Contemporary systems of healthcare and other industries are largely defined by their neoliberal, capitalist character. However, this parochial approach to understanding the political economy of healthcare misses the myriad activities that make up the “care” in healthcare. Receiving care is not isolated to capitalist exchanges, nor is it unquestionably tied to the neoliberal marketplace. There exist diverse economies of care within, outside, and alongside neoliberal capitalist ones. Moreover, there are multiple means by which we may define care that are often overlooked. In many cases healthcare that cannot be counted, does not count, as it relates to capitalist exchange. In this chapter, using the example of the banking and sharing of human milk I demonstrate that other economies of care are happening; and stress that they should be valued in their own right, not solely in relation to capitalism. Milk banking relies on diverse forms of labor—volunteer and paid—while also involving monetary exchange. Milk sharing encompasses barter and trade systems, gift exchange, and the distribution of surplus. Human milk is universally recognized as the best first food for infants. These two forms of accessing human milk make possible the provision of care to infants for parents who are not able to provide milk themselves. Simultaneously, the banking and sharing of human milk raises questions about access and who benefits from these diverse forms of care. Here I argue that the banking and sharing of milk represents economic diversity, yet there are structural limitations related to who can participate in these exchanges.
Naylor, L. “Diverse Economies of Care-full healthcare: Banking and Sharing Human Milk.” In The Routledge Handbook of the Political Economy of Health and Healthcare, edited by David Primrose, Robin Chang, and Rodney Loeppky, London: UK: Routledge, 2022.