Laurita Dianita

Reflections and art on the topics of public health, social justice, and love

Archive for the ‘feminism’ tag

On the occasion of Fidel Castro’s death, brief thoughts on Cuba and the US American Left

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I wrote this yesterday, as the world learned of Fidel Castro’s death, on my phone as a Facebook post. Today, with both kids napping, I finally have a moment to make it into a blog post.


In the upper left, my traveling companions and friends, Sandra and Clare. On the right and bottom, the gregarious and adventurous children we met in La Sierra Maestra.

Fidel Castro’s death comes at a time when the US American left-of-center is asking a lot of the questions about unity vs. diversity of cause that my friends Clare and Sandra and I were asking when we spent 3 weeks in Cuba in the summer of 2005. (This was Clare’s return to Cuba after having studied abroad there 2002 – 2003, the first trip there for me and Sandra).

We wrestled with many questions that trip, as we talked politics and history with our friends and hosts throughout the island (including La Sierra Maestra, where the revolution was fought and where I took the photos above) and as we poured through essays on the Bautista dictatorship and US Imperialism, La Revolución, the literacy brigades (a host family even taught us the song of the brigades — “alfabetizar, alfabetizar, venceremos!”), the healthcare system, public transportation, and more. We were so impressed by the egalitarianism and base level of health: everyone had food, shelter, potable water, healthcare, mental healthcare, education, and jobs. No children died of vaccine-preventable diseases or diahrrea. There was not much crime. Women and men were camaradas. The only people with a whole lot of extra stuff were those with family in the US sending them Playstations and dollars they could use to get “Divisa,” the tourist money. We were very impressed by the government support for artists and the arts, the celebration of cultural diversity, and the revolution’s efforts to increase gender equality.

And yet, from what we could gather, all of these reforms were done because of a “unity” that required repression of diverse viewpoints and a repression of the voices of those who were still not enjoying full equality. Race equity was better there than in the US, but most top government posts were filled by light-skinned Cubans, and the largest houses seemed to be all occupied by lighter-skinned Cubans as well. The government’s support for the rise of women in the professional world was not accompanied by as strong of a push for men to take up an equivalent share of the housework and childcare duties, or significantly reform sexist treatment of women. (Related to this, we experienced sexual harassment in the big cities, but never in the small towns.) Universal healthcare was great, but the standard approach to childbirth left much to be desired, from my perspective as a proponent of the empowering midwifery model of care. With few opportunities for advancement in certain kinds of jobs, the quality of effort and innovation seemed to be compromised. The limits on seafood for Cubans, which in effect meant that most of the time only tourists could eat the amazing lobsters and shrimp that were abundant in their oceans, grated on us (so we bought some lobsters from a fisherman we literally met while in the ocean, and cooked them with our friends in La Habana). In fact, there were a lot of systems that favored tourists at the expense of Cubans, and in one experience we had, used race informally as a marker of who to exclude. And of course, the imprisonment of gays and political dissidents, the government control of press, and the fact that Fidel still hadn’t ceded power was super messed up.

We had rich political conversations with many Cubans of all racial backgrounds and different professions and ages. Their perspectives were often a complicated mixture of admiration for and disappointment with their system and their leadership. Clare and Sandra and I asked ourselves a lot of questions about whether the US American Left would be more successful if we could concentrate on fewer issues and all gather behind a charismatic leader and an economic and egalitarian vision like Cuba had done. We wondered if each person concentrating on separate causes divided us too much to be able to compete with the hyper-organized and controlled Right. But we couldn’t reconcile the Cuban “unity” approach with the intersectional, anti-racist, feminist, pro-LGBTQ, freedom-loving vision we had for our future. We really couldn’t.

I have been thinking about those questions a lot in the last few weeks as I hear Dems saying we lost for lack of focus on a singular economic vision that Blue Collar whites in the middle of America could get behind, that we lost because our voices and causes were too diverse. I don’t know exactly what the answer is, but I would hope that we could learn from Cuba how to gather behind a bright and beautiful idea, but avoid the repression of voices that Fidel propagated, which left them a more hollow version of that vision.

Ciao, Fidel. A complicated legacy you left.


Billboards are used for public health and social messaging. This one says “Ideas are more powerful than nuclear arms.”


Our friends Beatriz and Denis, who we met at a party in the Verbenal neighborhood of La Habana. I am still in touch with Denis, 11 years later.


Children I met in La Vieja Habana while waiting for food — a cardboard plate of congrí with pork and green beans sold from a residential window.



One of my journal entries from Santiago de Cuba, on the Eastern end of the island



Enjoying lobster and congrí with Denis and his family in La Habana Vieja

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November 27th, 2016 at 1:31 pm

On Breastfeeding

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Oscar ( took this picture our first time eating out at a restaurant

The first few days of breast-feeding, I kept asking myself, “Why is it that the female of the human species has not evolved to have more arms?” The conclusion I came up with is that we haven’t needed them because humans are a cooperative and inventive species. Sarah Stevens, the lactation consultant at Geneva Woods Birth Center, said she thinks it’s because we have traditionally lived in tribes and had aunties and grandmas and sisters to help.

I think often of this help, of what it looks like today and what it may have looked like over our time on this planet. We have survived as a species because women have breastfed. For most of our existence, there was no alternative. And yes, there were wetnurses, but this was not available or affordable to most women. We have survived because women have breastfed successfully.

This fact might not seem remarkable at all, but the more I muddle through and learn in this process and the more I talk with other mamas and with those who work in the field of supporting mamas, the more evident it is that to survive, women have had to teach and support one another a considerable amount. Breastfeeding is not as easy as I thought, and struggling with breast-feeding related challenges is far more emotionally charged than I thought.

Breast is Best


I should preface anything else I write about the difficulties by saying that I don’t mean to scare anyone away from breastfeeding. It is absolutely the best choice for babies and mamas and families. It is free, it is convenient, it helps prevent postpartum depression, and it helps mom and baby bond deeply and form secure attachments, which will affect baby’s lifelong mental and physical health. It gives the child mom’s immunity to diseases and provides specific and responsive immunity to germs that baby encounters in the world. It protects against allergies, helps prevent obesity in the future, and populates the child’s gut with healthy microbiota. It also helps the child’s brains develop and contributes to higher IQs. Also, it’s just awesome—we can create the most nutritious food in the world from our bodies in whatever quantity our babies need! What a superpower!

But It’s Not Always Easy…


Knowledge & Support

We are meant to do this, but that does not mean that it all just falls into place naturally. There are baby issues, such as tongue-ties and high pallets. There are nipple issues. There are milk supply issues. There are all sorts of difficulties with latching.  Some women experience considerable pain because of some of these issues, and some babies are slow to gain weight until these issues are resolved. The very good thing is that with only some rare exceptions, they can be resolved and successful breast-feeding can be initiated and sustained.  However, this requires skilled lactation support.

When my mom was breast-feeding me and my sister, Claire, in the late 70s and early 80s, she had no real support. There were no nurses or lactation consultants to advise her on proper latch. She and my dad thought that bleeding nipples were just part of the deal. The “medical knowledge” about breast-feeding at the time, which my parents had access to as medical professionals, was often erroneous, such as the guidance to nurse only for eight minutes on each side. Fortunately, her milk supply was fine, and we plumped right up.

How is it that by the mid century in the United States of America, so much of our ancient breast-feeding knowledge was lost? Given that women have breastfed over the history of our species, I assume that there were always women in every community or tribe or family who were particularly skilled and were able to teach the younger women about latch issues, how to get their supply up, etc. In the US, I imagine there were people, probably outside of more urban areas, who retained their traditional knowledge of how to breastfeed even as it was lost in medicine. But boy oh boy the formula industry and medicine’s adoption of it really did some significant damage to our capacities as a whole.

We’ve come along way in medical and mainstream US American culture since I was a baby and my mom was a baby. We now have far more research on the science of breast-feeding. We have International Board Certified Lactation Consultants (IBCLCs), who go through extensive schooling, practice requirements, and examinations. We have personal breast pumps—which are finally covered by most insurance plans, thanks to the Affordable Care Act. Also thanks to Obamacare, employers have to offer breast pumping space and reasonable milk expression breaks to employees. Far more people have begun to understand the benefits of breast milk and question the sneaky tactics of the formula industry. WIC now encourages breastfeeding and gives out pumps. And there are more spaces now (especially online) for dialogue about changing the culture to accept public breast-feeding. As a result, far more women breast-feed now and do so for longer. (And yes, we have a long long ways to go yet.)

Fear, Inadequacy, and Shame

I have been involved in discussions of the cultural, medical, and economic issues around breastfeeding for a long time. I entered motherhood prepared to ask the IBCLC at Geneva Woods for help and prepared for the haters who were going to give me a hard time for nursing Ida in public. But I was not prepared for the feelings of fear, inadequacy, and shame I would experience when issues arose—feelings which, I have since learned from friends, are quite common among women who struggle with breastfeeding or whose babies have any kind of weight gain or other issues.

I hesitate to write about our experience because I am afraid of judgment, afraid of that societal chorus that hangs women out to dry for every outcome associated with their children, even afraid of a whole lot of well-intentioned (and often contradictory) advice about what I should have done differently. But I am writing about it anyway because so many of us go through these things and feel isolated and alone in the process.

I did everything I could to get Ida as much colostrum as possible and encourage my milk to come in. I wasn’t too too worried when her weight had dropped a good bit at her first Pediatrician visit, especially when I discovered at the end of the visit that my milk was coming in. She started to gain back her weight as my breasts became heavy and hard with milk. But then, about a week later, she stopped pooping regularly and she started nursing all the time, almost without break. She was acting hungry. (Though, as my mom and a few others said, she didn’t look like a worried, hungry baby and she was still strong and relatively content and alert and peeing a lot, so no one except me was exceedingly worried).

We didn’t have an opportunity to weigh her until she was 13 days old. When I saw the scale and saw that she was still 3 oz. below birth weight (you want babies to be back to birth weight by 2 weeks), I started to cry. I cried off and on through my 2 week visit and the lactation consultation. We had quite a few visits over the next few days and figured out that I needed to get my milk supply up and that Oscar and I needed to keep her awake and eating more actively. (She has this very slow approach to eating and can tend to fall asleep at the breast and just quiver her mouth instead of suck.) We also wanted to reduce anything that might be causing her to burn more calories than needed, so we turned up the heater in the house and took a hiatus from walks and even tummy time for a while until she was able to retain enough calories to poop.

By feeding her every two hours around the clock, trying different sleeping arrangements—including co-sleeping on the floor, which I said I wouldn’t do but baby girl was fussier and I had to feed her all the time so we did this for a few nights—, pumping after almost every daytime feeding, taking herbal tincture, upping my intake of fat, tickling and changing her to get her to stay awake and eat more actively, my milk supply increased significantly. By week 3, she weighed 6 oz. above her birthweight, she started pooping again, and I had (and still have) huge, heavy breasts.

But until we got that reassurance that she was alright, I was so scared. So worried, so embarrassed, so…ashamed. And I know better than to give in to shame! I know that shame is a toxic product of our culture and belief systems. I know that it’s useless. I know the importance of critical thinking, shame resilience, and connection with others. I tried to absorb the empathy offered to me to combat it. But I also didn’t want to be around people other than my mom and Oscar most of the time because I was embarrassed and scared. I didn’t want to talk about it publicly until it was over and resolved… until I could prove that I was a good mom, I think.

I think I experienced something shared by many mamas—we want nothing more than for our babies to gain weight and be healthy and happy. So when they aren’t doing this adequately, and it has something to do with us, we feel like we are failing our children, like our bodies are failing them, like our bodies can’t just do their jobs. I felt this same way about my body when it took us a while to get pregnant and everyone else I knew was getting pregnant all around me, many of them on accident. I am a critical-thinking feminist woman, and yet I had lodged somewhere in my psyche this old biblical, patriarchal (not to mention super gender essentialist) judgment system that came out to taunt me, to tell me I wasn’t a real woman.

Overcoming Shame and Secrecy


What the hell? How does this patriarchal stuff survive, even in the minds of feminists? One thing I know is that it survives much better in silence than it does when we share these feelings and experiences with one another. The women who shared their miscarriage stories after we miscarried (and the men who shared the miscarriage stories of their moms and sisters and such), the couples who talked about their efforts to get pregnant, and now, the mamas who have confessed to me similar feelings of inadequacy as they struggled with latch issues or the like—all this weakens the power of these woman-blaming discourses. Y’know, this old axiom:

El pueblo


Jamás será vencido!

(The people/united/will never be defeated)

I love how Anne Lamott describes both the fear and the triumph of this process when her son, Sam, is just a little older than Ida is now:

Sam is so much bigger every day, so much more alert. It’s mind-boggling that my body knows how to churn out this milk that he is growing on. The thought of what my body would produce if my mind had anything to do with it gives me the chill. It’s just too horrible to think about. It might be something frogs could spawn in, but it wouldn’t be good for anything else. I’ve had the secret fear of all mothers that my milk is not good enough, that it is nothing more than sock water, water that socks have been soaking in, but Sam seems to be thriving even though he’s a pretty skinny little guy.

I’m going to have an awards banquet for my body when all of this is over.

I have been a little hard on my body, and I think I owe it an awards banquet too.

For now, I will celebrate with a little image gallery of iPhone photos I’ve made representing how we spend much of our time—breastfeeding and falling asleep at the breast:

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February 22nd, 2014 at 12:49 pm

Protected: Week 36

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December 30th, 2013 at 9:14 pm

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25 weeks.

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This week Ash Adams came over and took the pictures for us, which was fun because  Oscar could be in them. It was a cold and rainy morning (you can even see raindrops in the photos). We made it as warm and fun as possible.

Baby is growing even faster now and sometimes wiggles so hard it feels like the little person is gonna come out of my skin. Here's baby's papi blowing a surprise raspberry on my belly.

What makes a baby

My senior year of college, the professor of my “Feminist and Queer Studies” class told us that she and her wife had recently had a baby. When asked which was the biological mother, they would tell people that they both were. What they meant by that, my professor explained, was that there are many ways in which we can biologically contribute to and affect a child. While one partner clearly contributes the eggs and half the chromosomes, plus extra mitochondria, the uterine environment for 9 and a half months, the nutrition and hormones and experiences that make their way through the placenta, and much more, the other partner—and the other people in the pregnant woman’s life—contribute biologically by providing food, emotional and logistical support, love, etc. or, on the other hand, by providing sources of stress and fear, unsafe conditions, and so on. Of course, the same is true after a child is born.

Given what we now know about the effects of the prenatal and early childhood environment on baby’s metabolism, muscular development, organ and brain development, and even how the baby’s genes express themselves (for real—this field of study is called “epigenetics”), along with the vital importance of human relationships for health, this makes sense. The pregnant woman is not the only one contributing to how her baby turns out–her family members, friends, colleagues, boss, etc. all contribute significantly. Ash, for example, contributes biologically to baby when she feeds me yummy cashew cheese or helps us with photos and the baby shower (thereby reducing stress hormones).   My mom and dad play a huge role, and not just as the contributors to my genes. And who else makes a difference? The folks running the institutions and governments that make decisions affecting our access to healthy foods, places to exercise, stress over income, sex education in schools, access to health care and other services, etc. So one of the implications of my professor’s words, I think, is this: that the responsibility for healthy pregnancies (and therefore healthy people lifelong and onto the next generation) is diffuse and belongs to many of us. Or to all of us if you count us all as potential community members and voters.

The other implication, and this is where I was starting in reflecting on these photos, is that dads and partners (male or female or trans, dad or not dad) matter.  A lot. And yes, I aware that this is not a new insight, just one worth reiterating. I have wanted to include Oscar in these photos because he contributes biologically much more than just his half of the chromosomes. Baby will be born familiar with his voice as well as mine. He feeds me and supports me to get good sleep. And as he remains involved in the process of going to childbirth classes with me and is present and supportive during labor and delivery, he too will get inundated with positive bonding hormones (prolactin being a principle one). I believe that in this way, through closeness and support throughout the processes of pregnancy, birth, breastfeeding, and beyond, the gap between the mother and father, or the mother carrying the child and the other mother, etc. can be bridged. Perhaps in bridging this, some of that pregnancy and birth-related sense of deep understanding about the delicacy and importance of life can be experienced by those around the mama too.

This, unsurprisingly, brings me back to gender and sex

I also wonder if this is one way to bridge the empathy gap between men and women. I reject the notion that men are just less sensitive, thoughtful, caring, empathetic, etc. than women by their genetic code. I believe we are all capable of the greatest humanity when exposed to the right conditions, and that girls and boys, men and women, aren’t so different in these respects. However, one argument that a number of people have posed to me over the years is that men really can’t experience pregnancy and birth and women can, which means that our biology makes us different in terms of our understanding of life. Being pregnant now, I am forced to take this argument more seriously because I am definitely experiencing things that my husband and dad and male friends cannot fathom and that I imagine will affect my awareness of the world in some profound way.

That said, I still have a few issues with the argument. One is that there are many women who cannot bear children or who choose not to or who have not yet done so, and they are no less women than I am, nor do I have any evidence that they are less empathetic or in touch with the value of life. Another is that while it has got to be true that having a person grow inside you and then come out of your vagina and then feed from your breasts does something profound to your understanding of life—and to the levels of the hormone oxytocin that you produce, which help you bond and attach—it is also true that we can bring men and boys closer to this process so that they can understand and experience more of it empathetically and hormonally (Seriously! Studies suggest that men who are present at birth produce more prolactin, which also promotes bonding).

I believe that if we encourage little boys to feel our babies kick in our bellies, to help take care of pregnant and nursing women, to hold and coo at new babies, maybe even to care for baby dolls, and if we let boys into rather than shut them out from the women’s world of pregnancy and birth, we will have much kinder and more connected boys. Likewise, if we continue to evolve our norms to encourage men to have more supportive and informed roles in their partners’, daughters’, sisters’, and friends’ pregnancies, births, and postpartum care, as well as in childrearing, we will see men becoming kinder and more capable of empathy (and less capable of dehumanization and violence).

Yes, the experience of pregnancy is amazing and profound and I am so grateful to be experiencing it. I can only imagine how much birth will rock my world, and how profound an experience breastfeeding will be. But, given the importance of everyone else around me (and everyone who responds to this blog online) to my experience of pregnancy, and in particular the role that Oscar plays, I don’t feel as though this is my pregnancy alone.

I love love love this series Ash made of us laying in our front yard.

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October 15th, 2013 at 8:21 pm

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24 weeks. That’s 6 months!

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A walk in our neighborhood provided some dreamy backgrounds. I don't think I've ever noticed the colors of fall in Alaska as much as I have this year. This project makes me evaluate places as potential backgrounds.

My hand hurts like hell from carpal tunnel syndrome and it’s time to get ready for bed, so I will share  just a few observations and thoughts instead of trying to construct a coherent story. And watch, it’ll still turn out long.

  • I watched the movie “What to Expect When You’re Expecting.” I wouldn’t recommend it. Nor would I recommend the book of the same title.
  • I love going to Zumba with my ever-growing belly, especially with the Alaska Club instructor named Divine who is a joyous ball of boundless energy and who embodies the reason why I love to dance. I dance because it is joyous. I dance because even before I knew that it filled me (and now, baby) with the best, happiest kinds of neurotransmitters and hormones, I just knew that when I danced I felt enlivened and on fire and like I belonged in the world. We are meant to do this, and in pregnancy especially this feels true (though with more pee breaks).
  • I’ve observed and felt two potentially conflicting societal pressures. One is to look small for your baby’s gestational age. That is, to look less far along than you really are, or at least not to look farther along. The other is to have a big baby (not gestational diabetes big, but on the bigger side). In the many places in which discourses on pregnancy and babies are generated (pregnancy and mommy blogs, facebook pages, and websites; movies such as the aforementioned comedy; advertising; books; conversations among family members, colleagues, friends, strangers, etc.) you can find subtle and occasionally explicit shaming of women who “fail” to do one or  both of these things.
  • I wonder what the stressors of pregnancy and around me during pregnancy would feel like if I didn’t have the hormonal emotional triggers of a teenager.
  • I am so excited to meet baby on the outside later this winter, and hold the little person in my arms and breastfeed and have a son or daughter with Oscar. But I am going to miss the feeling of being kicked and wiggled against and hiccuped against from the inside. I am going to miss the days when baby is having a party in my uterus, and even when I can feel baby wiggling around in there at night. I am going to miss friends and family putting their hands on my belly to interact with baby. Maybe it’s the privacy of these moments I will miss most.
  • It’s no single payer healthcare system, but I do really appreciate the Affordable Care Act and the many provisions it includes to promote healthier pregnancy, birth, and newborn care, to name just a few pieces. And I really appreciate what Elizabeth Warren, John Stewart, and Fernando Espuelas have to say about this whole shutdown over the ACA business.
  • How do women manage pregnancy when they don’t have a partner or family member or roommates who can pick up some more of the work so they can sleep? Seriously. I am so fortunate to be married to a man who understands this need. Thanks, amor. And thank you for these beautiful photos.

Alice in Wonderland-like backdrop

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October 7th, 2013 at 9:45 pm

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23 weeks

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¡Viva la mujer!

Pregnancy and Policy on The Night of the Government Shut-Down

It can be hard to feel like there is worth in writing about my pregnancy or pregnancy in general when the US government just shut down and families will go without pay and essential services will be disrupted. So I definitely understand if folks are not really interested in reading this. But I also work in public health and know how important so many provisions of the Affordable Care Act are to reproductive and children’s health and therefore to long-term health, so I guess writing about pregnancy-related issues seems relevant in my mind to the current government dysfunction, albeit in an indirect way.

I think of how painfully the personal and political are connected and how policy plays out in our bodies and our diseases, and also how ideologies of gender, race, class, health, worth, individualism versus communalism, etc. shape policy. Plus, now that I know what I know about how early life toxic stress, including prenatal stress, and Adverse Childhood Experiences (ACEs) affect brain development and coping behaviors, I often find myself wondering to what degree the toxic ideologies and politics around us are shaped by trauma and how cyclical this might be. (For example, rigid gender ideas create atmospheres in which sexual violence is more common and accepted, and experiencing or witnessing such violence as a baby or child damages the brain and provides poor role modeling, thereby putting the child at greater risk for both perpetration and victimization as a teen and adult). So, all that is to say that, uh, talking about and promoting healthy pregnancy and childbirth and postpartum bonding and attachment is all part of preventing problems later on that may (though I totally can’t prove this) contribute to the kind of idiotic politics we are all experiencing right now. Or maybe that’s just a self-agrandizing way to get you to look at my blog.

That said, I don’t actually have much to say right now. I need to catch up on my sleep. But these are things I plan to write about soon, including the first topic, which is related to the “¡Viva la mujer!” shirt I am wearing in this photo:

  • On how in awe I am of my friends who have just given birth and of the pregnancy and birth and breastfeeding process in general, and how I can try to make sense of this very sex-specific admiration within the context of the feminism I believe in—one that argues that gender (the attributes that are assigned to male sexed people and female sexed people) is mostly constructed and performed and not essential to who we are biologically.
  • On the importance of sound maternal child health policy at the governmental and institutional/organizational levels.
  • On what kinds of questions for expectant parents to ask/what to look for so they don’t get either a knife-happy/intervention-happy doctor or an unsafe midwife.
  • On how even an honest portrayal of a pregnant body such as the photos in this series provides is still curated and still represents visual choices. That is, the photos look different depending on how much food I’ve eaten before the photo is taken and how much air I put in my belly and what I do with my muscles and what angle Oscar shoots from and how he lights the shot and so on. So no matter how real they are, we still can’t depend on images of others to make us feel okay because images are not the same as what we will see in the mirror from minute to minute–we still need our own resilience, our own self-assurance and self-love, to feel good with ourselves and our changing bodies.

Plus, I am open to ideas from you on what to write about.

I also want to share with you the close-up of baby, drawn loosely from a Leonart Nillson photograph from inside the womb. And as I write this, baby is making my belly protrude with little hands and feet moving around. Baby is not quite as calm as in the drawing.

All photos taken lovingly and patiently by el amor de mi vida, Oscar Avellaneda-Cruz, who also carried Chino the dog onto and off of the roof safely for this photo session.

_ _  _ _ _ _ _ _ __ _  _ _ _ _ _ _ __ _  _ _ _ _ _ _ __ _  _ _ _ _ _ _ _

P.S. As is obvious from its appearance here, on my bio pic, and in many other places, I love my alma mater, Mount Holyoke College, and this Mount Holyoke sweatshirt that Virginia Speciale gave me.

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September 30th, 2013 at 8:56 pm

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18 weeks.

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18 weeks pregnant with baby, holding our other baby, Chino the Boston. That expandable gold panel, by the way, is how you make skinny jeans for ever-growing waistlines. Such a brilliant invention.

On Pregnancy Weight Gain

Again this week I agonized (well, for about 4 minutes) over the side belly photos, thinking, “Why does my upper abdomen, which has no uterus in it yet, have to be thicker? Why does my back have to get thicker? It has no placenta or baby inside it either. This doesn’t look like just a pregnancy belly…” I will spare you all the boring details of my insecurities and share only what my dad said to make sense of this change in my back and thighs and butt and other places seemingly unrelated to growing babies. He said, “Your body is giving you some reserves to get you through labor and the time right after, and for breastfeeding. You need them. You’re not doing anything wrong.” This made me feel better.

I share this, at the risk of sounding overly-confessional, to talk about the issue of pregnancy weight gain. It is, after all, a health issue, and I work and dream and breathe public health. Sometimes our discourse around pregnancy weight gain focuses on attractiveness, body image and how to feel sexy, whether Kanye is going to leave Kim Kardashian because she gained so much weight, what happened to the skinny Jessica Simpson of Dukes of Hazard, blah blah blah. I think sometimes this kind of discourse can alert us to and help us discuss health issues (Jessica Simpson’s pregnancy weight with her first child was really unhealthy and carried with it risks that perhaps we could learn from instead of shaming her), but more often than not, it casts aside the much more important conversations about what is healthy or risky for mom and baby, and what can we do to promote healthy weight and healthy nutrition before, during, and after pregnancy.

I am a little bit worried about gaining too much weight during pregnancy. And I don’t mean just more than the Mayo Clinic recommended 25 – 35 lbs. for healthy weight (BMI of 18.5 – 24.9) women.  Those make sense for some healthy weight women, and for sure underweight women need to gain plenty of weight. But those recommendations are considered excessive and not up-to-date by many health care and public health professionals, and are certainly not standard in all other countries with developed health systems. [Though to be fair, I have not done an exhaustive review of the literature on this issue so you may find evidence to contradict me.] What  I mean is I don’t want to gain more than about 23 lbs. I am 5’2″, so what do I need more than that for? I don’t want a big baby and difficult labor that carries a higher risk of c-section and episiotomy and tearing. I don’t want to put any more strain on my spine, which is already troubled by spondololysis, a condition that could be worsened by excess weight gain. Nor do I want to increase my risk of gestational diabetes or preeclampsia (and I know there are multiple factors that contribute to this, sometimes totally unrelated to overweight or obesity, but still. REALLY scary stuff.)

So it concerned me this morning when I weighed myself and it looked like I am a little ahead of my weight gain goals for  this early point in pregnancy–maybe I am doing indulging a little too much, exercising too little? I don’t think I am on a path to excess weight gain, but I want to be careful and thoughtful nonetheless. I believe the trick to managing a healthy amount of weight gain will require me to listen to my body and make good food and exercise choices without letting my ego (and therefore that useless monster, shame) have much to say. That is, without my eyes telling me that something is wrong because I don’t look like Beyoncé or Shakira did (they got certain blessings; I got different ones–c’est la vie), but rather, being thoughtful about my choices with my eye on the prize of my own healthiest body and the healthiest little brain and body of baby.

I wonder, then, what a popular discourse about healthy pregnancy weight would look like if it encouraged this–if it engaged neither in body shame nor in facile answers that fail to present people with the gravity of the health risks–and also, if it avoided that discourse I notice among many mommy communities of unthinkingly praising big babies without thinking of the potential risks. I know these healthy, middle ground discourses exist in the health world and in some families and communities and publications, and in high-quality prenatal care visits. (And I say high-quality because, unfortunately, this does not happen in all prenatal visits–the data on % of healthcare providers discussing maternal and childhood obesity with patients in Alaska is depressing, and personal conversations I’ve had with moms reveal that too many care providers fail to support patients with weight loss in between pregnancies as a way to reduce risk).

What would it look like if in health classes for teens and in sitcoms and in women’s magazines and in frank, honest discussions between friends, we  could talk about the many diverse ways that a healthy pregnancy can look? What about if we talked about the risks of pre-pregnancy overweight and obesity and excess pregnancy weight gain in terms of having a baby born with too much insulin (and then getting hypoglycemic) or increased risk of baby having chronic diseases in adulthood? Or if we talked about the difficulties in checking on babies during labor or getting baby out of the birth canal or the complications in healing from surgery? Or if we talked about how lack of nutrition–which can, and often does happen even with excess calories–increases babies’ risk for diabetes and heart disease later in life? It seems to me, as a child of science and health, that knowing these things would help, and that people are not given access to this information in many of the media where it would be appropriate. It seems to me that if we all knew these risks from a young age, many more people could try to get healthy and support girls and women in getting healthy before having babies, and demand that their politicians and institutions and communities support these efforts.

But am I being naive in thinking that families would be able to invest more in health prior to and during pregnancy if they better understood the risks of excess weight and the benefits of a healthier weight? Am I universalizing from how I resolve problems? I know that knowing is only a very small fraction of what is needed for behavior change, and I know that the American (and global) obesity epidemic is about SO much more than behavior choices. It’s about urban planning and zoning, agricultural policy, transportation policy, subsistence hunting and fishing policy, school foods, environmental chemical exposure, predatory marketing, childhood and prenatal trauma that changes the metabolism and creates epigenetic risk factors for obesity, childhood trauma that predisposes children to eat as a coping mechanism or to protect themselves, low-wage and high-demand jobs that make it hard for families to cook, all sorts of things. The solutions are NOT just individual solutions, and it is unfair to portray them that way.

Still, it strikes me that we deserve to have more conversations about thorny areas such as pregnancy weight in ways that allow us to reject the discourses of shame and the narrow definitions of beauty that feed them, and that allow us to be real about our health and the health of our children. We at least deserve to know, and to think through and plan through what to do about it with our healthcare providers and with our communities and families and friends.

For me, my what to do about it is to say no more often to sweets and fried things and simple carbs, to make more opportunities for exercise, to feel great about the wild Alaskan salmon and blueberries and the garden veggies I am eating, and to feel whole and beautiful and content within the body that baby and I are sharing for these 40 or so weeks–whatever that body happens to look like.

Speaking of baby, here is the close-up of the painting from this week, which I had the opportunity to make using Lennart Nillson’s groundbreaking 1965 photo from the cover of Life magazine.

All photography in this collaborative mami-papi art project by my creative, supportive, much-more-easygoing-than-me spouse, Oscar Avellaneda-Cruz of Avé Photo.

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August 26th, 2013 at 9:50 pm

17 weeks.

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17 weeks. Baby is ~ 5 in. long and her/his cartilage is transforming into bone.

Sex, Gender, and Not Knowing

Oscar photographed me this week in front of a friend’s house with umbrellas to keep out the rain that has been steadily pouring on Anchorage for the past 2 weeks. Using  both the pink and the blue umbrellas was Oscar’s idea to signify not knowing our baby’s sex and not needing to for now. (This is just what we felt like doing; I don’t think it’s better than finding out. We’re going to find out when baby joins us on the outside. In the meanwhile, it’s a fun mystery, and we remind each other to use the trans pronoun “yo” to talk about baby, but more often just say “baby.”)

I have noticed, since becoming pregnant and talking about it, that the first question most people ask me is, “Do you know what you’re having?” or “Are you going to find out the baby’s gender?”

[Side note, because I keep hearing this, especially on pregnancy websites and forms and surveys: Gender and sex are not the same thing. An ultrasound can see a penis or a vagina, and certain blood tests can see XX or XY chromosomes, meaning that they can detect biological sex. And yeah, I know, sex isn’t totally simple and binary either because there are intersex people and sex characteristics don’t all fall out neatly, because women can be hairy and men can have gynecomastia (breast tissue), etc., but the simple things that an ultrasound can pick up tell you sex, not gender. As the World Health Organization explains it:

“Sex” refers to the biological and physiological characteristics that define men and women.

“Gender” refers to the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women]

So, where were we? I’ve noticed that people often begin the conversation with sex and/or gender. It’s not that there’s anything wrong with this, but it strikes me that we are very focused on sex and gender in our culture (an interesting illustration of this is that a friend of mine was given simply an ultrasound photo of her baby’s penis at week 20, as though that were the primary and most important thing). It also strikes me that there are other things we could say to begin conversations with a woman about her pregnancy, perhaps. “How are you feeling?” is a nice one that some people ask. I always want to know about who someone’s care provider is or if they are getting midwifery care, if they are getting the kind of prenatal care and birth planning they feel comfortable with, etc., but this can be an awkward conversation to begin as well, and is not always appropriate.

What kinds of questions do you think are appropriate? Interesting? Affirming?

What kinds of questions did you want to be asked when you were pregnant or when your partner was pregnant?

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August 19th, 2013 at 9:18 pm

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Protected: You grow inside me, I grow around you

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July 25th, 2013 at 8:54 pm

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Toward Global Justice: La Casa de la Mujer Rosario Castellanos and Transcultural Feminist Dialogue

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I took this photo in 2002 in the market of Juchitan, Oaxaca.

I took this photo in 2002 in the Zócalo of Oaxaca City. I spent a lot of time with these sisters who sold scarves in the streets and didn't attend school.

I was reminded recently of why I should share my undergraduate thesis. Janie, the intern at the Alaska Native Epidemiology Center, where I work, found online a Master’s Thesis about the very little researched topic of Iñupiaq women’s pregnancy and birthing beliefs and experience. This was very useful for the work we were doing. I felt  grateful that this young student researcher shared his work publicly online. I told Janie about my student research and thesis, and she suggested I share it too. So here it is.

Despite having written this thesis 8 years ago and it containing some errors, and perhaps there being moments of naïeveté in my theory, I decided I should make it available because it is useful. It is original research that has not been published anywhere else, as far as I know. It brings together original research with feminists in Oaxaca and global human rights theory to make an argument about the need for dialogue about justice and gender justice across cultures. It makes an argument that I still stand strongly by and practice in my daily life and work, in ways beyond what I would have imagined when I wrote this as a 21-year-old.

This is my honor’s thesis from my senior year of college at Mount Holyoke College (2004), based on interviews I had conducted in the summer of 2003 in Oaxaca, México and a lot of immersion in history, feminist theory, sociology, political discourse, etc. Unfortunately, I have lost the cover page, which had a wood block print I made of downtown Oaxaca City, and I’ve lost the table of contents.

So, to give you a brief preview:

The introduction explains how I came to this topic and why it matters, and the theories behind it. It introduces why I think we need transcultural feminist dialogue in order to arrive at globally-valid concepts of justice and human rights.

The 1st chapter provides a history of feminism in México and its ties to other social justice movements there.

The 2nd chapter covers what I learned from the feminists at La Casa de la Mujer Rosario Castellanos, a feminist organization based in Oaxaca City. (Oaxaca City is the capital city of the state in México that has more ethnic diversity, in terms of indigenous groups, than any other state in the country.) This chapter discusses the organization’s work, how each woman became a feminist, how each woman conceives of the concept of justice,  and how that translates into the feminist work she does.

The 3rd chapter uses the themes about feminism, gender justice, and justice that the women from La Casa de la Mujer brought up to make the argument that feminism arises organically out of everywhere. Because feminism arises out of different environments, it is necessarily different across cultures, countries, etc. At the same time, there is an “hilo conductor,” that is, a wire that connects all feminisms everywhere. This hilo conductor is the idea that we should be able to live lives with dignity and free of violence. Because feminism is both universal and grounded in the local, we need democratic, equitable, transcultural feminist dialogue in order to establish what about gender justice–and justice in general–is universal and what isn’t. That way, we can create human rights standards that people all over can buy into and feel a part of.

I sent this thesis to La Casa de la Mujer Rosario Castellanos in 2004. When I visited in 2005, they were almost done translating it into Spanish, so I got to assist with some of the translation.  I have not returned to Oaxaca since, but when I do, I hope to find that is has been useful. And I hope that is is useful for you. If you do use it, here is a suggested citation (although when I wrote it, my last name was Norton-Cruz…):

Avellaneda-Cruz, Laura. (2004). Toward Global Justice: La Casa de la Mujer Rosario Castellanos and Transcultural Feminist Dialogue. Undergraduate Thesis, Mount Holyoke College. Retrieved online at author’s website:

Thesis_Global_Feminism_Oaxaca_2004_L. Avellaneda-Cruz_p

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June 3rd, 2012 at 12:31 pm