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The fight to protect individual choices about reproductive care, including breastfeeding, is an ongoing battle. The central lesson of the reproductive justice movement is that choice means little without access. That lesson applies equally to breastfeeding.

Though laws, in the and , are in place to protect the right to breastfeed, many low-income women and women of color face entrenched structural barriers that hinder their ability to breastfeed before they can even consider if it is the right choice for them. This problem is particularly acute for Black women, who have the lowest breastfeeding initiation rate of all racial groups at percent, compared with 85.9 percent of white women, and 83.2 percent of women overall. They also have the shortest breastfeeding duration, with 44.7 percent of black women breastfeeding at 6 months compared with 62 percent of white women and 57.6 percent of women overall.

In honor of and , let’s take a look at the barriers Black people face in the workplace, healthcare system, and society when it comes to breastfeeding.

Many Black people work, and breastfeeding at work is hard

Black women’s labor participation rate of percent is higher than the rate for all other women. Additionally, Black women are most likely to be the primary economic support for their families, with . This means that shortly after birth, many Black women experience economic pressures that motivate them to return to the workplace than any other race.

Black people are also less likely than their white counterparts to occupy jobs that offer , such as paid family leave, which is associated with a of breastfeeding.

Although provisions of the Patient Protection and Affordable Care Act (ACA) require employers to provide , many employers with this mandate. This is particularly true in , of which a disproportionate number of workers are Black women, . Additionally, due to intersecting race and gender discrimination, many Black workers may feel like exercising their right to breastfeed is too risky to be an option. Merely raising the issue of breastfeeding accommodations with an employer can create . Many who have done so have faced adverse consequences, reduced work hours, demotion, , and public shaming or harassment in the workplace.

Inequities in access to health care put breastfeeding out of reach for many Black people

More Black women have as health insurance or are uninsured compared to other groups. Although the ACA requires coverage of all recommended , including breastfeeding education, lactation consultation, and breast pumps, these benefits are not available for the majority of people in the – many of which with – that have opted not to expand Medicaid. As we might expect, states that have expanded Medicaid have seen .

Black neighborhoods are also lacking in hospital practices supporting breastfeeding. Forty-five percent of hospitals – those that have adopted a set of to ensure that their facilities are supportive of breastfeeding – are in cities where Black people comprise 3 percent or less of the population. Hospitals in communities with an above-average Black population are significantly to promote nursing than hospitals located in other neighborhoods. Black women are also more likely to experience , which is associated with lowered breastfeeding rates.

The relatively low breastfeeding rate for Black people is a product of that contributes to the overall poor Black maternal and infant health outcomes. To name a few, Black people experience the , one of the , and . To effectively address inequitable health outcomes and access, we must promote policies that aim to improve the health of Black people across their life course.

The societal stigma of breastfeeding is heightened for Black and brown people

Society has sexualized breasts to the point that people are routinely shamed for breastfeeding. Compounding this is the fact that Black bodies have been and degraded. The perception of Black women as sexually promiscuous by nature is a persistent that negatively . Additionally, the traumatic history of Black women during and after slavery as for white women means that for some, breastfeeding is associated with a . This history contributes to whether Black people have the social and societal support to initiate and sustain breastfeeding.

Advocacy around breastfeeding has been primarily led by white, cis-gendered women, and consequently centered on issues specific to that group. It is unsurprising that the choice to breastfeed has been primarily available to upper-middle-class, cis-gendered white women. Creating a new narrative, health and advocacy that center on the experiences of women of color are leading the charge to formulate an agenda that is inclusive of the unique experiences of Black women, as well as who breast- or chest-feed.

Certainly, there are to implement policies promoting breastfeeding. But breastfeeding promotion can also result in the pressure to breastfeed, putting those who choose not to or are unable to breastfeed and those without the ability to exercise their rights in a particularly impossible position. Battles to safeguard breastfeeding rights must be accompanied by efforts that remove barriers to making that right something everyone can exercise on equal terms. Neither where a person lives, works, and gives birth, nor a person’s race or gender should determine whether they have the option to breastfeed.