The Prison Birth Project

From 2010 to 2014, I volunteered as a childbirth educator and labor support doula with the Prison Birth Project.  PBP is a model of community-based support for incarcerated women.

Below, you will find PBP’s mission, six major issues affecting incarcerated mothers, PBP’s programs, a bunch of startling statistics, and suggestions for what you can do in your own community if you’re inspired.  I’ve included notes about teaching childbirth classes in jail, my one -page handout you can use about having a baby, and my one-page handout of postpartum instructions for incarcerated moms.

Click here to read the article Marianne Bullock and I recently published in Midwifery Today Magazine.

Click here to read my review of the TV show “Orange is the New Black.”

Here are some of the things I’ve learned:

1.)  85% of incarcerated women are mothers.  4% are pregnant.  The pregnant women at our local jail are a handful of the 12,000 pregnant women incarcerated in the US at any given moment.  I had never thought about this!  Have you?  There are some stunning statistics below.  Race, class, gender, economics, and government policies play huge roles in the burgeoning mass incarceration of Americans.  More than 1% of Americans are currently incarcerated, with women representing the fastest growing sector.

2.)  Incarcerated mothers face all the familiar challenges of mothers everywhere, plus a formidable set of additional challenges, particularly separation from their children, custody difficulties, and whatever set of circumstances resulted in their incarceration. Like all mothers, they deserve and appreciate kindness, respect, and support.

3.)  With an investment of time, compassion, and determination, it’s possible to set up a very beneficial program in your local jail. PBP was founded by Marianne Bullock and Lisa Andrews, a pair of young mothers who simply approached the jail with their idea to offer doula services.  Childbirth education classes and a mothers’ group were added soon after.  PBP is now experimenting with a collective organizational structure and creative fundraising.  There are a handful of similar programs around the country.

4.)  It’s important to include incarcerated and formerly incarcerated women in leadership and programming.  They are experts on their own lives and their own needs.  Leadership opportunities can be empowering for them and beneficial for the organization.

5.)  Incarcerated women can have nice birth experiences with good support — it’s one less opportunity for trauma.

6.)  Incarcerated women can breastfeed, if their babies live nearby and the babies’ caregivers are willing to pick up frozen breastmilk and bring the babies for in-person nursing visits.  PBP has provided breastpumps and several moms have breastfed this way.

7.)  Some states have small-scale prison nursery programs, enabling some mothers and young babies to remain together.  Massachusetts isn’t one of them, so far.

    Resources (Families Against Mandatory Minimums) (Women’s Prison Association) (Law Enforcement Against Prohibition)  War on the Family: Mothers in Prison and the Families They Leave Behind Mothers in Prison: The Impact of Incarceration on Motherhood Mothers of Bedford

PBP’s Mission

We are a reproductive justice organization working to provide support, education, and advocacy with women and girls at the intersection of the criminal justice system and motherhood. We support people physically and emotionally through the entire spectrum of reproductive health.

We follow a reproductive justice model of healthcare.  We believe that complete physical, mental, spiritual, political, economic and social well-being of women and girls will only be available when women are empowered and provided with the resources to make healthy decisions about their bodies, sexuality, and reproduction of families and communities.

Changes are needed on the individual, family, community and institutional levels to end all forms of oppression. We recognize eugenic and discriminatory practices and the regulation of reproduction. Often race and class define parental rights – not only who can’t have children, but who can, and who can have access to raising those children.

6 issues affecting incarcerated mothers

1.  Shackling/restraint

Ten states now have anti-shackling legislation: California, Colorado, Illinois, New Mexico, New York, Texas, Vermont, Washington, West Virginia and Pennsylvania. Women detained in 40 states, the District of Columbia and the Federal Bureau of Prisons lack such legislative protection. But even in those states with policies prohibiting the practice, shackling may still occur at the discretion of corrections officials.  Including in labor!

2.  Postpartum Isolation

Many prisons do not have drug maintenance in prisons and jail.   Pregnant women entering the system are able to maintain their methadone intake for the health of the baby but must withdraw from methadone directly postpartum; they are placed in Protective Custody and isolated until the process is complete. This policy puts women in a dangerous place (postpartum, separated from their babies, withdrawing from methadone, isolated, and possibly malnourished) increasing the likelihood that they will enter into severe postpartum depression.

3.  Lack of child visitation/ transportation

Half of all incarcerated mothers don’t get visits from their children.  There are very few prisons that have nurseries that enable mothers and babies to remain together.

4.  Many mothers lose custody because of outdated policies

ADSFA (1997 Clinton), regarding the permanence of children, states that if parent was not with child for 15 of the last 21 months, this is grounds for termination of parental rights.  But the average female prisoner’s length of stay is 36 months.  TPR is granted in about 92.4% of cases with incarcerated mothers (91% with fathers) and granted in 81% of cases involving a person incarcerated for drugs. Some states are creating discretionary acts.

5.  Lack of sound breastfeeding policy

PBP has worked to change a policy that thought of breastfeeding as a “privilege” within the DOC. We now provide a breast pump and lactation support at the facility and have facilitated the extended breastfeeding of several incarcerated mothers.

6.  Lack of nutritious food

Pregnant women’s bodies require enhanced nutrition and access to food that has high concentrations of vitamins of minerals such as fresh fruit and vegetables.  Prison food is badly suited to the needs of pregnant women and their fetuses.

Who’s in jail and why?

 More than 1% of US adults are in jail or prison right now.

If rates remain the same that means that 6.6% of US residents born in 2001 will go to prison or jail at some point in their lives.

The number of women incarcerated in the US has increased 832% in the past decade.

85% of women in prison are mothers.  2/3 were their children’s primary caregivers prior to incarceration.

4% of women in prison are pregnant.

That means that approximately 40,000 women incarcerated each year are pregnant upon arrival.

73% of incarcerated women are serving sentences for nonviolent crimes (property, drugs, prostitution) and many do not pose a flight risk.

2 million people are arrested each year for drug charges.

70% of women in prison are African American or Latina, and this is the fastest growing sector.  (Only 29% of all US citizens are African American or Latina.)

African American children are 9 times more likely than white children to have a parent in prison.  Latino children are 3 times more likely than white children to have a parent in prison.


What happened before they got there?

57% of incarcerated women have experienced sustained physical and/or sexual abuse.  (There may be more that do not report such abuse.)

84% of incarcerated women have histories of drug addiction. 

16-20% of incarcerated people have a history of mental illness.  There are 3 times more mentally ill people incarcerated than in hospitals, making jails and prisons (the only places where universal health care is mandated) the de facto destinations for the mentally ill.

In 1955, there was one psychiatric bed for every 300 Americans.  In 2005, there was one for every 3,000 Americans.

60% of transgender women reported being incarcerated at some point in their lives.

What about their children?

Prior to entry, 46% of incarcerated parents lived with at least one of their minor children.

1.7 million children (2% of Americans under age 18) have a parent in state or federal prison.  Another 6.6 million children have a parent in jail, on probation, or on parole.  (Jail is for those who have short sentences or who have not yet been sentenced; prison is for those serving longer sentences.)

The average age of children with an incarcerated parent is 8 years old.  22% are under age 5.

Especially in communities in which many of the fathers are already incarcerated, incarcerating mothers significantly increases the rates of children in foster care: 11% of mothers in state prison have their children in foster homes or agencies, compared with 2% of fathers.

However, 85% of those children were placed in foster care prior to their mothers’ first incarceration.

Children who “age out” of foster care at age 18 face disproportionately higher rates of incarceration, unemployment, substance abuse, homelessness, etc.

In 2004 59% of parents in state facilities and 47% in federal reported never having had a personal visit from their children.

Pregnancy and birth while incarcerated

Prison food is problematic.  Fresh fruits and vegetables, real meat and fish, and whole grains can be scarce.  Menus may rely heavily on texturized vegetable protein, which many women find undigestible.   Pregnant women may receive supplemental vitamins and extra milk and sandwiches, but research is needed to determine how well the needs of gestating women – and their fetuses — are met.  If women have money, they can purchase extra food in the commissary, though nutritious foods available there are limited.

The laboring mother is moved to the hospital under guard and is often shackled.  10 states have passed laws restricting or banning shackling pregnant women, and 14 more have introduced anti-shackling bills.  But currently, 40 states have no regulation of this common practice.

Some hospital personnel are respectful of incarcerated mothers and sensitive to their particular vulnerabilities.  Others are not.  Doula care can be tremendously helpful, even if relatives are allowed to attend the birth.  Doulas may be permitted to touch the laboring mother even when relatives are not.

After a short period (from no time at all up to a couple of days), some babies go to relatives or friends, and some go to foster care.  Mothers are returned to jail after a day or so.  Recently, a tiny minority of babies have been going to prison nurseries or to community-based residential parenting programs with their mothers.

Women kept on methadone maintenance during their pregnancies are weaned off postpartum, and often housed in segregation units.

Some jails and prisons support mothers in pumping their milk if relatives are available to pick up the frozen milk and bring it to the baby.  Some are supportive of mothers breastfeeding when they receive visits from their babies.  Many women do not receive visits from their babies due to distance and logistical or legal problems.

So far, nine states have prison nurseries, but they are each limited to a small number of participants.

Prison nurseries are relatively inexpensive to run and do not seem to harm babies, but they do reduce mothers’ recidivism dramatically, improve mother-infant bonding, facilitate breastfeeding, and decrease the need for foster care.

Most mothers approved for prison nursery programs have suffered drug addiction, poverty, and lack of education, and pose little risk to the community.  They could be better served in a community setting than in prison.

Community corrections programs have been shown to protect public safety and reduce recidivism at a fraction of the human and economic costs of incarceration and foster care. Research is needed on both prison nursery programs and community-based programs.

PBP Programs

1.  Childbirth Education

These differ from traditional childbirth education classes in two ways.  First, we often don’t know how long we will have with each woman.  We may see a woman only once, or we may see her every week for her entire pregnancy.  So we have to create curriculum that meets the needs of both extremes and the women in the middle.

Second, incarcerated women are dealing with issues that may overshadow the pregnancy itself: will they have custody?  have they suffered trauma or abuse?  are they in danger of having their birth experience become a source of trauma for them?  are they on methadone or suffering from diseases or addictions?  who will support them when they’re outside?

So classes tend to be less formal, with an emphasis on connection and sharing more than on covering a list of topics.  Videos are valuable.  We always bring in healthy food, which is much appreciated.

       2.  The Doula Project

Full spectrum of reproductive health including emotional health

Doula services, postpartum services, and then referral to mothers group

Options counseling and support

Networking with resources on the outside

3.  “Mothers Among Us” support groups

We explore the social landscape of motherhood and the myths of mothering.  We allow space for truth telling / story telling and community building both behind the wall and in community. We cultivate models of empowerment and leadership development within the group.  We focus on issues of reunification with children and getting support through recovery.

What’s unique: we address justice, healing, education, leadership development.  Mothers’ circles cultivate community relationships and strengthen each woman’s core. Participants become trained in facilitation and can run their own groups.

What can you do in your own community?

See or for current campaigns regarding shackling.

Start a doula project in your local jail or prison.  Include incarcerated and formerly incarcerated mothers in guiding the project and providing services.

Raise money and volunteer for your local doula project.

Organize mothers’ groups (see

Be a mentor to mothers during incarceration and/or after release.

Mentor at-risk teens.

Do research on prison nutrition for pregnant mothers.

Do research on alternatives to incarceration.

Do research on the causes and effects of mass incarceration (see

One-Page Guide: Childbirth Classes for Incarcerated Women

Vicki Elson MA, CCE


Food in non-glass containers (Can you get it donated?  pre-sliced cheddar/turkey/

ham, fresh grapes/berries/melon, celery/ tomatoes/broccoli/carrots with ranch dressing, healthy baked treats, sandwich makings, salad with cucumbers/tomatoes, granola with yogurt/kefir, and always orange juice.  Whole milk is appreciated.  Paper plates, plastic forks and spoons, cups, napkins.)

Notebook for doula intake forms, class attendance and topics covered

Packets of handouts (pregnancy/birth/postpartum info, breastfeeding/pumping info, resources inside and outside, blank notebook with permitted binding)

Books to lend, audiovisuals, realistic newborn baby doll (ethnically appropriate)

Pens you can see through, paper

DO NOT BRING contraband, including glass, knives (even plastic), electronics, etc.  If in doubt – ask!


is whenever there’s a new participant

1.  Establish trust, connection, and friendship

Discover favorite foods, food allergies, needs, pregnancy issues, due date

Don’t ask too many questions or ask about their criminal case

2.  Cover the most essential information

Explain your program, how to sign up for a doula, mothers’ group

Describe birth while incarcerated (transport, guard, shackling, postpartum)

Ask: what do you want from this class?

What really works for labor?

A little relaxation exercise, eyes open okay

3.  Homework in class or afterward

Who’s your support team?

What’s your passion in life?

How will you eat nutritiously inside?  After you get out?

What do you want to offer this baby?

After Class #1, offer more topics.  Physiology of pregnancy and birth, nutrition and fetal development, exercise and stretching, acknowledging fears and exploring whether they’re trying to tell you something, turning fear and anxiety into confidence, health and comfort in pregnancy, tools for labor, birth plans, complications, procedures, interventions, avoiding unnecessary interventions, cultural perspectives on birth, postpartum self-care, PPD, birth control, newborn care, breast/bottlefeeding/pumping, circumcision, immunizations, healthy babies, safety, childproofing, raising kids, balancing work/school and family, motherhood as an opportunity for transformation.


Vicki Elson, MA, CCE, CD Feel free to copy this.

Think of a time when you amazed yourself.

A time when you did something you didn’t think you could do.  Did you…

…climb a hill? move out? graduate? stand up for yourself? survive troubles?

Now, think about how you did that.  Did you…

…have somebody nice to support you?  take it one step at a time?  have faith?

just do it?  let instinct take over?  just keep breathing?  cry and keep going?

find a rhythm?  laugh?  sing?  repeat words to yourself?  invent a ritual?

soften your body?  take a walk?  take a shower or bath?  be gentle with yourself?

Whatever helped you then might be a clue to what will work for you in labor.

Even if you plan to have an epidural, it’s a very good idea to figure out some ways to relax your body and mind and cope with pain, because:

Even with an epidural, you still have to work to push the baby out.

You might not get the epidural as soon as you want it.

Sometimes epidurals don’t work.

Even if the epidural is perfect, coping skills are great for life…life with kids!

You might find that you don’t need an epidural after all (it includes an IV & bladder catheter, & possibly longer labor, staying in bed, & potential side effects).

Pain in labor is normal & healthy, even if it’s a totally unfamiliar new experience.

It comes in waves, with brief peaks and then longer painless moments.

Unlike other kinds of pain, there’s nothing to fix…and you get a prize at the end!

The stronger it is, the better it’s working.  That’s crazy but it’s true.  You can do it.

Pain stimulates hormones that are good for labor and good for the baby.

You will discover – and remember – how strong and brave you really are.

Pain and suffering are not the same thing.

Pain is just physical sensation.  Flow with it.  Suffering comes from thoughts.

Suffering is thinking that it shouldn’t be how it is.

Suffering is worrying that it will get worse or go on forever.

Suffering is feeling guilty or blaming somebody.

For now, let your body be in charge of your mind.  Stay open-minded and curious!

Plan on these things:

Eat excellent food: colorful vegetables, wholesome proteins, whole grains.  Sugar, grease, & white bread taste good but don’t nourish you or your baby.

Choose midwives or doctors who respect you and your wishes for labor.

Bring a nice labor companion to support you: partner, friend, relative, doula.

In consultation with your care providers, try to avoid interventions when they are not medically necessary. Learn the reasons, risks, benefits, and alternatives for: inducing labor, IV, continuous electronic fetal monitoring, drugs for pain, epidural anesthesia, pitocin, amniotomy, episiotomy, cesarean.

Prepare for the birth of your dreams, AND be nice to yourself no matter how it goes.

Stay upright and moving around as much as you can throughout labor and birth.

Pushing: Use gravity — don’t lie on your back. Follow your body’s urge to push.

Keep your baby with you, skin to skin with blankets on top, and breastfeed if possible.

Get lots of help and support after the baby is born, and always.

Enjoy your baby!  Unconditional love from parents is the gift that lasts forever.

One Page Guide: Postpartum Notes for Incarcerated Mothers

Vicki Elson, MA, CCE Feel free to copy this.


After my baby is born I will:

Lie down and rest

as much as possible for the first two weeks, breathing deeply, relaxing my face, jaw, belly

Send love to my baby

my baby will feel my love no matter how far apart we may be

if I have physical or emotional pain, I will still remember to focus on love, a lot

Be kind to myself

I am a worthwhile person, making the most of my life and moving forward

I offer myself loving kindness, and I can receive loving kindness from others

I acknowledge anger and confusion as parts of grief, and I try to be soft around them

I allow myself to cry as much as I want to and need to – it releases stress

Seek support

from kind people that I trust to just be with me as I go through this time

if I am using a breast pump, I will seek answers to all my questions

Wash my hands a lot

before and after using the bathroom, to prevent infection

Pay attention to my bleeding

I will call medical/midwife/doctor if I soak through more than one pad in one hour

Feel my uterus (womb)

it should be firm and grapefruit-sized or smaller

Pee a lot

even if I don’t feel like it – this will help my uterus (womb) return to nonpregnant size

Take my temperature

four times a day to make sure I don’t have an infection (it should be below 100.4)

Drink plenty of water

and juice, soup – whatever liquids (except coffee) are available

Eat lots of the healthiest food I can find

veggies, fruits, milk, proteins (meat, chicken, fish, yogurt), whole grains if available

I’ll avoid constipating foods like cheese and peanut butter for a few days

I will call medical/midwife/doctor immediately if:

my temperature is above 100.4

I have chills, or I feel like I have the flu (muscle aches, headache, fatigue)

I soak through more than one sanitary pad in one hour, or I worry about how much I’m bleeding

my lochia (bleeding) is foul-smelling (not just earthy), or I notice pus or gray-green discharge

my stitches don’t look or feel right (red, swollen)

I have trouble peeing

my uterus is not firm, or is bigger than a grapefruit

I have pain, tenderness, a hot spot, or a lump in my breast, or I have pain or swelling in my leg(s)

my breathing is fast, difficult, or odd in any way

I am nauseous, vomiting, constipated, or not hungry

I am anxious, restless, stressed, faint, dizzy, confused, overly sweaty, or overtired

I feel moody, lonely, out of control, unable to function

I notice frightening thoughts about harming myself or the baby

I am troubled by any weird symptoms or problems – I will CALL!  I won’t be shy!



  1. OKD

    Thank you so much for this page, it is chock full and every bit USEFUL! Simple and straightforward. I came to your page by a link in the Resources section of the Feminist Breeder and am very glad I did. I was recently in contact with the PBP while working on the anti-shackling legislation here in Florida (HB367- good news, it finally passed!). Thanks so much for the work you all do. I have a question about the article in Midwifery Today referenced in another blog post (What you can do in your own community for pregnant women who are incarcerated). Do you know what issue it was in? Or is it what is printed here/above? Looking for everything I can find. Thanks!

    • Thanks for your kind words, and good luck! The Midwifery Today article is in the current issue that came out around March 1, 2012. By the way, the authors were switched — Marianne Bullock is the lead author, and a very inspiring young mama!

  2. April

    2 1/2 yr ago I got a dui in Illinois , th e judge got ill and me and my husband of 12yrs moved to florida with our 13 and 10 yr old boys due to his work . Well in shock 4 months ago we delivered a baby boy of course my last we werent aware I could still carry a child but soo happy. I am 29 and breastfeedin g exclusivly for my first time he has never had a bottle. Well my lawyers called and said my case needs to be closed that I will lose in trial and to plea to 7 months . Keep in mind this event was 2 yrs ago I dont even live in illinois I dont know what to do, my baby is a lil over 4 months never has had formula please help ive askd my lawyers about housw arrest or pumping or bringing my baby keep in mind also that I dont even residw in that state and wasnt planning on a new baby, I fwel let down and I am not giving u p the fight. Any information on this matter will help..thank you

    • vickielson

      I am so sorry that you’re facing incarceration that may interrupt breastfeeding and parenting. DUI is a serious issue, but so is keeping families together. To continue breastfeeding, I’d suggest gathering materials NOW to present to the medical department at your jail. 1. You will need to show that in some places, breastfeeding while incarcerated is facilitated by the jail. The mother goes to Medical 4-6 times per day to pump. 2. You’ll need a way to get the frozen milk to your baby. If you are incarcerated far away, this won’t be possible — somebody needs to pick it up once or twice a week. 3. If the jail doesn’t have one, you’ll need a good breastpump and a supply of breastmilk bags, and they’ll have to go through security checks. If you can’t afford it, you can probably use social networking or a breastfeeding support network to get a pump donated. It will have to be sterilized between users, or have interchangeable parts to prevent trading germs with other mamas. Good luck! Use your time inside to write to your kids, send them love, be creative, nurture others, learn a new skill or subject, and practice whatever spirituality is meaningful for you. May your heart be strong.

  3. Ceylan

    Thank you so so much for sharing this info!! We are starting a similar program in Austin, TX. I am so happy to see other women are out there helping women and that there are such great resources being shared. Thank you for all you do!!

    • vickielson

      That’s terrific!! Please let me know how I can contact you to compare notes! Please click on “contact” at the top or bottom of my webpage.


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