Evidence-based Policies Needed in Prison Populations

by Donna Jackson-Köhlin, CNM

One reality of midwifery practice in these times is that all of us will—if we haven’t already—care for women who are affected by the criminal justice system, whether they are incarcerated themselves, or the child, parent, or partner of someone who has been in the U.S. prison system. Thanks to the relationship between the community health centers where I practice with Baystate Midwifery and Women’s Health in Springfield, MA, along with the Hampden County Correctional Center, I have been able to provide obstetric and gynecologic care to incarcerated women inside a regional women’s jail for the past six years.

Caring for incarcerated pregnant women is demanding. Standards of care must be meshed with jail concerns around security, planning for the baby at/after birth, confidentiality concerns, and trying to facilitate normalcy in what is not a “normal” setting.

Shackling of pregnant women has received media attention, and for good reason. Few states have legislation in place regarding standards for prenatal care or restraints for labor/birth. Prison nursery programs that help foster bonds between mothers and infants are uncommon. The current practices at my facility in Massachusetts have been put into place due to a commitment to proactive policies, and good graces of the correctional medical and administrative staff. However, they are not part of state policy, and as such, they can be reduced or discontinued at any time.

It was with great interest that I received the report from The Rebecca Project for Human Rights/National Women’s Law Center, “Mothers Behind Bars: a state-by-state report card." I recommend that you read this document, consider what your past experience has been with this population where you practice, and think about what you can do to advocate for more humane, evidence-based beneficial policies and legislation that influence the family, community, and society long after a woman’s time in the prison system has passed.