I pretty much always planned to breastfeed. It seemed like a given—not even a choice, really, but something I had to do. I knew that breast was best, because that message is everywhere from billboards, to magazines, to social media, to the posters on the wall of my doctor’s office. When the nurses asked me, “how do you plan to feed your baby?” I told them I was breastfeeding. Their smiles made it clear I had answered correctly.

When she was born, the first thing I did was nurse her. As a “Baby-Friendly” hospital, they encouraged all new moms to breastfeed exclusively. I carefully logged her feeding sessions on the chart they provided—30 minutes, 45 minutes, 15 minutes. When the nurses came to check on me, they said things like, “you’re doing such a good job, mama” and “everything looks great.”

After the first 24 hours of motherhood, I felt like a rock star. Everything was going exactly as planned. Then the next 24 hours were brutal. My daughter alternated between nursing and screaming. She couldn’t stay awake to nurse, but wouldn’t stay asleep if I put her down. She cried; I cried. I was too exhausted to think.

The next morning, I called the La Leche League. They told me to “just keep breastfeeding.” Everything would work out, and my baby was fine. Then I called the hospital lactation consultant, who said the exact same thing. My milk likely hadn’t come in yet, the baby was fine, and I shouldn’t worry as long as I kept nursing. She scheduled an appointment for me to come in the next day.

I didn’t want to fail at breastfeeding. It was not an option. As I reread my worn copy of The Womanly Art of Breastfeeding, I started to panic. I knew deep down something was wrong, and she wasn’t getting enough milk, but I was doing everything right, and I wanted it to work so badly.

Everyone said that breast was best. My friends, family, midwife, and the brochure they gave me at the hospital. When I had my baby, I worked for a women’s health provider, where we talked about breastfeeding with our clients, as if it was the easiest thing in the world. Public agencies like the Centers for Disease Control promote exclusive breastfeeding, as if it’s a simple problem of awareness. The truth is breastfeeding is hard, and sometimes not even close to possible. This pressure is not only unfair, and misguided, but parents and babies end up getting harmed in the process.

At the time though, I thought I just had to try harder to make breastfeeding work. I mean, obviously the problem was me. I met with the lactation consultant. She pressed my breasts into hamburger shapes, and squeezed my nipples to produce drops of milk. I felt my daughter’s tiny mouth latch on like a snake. I felt pressure in my chest, as I saw that the number on the baby scale had dropped. My daughter was starving. I was starving her.

My baby was admitted to the hospital for jaundice and dehydration. As I watched her gulp down formula, I felt like a failure. I told myself that I would just have to try harder, to do anything it took. There was a “breast is best” sign on the NICU wall. I asked for a breast pump and left her lying there under blue lights. When I returned with less than an ounce of breast milk, the nurse said, “is that all?” I felt the weight of her disappointed gaze.

I didn’t want to fail at breastfeeding. It was not an option.
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When my daughter was discharged, I started the impossible routine of breastfeeding, supplementing, and pumping 10 times a day, to boost my supply. I don’t really remember much about the next few weeks, aside from the pressure and pain of trying to make breastfeeding work. I should have spent the so-called fourth trimester loving my baby and learning how to be a mom. Instead, I was so preoccupied with breastfeeding, that I didn’t get a chance to really be her mom. I don’t really remember things like her first smile or laugh. I just remember the pumping.

I felt so much pressure, not just to breastfeed, but to breastfeed exclusively, as though my entire existence depended on increasing my supply. My midwife secretly prescribed me expensive prescription drugs that aren’t approved in the U.S.  I drank breastfeeding tea, took herbal supplements, and ate food reputed to increase supply. My nipples bled and cracked. My supply increased, only to dip again, and never became enough for my baby. I continued for months, not taking time to sleep, eat, or bond with my baby.

I felt shame. Rather than be seen in public giving her a bottle, I would hide in the bathroom to feed her. My identity was so wrapped up in how much milk I was making. I thought I was selfish, lazy, and a bad mother. Other people thought this too—the woman in the formula aisle said, “don’t you know that breast is best. The relative at my grandpa’s funeral said, “oh, you stopped breastfeeding? That’s so sad. My breastfeeding friend said, “you should just try harder.” Strangers on the Internet went so far as to tell me that formula was like feeding my baby McDonald’s or that it would make her sick. Hell, even the can of formula has the phrase Breast Is Best on the side.

As a woman, I’d spent my life under pressure—to be pretty and thin, to be pleasant, to succeed, to get married and have babies. I had been molded by society and myself into a perfection-seeking missile, never wanting to miss the mark. After 30 years of living up to expectations, there was no way I was going to fail to provide the best for my baby.

Eventually, I cracked under the pressure. I started to think my daughter would be better off without me. I made plans for her, once I was gone. I figured that my husband would be fine. He would have help from my parents. Or maybe someone else could care for her. A breastfeeding mom could nurse her. I wasn’t able to think straight, to really process what I was feeling or how the pressure to breastfeed was making me hate myself. My daughter was thriving on a combination of formula and breast milk, but I still thought I was not enough.  

Hell, even the can of formula has the phrase Breast Is Best on the side.
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Now, I have breastfed and formula-fed three babies to varying degrees, and I learned there are so many more important parts of being a mom. The constant refrain of “breast is best” made me hinge my success as a mother on something I couldn’t control—the physical ability to exclusively breastfeed—which I later learned was never going to be possible for me. It actually isn’t possible for a lot of new moms.

As human milk researcher Shannon Kelleher, PhD notes on themomvist.com, between 10 and 15 percent of moms can’t produce milk, and many more cite supply issues as the reason they stopped breastfeeding. While organizations like the World Health Organization and the Baby Friendly Hospital Initiative (BFHI) recommend exclusive breastfeeding for at least six months, only 22 percent of moms in the U.S. meet that goal.

Recommendations like this sound awesome, but fail to acknowledge how physically challenging breastfeeding is. Not to mention other pressures moms face in our society to “do it all”—working jobs with no parental leave, and not having enough support to raise babies, let alone exclusively feed them with our bodies. For many of us, the pressure to breastfeed contributes to postpartum depression, which impacts an astonishing one in seven new moms.

In July, Trump Administration rejected a breastfeeding resolution at the World Health Assembly in Geneva to promote exclusive breastfeeding worldwide and fund initiatives like the BFHI. And while people largely dismissed this move as patently bad, I had a moment of relief. As a culture, we’ve set the bar so high, and put new moms under so much pressure to achieve the impossible, that they are literally dying.

When you consider that in the U.S., babies do just as well on formula as breast milk, it’s time to take a step back from the “breast is best” rhetoric, to support all new parents in choosing to feed their babies in a way that works for them, and relieve some of the pressure of new motherhood, which is hard enough as it is.

As a culture, we’ve set the bar so high, and put new moms under so much pressure to achieve the impossible, that they are literally dying.
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I still remember the day the pressure started to dissipate for me. In the middle of my panic over breastfeeding my first child, I called a friend, the only formula-feeding mom I knew. I don’t know why I called her that day, but she came over. She sat with me, while I called my doctor to schedule an appointment. She held space for me to cry and vent all of the worries, and fears I had about formula, and all of the shame I felt about not breastfeeding. She offered no pressure, just support.

Most importantly, she told me about how her kids had done well on formula when breastfeeding didn’t work out for her. As we watched our beautiful children smile and coo from a blanket on the floor, I knew that she was right. Breastfeeding or not, I was enough. Formula was enough, or maybe even best for us. It was like being reborn as a new mom, without the crushing pressure to breastfeed. Slowly, but surely, I began to thrive, and my baby thrived, too, without another ounce of breastmilk.

When engineering teams aren’t diverse, only certain people’s problems get solved.

On April 27–29, MIT Media Lab will host its second Make the Breast Pump Not Suck Hackathon. The aim of the hackathon, the first iteration of which took place in 2014, is to bring technological equity to the table, to develop improved lactation devices, to fight the stigma of breastfeeding, and to brainstorm services that better support women who want to breastfeed their babies in a society that often shuns the practice. Centered on collaboration over competition, the hackathon brings together top CEOs of women’s health companies, teams of doulas, mothers of color, and LGBTQ parents and families to help generate better solutions for the breast pump.

Even for people who are not mothers, the hackathon highlights the need for collaborative innovation that reflects a wider community, making room for equity by design. But, breast pump? For many, that’s still a hard pill to gulp down, at least at first.

I’ll admit that I don’t think much about breastfeeding and I think of breast pumps even less. I’m a 48-year-old, unmarried, unpartnered woman. It’s more likely that I’d be struck by a bolt of lightning inside my own apartment than become anyone’s biological mother. And basically, a hackathon is like spring break for nerdy white dudes, so why should I care about what they’re doing? I have no tender mound of nipped flesh in this game. I’ve no breast in this pump.

The thought of breastfeeding conjures mythological images for me, like the 13th-century sculpture La Luna Capitolina, the Capitoline Wolf, nursing the frozen forms of Romulus and Remus. The lean she-wolf grimaces as the greedy twins, mouths and hands open, wait for her milk to rain down. My mind skips ahead 400 years to 1977, when Buffy Saint Marie breastfed her then baby, Dakota “Cody” Starblanket Wolfchild, on Sesame Street, while Big Bird observed.

In a recent television ad, Wisconsin gubernatorial candidate Kelda Roys not only challenges Scott Walker’s reign, but takes on the stigma associated with breastfeeding by nourishing her baby while delivering her campaign message. This seems like a revelation, so infrequently do we see breastfeeding in our culture.

Until last week, I didn’t know my own mother breastfed me. She never told me, and I never asked. I never even thought about it. This revelation just slipped out during a conversation between commercial breaks while watching Scandal. I thought about my bond with my mom, how strong it is, and how important it must have been to her back then, as a politically active, working mother and wife in 1970, to create space to breastfeed me in a time when women were also boldly expanding the territories of feminism and the meaning of womanhood.

The Troubling Erasure Of Trans Parents Who Breastfeed

Today, we treat breastfeeding as a solely natural occurrence. I mean, you don’t ask grass how it grows, right? We expect all mothers to be capable of breastfeeding, and to disappear from public life to breastfeed behind closed doors, or in dirty toilet stalls. Insurance companies give free, but subpar, breast pumps to poor and working poor mothers. But when those break, they suggest mothers have failed to adequately use said breast pump, which seems to have as many moving parts as a pocket watch, and then pressure them into feeding their baby factory-made formula when that’s not their preference, often as a result of their “failure” to express their milk using the pump. (It’s important to note too, of course, that women should have the freedom to decide the best way to feed their children, be it breast or formula or some combination of the two.)

We gaslight mothers by saying things like, “breast is best,” while ignoring the need for an equitable infrastructure, like paid family leave, so they actually have time to bond with their children. We tell women we value them most when they become mothers because, “[we] believe that children are our future,” and then we rob them of the time to actually parent their kids. How is this all supposed work?

Catherine D’Ignazio, an Assistant Professor of Civic Media and Data Visualization Storytelling in the Journalism Department at Emerson College, and co-founder of the Make The Breast Pump Not Suck Hackathon, was a graduate student with a newborn pondering the answer to this question while dealing with the complications of feeding her third child and getting to class. Using a breast pump became an essential part of her life and routine when she faced a medical crisis. This need for a breast pump also revealed many of the problems women face in the pursuit of using the machine.

We gaslight mothers by saying things like, ‘breast is best,’ while ignoring the need for an equitable infrastructure.

“A couple months in, I couldn’t breastfeed for 48 hours,” D’Ignazio tells me in a phone interview. “It was a little insane I couldn’t find any help. I was a privileged person, I could pay out of pocket, and I literally couldn’t find anyone to help me. It was fine, he didn’t die, but the experience was traumatic.” D’Ignazio explains that while she possessed the affluence to obtain high-quality health care, key elements of postpartum support, like an efficient breast pump, and the infrastructure of time and space to use it was lacking.

Her third time pumping, D’Ignazio says she had a revelation:

“Shit, I’m sitting on this bathroom floor pumping, at MIT, in this super fancy building in the most elite engineering school in the world. Why am I sitting on the fucking floor?”

Her frustrations led D’Ignazio to reach out to her colleague, Alexis Hope, a designer and research affiliate at the MIT Media Lab and Center for Civic Media, to tackle the problem head on. “That was the starting point of the whole thing,” D’Ignazio says. “We were in a position of power — we could do something about this!”

In 2014, the MIT Media Lab hosted its first hackathon to improve the breastfeeding and breast pumping experience. That’s not to say making the hackathon happen was an easy sell. “[The Make the Breast Pump Not Suck Hackathon] was perceived as weird by students, faculty, and administrators at first,” D’Ignazio says. “Like, why are you doing this?” But soon, more people got on board. “One particular group was so moved by the talks and energy of the event that they dropped out of volunteering and formed their own team. They developed this warm pump cover to make the pumping experience more warm and fuzzy.” She recalled some team members said, “I see why this matters.”

Your Attitudes About Parenting Might Be Classist

While 2014’s Hackathon was a fun event that brought together 150 engineers, designers, health-care providers, parents, and so many babies that the event set a Guinness Book of World for the most babies at a hackathon, it was a predominantly white experience that seemed to be designed for a privileged few. Ultimately, the hackathon rendered solutions for the breast pump that mostly only wealthy people could afford, like a $1,000 breast pump — not exactly what D’Ignazio had in mind.

“[Innovators] made a lot of assumptions about people’s job situations — that they had a private office to pump in, access to outlets,” D’Ignazio says. Innovators assumed that they’d provided solutions to serve the needs of all women. But innovation requires equity; otherwise you end up with technology like soap-dispensing sensors that only trigger soap when a white person uses them. Real change comes when the most marginalized in society are able to harness the power of equity to move forward.

That’s why even I, a childless human, am on board. It’s time to create a world that works for everyone, not just the privileged few. The breast pump is as good a place as any to push for inclusion in design, and that can’t happen without equity on all fronts.

Real change comes when the most marginalized in society are able to harness the power of equity to move forward.

Kimberly Sear Allers, author of The Big Let Down: How Medicine, Big Business and Feminism Undermine Breastfeeding, and the Media and Communications Strategist for the team, has been instrumental in the shift of perspective on the hackathon. According to D’Ignazio:

“[Allers’] book was a galvanizing force to think about how we address these things in a more systemic way while maintaining the playfulness and let’s-do-it spirit of the first hackathon, at the same time recalibrating who’s innovating and who’s at the table.”

D’Ignazio says Allers’ research provides a pathway to understanding the power of shifting the narrative of breastfeeding from corporations and insurance companies — with their shitty products and policies that profit from our collective silence — to sharing personal stories that support the expansion of breastfeeding knowledge between mothers, their children, and their families. And by giving nursing mothers a place to share their stories, engineers can hopefully better understand what they really need.

Allers explained that “it’s not okay to have a group of white male engineers designing something that needs to also help low-income white women, and when there are many black and brown engineers who should be at the table as well.” Black and brown voices will also be amplified in the hackathon’s participants and teams.

Bad Advice On Foster Daughters And New Mom Nudity

The Make the Breast Pump Not Suck now hosts four organization communities through its Community Innovation Program Breastfeeding Innovation Fellows. The Boston Team, under the leadership of Nashira Baril, is working on the creation of a free-standing birth clinic to be based in Dorchester, Massachusetts. Harambee Care of Detroit, led by Executive Director Anjanette Davenport Hatter, is developing tools for self-advocacy and to increase the availability of lactation support based on the individual needs of mothers and infant care. Rachael Lorenzo, Founder of Indigenous Women Rising, is working with Pueblo and Apache seamstresses to develop breastfeeding-friendly regalia that will allow mothers to breastfeed while maintaining their sacred practices. And the Tupelo team, spearheaded by Toni Hill of Northeast Mississippi Birthing Project, focuses on breastfeeding equity and culturally appropriate care.

Along with the diverse voices of the teams participating, hackathon organizers will present the findings of their story collection project from the previous hackathon. Many expressed their displeasure with the time it takes to clean the pump, the god-awful sound it makes when in use, the need for more discrete ways to pump when in public, and the pain of having one’s nipple suddenly sucked into a plastic, conical-shaped cup. The story collection also yielded compelling arguments for not only better breast pumps, but improved postpartum services for mothers and families.

“The reason we are doing this again is the immense story collection and analysis process that happened after the last one,” Becky Michelson, Project Manager at the Engagement Lab at Emerson College and the Program Manager of Make the Breast Pump Not Suck Hackathon, says. “During the last Hackathon there was an email open to the public that said ‘share your experiences and we’ll share them with engineers, technologists, and researchers.’ People thought a few dozen would come in. More than 1,100 stories came. Some of the findings were…there was a lot of internalized shame, guilt, anxiety , and depression, because people felt they are failing.”

The Tech Bias: Why Silicon Valley Needs Social Theory

According to Michelson, the stories revealed that a better breast pump is a societal issue. Our culture, while pressuring new mothers to breastfeed, is not set up to help women and new parents succeed at breastfeeding and pumping when they need support. “We need to take on a more system-level approach to change and to galvanize creativity, innovation, and advocacy for breastfeeding and pumping support,” says Michelson, “so it’s not just about the pump this time around; it’s about the ecosystem, technology, and program services for the postpartum experience.”

Adds D’Ignazio:

“The stories were about way more than a breast pump. They were stories about going back to work, the stigma of breastfeeding, the places where people were pumping. There were stories of women feeling like failures. That’s what galvanized us to think about how to address this in a more systematic way. We needed to turn that negative energy on the system that was failing us.”

The us means ALL of us — even no-baby-having people like me, because in order to create real change we have to center the most marginalized to see that change.

Included in the latest iteration of the hackathon is the work of Kate Krontiris, Principal Investigator on the Hackathon’s Leadership team.“The design [of the breast pump] itself is an issue of equity,” Krontiris says. “We don’t value parents’ time. If your baby requires triple feeding [to up a mother’s milk supply], if your baby had to eat every three hours — two out of three hours are spent feeding and cleaning the pump, and that’s one hour of sleep every three hours. Designing a pump to be a much better and more efficient process actually has real implications.”

While the need is obvious to hack the breast pump, Kimberly Sears Allers cautions us all to question our reliance on machines, even breast pumps. Allers suggests that we balance innovation, policy, and equity if we really intend on fruitful results of this hackathon.

“I feel very strongly that breast pumps are a necessary evil,” Allers says. “Women actually deserve time to mother. We can’t let the pump enthusiasm distract us from the fact that it is a crime that women are going back to work two weeks after giving birth and that we have to rely on a machine to finish the job that we’re not allowed to do ourselves. We have to not become a Pump Nation and turn the pump into the all mighty thing to save us, when what we really deserve is time to mother, time to breastfeed and be with our kid.”

Even so, Allers says that breast pumps should at least work efficiently if we must use them, and that tied to efficiency, this is the true value of using the machine — the value of a parent’s time.

The breast pump is a tool, and one whose use affects all of us, breastfeeders or not. Let’s make better ones that work for everyone.

Racial inequality in the U.S. is so entrenched, so debilitating, that even Black babies—even, sometimes, within their first hours of life—are impacted by it.

Consider, for a moment, these chilling facts:

The infant mortality rate for Black babies is 2.4 times higher than it is for white babies in the U.S.

Black infants are two times more likely to die from SIDS and SUID than white infants.

Black infants experience nearly four times as many deaths related to short gestation and low birth weight.

Black preterm infants, compared with white infants, are three times more likely to suffer from necrotizing enterocolitis (NEC), and twice as likely to die from the condition.

Not surprisingly, bigotry plays a critical role in this disparity; research shows that racism-induced stress can have adverse effects on the health of Black women and, subsequently, on their babies. Lack of access to quality care also contributes to the mortality gap.

But there’s still another factor at play here, and it’s one that often goes overlooked, perhaps because it taps into a controversial debate: breastfeeding.

For too long, the dialogue around breastfeeding has been a deeply privileged one that erases and ignores Black women. And until we confront this fact, we can never fully address what amounts to an alarming health crisis for Black mothers in America.

It’s not a coincidence that Black mothers, while facing high rates of infant mortality, also have the lowest breastfeeding rates in the nation. There is a direct link between breastfeeding and infant health — studies show that breastfeeding helps lower incidences of SIDS, a leading cause of infant death, and reduces the occurrence of NEC, a condition that causes bowel tissues to die and is the leading cause of death in low-birthweight infants. So why do so few Black mothers breastfeed their children?

Part of it may have to do with the legacy of slavery: Some Black women have been reluctant to breastfeed, experts note, because slaves were often forced to nurse their slave masters’ children. Further, the advent of formula in the 1920s through ’40s brought with it “aggressive marketing” to Black communities; formula companies pushed the notion of their products being “the substance for sophisticates” and the choice of the elite.

Moreover, the health-care system has turned its back on women of color. Put simply, Black mothers often lack the community resources they need to successfully learn about and initiate breastfeeding. (Many of these forces, it’s worth noting, have also impacted American Indian/Alaska Native women, who breastfeed at higher rates than Black women, but lower rates than white women.

As a Center for Social Inclusion report put it:

“Many mothers want to choose to breastfeed because of the significant, inarguable benefits it offers both the mother and child, but without the right support, the choice is made for them.”

One of the most significant barriers to support exists in the very first place many infants see: the hospital.

Because hospital practices in the first hours and days after birth are essential to the success of breastfeeding, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have requirements in place for what they call “Baby-Friendly” hospitals. Facilities with this designation must, for example, initiate breastfeeding within the first hour of birth and train all staff to implement breastfeeding protocols. Some of the policies of the Baby-Friendly initiative — like a requirement that there be skin-to-skin contact between a mother and her baby immediately after birth — have been criticized by doctors and mothers for being ineffective and unsafe. Still, research shows that breastfeeding rates are higher in these hospitals. Moreover, Black breastfeeding rates in particular are significantly better in these hospitals. In a 10-year study of an inner-city neonatal intensive care unit, breastfeeding initiation rates for Black infants increased by 28% (compared to 10% overall) since the hospital’s designation as Baby-Friendly.

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The health-care system has turned its back on women of color.
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The problem? In areas where more than 12% of the population is Black, most hospitals do not follow recommended breastfeeding practices, and Baby-Friendly hospitals are nowhere to be found. This lack of initial support, combined with the implicit bias in health care that women of color already face, set Black women up for failure from the literal beginning.

As a result of these institutional barriers “in that first 28 days of life, a good chunk of our Black babies are not making it to that first year,” Andrea Serano, certified lactation counselor and program manager at ROSE (Reaching Our Sisters Everywhere), a breastfeeding support organization, tells me. “What we’re finding in our community is that there is this limited access to breastfeeding resources across the spectrum.”

ROSE is one of many organizations fighting to fix this resource gap; in addition to supporting Black breastfeeding through interventions, its members sit at the table with policymakers who can influence breastfeeding support efforts nationally — crucial in a landscape where racial disparities in breastfeeding are proven to decrease when the law supports breastfeeding. Black Mothers’ Breastfeeding Association is another organization working diligently on this front. Through advocating for legally mandated pumping breaks and private spaces for working mothers, championing to require insurance companies to provide no-cost lactation services, prohibiting child care facilities from discriminating against breastfed infants, and pushing for national legislation protecting a wider group of working moms, these organizations use policy and the law to help close the breastfeeding class and race gap.

But the solution to this troubling gap in infant mortality will take more than organizations like ROSE and USBC pushing for change. It will also take re-framing the debate around breastfeeding altogether.

While there is ample research supporting the benefits of breastfeeding, there has been a movement in recent years to challenge its hegemony. Movements like “Fed Is Best” are predicated on the idea that, quite simply, mothers should be supported in choosing whatever clinically safe feeding option is best for them, be it breastfeeding, formula, or a combination of both.

In many ways, pushback against the “breastfeeding only” approach is understandable: In a society that sadly insists on cultivating “mommy wars,” it’s important to respect the autonomy of all mothers.

But at the same time, this debate is a problematically privileged one. Black women not only face immense barriers to breastfeeding, but according to the CDC, are sold formula in hospitals at higher rates. As previously mentioned, there’s historical precedence to this resource disparity as well: The emergence of formula in the 1920s and ’30s led to lower breastfeeding rates across the U.S. — but when evidence began showing the health benefits of breast milk, white mothers gained greater access to that information, and began nursing again at higher rates.

When there’s such historic, disproportionate access to education and resources, what’s presented as a choice is really no choice at all.

“The reality is that we have to talk about race, and that is a very uncomfortable topic, and many have issues with coming to terms with it,” said Serano. So instead, we dismiss the benefits of breastfeeding as overstated, citing the weak correlations between breastfeeding and lower food allergies. We talk about the struggles of women who initiated breastfeeding with support and could not continue. These discussions are important — but while Black infants are dying and evidence tells us that initiating breastfeeding could turn that around, they should not be centered as the most important discussions.

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The reality is that we have to talk about race
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Instead, we must focus on the disparities that need to be addressed in order to ensure women of color have access to breastfeeding resources and are empowered enough to make the choice to initiate breastfeeding. We must stop dismissing the maternal health inequities that Black women face as purely socioeconomic, when evidence shows that this is not the case — cultural factors, including attitudes toward breastfeeding influenced by slavery, and stress and depression caused by racial disempowerment and systemic discrimination, have played a key role in the infant mortality gap.

What’s happening in this country with Black infants is nothing short of a public-health crisis. If there’s a national discussion to be had about breastfeeding, let it be that one.

In many Indian homes, the intensely personal decision to have a child is not limited to the space between spouses, and certainly not to women alone. I often joke that discussing procreation and being inquisitive about people’s desire to further their progeny is a national pastime.

I’ve had distant relatives — people I don’t know well — feel no hesitation in checking up on my plans to start a family. But there’s more to it than relatives making polite conversation at family gatherings. Friends report being grilled about their reproductive choices at staff meetings, conference calls, job interviews, and even on first dates. There’s just no winning, even with a baby in tow — one-time mothers are often chided about not having a second child, while ones with daughters are pressured into having another in the hope that it will be a boy.

And yet, despite these forces, I was initially ambivalent about the prospect of motherhood. Culturally, it’s deeply ingrained as a crucial milestone of adulthood, so I believed that sooner or later I would “lean in” and accept it. But over time, this ambivalence turned to clarity that motherhood was not for me. For one, I never felt the pangs of maternal instincts that so many women speak of. Thankfully, the myth that all women want children has been busted. Also, I couldn’t think of a single aspect of my life that I wanted to off-load (even temporarily) to make room for a child. But most of all, I intuitively knew that motherhood just didn’t call out to me.

As an Indian woman, my decision to not have children meant facing a barrage of intrusive questions, fielding off unsolicited advice, and steeling myself from unwanted “treatments” and “fixes” — all offered to correct this “obvious flaw.” There is a common notion that motherhood “completes” a woman in a way nothing else can, and I felt lonely in my choice.

I was 31 when I stumbled upon Megan Daum’s anthology Selfish, Shallow, and Self-Absorbed: Sixteen Writers on the Decision NOT to Have Kids — a book of essays by a range of writers, men, and women of varied sexual orientation describing their decision to not have children. In this anthology, I found comfort, peace, and a sort of camaraderie that made me feel less isolated about eschewing motherhood.

At the same time, I found company in a tribe of Indian women who echoed my sentiment. They listened, without belittling or rushing to offer a solution to alter my thinking. Having faced their share of meddling questions and conjecture about their reproductive choices, I knew they’d appreciate the essays in Daum’s book as much as I did.

I set out to talk candidly with four friends about the book . . . and to gain insight into their own decisions to challenge motherhood — a concept inextricably linked with my culture’s ideal of the perfect woman.

“I don’t hate children. The children of family and friends are much loved and pampered by me,” my friend Chandni starts off. “Just because I don’t want my own, do not assume that I won’t be interested in activities involving children.”

Contrary to the most common assumption about choosing to not have children, I — like Chandni — do not hate children. Nor do I hate people who choose to have them. An inability to acknowledge the possibility that some of us are simply not excited by a life caring for little ones dismisses our agency to find purpose in places and activities outside of motherhood.

Roshni is 40 years old and an accomplished author. She tells me that motherhood didn’t particularly ever appeal to her. She finds the lives of those with kids stressful, burdened, and not enviable. But social conditioning runs deep, and she bore some guilt when having to acknowledge a future without motherhood.

On finding solace within Daum’s book, she says: “The book provided some useful reference points to help me begin letting go without feeling unnecessary guilt or attachment to ideas I had been holding on to as a consequence of social conditioning.”

We both agreed that Pam Houston exemplified this concept of self-determination in her essay, “The Trouble With Having It All,” in which she writes:

In this and other ways, the book does a fantastic job of plainly presenting the spectrum of reasons to choose a life without children. My friend Shilpa says it took her upwards of 30 years to really grow into herself as a person and become comfortable with her own body and in her own skin. As such, the idea of stepping into motherhood and inevitably unsettling that newfound comfort never appealed to her. Her favorite essay, “Mommy Fearest” by Anna Holmes, states:

“These days, as I enter my forties, I find that I am only now beginning to feel comfortable in my own skin, to find the wherewithal to respect my own needs as much as the others’, to know what my emotional and physical limits are, and to confidently, yet kindly, tell others no. Despite (or because of) my single status right now, becoming a mother would feel like a devolution as much as an evolution.”

The book also doesn’t shy away from acknowledging that even the most self-assured women amongst us cannot sidestep the painful possibility of waking up to realize that, perhaps, we made the wrong choice. But as Jeanne Safer eloquently put it in one of the most relatable pieces for me, “Beyond Beyond Motherhood”:

“There is no life without regrets. Every important choice has its benefits and its deficits, whether or not people admit it or even recognize the fact: no mother has the radical, lifelong freedom that is essential for my happiness. I will never know the intimacy with, or have the impact on, a child that a mother has. Losses, including the loss of future possibilities, are inevitable in life; nobody has it all.”

I sometimes wonder if being selfish about what I want out of and for my life is really such a bad thing — especially when I consider the crucial fact that in most Indian families, childcare is shouldered almost entirely by women. Even the most hands-on father will never experience pregnancy, childbirth, recovery, or breastfeeding, leaving women to be primary caregivers.

In “Maternal Instincts,” Laura Kipnis debunks the idea that society favors parents. She posits:

“Until there’s a better social deal for women — not just fathers doing more child care but vastly more social resources directed at the situation, including teams of well-paid professionals on standby (not low-wage-earning women with their own children at home) — birthrates will certainly continue to plummet.”

My friend Nisha lives in Chicago; her immediate family lives across the world. The distance from this support system means she has to carefully consider everything that she will need to give up in order to transition to parenthood. “If it was easier to visualize a life with children, I bet more women would choose it. But without help from family or financial resources to hire people to take care of cleaning, babysitting, shopping . . . it’s definitely not an easy choice.”

Fortunately, increased dialogue around this means we’re also opening ourselves up to the idea that it’s okay to make this choice. Those who have chosen to not have children are finding common ground in circles of likeminded folks, often joining Facebook groups to share essays, books, and resources. In this way, we are engaging with others who, like us, acknowledge that parenthood and living a wholesome, meaningful life are not mutually exclusive.

I’m a willing and happy auntie not just through blood ties but through bonds of friendship of my choosing, and I have, at various points, contributed to and been a part of some milestones in parenthood along with my closest friends. Like Daum said in an interview:

“These essays have so many people talking about the ways that they do have relationships with kids, nieces or nephews or kids that they mentor. You’ve heard the cliché ‘it takes a village.’ There are so many ways of being a responsible villager.”

Accepting what is right for you, even if it means embracing an unpopular choice, requires conviction and courage in a society that has no trouble exerting its opinion on you at every turn. It means going against the grain and shunning motherhood even if it’s perceived as a weakness or selfishness.

I would love more well-meaning aunties to read Daum’s introduction: “It’s about time we stop mistaking self-knowledge for self-absorption.”