Birthing behind bars, but not alone

Reading a recent article in the Seattle Times on doulas in the state prisons, I wasn't sure whether to feel ashamed or proud of my state. It’s a horrible thing for babies to be born in prison—horrible for the mother and boding horribly for the child—made worse by the inhumane ways most prisons treat laboring women (some prisons actually handcuff women to the bed during labor, and prison health care is rarely good). Although the article describes doulas as having been resources for pregnant women for centuries, and it’s true that there have always women who’ve informally offered other women their expertise about childbirth, in fact doulas as such were created only in the last few decades by the women’s health movement, with a prominent role by activists in Washington state, including Penny Simkin.

Typically doulas attend births, while it appears the doulas in the Washington prisons are mostly restricted to prenatal counseling and attend birth in only a few cases. That’s too bad, because studies (PDF) have found that having doulas supporting mothers during labor and delivery dramatically improves health outcomes and reduces C-section rates. Which is a good thing even if you don’t care about incarcerated women; reducing C-sections and reducing complications in birth saves a lot of money for the state’s taxpayers.

The Times article failed to mention that the rate of babies born to incarcerated women has skyrocketed in recent decades, as the female incarceration rate has skyrocketed. U.S. imprisonment has been rising dramatically across the board—we now have the biggest prison population in the world, 1 out of every 100 American adults—but it has been rising much faster for women than men. The female incarceration rate is up 775 percent since 1971, double the rise for men. The single biggest factor in that rise, according to Silja Talvi, author of Women Behind Bars, is the drug war, as I noted in an earlier post.

Again this is an issue worthy of concern whether you’re a bleeding heart or not; imprisonment is expensive. Drug treatment, on the other hand, is cheap.

The Times reporter barely brushed against the other horror of female imprisonment: Most women in prison have been sexually abused. Nearly every one of the hundred or so women Talvi interviewed for her book had been a victim of sexual abuse or domestic violence, and many had been raped. Giving birth can bring the trauma of that experience back to the surface, according to Simkin, who offers special counseling and birth support for abuse survivors.

It will be interesting to track whether the state continues this program and whether it expands it to provide labor support. And keep on eye on whether Washington’s female prisoner population continues to grow. Perhaps as state budgets grow ever tighter, bean counters will notice this huge budget item and see an opportunity.