Laura Bujold, DO, MEd
The office is about to open when my office manager—I’ll call her Sally—walks up to me and says, “Did you see the pumping space I made for you?”
“No,” I respond. Sally and I walk in the door to an office that holds two nurse triage personnel. There is a rod with a shower curtain hanging that exposes a 3 x 21/2-foot area at best. One of the “walls” is the bookshelf and the other two walls are the corner of the office. The fourth “wall” is the shower curtain. Sally says she bought the supplies herself, smiles, and then leaves.
I run to grab my pump and pumping bag while panic consumes my confusion. There is no room for my pump. Even in a true office space, I could barely manage enough room for the pump, tubing, flanges, bottles, paper towels, water, and nursing bra, let alone the cooler for the milk.
I move quickly—my first patient will be here soon. I search the office for a small table and I find one in the bathroom; I put it immediately outside the homemade cubicle. I put my pump on the table. The electrical cord to my breast pump doesn’t reach any of the outlets. My heart skips a beat. My patient will be here any minute. I move the table toward the closest outlet. With the breast pump’s electrical cord completely extended and the tubing stretched, my pump is plugged in but it is sitting about 1 foot outside of the cubicle.
In order to breastfeed and meet patient access demands, I am dividing my lunchtime throughout the office day to pump. However, this dedicated pumping time frequently gets booked with patients. When I ask for the patients booked in my pumping times to be rescheduled, I am told “Oh, you can’t see them?” or “Are you sure?” or “But there isn’t another time available in your schedule.”
The following Saturday I have acute hours at our other office location which is also run by my office manager, Sally. I ask the front desk staff, Erin, if there is a place to pump. Erin says “Sally’s office.” I raise my head in surprise.
“Sally has a ‘mom at work’ sign to hang up on the office door. Sally just stopped pumping herself as you probably know, but she lets Dr Rivera (one of our OB/GYNs) pump in her office all the time.”
Emboldened by this discovery, I gain the courage to address the disparity in my own pumping accommodations. On Monday, I walk into Sally’s private office and inform her “That pumping space won’t work.”
If any woman experiences this, I recommend rallying the women and men around you who support breastfeeding, reviewing the federal and state laws for breastfeeding mothers, the AAFP guidelines, and WHO guidelines for breastfeeding.
If you are in a small office, find supporters in other offices or your local hospital. If you are in a large system, reach out to people in that system. There is power in numbers. Collect support and evidence and bring it to your medical director. If your medical director doesn’t take action, take it to the person above him or her. Do not accept a makeshift closet as a pumping area, do not accept people walking in on you while you pump, do not accept that this is the way it is.
Supporting breastfeeding moms now benefits companies later.
After my experience, I rallied the women in my system and we created a breastfeeding policy. The policy was presented to our chair committee and approved. However, the policy works because of the excitement behind the policy and the dissemination of the policy. It has benefited many women at that institution and thus continues to be utilized and advertised.
Dr Bujold shared her experience at her first family medicine job. She is now working at Eastern Connecticut Health Network in Connecticut.
STFM Blog 
Thanks for this. Power in numbers, for sure.
Thank you for reading!
Dr Bujold
Thank you for sharing your story and pointing out what all too often are the barriers and challenges that mothers face with breastfeeding in the workplace. Indeed, lack of support for mothers expressing milk in the workplace is often cited as a reason for premature discontinuation of breastfeeding. Finding supportive employers, appropriate space, storage for breastmilk and ample time for expressing breastmilk can be a challenge. It is especially concerning that this happens in medical offices, hospitals, medical schools or residencies that should be the best examples of the support for breastfeeding.
Many employers are not aware of the changes in the US Patient Protection and Affordable Care Act that provide for ample time and space for expressing breastmilk. Except for hardship exemptions, and those would be rare, I would hope that all medical facilities and training programs would provide appropriate and comfortable accommodations to allow for expressing breastmilk.
Breastfeeding is a human right and provides significant and well recognized health benefits for infants as well as mothers. Breastfeeding is an important public health issue that must be supported in the workplace. In addition to an adequate and comfortable space for milk expression, it is important that fellow workers and managers understand the importance of breastfeeding for the infant, the risks of formula, and the flexibility needed to pump on demand to maintain mother’s milk supply. As a family physician, in a small office, my personal office converts to a comfortable, quiet pump room for my employees and they are given adequate time to express milk and their work is covered by other supportive staff.
I applaud your efforts to rally the supporters in your organization to take action to change and develop a breastfeeding policy that will support future mothers in their desire to breastfeed their infants.
Having served on the AAFP Commission on Health of the Public and Science, I know that the AAFP continues to be committed to the support and promotion of breastfeeding. I would urge all family physicians to review the AAFP Breastfeeding Position Paper. I would also hope that STFM leadership and members understand the significance of you blog post. They should use it as an example to review the breastfeeding challenges that STFM members face in their workplaces and training and develop policies and rally supporters to make necessary changes for the benefit of breastfeeding families.
Tim Tobolic MD
President, Academy of Breastfeeding Medicine
Hi Dr. Tobolic –
Thank you for your thoughtful response. It is amazing that your office converts into a comfortable pumping space for women.
The one concern many physician women had at my previous employer was RVUs. For me, I broke up my lunch in order to pump otherwise my RVUs would be low and thus productivity less.
With the new breastfeeding policy, expected productivity was adjusted for the pumping time which was one of the most exciting aspects of the policy. I know other workplaces are not as generous or progressive.
I would love to make an effect at a larger scale.
Laura
Laura
Maybe you can have a greater impact.
I have attached the Academy of Breastfeeding Medicine’s position paper on Breastfeeding in the Workplace that highlights some workplace payment accommodations. I am not sure if there is one, but having the AAFP and STFM establish a policy that clearly supports breastfeeding or pumping breaks that does not impact pay or in your case RVUs would be a step in the right direction. This would have to be proposed as a policy resolution thru the congress of delegates and likely would be directed to the AAFP Commission on Public Health and Science where breastfeeding issues are evaluated and I know we have good support in that group.
Tim
Click to access abm-position-workplace.pdf
Tim
thank you!