Birth Issues Journal > Reviews

OUR BODIES, OUR BABIES* (TE0080)
Kerreen Reiger
Melbourne University Press, Melbourne, 2000

Review by Julie Smith

Having been struck by the coherence and perceptiveness of Reiger's earlier commentary on breastfeeding and feminism,¹ I was looking forward to this book. I hungered for the extension to a wider front of the breadth of understanding which that piece revealed. I was not disappointed.

As the author points out, 'maternity is such a taken for granted aspect of life that it rarely rates much public attention'. The irony is that having babies 'is central to the very continuation of society'. Earlier this century, mothers took action as citizens rather than private individuals with a 'maternalist' perspective. This emphasised that 'maternal citizens' contributed, just as did 'citizen soldiers', to the nation's strength, and demanded rights to services as well as financial support. A shortage of babies aided the activists' work.

Our Bodies Our Babies starts by reviewing the origins and emergence of key maternalist groups in postwar Australia, placing the evolution of organisations such as Nursing Mothers', the Childbirth Education Association (CEA), and Parents Centres Australia (PCA) in the context of the postwar baby boom and the medicalised model of childbirth and infant nutrition that emerged during the 20th century. This movement paralleled but maintained an ambiguous relationship with the women's liberation movement of the 1960s and 1970s. The middle section of the book provides a fascinating account and analysis of the practicalities and politics of these mothers' organisations, and of the characters and forces that were shaping them. The final section assesses the achievements and challenges of this reform movement, and examines the forces behind the loss of momentum since the late 1980s before looking to future directions for the movement.

The style of the book especially in its earlier parts, is reminiscent of Janet McCalman's informative history of maternity care;² it is meticulous, scholarly and comprehensive, and has the feminist historian's sharp consciousness of potential biases in sources. While using material published in the medical literature and the media, the author relies on the voices of women themselves - detailed scrutiny of organisations' archival records, and over a hundred formal interviews with those involved in the movement and its main organisations, including senior medical and health professionals. I found it interesting in itself that the 'meticulous abundance' of written records of Nursing Mothers' threatened, in the author's words, to 'take over the study'.

The account of postwar maternal activism in the first and second part of the book nicely balances historical analysis and commentary with anecdote and example, and tells a compelling, and, for this reader, convincing story. Contrasting and comparing the evolution of diverse and more loosely structured childbirth organisations such as the CEA with the tightly structured and strongly led Nursing Mothers', is a technique used deftly to draw out the strengths of these different organisational structures, and expose their underlying tensions and vulnerabilities of the two approaches to achieving change.

The particular strengths of this study in my view are its persuasive and scholarly account of maternalist organisations as part of the postwar 'feminist' movement, and its insightful identification and explanation of the 'parallel paths' trodden by the maternalist activists, and 'mainstream' feminists. This theme appealed to this reviewer. Since reading Adrienne Rich's powerful analysis of the contradiction of women's reproductive powers with their social oppression,³ and Marilyn Waring's later expose of the hidden 'market-dominated values' in some feminist reform agendas,⁴ I have watched with frustration as many 'feminists' including 'women's health' advocates, have marched on separately from and with considerable disinterest in childbirth and breastfeeding activism.

From a personal viewpoint, this book provided a fascinating backdrop for my own journey since the early 1980s as a young, single, working mother, invigorated by the experience of natural birthing and extended breastfeeding, through the Canberra 'femocrat' network of the 1980s and 1990s, and the subsequent home-birthing and extended breastfeeding of two later children. Many readers will likewise relate strongly at the individual level to the struggles of the maternity activists in these and earlier decades. We gain understanding as well as admiration for mothers like those in Reiger's book who vigorously took on the system in a more or less systematic way through their work in such organisations, while struggling to remain true to their own family-oriented convictions and values.

Those many women whose life course has been changed, political awareness raised, and personal growth accelerated by involvement in the childbirth and breastfeeding movement will also find this account most informative and affirming. The accuracy of its account of the personal, not to mention political, conflicts for dedicated and overworked Nursing Mothers' volunteers is uncanny, and can only have been written by someone with a deep understanding and knowledge of both its inner workings and wider vision. While some key players in such mothers' organisations will no doubt squirm at public exposure of some 'skeletons', the story is told in a way which skilfully teases out the underlying - and important- dilemmas and issues which faced such radical enterprises, without lingering on the uninteresting details of personal animosities or the organisation's factional fights.

Yet another of its strengths is the ability to stand back from the details and analyse. Reiger's explanation of Nursing Mothers' success, and the limited nature of that success, is persuasive, as is her interpretation of the less obvious, but nonetheless very real successes and struggles of the childbirth movement typified by the CEA and PCA and offshoots. This latter element of the maternalist movement was both more radical and more threatening to existing medical power structures and cultures. Reiger's analysis is the more satisfying because of the real grasp she obviously has of the political power structures defining the action and outcomes, and because she is able, to an extent that is not apparent, for example, in later chapters of Sex and Suffering, to evaluate change in maternity care while standing back from the perspective of the 'medical model'.

The main disappointment of the book, in my view, is in its final chapter. After the insightful and sharp analysis of earlier chapters, the way forward is sketched only lightly and relatively superficially at the close. For example, Reiger observes in early chapters the declining birth rate as a factor empowering women as consumers in the 1970s and 1980s; logically, strong societal concerns at declining fertility and family pressures should again provide the opportunity to develop a strong strategic basis for action. However, the opportunity is not taken to develop this insight further. While the book draws attention to the paradox of success in 'humanising' maternity care alongside the losing battle against intervention and escalating professional and technological management of birth and lactation, I was also disappointed that the closing chapter offers no specific future strategies aimed at resolving this fundamental contradiction and the associated 'backlash' against natural birth and infant feeding. While Reiger's recourse in the final chapter to international treaties and 'rights' as the basis for a future discourse on childbirth and breastfeeding issues may be intellectually satisfying and of academic interest, such a strategy seems unpromising in the present Australian political and ideological environment. There is also little in the history revealed by this book that supports it, because as Reiger knows well from her previous research, the social value placed on maternity, and the basis for the success of maternalist's organisations' in pre-war decades, depends most on whether the nation feels it needs more strong and healthy babies.

The more 'street-smart' approach to changing public policy suggested by this history is touched on in the closing chapter, but not strongly developed. 'The economics of the highly medicalised system in which women with no medical complications are using specialist obstetricians and acute care facilities provides a starting point' says the author. This point applies equally to advocacy regarding breastfeeding and the costs of artificial infant feeding. A useful approach would be to hitch the maternalist cause to the practical problems of government in the present day, by framing demands for childbirth and postnatal support as solutions to pressing public issues of public health funding shortages and rising health costs. These include the problems of a system relying on private health insurance and driven by technological change rather than health need and 'consumer-focused' care. Further-more, the climate is favourable to the movement tapping into widespread concerns including those from employers and business about the future quantity and quality of the labour force and future citizenry because of excessive pressures on mothers when children are very young.
The central theme of growing convergence between the broader feminist movement and the maternity movement in recent years is a strong and significant feature of the book. Although the author does not build on this as much as she might in suggesting strategic directions, it is a theme that 'mainstream' feminists as well as 'maternalist feminists' should ponder as they position themselves for the battles of the next decade. Reiger's theme of convergence serves to remind us that present conservative government concerns to build 'stronger families and communities', while sitting uncomfortably with some feminist philosophies and organisational rivalries of the 1970s and 1980s, are the opportunity for strategic alliances among otherwise diverse women's groups which could provide sustainable gains for mothers in an otherwise hostile political and ideological environment. For instance, is now the time for a broad feminist/maternalist push for a tax credit for all families with an infant under 12 months, so as to widen families' practical choices about breastfeeding and high quality care for infants? The present hotpotch of tax allowances and maternity pay for new mothers is a costly and inequitable abomination. It has great potential for restructuring to provide financial support to all mothers during the demanding first year or so after childbirth. On maternity care, the principle of publicly funded 'vouchers' to be used for private or publicly provided services is a key element of current government policies in education and childcare. Why not as a way of providing wider access to independent high quality midwife care or breastfeeding advice? Reiger accurately and revealingly points to the lack of policy development capacity of the maternalist organisations as a limiting factor in their long-term influence, without exploring the implications of this important observation for future organisational strategy.

Disappointment at the closing stages is however, a minor quibble about a book which is otherwise breathtaking in its scholarship, its insightfulness, and its ability to inspire. Our Bodies Our Babies is destined for the 'must-read' list for today's mothers, and will contribute substantially to our knowledge and under-standing of past and present women's liberation at the grass roots level in Australia.

Julie Smith
Canberra
* The reviewer writes from a perspective as an active participant in Nursing Mothers' and 'the politics of breastfeeding' since the early 1990s, as a member of several birthing organisations in Australia and New Zealand for the last two decades, and as a feminist economist working over the same period on the economics of breastfeeding and unpaid work, and the taxation of families.

1. Reiger K. Women's bodies, Women's rights. Breastfeeding Review 1998;13:29-30.
2. McCalman J. Sex and suffering: women's health and a Women's Hospital. Melbourne: Melbourne University Press, 1998.
3. Rich A. Of woman born: motherhood as an experience and institution. New York: Bantam Books, 1977.
4. Counting for nothing: what men value and what women are worth. Sydney: Allen and Unwin, 1988.

Birth Issues 2001;10(3/4):110-113

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