Across the country, doulas and those who support them have been heading social movements to protect the reproductive rights and experiences of incarcerated women. Hundreds of babies are born each year to mothers who are physically shackled at wrists, ankles, abdomens, and/or to their hospital beds during and after labor, and the c-section rate of inmates is twice the national average at over 60 precent. New mothers and babies are usually separated within 48 hours, and many women labor alone. Doula groups are working to change this situation.

Doulas are on their way to becoming a common part of American women’s childbearing support. The largest doula certification organization, DONA, has certified more than 10,000 doulas since its inception twenty years ago, and its membership has increased tenfold over that period. More and more laypeople have become familiar with the term. A doula is a trained, non-medical companion who offers emotional, physical, and informational support for events in a woman’s reproductive life. Most commonly this means childbirth, but birth doulas are being joined by post-partum doulas, who support moms through infant care and the transition to motherhood, and full-spectrum doulas, who support women through abortions, miscarriages, fertility treatments, and any other vulnerable reproductive situation. They are filling a crucial gap in the United States’ healthcare system.

Incarcerated women are a particularly vulnerable group. Overwhelmingly, they are socioeconomically disadvantaged and arrive in prison from unstable living situations, and women of color are incarcerated at a much higher rate than white women. Prison may be a relatively secure environment with access to better prenatal healthcare than would have otherwise been the case. Most inmates are sentenced for short periods – two years or so. Becoming a mother can be a transformative experience that motivates incarcerated women to improve their living situation and take better care of themselves. By supporting and encouraging this possibility, rates of recidivism could be greatly decreased.

When women feel nurtured during their childbearing, they are able to extend that care to their infants, which is particularly important for women who have had difficult lives. Chicago doula activist Loretha Weisinger says “you have to nurture the mother so she can nurture the baby” – the teen mothers she works with are able to make responsible life decisions following her support as a doula, and in turn raise babies who are themselves less likely to become teen moms. Also important towards this end is having a doula who comes from a similar background as the mother. In California, the San Francisco-based Birth Justice Project just received a$200,000 grant from the Alameda County Public Health Department to train formerly incarcerated women as doulas, and to support their work helping pregnant inmates.

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Shackling of laboring inmates is dangerous and inhumane, according to the ACLU. Earlier this year, Massachusetts and Minnesota became the 20th and 21st states to adopt anti-shackling laws, and in both places there is a group of activist doulas working to help incarcerated women give birth: The Prison Birth Project in Massachusetts, and The Isis Rising Prison Doula Program in Minnesota. These states join Arizona, California, Colorado, Delaware, Florida, Hawaii, Idaho, Illinois, Louisiana, Maryland, Nevada, New Mexico, New York, Pennsylvania, Rhode Island, Texas, Vermont, Washington, and West Virginia. In over half the states no protections are enacted.

Removal of infants from their mothers has become common since the 1950s, due in part to the huge increase in numbers of incarcerated women and the cost to the state of raising a baby in jail. The amount of time an infant can stay with its mother varies by state, from 48 hours to the length of the sentence (though the latter is uncommon). The benefits of leaving a baby and mother together, instead of sending it to foster care or a family member, are multiple and include a greatly reduced risk of recidivism. Supporting women to raise their children through difficult circumstances may not only be ethical but financially prudent in the long run.

The potential for doulas to help incarcerated women is clear and substantial, and needs state support. Earlier this year, on the heels of its anti-shackling law, the Minnesota legislature voted that pregnant inmates may have doulas in labor. This protects the right of the Isis Rising doulas to offer their support, which previously hung on their good relationship with prison staff, and opens up the possibility for the privately funded group to receive state funding. If such public support can be pushed into law – and funded – more widely, the social benefit will be enormous.

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