The female prison population in the United States is growing at twice the rate of the male prison population. Despite this growth, there are few allowances made for the physical, emotional and social needs of women where they differ from the needs of men. One of these areas of need is pregnancy and childbirth.
It may come as a shock to most people but prisons are not mandated to provide physical or mental health care services, and there is no oversight to ensure that a prisoner's medical needs are met. This includes the area of pre and postnatal medical assistance for pregnant women and new mothers in the prison system.
Women are more likely to be incarcerated for offences involving traffic violations, unpaid fines, alcohol and drug use and theft. They are rarely kingpins or violent criminals, and when they do commit a violent crime, it is most likely to be against an abusive person in their life, so they are rarely a violent threat to the general public.
Failing to provide support and care to pregnant women in prison may actually cost society more in the long-term. The reoffending rate for women is generally around 25%. For women who were pregnant and gave birth in prison and were part of educational programs, the rate was less than 8%.
15Not A Small Number
It may come as a shock, but an estimated 6-10% of the female prison population is thought to be pregnant. The majority of these women were well along in their pregnancy when they were sentenced and enter the prison system at between four and seven months pregnant.
The figures for the county jail system are slightly different. Here women are more likely to be in the earliest stages of pregnancy while they are incarcerated. This is because women in the county jail system are frequently held for traffic violations, failure to appear in court or outstanding warrants but are unable to raise the bail money needed to get out again while they await their day in front of the judge.
In total it is thought that 1400 women a year give birth while they are in either jail or prison.
14Little To Zero Care
There are examples of women in the early stages of pregnancy suffering from morning sickness, losing blood or having other symptoms most people would see a doctor for, but they're being denied any medical treatment at all.
In some cases, prison staff is suspicious that women are using their pregnancy to obtain special treatment or time away from their cells and, as a consequence, the staff consider all requests for help with suspicion.
In addition to the general lack of medical care, many women in prison have no access to any prenatal education. This can cause an additional layer of anxiety to many moms-to-be but especially so for those who are first-time mothers. Imagine being pregnant and having no medical checks to see if your baby is healthy, or even to find out if you are gaining weight and growing at the correct rate.
13Don’t Have An Emergency
What is even more shocking than the lack of necessary monitoring for the mom and baby's health is the absence of emergency care. While the majority of women have a relatively trouble-free pregnancy, there are those that have severe health issues, either for themselves or for their babies.
The rates of risk to the mother or child are actually higher in the prison population than in the general population because African American women are at increased risk for most pregnancy complications and make up a greater percentage of the jail population.
There are documented cases of women who have had their baby stop moving, been leaking amniotic fluid, or losing blood in the later stages of pregnancy and have received no emergency medical treatment.
In some cases, women have lost their babies because they did not receive timely medical care.
12Treatment Is No Picnic
Some women are able to access medical services during their pregnancy, especially if the mom-to-be is a high-risk mom. For example, women with type one diabetes or other severe medical conditions may find it easier to get care.
Even when they do get care though, it can be extremely unpleasant. Expectant prisoners are handcuffed and placed in belly chains before they leave their facility. To add to the humiliation, they are also strip searched on every occasion they leave, no matter how far along they are.
Once at a doctor's office or hospital, the prisoner must stay in restraints except at the express request of the physician in order to facilitate treatment.
This strip, search and shackle routine happens for every medical visit, no matter what the woman's offence. An eight month pregnant woman who was unable to pay a traffic fine is still subject to a strip search before leaving the facility, in the same way a murderer would be.
11It’s A Secret
For women who are already in the system when they discover they are pregnant, most facilities will not give them a due date. While your due date is only a guide, it is one of the first things most pregnant women want to know, yet it is withheld from women prisoners. The justification for this is the risk that these women might use the knowledge of their due date to hatch an escape plot around their birth.
The same goes for women who will have to have an elective cesarean. They are not told the date of the delivery for security purposes and must spend most of their time towards the end of their pregnancies wondering if ‘today is the day’ that guards will come and get them for a transfer to the hospital.
In the meantime there has not been one documented occurrence of a woman who has just given birth either vaginally or by c-section, jumping out of her hospital bed, climbing out of the window and running off to freedom.
10Some Places Educate
Fortunately for women in the justice system, the tides are turning a little in some areas of the country. It has been recognized that a prisoner's punishment is supposed to be their lack of freedom and to administer further punishment by withholding something as basic as necessary medical care. This is unconstitutional.
While women may not be able to leave a facility, and indeed, given the whole strip search and shackle process, they may not want to, antenatal classes are becoming available in some of the more forward-thinking facilities.
Parenting classes are provided as well as additional programs for women with addictions, psychological problems, and mental health issues. This effort to educate and support the pregnant women in the system has been shown to result in better outcomes for both the women and their children.
9Shackles During Labor
Only five states in the US have laws on the books expressly forbidding a woman in labor being shackled. A few state correctional departments have policies against it, but in the majority of the United States, a pregnant prisoner in labor will be bound to the bed up until the actual moment of delivery and shackled shortly afterward.
Depending on the part of the country the woman is held in, she might have both legs shackled to the bed or one arm and one leg.
Illinois enacted the first law forbidding some restraints during labor in 2000. "Under no circumstances," it says, "may leg irons or shackles or waist shackles be used on any pregnant female prisoner who is in labor."
The restriction of movement during labor poses medical risks to both the mother and the baby and the vast majority of these women are in custody for non-violent crimes and are not flight risks.
8A Lonely Labor
Prisoners in labor at all but eight correctional facilities in the US, have to labor alone. Two correctional officers will be present in the room, but they are not part of the process, they are there to stand guard and to stand guard only.
Nobody is allowed to touch the prisoner for any reason other than a medical intervention, and even medical staff are actively discouraged from doing something as simple a holding the prisoner's hand or rubbing her back.
The family of a woman in labor is not informed of her condition or of where or when she will give birth. A family member is only alerted after the baby has been born and the mother has been taken back to prison. They are only told this much if they are coming to the hospital to take custody of the baby.
7The Lucky Few
In eight facilities there are programs that allow a pregnant prisoner to develop a relationship with a prison program midwife or doula. The doula or midwife are able to teach the prisoner about the birthing process and help them learn about their pain options, how to breathe and what will happen to them when they are giving birth.
Even these programs are not as forward as they could be. Even at a facility with a support person, the authorities will not alert the doula or midwife until the doctors say the pregnant women is very close to delivery. Until that point, the woman must labor alone, again with only guards in the room with her. It is not unheard of for the support to be called so late in the labor that by the time they get to the hospital, the baby has already been born.
6Twenty-Four Little Hours
No matter the condition of the baby or the mother, the new mom will only be allowed 24 hours with her newborn. During this time she may have her child beside her in a crib but she will be shackled. If the prisoner wants to breastfeed she can do so, but again she must try to begin the difficult process while her ankles are affixed to the end of the bed and, more often or not, she is handcuffed. Handcuffs usually go back on within an hour or so of labor and stay on until the mom is back in prison.
When the 24 hours with her baby is up, the prisoner must hand over her newborn to the hospital staff and leave. One inmate starved herself for three days just to get a little longer with her baby but gave up her hunger strike when she was told her baby was going to the nursery and she would no longer be able to see her.
5High Rates Of PPD
Not surprisingly, women who give birth in the correctional system have a much-increased risk of developing postpartum depression than their counterparts outside of the penal system.
These women may not have the exhaustion of looking after their newborn to deal with, but they do have the plunging hormone levels, no support, and most importantly of all their baby taken forcibly from them. This is not to mention the fact that they have just delivered a baby while alone and shackled to a hospital bed.
If you take all of this, natural hormonal fluctuations, the trauma of the birth and separation experience, and then what happens next, it is no wonder women who have babies in prison have high rates of PPD.
When they return to prison the women who gave birth just 24 hours previously are put straight back into the general population where they often suffer from bullying, physical abuse and sleep deprivation.
4They Might Never See Their Child
If a woman who is pregnant in prison is lucky enough, she may have relatives whom she can ask to take care of her child while she serves out the remainder of her sentence. Ideally this would be the child's father, but more often than not this is not the case. Over 90% of men in prison report that their children live full-time with the children's mother but only 28% of incarcerated women can say their kids are living with their father.
If a family member is not available to take care of the baby, the child will be placed in foster care through the state child welfare system. If the mother remains in prison for two years or more, she is considered to have abandoned her child, loses all parental rights and the baby is usually then adopted by the foster family. If the mom is lucky, the family might allow contact but they are under no obligation to do so and the mother might never hear of or see her child again.
A small handful of correctional facilities have developed mom and baby programs and in prison nurseries. Although there are nowhere near enough places for each woman, the eight units between them provide up to 160 spots where women can stay with their babies. The programs vary in length with some offering only 30 days and others lasting as long as two years, but they do provide some opportunity for mother and baby to bond in the crucial post-birth period.
The nursery units have strict rules about who may participate. Nobody who is serving time for violent crimes is allowed, and if any woman breaks any rule she will have to leave, and her baby will be sent to be cared for by others.
This may seem like a cushy option but the women are still subject to the same rules as the rest of the prisoners and have to raise their children in a small unit with bars on the window and restricted opportunities.
2Some Things Are Possible
If a woman's child has been placed with a family member or a foster family in proximity to the correctional facility where they are incarcerated, feeding her baby with breastmilk may be possible. If the woman would like to and if the care family are willing, a new mom can pump her breast milk and have it frozen in prison.
The caring family is then responsible for traveling to the jail every day or two to collect the milk for the baby.
The new mom will not receive any special consideration for the fact she is pumping breast milk. There are no additional fluids or foods and there are limited opportunities for her to express her milk with any privacy. Once the milk is pumped, the mother is also dependant on the goodwill of the prison guards to come and collect it from her and freeze it straight away.
1Short Term Vs. Long Term
It might be tempting to think that a woman who has broken the law has no right to expect any support, care or education while she is in prison. After all, it is her fault she is there, and she should have thought about that before she offended right?
The thing is that by treating a woman well during this critical period, providing her with the tools to be a better parent and allowing her to build a bond with her baby, you are giving both the mother and child a better chance of staying out of the justice system in the future.
Spending an average of $30,000 a year per baby on a mother and baby unit is not only financially cheaper than the $80,000 per year it costs to keep a child in the foster system, but you are more than likely saving that mother and child from becoming habitual offenders in the future.
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