Research is vital to any successful program. For coordinators and facilitators to make sure they are
implementing a program effectively, data needs to be gathered and reviewed, and procedures and programming changed or discontinued if ineffective. The Minnesota Prison Doula Project (MNPDP) works in conjunction with researcher Dr. Rebecca Shlafer from University of Minnesota, and today we met her. With the MNPDP doulas providing hours of services and collecting data from willing mothers, Dr. Shlafer analyzes the birth outcomes for incarcerated mothers and their babies. Because of the coordination between the doulas, this researcher, and incarcerated mothers, the evidence of positive outcomes from the MNPDP program has played a role in creating a pregnancy anti-shackling law in Minnesota. This means that by law, incarcerated mothers in Minnesota are no longer allowed to be shackled in custody while pregnant and have full access to postnatal education services. There are only 18 states that have a similar law in place.
We also made a visit to the Ramsey County Jail this afternoon. MNPDP has reached beyond state prisons at the request of mothers within the prison. Why? Because many women spend time in county facilities awaiting trial or sentencing. Their time in county facilities is much different, and the lower amount of programming offered in most facilities is generally blamed on the short stay of the persons in custody. Except, fortunately, Ramsey County. The MNPDP brought doula support services to several county correctional and holding facilities and is seeking to expand to others, but the program shift from prison to jails is an entirely new system. Jails have high turnover rates, making everything from doula-client connection to paperwork much more complicated. Although this is a new and different environment, the Ramsey County jail has plenty of programming in place for their women. They offer options for the women from the MNPDP doula services to culinary classes and certification. Coordinating these programs is a social worker seeking to offer therapeutic and educational services to the women for however brief or extended of a period they sit in the jail. An on-site doula and counselor meets with women in individual sessions to listen and check-in with the women, and they are building opportunities for face-to-face visiting with children. Currently they must see their kids via a computer screen.
Let’s back up and take a quick look at why so many mothers are incarcerated. Mandatory drug sentencing laws in the mid 80’s created an explosion in female incarceration rates, over 600%, in the following decades. There isn’t a lot of published research about incarcerated mothers, but we are learning that nearly 80% of women in custody are mothers of children of all ages, and 3-4% of them come in pregnant. Three fourths of women who encounter the justice system have a history of trauma, both physical and sexual, and the level of mental illness is disproportionately higher among them, as well as rates of chemical dependency.
Outcomes from the MNPDP are beginning to emerge as the doulas bring more programming and support to more women in Minnesota facilities. Cesarean rates have sharply declined. They hover at around 10%, when they used to be as high as 63%. About half of the women giving birth in prison are doing it without medical pain relief, as they want to have a sober birth, keeping themselves and their babies away from exposure to narcotics. Infant weights are higher, and, amazingly, babies have not been born prematurely. Less than 5% have been born between 35 and 37 weeks. Almost 2/3 of these moms initiate breastfeeding after birth, giving their babies the bolus of colostrum critical to their infant’s first immunization, early bowel movements, and microbial gut colonization.
At the New Mom’s support group in Shakopee, a mother we met, who was 2.5 months postpartum, was pumping her milk on the inside to maintain lactation until she could be released at her end of sentence. In less than a week, she would be able to put her baby to her breast and encourage a latch, knowing that she had pumped at least 12 ounces of milk daily while in prison. She left group armed with information about WIC and supplemental nursing systems if latching her baby became difficult. Evaluations have shown that the mothers with doulas and parenting education are connecting more with their other children, not just the babies born while in prison. They are writing and receiving more letters and making more phone calls and visits.
So we have outcomes from Minnesota to guide us in our work in Alabama. And we can look at other factors as well. Alabama is a state where infant and maternal morbidity and mortality are unacceptably high among all mothers, and especially minority mothers. We will measure birth outcomes for these babies. We will encourage and educate about breastfeeding as a healthy and normal way of feeding babies for however long is possible. We will measure preterm birth rates, Cesarean rates, and the rates their babies require expensive medical care in specialized nurseries. We also will follow re-entry success and are exploring ways to continue the relationship when these mothers leave the walls of Tutwiler. Will they be less likely to return?
We have much work to do. As we fly back to Sweet Home Alabama, from a liberal state to a conservative one, we will build alliances with those who want to make a difference. Our program is not about politics, it is not about a former offense, it is not even about Tutwiler’s history. It is about recognizing human dignity. Here in Alabama, we have support from all levels of the Alabama Department of Corrections. The Alabama Prison Birth Project is connecting with those that believe that incarceration is about correction and re-alignment, not further punishment. We are connecting to those who want the best for the children of incarcerated mothers so they do not continue a life involved with the justice system.
Will you join us?
“Mercy is the bridge that connects God and humanity, opening our hearts to the hope of being loved forever despite our sinfulness”- Pope Francis