Separation of Incarcerated Moms and their Babies

I know the benefits of breastfeeding through my medical school courses, but I had actually only seen breastfeeding on a few occasions during my last two years of medical school, working with patients who are breastfeeding moms. I had never seen breastfeeding in my family, my sister and I were formula fed, and my family members do not talk about anything having to do with reproductive organs! This elective increased my knowledge about breastfeeding so that, as a future family medicine physician, I can help guide breastfeeding moms, know when to consult a lactation expert, and understand which resources are available and most helpful. But, what will be most memorable part of this course for me was seeing the joyful, exciting experience of helping a new mom-baby pair successfully breastfeed. As mom recovers from her delivery, she remains the baby’s everything; if she chooses to breastfeed, she is the baby’s milk supply, the baby’s comfort, and their safe place. The emotional connection between mom and newborn baby as they learn to breastfeed is probably one of the most beautiful things I have witnessed in medical school.

      I recently wrote a paper about the incarceration of women and mothers who use drugs, and this breastfeeding course made me think about all the moms in prison who are separated from their newborn babies within 2-3 days of giving birth. Since the Anti-Drug Abuse Act was passed in the 1980s, which criminalized substance dependence, the number of women incarcerated in the US drastically increased by more than 800%. One third of incarcerated women are in jail for non-violent drug-related crimes compared to one fifth of incarcerated men, and about 25% of women are either pregnant or gave birth less than a year before they were incarcerated. What structures and policies are in place in correctional facilities to support pregnant and postpartum moms, to allow them to see their newborns and to help support breastfeeding? Are there not alternatives to imprisonment for nonviolent drug-related crimes that would prevent the trauma and detriment of separation, for both mom and the next generation of her family?

         In prison, many women experience stressful and unsupported pregnancies and deliveries. A stressful pregnancy can lead to maternal depression, preterm birth and low birth weight. Within 48 hours, women are separated from their babies and sent back to prison. While some women do breastfeed during these 48 hours, other women don’t want to, knowing that they are about to be separated from their child; or if they are having difficulty breastfeeding, they do not want to spend the little time they have with their child, trying to overcome breastfeeding challenges. In the majority of prisons, there are no pumping programs, which would create designated places for mom to pump and the option to store and transport her breast milk to her baby, thus depriving both mom and baby of the benefits of breastfeeding and pumping. For some moms, their imprisonment means permanent separation from their child, as they may be placed in foster care or their children may not be able to visit, due to cost of travel and lack of transportation. Judges enforce gender-neutral incarceration policies to prevent discrimination, but it is to the detriment of women who deal with sex-specific issues such as pregnancy, childbirth, and lactation.

            In order to help these incarcerated moms and their babies, there needs to be a greater push for the creation of prison nurseries, in-prison pumping programs, and for alternative sentencing for non-violent drug-related crimes in the form of community-based programs. Separation during imprisonment prevents many children with incarcerated parents from developing a secure attachment.  Insecure attachments that develop from parental incarceration are associated with the hindrance of healthy development, detrimental social and emotional outcomes—including depressive symptoms, aggression, delinquency, criminal behavior and social exclusion—and increases likelihood of substance dependency and incarceration. Prison nurseries or community-based programs would allow for contact between mom and baby, the option to breastfeed, and the development of secure attachments. These programs not only promote maternal-infant bonding and keep children out of foster care, but these programs also allow women to receive substance-use and trauma recovery treatment as well as parenting and life-skill classes, which have proven to reduce rates of relapse and recidivism. As future physicians, and especially for those interested in public health policy reform, we must push for change and raise awareness of the diminished rights of incarcerated women. We need to do better to prevent the unnecessary separation of mom and their babies.

 

 Camille Singh  DUCOM 2020

Citations

• Kotlar B, Kornrich R, Deneen M, et al. Meeting Incarcerated Women's Needs For Pregnancy‐Related and Postpartum Services: Challenges and Opportunities. Perspectives on Sexual and Reproductive Health. 2015;47:221-225.
• Kanaboshi N, Anderson JF, Sira N. Constitutional Rights of Infants and Toddlers to Have Opportunities to Form Secure Attachment with Incarcerate Mothers: Importance of Prison Nurseries. International Journal of Social Science Studies. 2017;5:55.
• Plec E, Schneeweis A, Cook AB, et al. Demystifying the Big House: Exploring Prison Experience and Media Representations. Carbondale: Southern Illinois University Press; 2018.