I remember putting together my birth plan – wanting it to be comprehensive enough for my needs to be heard but not wanting it to be so detail-ridden that my midwife would throw it right back at me. One thing I was definitely not budging on was the ability to move during my labor. I wanted the ability to move around my room, take a shower, and dance if I wanted to. I wanted the space to be able to squat, kneel or simply lie down whenever I felt the need to. Movement meant listening to my body and yielding to it. Movement meant tapping into the primal part of me that instinctively knew what to do. Movement was freedom. So when I try to imagine the horror of being shackled to a bed while laboring, denied the ability to move, I am paralyzed with anger and anxiety. This is the harsh reality that most incarcerated birthing women face - forced to deliver in handcuffs, surrounded by unfamiliar faces and voices who do not offer support or words of encouragement. Returning to cells without the baby they’ve brought earthside – breasts full and painful with milk. Some tending to wounds and scars from caesarean sections in isolation. All of this under the cruelty that is the prison industrial complex, where the first thing that is taken is one’s freedom.
The number of women entering the prison system has been steadily on the rise, while the rate for men has been declining. In a 2016 study, women were shown to make up about 23 percent of all prison admissions. This is up from 15 percent in 2000. Then you add the layer of complexity of the nuances between Federal prison vs State prisons vs local jails plus detention centers and youth detention and what you get is over 200,000 women across in the US who are behind bars. And because racism is the lifeblood of all systems of oppression, Black women are imprisoned two times more than white women. We all know and understand women to be the heartbeat of a family. When she is ripped away from that family, the lifeline is severed – women are threatened with the loss of their jobs, housing and even their parental rights. Another glaring injustice is that well over half of women in prison have not been convicted of a crime. They are simply too poor to make bail. Most women in prison are of child-bearing age – yet there have been no systematic studies to look at the specific needs of women’s health in general, or pregnancy or birth outcomes in particular for this population. None. Zilch. Nada. What happens to these women once they enter this punitive and cruel space? The Eighth Amendment “ensures” that people in prison have access to “adequate” medical care. But again, there’s no mandatory reporting or data that can be mined to review what adequate looks like, and since any model of healthcare for the incarcerated person has been based on male inmates, we definitely have no insight as to what pregnancy care looks like.
A recent study in the American Journal of Public Health looked at pregnancy outcomes in a sample of 22 prisons over the course of one year. In that small sample they found about 1400 pregnant women in prison at that time. 90% delivered live babies and there were no maternal deaths. While it is well known that Black women suffer disproportionately from poor birth out comes, the report cites limitations on being able to collect demographic data such as race along with any pregnancy history for their sample. It is also a fair assumption to make that the facilities that participated were probably doing a better job with their prenatal population to begin with. There obviously is a vast divide that needs to be bridged with research and legislation.
There are many individual studies and stories alike that describe in detail the inhumane conditions that pregnant women are under while they are in prison. From being shackled to beds during labor and pushing with an armed guard standing watch, to being forced to miscarry in isolation. And you can forget about postpartum care. How about if you’re not pregnant? Got a period? Well don’t count on such luxuries as pads and tamponsto get you through your time of the month. The work on the ground by activists, lawyers and people who were previously incarcerated has been arduous around this topic. The FIRST STEP Act was recently signed into law in December 2018 (insert Nancy Pelosi clap). And although this criminal justice reform bill makes such provisions as banning the shackling of pregnant women and guarantees free pads and tampons, it only does so for women in federalprison. By the numbers that only supports about 7 percent of the total population of women in prison. We got 50 states. Which means this has to get pushed 50 different ways to Sunday. (Technically 22 states already have some form of antishackling law in place, but this is always discretionary). Other steps at the local level have been taken to ensure pregnant women get the support they need in labor. There are prison doula projects in a handful of states (including Illinois). These doulas are able to offer the kind of support and encouragement that every woman needs and deserves during her pregnancy and labor. Other groups are working to allow women to pump their breast milk while in prison. There are groups working to provide prenatal and parenting education and pushing prisons to allow more time with children. And while I can’t wait for a day when we do away with the prison system, I respect the tireless efforts already in place.
If you are interested in more information or ways to get involved, check out the links below:
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