Doulas and the Criminal Legal System

It’s 3 am when her phone rings; the prison is calling to give notice that her incarcerated client is in labor and has been admitted to the hospital. She collects her things, heads out the door and makes the drive to a suburban hospital just south of the Twin Cities where her client awaits her. All the while thinking about what the day will bring, she knows she’ll need to help her client stay focused in the moment of birthing her baby and initial bonding, not what is to come two days from now. Walking into the hospital room, after showing two forms of identification, she sees her client with two correctional officers at her bedside, an unnatural sight she will never get used to. Since the facility does not allow hugs at all, this is the first thing she does when she enters the room. Today is the only time that physical touch is allowed between doula and client. The doula knows her job today is important; it’s more than providing physical, emotional, and informational support to someone giving birth. Today is about preserving the positive memories, mom and baby meeting and spending time getting to know each other before they will be separated when the baby is just two days old.

Women in Prison

Incarcerated women are the fastest growing population in the U.S. criminal justice system, increasing by more than 800% in the past 30 years. Today, more than 230,000 women and girls are incarcerated in the U.S. Due to structural racism, a disproportionate number are women of color; 90% come from poverty; 85% report a history of trauma; and most are of childbearing

Raelene Baker Erica Gerrity

age. In 2020, over 24,000 women and girls came under correctional control in Minnesota, of these 4-6% were pregnant. Incarcerated women are more likely to suffer from substance abuse, mental illness, chronic health conditions, infectious disease, and maternal stress, all of which decrease their chances of carrying a healthy baby to term. In many states, those who give birth behind bars are separated from their babies soon after birth, a practice with profound and long-lasting negative consequences for both parent and child. The trauma of incarceration and parent-child separation can cause developmental stagnation, behavioral development delays, and lasting neurological vulnerability in children, leaving them more susceptible to abuse. Imprisoned parents and their children see poorer lifetime health, developmental, and social outcomes— all due to a carceral system ill-equipped to support childbearing, birth, and strong parental relationships. As the number of women and children affected by these inadequacies grows, their impact extends beyond prisons and jails into communities, contributing to higher rates of depression, child abuse and neglect, trauma, and familial dysfunction. In Minnesota a vast majority, 77%, of pregnant women are in prison because of a technical violation of a probation or supervised release and will only return to prison for a short period of time. The median sentence for pregnant women is just 4.5 months.

Prison Doulas

In the early 2000s incarcerated women in Minnesota expressed their needs surrounding pregnancy, birth, postpartum, and parenting to the founders of the Minnesota Prison Doula Project (MnPDP) through a series of talking circles at the prison. Together ideas were formulated and after a period of development were implemented at Minnesota’s only state prison for women, Minnesota Correctional Facility-Shakopee, in 2010. The unique needs of women and birthing people are almost always left out of the conversation of criminal justice reform. MnPDP works

to ensure these voices are heard and become part of the solution. The Minnesota Prison Doula Project aims to nurture healthy parent-child relationships, increase parenting confidence and skills, reduce the intergenerational trauma of incarceration, and increase access to opportunities that build health, healing, and change. Their mission is to work in compassionate solidarity with incarcerated parents to create community, opportunity, and change. What started out as a small doula program has grown to offer many different components for justice involved parents including comprehensive doula care, prenatal and parenting education groups, 1:1 parent counseling, supported parent/child visitation, lactation services, and reentry support. These services have expanded to other correctional facilities across Minnesota and even into the state of Alabama. In 2018 the founders of MnPDP launched a national non-profit organization called Ostara Initiative. This became home to the program and to others including one in Alabama called the Alabama Prison Birth Project. Ostara’s mission is to collectively transform systems by reimagining justice, advancing health, and reclaiming dignity in policies and practices for all pregnant and parenting people with the goal of ending prison birth in America.

Notable Outcomes

The average gestational age of infants born with the support of the program is 39 weeks and 2 days; just 3% of births result in a primary cesarean and 97% of newborns are born at a healthy weight. In 2018, 92% of incarcerated women in Minnesota received the support of doula initiated breastfeeding during their hospital stay. In 2014, MnPDP worked to help pass legislation making it illegal to shackle those who are pregnant and postpartum, the bill passed unanimously and was signed into law. This law also includes a provision that incarcerated pregnant and postpartum people are able to access a doula for support if they choose.

How to Connect and Partner with Prison Doulas

Incarcerated patients anywhere in Minnesota can be referred to the Minnesota Prison Doula Project through their website https://www.mnprisondoulaproject.org/ make-a-referral. If you have a client who is incarcerated, make space to provide them with opportunities to ask questions and express fears. Understand that the greatest separation of their life is looming and offer additional supports available at your medical facility. Please also offer to refer them to the Minnesota Prison Doula Project for free doula care and support. Doula services cover pregnancy, birth, and up to one year postpartum for any justice involved parent who requests it. Please visit https://www.ostarainitiative.org/read–watch.html to learn more about strategies to reduce systematic harm, improve quality of care, and outcomes.

Editor’s Note: On May 14, 2021, Governor Tim Walz signed the Minnesota Department of Corrections (DOC) Healthy Start Act into law, providing new resources to support the health and well-being of incarcerated mothers and their newborn babies. http:// bit.ly/HealthyStartAct

Raelene Baker, Program Director of Minnesota Prison Doula Project.rbaker@mnprisondoulaproject.org. Rae is the director of MnPDP. She also facilitates childbirth education and attends births of those incarcerated at Minnesota’s only state prison for women.

Erica Gerrity, Executive Director of Ostara Initiaitve. egerrity@ostarainitiative.org. Erica is the founder of MnPDP. She is a psychotherapist specializing in families affected by incarceration.