Breastfeeding on a Nickel and a Dime: Why the Affordable Care Act Won’t Help Low-Wage Mothers

Abstract

As part of the Patient Protection and Affordable Care Act of 2010 (also known as “Obamacare”), Congress passed a new law requiring employers to provide accommodation to working mothers who want to express breast milk while at work. This accommodation requirement is a step forward from the preceding legal regime, under which federal courts consistently found that “lactation discrimination” did not constitute sex discrimination. But this article predicts that the new law will nevertheless fall short of guaranteeing all women the ability to work while breast feeding. The generality of the act’s brief provisions, along with the broad discretion it assigns to employers to determine the details of the accommodation to be provided, make it likely that class- and race-inflected attitudes towards both breast feeding and women’s roles will influence employer (and possibly judicial) decisions in this area. Examining psychological studies of popular attitudes towards breast feeding, as well as the history of women’s relationship to work, the author concludes that the influence of cultural attitudes on interpretations of the Act is likely to have a disparately negative impact on low-income women, perhaps especially those who are African-American. In short, the new law is likely to help produce a two-tiered system of breast feeding access, encouraging employers to grant generous accommodations to economically privileged women, while increasing the social pressure on low-income women to breast feed, without meaningfully improving their ability to do so.