On Birth and Life and the World

Just as we rarely really truly talk about birth, we seldom speak of what life is like for women who are incarcerated. Combining these two topics is even more infrequent. Truth be told, before my third workshop at CLPP the thought of reproductive freedom in prisons had never crossed my mind. This workshop awakened me in a very strong way.

Marianne Bullock, who spoke at Empowering Birth also spoke in this third and final workshop for the day, Organizing Against Reproductive Oppression in Prisons. Marianne is co-director of the Prison Birth Project, which does phenomenal work supporting incarcerated women and their needs in the reproductive health. Marianne was joined by Jenny Vanyur, an MSW who works with a reproductive freedom project at the ACLU of Pennsylvania, and Theresa Martinez, a woman who has served 26 years in prison and now works with Justice Now, a San Francisco based organization that promotes rehabilitation, inmate rights, and prison abolition.

First, this workshop pointed out that the very large majority of women incarcerated today are non-violent criminals, and most are not “bad people,” they’ve just been forced into a corner due to a bad upbringing. Most women incarcerated in the United States are serving terms for non-violent, drug-related charges. Most women in the criminal justice system are also mothers. Prison will likely do nothing for them, except hurt another generation of children. What they need is support to get back on track.

They also need support while in prison. Among the reproductive issues that incarcerated women face:

• Lack of birth control. Women are not allowed to continue hormonal birth control while incarcerated. For women with longer sentences, this has little effect, but many women are only in prison briefly. If a woman is on the pill, missing several weeks or a few months means that they’ll need to start from scratch once released, meaning they are vulnerable to unintended pregnancy for a time. Research has also suggested that women who continue the routine of taking the pill, or who begin taking the pill while in prison, are much more likely to take it correctly once released and less likely to experience unintended pregnancy.
• Poor nutrition for pregnant women. The nutritional content of the food offered in our correctional facilities is abysmal. No fresh fruits or vegetables are offered, and the meat served in prison is increasingly being replaced with cheaper soy products, a diet that is not particularly healthy for an adult, and especially damaging to a growing fetus. One woman in the audience spoke of a pregnant inmate she met during a course who told her that the only additional supplementation they gave her was a peanut butter sandwich and a glass of milk before bed. This might be okay for covering the additional caloric requirements in pregnancy, but certainly it can’t replace the nutritional content that this mom-to-be required.
• Lack of support while in labor. The Prison Birth Project has a doula program, providing pregnant inmates with childbirth education, and then supporting them through labor and delivery. As inmates, these women don’t have access to the support networks that other laboring women have. While in labor, we inherently seek out comfort and support from others, but these women are not able to bring a birth partner or friend, and hospital staff, who are focused on medical support rather than emotional support, are even less likely to offer extra care to someone who has been convicted of a crime. Additionally, the medical practitioners are often too involved in providing medical care to think about physical restraints (more on shackling to come). In Massachusetts, where the Prison Birth Project operates, shackles are only to be removed for active labor and delivery. It is often the doula that points out that the woman is in active labor, and that the shackles need to be removed.
• Poor access to abortion. The Prison Birth Project assists incarcerated women who seek to terminate their pregnancies. An incarcerated woman does not lose her right to abortion. However the justice system makes it incredibly difficult for women to obtain their legal abortions. In order to undergo any medical procedure, it must be signed off on by an official in the prison system. If the official is pro-life, they could refuse to sign off (citing other reasons, of course), or wait until the woman is past the point of terminating her pregnancy legally. Once a woman has gained approval for an abortion, she has the added burden of finding a way to pay for it. She is also responsible for arranging her own transportation and guard coverage. More money. The Doula Project helps women find funding for their procedures, and arranges their transportation, allowing women the freedoms that the government promises.
• No option to breastfeed. The Prison Birth Project assists eligible women with breastfeeding. Many women in prison are only there for short sentences. If a woman is weeks from her release date, the Prison Birth Project will help her pump her breast milk, arranging for whoever is caring for the infant to pick up the milk. Once released, the women are then able to feed their infants at the breast. How amazing!
• The shackling of women during labor and delivery. In the federal prison system there are laws against shackling women during labor and delivery, however in detention centers, where most female inmates are held, there are no regulations. Of the fifty states, only ten have their own laws against shackling in labor, including Vermont. Shackling of non-violent women (most of them) seems inhumane, especially since armed guards are also present. Here are five other identified reasons why shackling of women during labor and delivery is problematic:

1. Shackling during transportation to and from the hospital. If a woman’s hands are bound, and the vehicle she is in has an accident, she us unable to brace her body. This is problematic for any person, but especially damaging to a vulnerable fetus.
2. Psychological management. Birth is already a highly emotional experience, and for inmates without a support system, it is even more difficult to handle the emotions surrounding birth. Add in the frustration and shame of shackles, and the process becomes unbearable. It is cruel.
3. Interference with assessment. A birth practitioner has added hurdles to assessing laboring women if they are dealing with added interference and physical restrictions.
4. Interference with emergency care. It is not unusual for women to be shackled around their wastes during labor and delivery. It sounds cruel and unusual, but it also severely impacts the care an inmate may receive in an emergency situation. If a practitioner doesn’t have access to the part of the body where the baby is, it makes it a lot more difficult to give rapid care!
5. Shackling continues postpartum. When a woman knows she must hand over their baby within days and shackled, the odds are good that she’ll struggle some sort of postpartum depression. Not to mention that these women are prohibited from moving around and aiding their recovery.

It was a hearing a first hand account of a formerly incarcerated woman which really revved me. Theresa Martinez’s story is harrowing. Her mother was an addict, so she was raised with little parenting and in poverty. Theresa began using drugs at eleven, and got involved in prostitution at thirteen. By fifteen she was pregnant and in juvenile detention. After giving birth (while incarcerated) Theresa believes she was sterilized against her will. Her daughter was born when she was 15, and in the 28 years since, she has never been able to get pregnant again. Sadly, it could be true. There are many cases of prisoners being sterilized against their wishes, or with clouded consent. Theresa recalled the story of another woman who was serving a life sentence. The woman had been diagnosed with ovarian cysts. She underwent surgery to remove the cyst (which is rare on its own) and when she woke up, she discovered they had removed both of her ovaries. When she challenged the doctor, he said some version of “well it’s not like you were going to have any more children anyways, right?”

While in prison, Theresa tested positive for HIV. She was given the anti-viral drugs, and underwent a lot of emotional turmoil. It took a number of years for her to accept her diagnosis as something permanent. Five years after her diagnosis she was retested. The test was negative. They retested her: negative again. Theresa had never been HIV positive, and yet she had been subjected to medication, stigma and emotional pain for five years. She sued the doctor who had originally diagnosed her, but lost the case. Proof of her original HIV test and diagnosis were never found.

Theresa was in and out of prison for twenty-six years. Thanks to Justice Now’s help, she was able to leave prison behind for good and is currently off parole. She now works with Justice Now, teaching incarcerated women about their rights. I was incredibly moved by Theresa’s candidness, her dignity and her intelligence. For a woman who was not educated past the ninth grade, she was incredibly well spoken. She absolutely shattered my perceptions of incarcerated women and I was glad to be able to speak with her after the workshop and to share a hug with her. It is amazing how guilty I feel about her experience. I feel so sorry that our society has failed to support women like her. I’ll forever be grateful for the opportunity to tell her how much I admire her ability to fight her back and support other women from unfortunate circumstances.