During her time as a resident at the University of Pittsburgh Medical Center Magee-Womens Hospital, Dr. Deborah Landis Lewis says she remembers female prisoners arriving at the hospital for surgeries wearing shackles. "[I had] discussions with the officers who were present about why [a female patient] shouldn't be shackled at the time of surgery, when she would be under general anesthesia on the operating table," she recalls. Those experiences were jarring, but ultimately inspired Lewis to build a career centered on women's health — including incarcerated women.
Today, Lewis is the Associate Program Director for the residency program in Obstetrics and Gynecology at St. Joseph Mercy Hospital in Ann Arbor, and she's firm in her stance that pregnant prisoners deserve the best care possible. Although Lewis says shackles are not commonly used in Michigan during childbirth, she adds, "There's no legislation in Michigan, currently, that addresses shackles."
In Michigan, there are no laws that regulate the standards of care that pregnant women receive in prison. In their absence, the Michigan Department of Corrections works under its own set of internal policies when interacting with pregnant inmates. But the application of those policies, Lewis says, often "feels very arbitrary."
Two recently introduced bills could change that, though, by codifying the standards of care for incarcerated pregnant women in Michigan. If passed, Senate Bill 830 would ban the shackling of pregnant prisoners, codify access to breastfeeding and doula programs, prohibit officers from being in the room during labor and delivery, allow new mothers to remain with their newborns for 72 hours, and permit a support person to be present during childbirth. An additional bill, SB 831, would establish an advisory board to oversee conditions at the state's only women's prison, in Ypsilanti, and increase accountability within the system.
"Prison is an awful place for those who are pregnant," says state Senator Erika Geiss, who introduced the bill. "It exposes them to trauma, risk of violence, communicable diseases, poor nutrition, social isolation, and damaging disconnection from their newborns or other children. This legislation would make sensible changes to current law, so incarcerated individuals are treated humanely and with dignity."
The issue received widespread attention when Detroit activist Siwatu-Salama Ra was forced to give birth while in custody of MDOC in 2018 after brandishing a registered, unloaded firearm in self-defense during a 2017 altercation. Her attorneys requested that she be allowed to serve the sentence after she gave birth or be allowed out on bond at her due date, but Wayne County Circuit Court Judge Thomas Hathaway denied the motions. Ra was driven to a birthing hospital in Washtenaw County to give birth, where she was allowed to recover with her child for two and a half days before being sent back to prison, where she says she became depressed.
Recently, Lewis says she conducted a review of the charts of pregnant inmates from the Women's Huron Valley Correctional Facility in Ypsilanti that had given birth over the last decade. "Upwards of one in five [...] were denied infant contact," she says. "So that would mean that a baby was born, and then that baby would be taken away — and the mom, during the rest of her hospital stay, would have no contact with the baby." And that's important, because studies have shown that contact between mothers and newborns is critical to their cognitive development.
"People do not cease to be human beings with human rights because they have committed a crime," says Jacqueline Williams, co-founder of the Michigan Prison Doula Initiative and program associate at the American Friends Service Committee Michigan Criminal Justice Program, an advocacy organization that provided support for the bills.
Williams says the new legislation could help improve conditions for women confined to the state's prison system who often come from underprivileged backgrounds. "Prisons should not be the place where people land when the societal safety net has failed," she says. "There are so few resources out here for people who are suffering from systemic poverty or disenfranchisement, substance abuse, mental health disorders, and chronic homelessness."
Prison-reform advocates from the Prison Birth Project at the University of Michigan, a student group in Ann Arbor, have also spoken in favor of the new legislation. "We are in favor of the limits [SB 830] places on shackling of pregnant women, extending the amount of time mother can spend with baby, and especially its promotion of a prison doula, which would allow for the Michigan Prison Doula Initiative's programs to have more autonomy," board president Sitara Murali and communications director Neha Gogineni said in a joint statement. "Currently, MPDI's doula services can be taken away by MDOC, and the passage of SB 830 would prevent that."
Despite that possibility, Kate Stroud, co-founder of the Michigan Prison Doula Initiative, describes her current relationship with Women's Huron Valley and its birthing hospital as "really great." Under a partnership with the women's prison, Stroud manages a team of nine doulas that offer services to pregnant prisoners ranging from prenatal to post-delivery support.
Stroud says she believes every woman who wants a doula should be able to access one — even in prison. "The incarceration system was built for men," she says. "And we have an influx of women who are becoming incarcerated ... and there's this smaller demographic of folks who come in and have to give birth in prison — and the prison is just not built for it."
Some medical researchers are working to change that, though, by collecting important data about pregnant women in prison. Dr. Carolyn Sufrin, assistant professor of gynecology and obstetrics at the Johns Hopkins School of Medicine and research director at the Advocacy and Research on Reproductive Wellness of Incarcerated People (ARRWIP), says one of the reasons policies to protect pregnant prisoners are often lacking is the absence of data. "When you don't know the scope of what you're dealing with, it's really hard to make recommendations about what policies and services should be available," she says.
After working in the area of reproductive health for incarcerated women for over a decade, Sufrin says she realized that statistics about the pregnant prison population had become outdated. "In papers that I would write and talks I would give [...] I started to look more at the reference that I would cite and realized that there was really no good explanation of the methods of how that statistic was devised," she says. "And while there were subsequent reports from the Bureau of Justice Statistics, those were from surveys done in 2002 and 2004. The only national assessment of the number of births in prisons was in 1997."
That realization led Sufrin and a team of colleagues to spearhead the groundbreaking Pregnancy in Prison Statistics (PIPS) Project. Between 2016 and 2017, the team collected data from 22 state prison systems, the Federal Bureau of Prisons, six jails, and three juvenile justice systems regarding the numbers of pregnant people in custody, the outcomes of those pregnancies, maternal and newborn deaths, substance abuse, mental illness, breastfeeding, and other issues.
Although several states, including Michigan, declined to provide statistics for the study, documents acquired from the Michigan Department of Corrections through a Freedom of Information Act request reveal there were 27 deliveries, one miscarriage, and two voluntary terminations of pregnancies by incarcerated women in the state in last year.
Kyle Kaminski, Offender Success Administrator at the Michigan Department of Corrections, says there are currently two pregnant prisoners serving time at Women's Huron Valley. Earlier this month, prison-advocacy groups across the country, including ARRWIP, called for the release of pregnant prisoners due to the increased risks associated with COVID-19. Kaminski says both pregnant women have remained in prison throughout the pandemic, although a third pregnant inmate was released on bond in April. (In April, as the coronavirus spread through Michigan's prison system, inmates filed a class-action lawsuit in U.S. District Court for the Eastern District of Michigan accusing MDOC of violating inmates' Eighth Amendment rights, which prohibits cruel and unusual punishment. According to the Marshall Project, MDOC has more coronavirus deaths than any other state prison system.)
Under current MDOC policies, Kaminski says that pregnant prisoners are transported to an offsite birthing hospital during labor and do not give birth in prison. He says current policies also dictate that inmates known to be pregnant cannot have any restraints other than handcuffs placed in front of their bodies during transportation, and no restraints are currently used during labor or delivery at the hospital "unless there was some really significant concern related to escape risk," adding that he is not aware of any cases where that has happened. Kaminski says that post-delivery contact between an incarcerated mother and her newborn is determined by "other agencies [...] like Child Protective Services and the Department of Health and Human Services."
Kaminski declined to comment on the proposed legislation at the time of his interview, pending its review by MDOC, but says conditions for pregnant prisoners in Michigan have improved in the last couple of years due to the adoption of updated policies. Still, he admits that circumstances haven't always been ideal. "If you interviewed somebody who, four or five years ago went through [pregnancy in prison], their experience would be very different than it is now," he says.
Those inconsistencies are what worry prison-reform advocates like Williams, who says determinations about whether a mother can have contact with her newborn seem to be based on what Williams calls a "vague and arbitrary" set of criteria.
"There's this idea that once a woman is pregnant, she is a vessel and her life and rights don't matter — it's [solely] the life and rights of the baby that matter," Williams says. "I would argue that what happens to one happens to the other. A woman deserves the correct care and the opportunity to thrive if she's pregnant or not."
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