Alma Mater? Lactation Rooms as a Case Study for Centering Place-making in the Quest for Inclusion on College Campuses

In the 2019-2020 school year, there are at least 30,000 pregnant students on U.S. university campuses who might need a place to pump or nurse while in school. National policies protect the need for time and space for employed lactators, but there are only suggested protections for space for lactating college students. Many postpartum people, members of the campus community, are falling through the gaps of support by their universities. Some universities have developed policies that require lactation rooms for capital construction projects. The state of the policies themselves and consistency of the application in the built space is poorly understood. Few policies address the larger issue of inclusion for this diverse population. This study investigated the issue of lactation rooms on campuses from three different perspectives or domains of knowledge. The work explored the claims made by universities about postpartum support and lactator inclusion (proclamations); the manifestation of those policies in the lactation space (actions); and the user experiences of lactating on their campus (perceptions). The perspectives provide contrasting views on the adequacy of lactation space in this complex ecosystem and the needs for improving the process of developing new policies, the application in capital construction, and the operation of lactation rooms. Merging the socio-ecological model with the human rights model (Availability, Accessibility, Acceptability, and Quality (AAAQ)), lactation policies on two case study campuses were assessed to evaluate the claims made by universities about inclusion and dignity as represented in the built environment. Using a mixed-methods approach of institutional ethnography, an environmental assessment (merging photovoice and indoor comfort measurements), and narrative interviews with lactators, the study centred the lactation room as a site of place-making to demonstrate the overall impact of the interrelationships and intersection of these three domains of knowledge. The results indicated that design and construction standards on the case study campus have changed over time in response to national policies and other influences. The findings illuminate that the facilities themselves have not changed to meet the contemporary needs of lactating bodies of varied academic intersectionalities. Despite policies focused on improving spaces for lactating people, best practice guidelines for lactation rooms, and many publications describing the barriers that users experience in meeting this basic need, universities are still struggling to include all of the lactating people in developing their physical infrastructure and to create the supporting social infrastructure. To address some of the gaps in the immediate future, universities could include the variety of lactating people when creating web-based messaging for lactation room access. Future needs include developing postpartum provisions for the lactators and clearly communicating what is available to them. Universities should develop additional sessions on postpartum support to include in their diversity, equity, and inclusion (DEI) trainings for supervisors. The dramatic change in abortion policies in the U.S. directly impacts this age population. Therefore, student health tracking systems need to incorporate more questions on birth experiences, postpartum needs, and lactation. Universities are unique ecosystems and the current desire to improve in policy and action. There is now an incredible opportunity to explore multi-tiered approaches to improving the DEI landscape.