Being Serena – Starting an Overdue Conversation on Breastfeeding in America

Whether or not a baby is breastfeeding at 6-months can greatly reduce risk of asthma, ear infection, diarrhea, as well as diabetes. However, a recent CDC report  showed only 64% of black women are initiating breastfeeding compared to 81.5% of white, non-Hispanic and 81.9% of Hispanic women.

Breastfeeding Rates Racial Disparities CDC

(Photo: from 2010, rates have since changed. U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention. National Immunization Survey (NIS).

Black women in America continue to have lower breastfeeding initiation, duration, and exclusive breastfeeding rates than white women. Luckily, there are resources available to women of color such as: Black Mothers Breastfeeding Association, and National Association of Professional and Peer Lactation Supporters of Color. However, this is not enough, it is time for a change in the way we teach  and discuss breastfeeding in health professions.

While breastfeeding is a complicated topic, there is an alarming and glaring gap in the healthcare system: blatant racial disparities in access to well equipped and highly educated health care providers (Lind, JN). Current health provider education includes a focus in simulation training in order to promote patient safety and less medical errors through repetition (Issenberg, S). However there are some drawbacks in the the current state of simulation education, the most prominent being that majority of these simulators are one shade: white. LiquidGoldConcept has a vision of providing high quality lactation education for all, regardless of race and ethnicity.

Being Serena recently aired on HBO. In this documentary, we get an inside look as Serena Williams, a beacon of strength, resilience, and integrity for so many shows a side few have seen before, we see her scared. While watching this it becomes clear that while access is a key component in health care, there is one great equalizer: fear. Serena left her beautiful home with her doting husband and entered a VIP suite at St. Mary’s Medical Center in West Palm Beach, where she quickly admitted she was scared she “didn’t want it to hurt.” As her labor became more high risk and she faced various health scares and challenges she was the one that told the doctors what was wrong, she advocated for herself as she stated: “I know my body.” Serena was able to advocate for herself, but sadly majority of people are not able to.

St. Mary’s Medical Hospital mentions on its website that it is “ready for every possibility” with a long list of specialties and a Level III NICU. However, St. Mary’s is not a Baby Friendly Hospital. Therefore, it does not follow the Ten Steps to Successful Breastfeeding, and does not meet the minimum criteria to be considered a Baby Friendly hospital such as additional staff training and available breastfeeding education for new parents. Maybe they are ready for every possibility for baby, but as for mother-baby dyad care they may be falling short. Do you think Serena would have had better health outcomes if she had given birth in a baby-friendly hospital?

Serena has the world at her fingertips, a team of world class medical professionals who all want nothing more than to keep her in optimal health, and yet she still reveals confusion around breastfeeding. From the first physician visit a viewer sees where she states: “I don’t even know what I’m looking at” to when she is deliberating her delivery in which she states: “I just want my baby to be healthy.” These are statements that could come from any mother anywhere, but I wonder throughout where is her provider communicating support? It’s hard to tell if it was just the way the show was edited, or if it was really not there. The only supportive communication we see is from her husband, Alexis who appears to have a high health literacy following along with doctors thought processes and ensuring Serena is well taken care of, while explaining procedures to his obviously exhausted wife along the way.

Breastfeeding is natural, however it is a skill learned by practice and unfortunately more often than not the practical aspects of breastfeeding are not included in medical training (“Women, Infants and Children, Family Health Services, NJDOH”). A pivotal example of this is Serena turned to social media to ask for suggestions on what experiences other moms have had with breast feeding, and how long they waited to stop.

Breastfeeding Serena Williams Instagram

(Photo: Twitter @serenawilliams)

While Being Serena, gave viewers an important glimpse into the world of a working mom, it did not show if she consulted a lactation consultant or a physician during the time she was deciding to give up breastfeeding, just one very poignant conversation with her tennis coach, a father himself. I am by no means a world-class athlete, and I will never claim to know the gravity of the decision Serena had to make to get back in shape for her career, however I really question where the intentions of her team lie and where her health care providers were in this decision?

Serena pumping breast milk while warming up for a tournament is one of the most empowering moments I’ve ever seen.

Pumping Breastfeeding Serena Williams HBO
(Photo: HBO Being Serena Episode 3)

BUT could she have gone back to work and continued to breastfeed for as long as she did without the incredible support system she has around her? Would she have been more successful if, as she stated, the tennis association allowed new moms some leverage so she didn’t feel as much pressure to immediately return? Serena has an amazing support system full of not only highly trained health professionals that make house calls and are paid to keep her in optimal health but also, her husband who literally put billboards up in her honor:

Breastfeeding Billboards Serena Williams       (Photo: @alexisohanian, Twitter)

Sure, we can’t all have billboards in our honor, but is it to much to ask for health professionals to know how to maintain our unique bodies and ensure our babies’ health?