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Pregnant and imprisoned

U researcher Rebecca Shlafer evaluates a doula program at the Minnesota Correctional Facility in Shakopee.

May 2, 2014

In this day of reality media, viewers are treated to every detail of famous women’s pregnancies, deliveries, and postpartum life.

Their experiences contrast sharply with what happens to those at the opposite end of the scale: women facing pregnancy, childbirth, and mandatory separation from their newborns within prison walls.

For 10 years Everyday Miracles, a Minnesota nonprofit, has been providing doulas for low-income, at-risk women. In 2007 two doulas, Erica Gerrity and Rae Baker, founded Isis Rising, a project to expand the service to incarcerated women, beginning with the Minnesota Correctional Facility in Shakopee. http://prisondoulas.blogspot.com/p/news-articles-and-videos-featuring-is...

Isis Rising soon attracted the attention of Rebecca Shlafer, an assistant professor in University of Minnesota’s Department of Pediatrics.

“I’d always worked with children and families affected by incarceration,” says Shlafer, now research director for the project. “I had put out feelers in the state Department of Corrections (MNDOC), asking how programs were being evaluated.”

What Shlafer has observed is both an eye-opener and a beam of light for those going down the rocky road of prison pregnancy.

Enter the doula

By all accounts, the emotional support and labor coaching of doulas, along with a peer support group for pregnant inmates, has had a deep impact at Shakopee.

“When I was an intern at the prison 10 years ago, I noticed women coming back from childbirth at St. Francis Hospital, and it was taking a tremendous toll,” says Gerrity, the program director for Isis Rising. “Babies are taken from mothers between 48 and 72 hours after birth, putting each mother in the position of being kept from her baby just at the time when her whole body is geared to protecting and caring for it.

“I said to myself, ‘I think something could be done here.’”

Founded in 2007, Isis Rising had its first doula-supported birth in fall 2011. Shlafer joined soon after, and in 2012 she secured a $25,000 grant from the U’s Clinical and Translational Science Institute, which formalized the project and Shlafer’s participation. 

Now, doulas meet with pregnant inmates six times: twice before and after birth, during labor, and at the moment the baby is taken away.

“Doulas coach the mother emotionally,” says Gerrity. “She might say, ‘I know you’re scared of what will happen in two days, but … think of what you can give your baby in this moment, so when you meet again, you will have a bond.’ And the mothers will hold the baby, skin to skin, for the whole time in the hospital.”

Writes one inmate: "I couldn't imagine having to go [through] it alone. I'm so thankful for the doula program, my doula helped me focus on the greatness of my son's birth rather than on having to leave my son to go back to prison."

Research indicates that the quality of the birth experience and the first few days of life can predict which parents will and won’t abuse their child, Gerrity notes.

Statistics show that in the year before Isis Rising systematically provided doula care at Shakopee, seven of 11 (63 percent) babies born to inmates were by costly cesarean section. The number dropped to one in 29 (three percent) among babies born with doula support (October 2011-October 2013). Also, no doula babies were preterm or low birth weight.

A growing need

The need for doulas in prisons and jails has never been greater. The number of mothers incarcerated rose about 80 percent between 1991 and 2007, says Shlafer.

“Sociologists have pointed to a number of reasons for this increase, including changes in drug sentencing laws,” she explains.

According to Greenhope, a residential facility for formerly incarcerated women in East Harlem, New York, women are “overwhelmingly low-level, nonviolent offenders who are selling or possessing drugs to support their own habits.” Often used as drug mules or one-time carriers, they may receive sentences as harsh as kingpins because they have no information with which to plea-bargain a reduced sentence.

Also, says Gerrity, “there’s a great disparity in sentencing by county, judge, race, and class.”

Many female inmates have clinical depression, more than 50 percent of Isis Rising clients report abuse as a child, and more than two-thirds report exposure to domestic violence as adults, according to Shlafer and Gerrity.  Together, these factors produce an inmate population with dim prospects for a healthy pregnancy and birth.

But with Isis Rising, “they’re getting important education about childbirth and parenting, and being supported in their roles as women and mothers,” says Shlafer.  

A more humane future

Shlafer and Gerrity work with MNDOC to improve conditions for female inmates without compromising the safety of inmates or correctional officials.

MNDOC already is ahead of many of its peers nationwide. For example, its policy welcomes doula support, and its current standards require pregnancy testing at intake—so prenatal care can begin—and prohibit the shackling of inmates during labor or delivery. A bill before the Minnesota Legislature would codify these and other practices to support pregnant inmates in custody. Shlafer and Gerrity both testified on how such a bill could improve outcomes for mothers and babies in Minnesota correctional facilities.

“I think Isis Rising is making great progress in its community-University partnership with the Department of Corrections to work together and support this population of women who need it,” says Shlafer. “This problem is bigger than any one agency. It has to be a multisystem approach.”

Isis Rising has recently expanded to Hennepin and Ramsey County jails. It also has a grant from the U’s Program in Health Disparities, along with visions of a brighter future.

“Our goal for Minnesota is to have, by 2020, the most comprehensive doula project for incarcerated women in the country,” says Gerrity. “Every pregnant inmate will have one.” 

Read about Shlafer's workk with children of incarcerated parents.

Contact the writer at morri029@umn.edu

At top: 
The Isis Rising project serves inmates of the Minnesota Correctional Facility at Shakopee.
Photo Credit:
Brady Willette

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