Hello, all...
I am an old lactnet renegade coming back home. Actually, my heart never left
the issue of breastfeeding, and one does have to earn a living for herself and
her family. And my living, then, was not into breastfeeding. But now, our public
health system has realized that promotion, protection and support to
breastfeeding has public health impact, and I am back, though in another region
!
I am a physician, a 3/4 of a pediatrician, but have been working most of my
career in Maternal and Child Health in the province of Québec, Canada (just
north of New-England...); I am now a specialist in public health and I am
currently enrolled in a master's degree in Occupational Health, my new passion
(that also provided food for the family while bf was out of "fashion"). I split
my time between occupational health and health promotion (specifically promotion
of breastfeeding). While doing occupational health, I focus on a program called
"Pour une maternité sans danger" or, something like "for a dangerless maternity"
(translation mine and probably very approximate). And I am constantly faced with
a philosophical question, that I would like to share with your collective
wisdom:
There are some risks related to the combination of being pregnant /
breastfeeding and being active in the workplace. These risks are sometimes well
known (such as exposure to lead and pregnance), somewhat known (lifting heavy
weight and pregnancy), and, most often suspected or simply not known at all
(how many hours standing are too many ?). Notice that I do not give any example
for breasfeeding: we know sooo little... Usually, there a great number of
exposures in the workplace carry a risk, albeit a small or very small one. The
examples of Hepatitis C and HIV are a case in point: should a breasfeeding woman
be exposed to the risk of being hurt by a blood stained piece of equipment ? Our
law states that "a pregnant or breastfeeding woman has a right to be assigned to
tasks that do not carry any physicaldanger for the pregancy or the breastfed
baby..." In face of a small or very small risk (getting infected by HIV for
medical personnel has been evaluated at 1 for 14 000 000, as small as winning
the lottery in our province !), we are faced with 2 possible actions:
- state that the risk is small, recommand reassigning the pregnant/breastfeeding
lady. The immediate reaction (and believe me, this reaction is not always
professionnally stated... I never heard so much name calling !) is "if you do
not accept any risk, you might as well forbid all women of childbearing age to
enter the workplace"
- state that the risk is small, thus acceptable. Reaction : how dare you to
decide what is acceptable ? on what ground ? (this is so unethical of you, and
yaddi-yadda...)
What are your feelings, emotions, and, maybe, rational reactions to this problem
? By reading them from you, in a non threatening fashion, I might be able to
develop answers and reactions to these much more threatening opinions that I
hear from colleagues, and it could help ME make up my mind, torn between my
desire to see mothers work safely, and my hope to see my daughter be able to
find meaningful employment when she comes of childbearing age. Here, more than
60% of mothers work outside the home mostly out or financial need, pregnancy
leaves are more generous than in the US, but much, much less than in many
European countries.
Thank you for your input, please forgive my english, as it is not my first
language (I am a French canadian).
Louise Denhez, MD, MPH
also mother of 3, all breastfed, especially the third one for whom I went all
the way: pumping at work, wearing bf dresses and clothing, and nursing until he
was 4 and decided there was no more.
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