programmes and practices are likely to increase the chance of a CS being performed brings about many questions as to how this in any way is beneficial for the overall health and wellbeing of women. It is generally accepted by the WHO that an increased level of CS equates to better access to medical services and when medically legitimate, an improvement for maternal and infant mortality. Perhaps an equal focus should be placed on interpreting what is meant by an almost 10 fold increase in CS in terms of quality of life for women. The aim of policy and development programmes is to improve life expectations for both women and babies, but the lack of distinction in regards to the quality of treatment and recognition of the woman’s experience has serious consequences in regards to local practices and dominant medical discourse.

The call for papers for this conference stated that “Violence committed to establish to maintain power relations between genders continues to be a major global health problem” – the normalised violent practices that many women are subjected to in pregnancy and childbirth translates to a situation where universal attempts to improve health are actually part of the problem.



[1] In Mexico the OECD base their estimation on public hospital records and data obtained in the National Health Surveys. Estimation is required to correct for under-reporting of c-section deliveries in private facilities source: http://www.oecd-ilibrary.org accessed 29/10/2011.[2] First time mother 


References

Barber, S. L. (2010). "Mexico’s conditional cash transfer programme increases cesarean section rates among the rural poor." The European Journal of Public Health 20(4): 383-388.               Brentlinger, P. E., H. Javier Sánchez-Pérez, et al. (2005). "Pregnancy outcomes, site of delivery, and community schisms in regions affected by the armed conflict in Chiapas, Mexico." Social Science & Medicine 61(5): 1001-1014.               
Castro, A. (1999). "Commentary: Increase in Caesarean Sections May Reflect Medical Control Not Women's Choice." BMJ: British Medical Journal 319(7222): 1401-1402.               
Castro, R. and J. Erviti (2003). "Violations of Reproductive Rights during Hospital Births in Mexico." Health and Human Rights 7(1): 90-110.
               
Diniz, S. G. and A. S. Chacham (2004). ""The Cut above" and "The Cut below": The Abuse of Caesareans and Episiotomy in São Paulo, Brazil." Reproductive Health Matters12(23): 100-110.
               
Gonzalez-Perez, G. J., M. G. Vega-Lopez, et al. (2001). "Caesarean sections in Mexico: are there too many?" Health Policy and Planning 16(1): 62-67.
               
Harvey, D. (2005). A brief history of neoliberalism. Oxford, Oxford University Press.
               
Kendall, T. (2009). "REPRODUCTIVE RIGHTS VIOLATIONS REPORTED BY MEXICAN WOMEN WITH HIV." Health and Human Rights 11(2): 77-87.
               
Nazar A B, Salvatierra BI, et al. (2007). "Atención del Parto, Migración Rural-Urbana y Políticas Publicas de Salud Reproductiva En Poblaciòn Indígena de Chiapas, Mexico."Ra Ximhau Revista de Sociedad Cultura y Desarrollo Sustenable: 763-779.
               
Qadeer, I. (2005). "Population Control in the era of Neoliberalism." Journal of Health and Development 1(4): 31-48.
               
Salud, S. d. (2007). Programa Nacional de Salud 2007-2012. S. d. salud. Mexico, Secretaria de Salud.
               
Tinoco-Ojanguren, R., N. M. Glantz, et al. (2008). "Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico." Social Science & Medicine 66(5): 1057-1069.
               
Urquieta, J., G. Angeles, et al. (2009). "Impact of Oportunidades on Skilled Attendance at Delivery in Rural Areas." Economic Development and Cultural Change 57(3): 539-558.
               
WHO (2008). Mexico: Country Profile Maternal Mortality, WHO Director-General Roundtable with Women Leaders
on Millennium Development Goal 5, World Health Organisation.
               
WHO (2009). Rising caesarean deliveries in Latin America: how best to monitor rates and risks, World Health Organsiation.
               

This was posted with permission from the author.

Wednesday, March 7, 2012

Happy IBCLC Day!

Have you thanked your IBCLC today?




What is an IBCLC?

IBCLC stands for an International Board Certified Lactation Consultant. This is the gold standard in lactation consultants. IBCLC's go through extensive training, hours, and examination to receive this certification.

The International Board of Lactation Consultant Examiners (or IBLCE) says,

Attainment of the IBCLC credential signifies that the practitioner has demonstrated knowledge to:

- work together with mothers to prevent and solve breastfeeding problems
- collaborate with other members of the health care team to provide comprehensive care that protects, promotes and supports breastfeeding
- encourage a social environment that supports breastfeeding families
- educate families, health professionals and policy makers about the far-reaching and long-lasting value of breastfeeding as a global public health imperative.

Among those who become IBCLCs are nurses, midwives, dietitians, physicians and experienced breastfeeding support counselors. IBCLCs work in a variety of settings including hospitals, clinics, physicians’ offices, neonatal intensive care units, human milk banks and private practice.

I encourage all my doula clients to contact an IBCLC if they are having any breastfeeding issues or have any concerns. Honestly, these (generally) women work miracles! They know every trick in the book, and can even help women breastfeed their infant even after they've stopped.

Unfortunately, there aren't a lot of IBCLC's around, and definitely not enough from minority populations. And just because you saw a person in the hospital postpartum who called themselves a lactation consultant does not mean you saw an IBCLC - very few hospitals employ them. But some do, so be sure you demand one!

Having an IBCLC is a great way to overcome those breastfeeding Booby Traps!

Further reading:
What to look for in a lactation consultant
Why hire a lactation consultant?




Interested in becoming an IBCLC? 
This is a very long road. It can take years to obtain the education, training, and thousands of required clinical contact hours. Its also a lot of money. Then, you have to take a rigorous examination, and pass it again every 5 years.
Anyone who wants to become an International Board Certified Lactation Consultant (IBCLC) must meet all of the following requirements:
  • Prerequisite higher education in the health sciences
  • Clinical practice in providing care to breastfeeding families
  • Education specifically about human lactation and breastfeeding
Different pathways have different requirements. Pathway 1 is done via clinical experience (either professional, like a nurse, or volunteer), Pathway 2 is done through an educational program (for instance, the Carolina Breastfeeding Institute, or pathway 3, which is an apprenticeship (read more here). 

Public Health Doula, also an IBCLC who works in a hospital, explains it this way:

1) Becoming an IBCLC already having some kind of medical/nursing/clinical degree. To qualify to sit the exam, these people have to have some lactation-specific education (although it is not standardized - hours from a vast array of providers and topics can count), and they also have to meet a minimum number of hours spent working with breastfeeding dyads. Importantly, these hours do not need to be under the direct supervision of an experienced IBCLC and can happen as part of the professional's regular work. So a nurse on a postpartum floor, a pediatrician, a dietitian at a WIC office - all of these people may be able to get their minimum hours through their work. (Pathway 1 in the current system.)

2) Becoming an IBCLC without having any kind of clinical degree. To qualify to sit the exam, these people have to also have lactation-specific education, and they need to meet a minimum hours requirement. However, their minimum hours need to be completed under the mentorship of one or more IBCLCs who have recertified at least once. (Pathway 3 in the current system.) These people can also do an educational program approved by IBLCE (Pathway 2), which provides the mentoring, hours, etc. all in one package, and requires somewhat fewer minimum hours, but those programs are few and far between.

(If you're interested in becoming an IBCLC, I encourage you check out more of her posts on her journey to certification, and even shoot her an email)

Sunday, March 4, 2012

Pixar's First Female Lead: Brave from a Feminist Perspective


The other day I was reading the Time magazine article on Pixar's first film with a female protagonist, Brave, and it sparked several thoughts.

[The article, "Pixar's Girl Story," is unfortunately only available for Time subscribers, so unfortunately I can't send you off to read it online. The premise is that Pixar's movies, clothes, toys, clothes, rides, video games, and tv shows all have male leads (and what the author calls "very male leads" - cowboys, robots, astronauts, cars, and of course, men)]

Firstly, that working at the Pixar studios sounds awesome, even if the article's author describes it as a playground for boys:
"...plastic bins dispensing every kind of cereal, free. Men pedal scooters past me. On Friday mornings an employee named Mark Andrews stands on the front lawn in a kilt, challenging co-workers to actual sword fights... animators work inside toolsheds designed like castles, jungles, and Old West jails. In one office, a fake bookshelf opens onto a secret lounge. Guys carry official Pixar laminated cards in their wallets that read, 'this card entitles the bearer to one Star Wars reference in a meeting." 
But then he goes into the fact that Pixar has a girl problem because "there are no rooms full of princess costumes to dress up in. No frosting stations. Not one My Little Pony poster." And this makes me heave a big sigh.

Why does the lack of princess costumes mean that the Pixar studios are not a girl-friendly place? (excluding for the moment that Pixar hasn't had a film with a female lead before now, and the fact that all the employees are men). I am a girl and I LOVE free cereal, scooters, fake bookshelves, and Star Wars.

But the article passage that really struck me and got me thinking was this:
"Brave's medieval Scottish princess, Merida, almost never wears princess clothes. Instead, she rides a horse and shoots a bow and arrow."
We'll know that we truly don't need feminism anymore when sentences like that no longer exist.  But that sentence (and the sentiment) does exist. This says a lot about the state of society and the need for change that feminists are trying to bring about.

When the day comes when its no longer abnormal, shocking, or interesting for a princess, or any female, to ride a horse and shoot a bow and arrow. When "princess clothes" just means whatever a princess happens to wear, whether its a dress or pants, ball gowns or armor. Not that there is a contradiction between wearing princess clothes and riding a horse with a weapon in-hand.


Moreover, this story is really all they could think of for their first female lead movie? Its almost like they're trying too hard. "Look! Girls can be 'brave,' too! We've got a super strong badass female lead who defies conventional female standards by not wanting to marry some random guy just because she's a princess so she's going to go ride horses and shoot arrows instead!" Wasn't this sort of done already, for instance in Pocahontas or Mulan? She is dissatisfied with society's expectations of her as a girl, doesn't fit in and wants action and adventure. Why is it that her life begins to have meaning, and she's able to be awesome, because she rejects her "feminine" qualities of princess and wife and embraces her "masculine" qualities? Also, she's STILL A PRINCESS. Do all female heroines in animated films have to be princesses?

A feminist version of a Pixar film would portray men and women without expectations of fulfilling or going against binary gender roles.

Now don't get me wrong, I think Brave looks awesome and I'm definitely going to go see it. I love Pixar despite its former lack of female leads and despite its creativity in story line here (saying this before seeing the film, obviously). Also, Pixar hasn't done a bad job portraying women, and they're not actually anti-feminist - Jessie in Toy Story and Helen Parr in the Incredibles were both great. And I love bad-ass female leads, bow and arrow shooting, and medieval period pieces. And I honestly do have a soft spot for fairy tales. I also think the Scottish setting will be fun.

Some things I did like in the article, though, include this:
"Chapman isn't worried that boys will shy away from a film about a princess, even though industry research indicates that boys have more influence than their sisters in convincing their parents which movies to see. 'Back in my day, boys and girls both went to see Cinderella and Snow White and Sleeping Beauty,' he says. 'It's just a change in media and advertising.' When I ask Lasseter why boys would see Brave, he answers... 'Because its awesome! It's got awesomeness in it! It's got bear fighting in it!'"
And even though I think both boys and girls can appreciate bear fighting (if its appropriate to the story line and entertaining), I really like both answers given above. Of course boys will want to see Brave, because its going to be awesome entertainment! And that should be all it's about.

What do you think of the upcoming movie Brave? 



The Trailer for Brave:
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