Orange is the New Black review

 Raising Awareness or Warping Reality?

  By Vicki Elson

Do you have a friend in jail?  If you answered no, you are statistically likely to be white and affluent.

There’s a popular TV show that’s so engaging it might give you the emotional experience of having a friend in jail, and you might learn something important about our country.  If you’re black, brown, or poor, the show might make you laugh, cry, or cringe.

Orange Is The New Black is part of a new media phenomenon, a 13-part TV series released all at once by Netflix, giving rise to the new term “binge-watching.”

Set in a women’s prison, it’s also a social phenomenon that may affect public perception of the “War on Drugs” and the mass incarceration of Americans.  Hopefully, audiences will become more interested in the fact that the U.S. incarcerates more of its citizens than any other country on the planet. (We’re #1, Iran is #39, Syria is #191, Nigeria is #214…)  Hopefully, audiences will feel like they can personally relate to the fastest growing segment of the incarcerated population: the number of incarcerated women has increased more than 800% in the past decade.

I’ve been following the series and all the hoo-hah around it. I actually think it might be part of the turning tide that includes the Attorney General Eric Holder’s recent “smart on crime” call for reducing mass incarceration.  And the federal court’s finding that stop-and-frisk in NYC is racist and illegal.  And, if I may say so, our own Prison Birth Project‘s small efforts to humanize life for incarcerated women and their families.

But it’s a shame that the show includes some cartoonish stereotypes of both incarcerated women and corrections officers.  And it’s a shame that in order for white audiences to appreciate the realities faced disproportionately by black and brown people, we still “need” to see the world through the eyes of a white character.  According to the show’s virtuoso creator, Jenji Kohan (who also created Weeds), the studio never would have funded the show without its fish-out-of-water white main character.

That character is Piper Chapman, based loosely on Piper Kerman’s memoir.  She’s an atypical prisoner: white, yes, and also college educated, affluent, healthy, and serving a relatively short sentence.  Kohan uses her as a “Trojan horse” to hook the studio’s target audience into an exploration of the lives of women of many ethnicities, body types, health issues, and sexual orientations.

That’s refreshing, and it’s actually an improvement on Chapman’s original book. The show gives many of its deeply engaging characters a backstory: who are they? how did they get into trouble?  I like to imagine that the average viewer might be liberated from the usual good-cop bad-criminal mindset into a worldview that is more compassionate and nuanced.

The real Piper has been in the media a lot since the show’s release, acknowledging the differences between her story and the made-for-TV version, and touching on the greater issues that plague the American criminal justice system.  She is active with the Women’s Prison Association, which focuses on family and re-entry issues.  She may not be the right demographic to relate personally to culturally institutionalized oppression, but she’s an ally in the pursuit of more appropriate systems of justice.

Orange is a very well-made show: a great soap opera, with some wonderful comedy.  And it’s brilliantly cast, with many members of the large ensemble really given an opportunity to shine. It’s worth watching for “Crazy Eyes” (Uzo Aduba) alone.  A former Star Fleet captain (Kate Mulgrew) plays the captain of the kitchen.  Singer and comedienne Lea DeLaria is captivating as Big Boo.  And for once, a transgender woman (Laverne Cox) plays a transgender character. Tidbit: Cox’s twin brother appears in the flashback to her previous life as a male fireman.

Is the show accurate?  Parts of it are, most poignantly the re-incarceration of a recently released woman who has found that the world outside offers no housing, jobs, or voting rights for “ex-cons.”  And a lot of it is pure Hollywood. Drugs are smuggled in boxes of vegetables — I’m not sure about the drug part, but our local jail hasn’t seen fresh produce in forever.  Plus, there are plenty of good hiding places for illicit sex — hello, ratings.  The show features an unlikely percentage of spectacularly talented singers and dancers, a ratings-booster that makes jail look like more fun than it really is.

Orange plays with the good/bad dichotomy of cops and baddies by making the incarcerated women complex and redeemable, while the corrections officers are simplistically portrayed as stupid, conniving, cruel, and/or unprofessional.

In the real world, CO’s are a mixed bag, just like everybody else.  Some are malevolent, sure.  Some behave oppressively because the system has created overcrowded and potentially violent environments.  There are many CO’s who are just there for the steady work.  And there are a number of heroes who are working hard to help the people in their care.  The show’s failure to acknowledge those heroes will discredit the show among those who might really benefit from seeing it.

Orange has only one CO who perceives herself as innately equal to her charges, and what happens to her character is discouraging.  And (spoiler alert!) we are made to feel warmly toward a dreamboat officer who tenderly impregnates an inmate.  That’s. Just. Not. Okay.  Puppy eyes aside, they hardly know each other, and the power disparity makes it both illegal and inexcusable.  He’s cute, and he’s a criminal too.

The most egregious Hollywoodization is the cliffhanger at the ending of Season 1.  (Spoiler alert!)  An officer fails at his most basic duty, and Piper goes off the deep end in a way that the real Piper would not recognize in her wildest nightmares.  Let’s hope it’s a dream sequence.

I’m hoping that Season 2 does even more to humanize its characters, and that it does a better job of de-stereotyping. And I’m hoping it more deeply explores motherhood behind bars, to reflect the reality that 85% of incarcerated women are moms, and that 2/3 of them were their children’s primary caregivers before they were jailed.

As a childbirth educator and doula at the local women’s jail, and as a filmmaker concerned with mass media portrayal of childbirth, I was very interested to see what happens when a TV woman gives birth while incarcerated.  In a minor Orange subplot, a character goes into labor, and, as in real life, she is comforted by other moms until a CO decides she should go to the hospital.

We don’t see the strip search, the shackling, the presence of an armed officer throughout labor, the way she is treated at the hospital.  But we do see the hardest part: her return to jail, minus her baby.  We see a roomful of women fall into sad and respectful silence as she passes among them. That’s not unrealistic.  While some of us are fretting about diapers, incarcerated mothers are agonizing about separation and custody.  Some people say that TV shows about criminals and prison  (including this one) contribute to the normalization of mass incarceration as a fact of American life, kind of like slavery seemed normal in 1850.

That may be so,but I hope that this show, at least, helps Americans explore the facts that “tough on crime” rhetoric is simplistic, that better mental health and drug treatment programs are sorely needed, and that the relationships between security, rehabilitation, and incarceration must be continually re-evaluated. Have you seen the show?  If you’ve never been incarcerated, did it increase or decrease your compassion? If you have been incarcerated, did you think it was realistic or bogus?  If you work in criminal justice, was there some truth to it, or did you just feel dissed?  Let’s keep talking.


Giant Baby: Credit Where Credit Is Due

A doctor who helped a mother give birth to a 13 lbs 11 oz baby girl was quoted as saying, “We are all very satisfied with the work which we carried out.”

The hospital staff deserve to be satisfied! They did at least one thing flawlessly: supporting the mother in having a vaginal birth. They may also have used technical skills to help guide the baby out, and to help the baby thrive once she was born.

But the real credit goes, of course, to Maxine Marin, the 40-year-old mother of four (her other babies were no shrimps either), who did all the work, without even an epidural.

I don’t want to glorify natural-birth moms at the expense of those who require interventions to birth their babies. But I do want to celebrate this strong mama and her care providers for showing us all what is possible.

Birth: a Messy, Marvelous Metaphor for Parenthood

Giving birth is painful, joyful, messy, unpredictable, and all-consuming.

So is parenting.

Giving birth requires surrendering to whatever happens.

So does parenting.

Giving birth might be something you can do yourself, or something you need people to help you with, or something you can hire people to do for you (i.e. scheduled cesarean), but ultimately it’s you who will carry the experience, the consequences, and the responsibility.

Ditto for parenting.

Birth can be painful because of the physical sensations of labor, but also because it opens up a world of emotions. You need to cultivate your core, your center, your strength, to carry you through whatever comes up. Parenting is the same. The physical sensations might include back pain from lifting a squirming toddler, or being bitten while breastfeeding. And the world of emotions might include reflecting on your own childhood, working harmoniously (or not) with your parenting partner(s), and being responsible for a vulnerable, cherished human being for the next 18 to 100 years.

Birth can be joyful because you get a baby – a whole human being emerges from your body, and you feel a whole new kind of love. Parenting can be joyful because you get a smiling infant, a toddling toddler, a playful child, a student delighting in learning, a houseful of their adorable friends, and ultimately a beloved, capable adult who promises (if you’re lucky) to look after you in your old age.

Birth is messy because of the body juices: sweat, pee, poop, blood, and amniotic fluid. Parenting is messy because of sweat, pee, poop, occasional blood, and grape juice. Little kids are little slobs, and most days you can’t keep up with the chaos no matter how hard you try. You cope with the messiness of birth, and parenting, by getting help and by letting go of perfectionism.

Birth is unpredictable (even if you’ve done it before) because you don’t know (and you can’t entirely control) how your body and your baby will adapt to it. Parenting is unpredictable because you have no idea what kind of children you will get, and what will happen to them. Even kids with the same DNA from the same parents and the same upbringing can turn out wildly different from one another – different gifts, different challenges, different suffering, different delights. How does one prepare for such a randomized reality? You cultivate unconditional love for yourself and your family. You find trusted friends who can bear witness to your struggles without judging you or trying to fix you. You take lots of deep breaths and tune in to that part of yourself that’s always calm.

Birth is all-consuming. You can’t read the funnies or check your email or even finish complete sentences once it gets going. Parenting, too, will radically recalculate your priorities. You can’t go to work, buy a quart of milk, take a nap, or even go to the bathroom without figuring out how to keep your child safely in the company of a responsible adult.

Birth requires surrendering your mind over to your body, and surrendering your preferences over to the reality of whatever comes up. That doesn’t mean you relinquish responsibility, however – you have to make the most informed and thoughtful choices you can in any given moment. Parenting is the same.

Giving birth is an experience that can help you understand who you are. For some, it’s an opportunity to discover what you’re made of. But building and birthing a new human is just the beginning of a much greater task.

Would you agree that raising children — and doing it well — is the most important work in the world? What sorts of skills and values do you want your child to possess when s/he launches out into the world a couple of decades from now? What parts of your own upbringing have had the most profound effects on your life? What would you like to do better than your own parents did? How will you learn to accept the aspects of your children that are wildly different from yourself? What challenges will you be ready for, and what delights are you looking forward to?


Nutrition?  Bonding?  Countless health benefits?  Baby poop that doesn’t stink?  All great reasons to breastfeed.


 Here’s a new one: There’s a global shortage of baby formula.


Why?  In 2008, there was a contaminated milk scandal in China that killed six babies and sickened 300,000.  So the Chinese prefer foreign brands from Australia and New Zealand.


 But a drought down under has limited the supply, so the Chinese are stockpiling formula from other countries, and parents in Europe and elsewhere are stockpiling in response to the shortage caused by the Chinese stockpiling.



The solution to this problem is inside your bra.


Don’t cut the cord yet!

Here is a remarkable series of photos showing how the umbilical cord keeps delivering blood to the baby for a little while after birth.

 Research shows that this portion of the baby’s blood is helpful in preventing anemia, and it contains beneficial stem cells.  That’s why, especially for premature babies, it’s helpful to delay cutting the cord till its work is done.  It doesn’t contain much oxygen, though, so it’s important for the baby to start breathing air soon.   

Slow Labor? Five Good Ideas

My first labor was 30 hours long.  Nobody made a big deal about it, and nobody rushed me — at the time, I had no idea how lucky I was.  When it got really mild, I remember sitting around talking about Steve Martin movies. 
 My next labor was 5 hours.  That meant I had to do six times as much work per hour.  I haven’t decided which I prefer — shorter and harder, or longer and more gradual — but it doesn’t really matter, since I didn’t have a choice anyway.  My body, in its own mysterious wisdom, got to make that call.

In case of a “slow” labor…
1.  BE PATIENT.  Slow labor is in the eye of the beholder.  Any description of “normal progress” is going to be irrelevant for many mothers.
2.  MOVE AROUND!  Often, with a long labor, the baby is positioned awkwardly for birth, and nobody diagnoses it for a long time.  Babies fit through the pelvis and birth canal best if the crown of the head is toward the mother’s front.  In other words, the crown of the head is “anterior.”  (This terminology can be confusing, since the baby’s position is the opposite of the way the baby’s face is facing!)  So if labor is slow, or if there’s a lot of back pain, it’s useful to assume that the baby’s head is facing backward (“posterior” or “sunny side up”) from the ideal position, or a little crooked (the medical term is “asynclitic”).  Babies can be encouraged to find a more effective position by the mom moving her pelvis around: walking, crawling, squatting, stair-climbing, lunging, dancing, swirling the pelvis in circles.  Even if the baby is in an ideal position (“anterior”) there’s no harm in those movements, and they might feel good and give the mom something to focus on besides pain.
3.  RELEASE TENSION, AND KEEP YOUR ENERGY UP.  There’s no downside to eating, drinking, massage, warm (not too hot) baths or showers, talking through feelings, encouragement, reassurance, deep breathing, melting and surrendering, and plain old LOVE. 
4.  MAKE CAREFUL CHOICES ABOUT USING ARTIFICIAL HORMONES.  Like any other mammal, a human mother needs to find her own groove, her own rhythm, and her own way of coping with the intensity of labor.  A brilliant natural hormonal symphony is taking place during labor, and it usually works best if it’s not interfered with.  Pitocin (an artificial form of your body’s own oxytocin) might be helpful if there’s a good reason to speed up labor, but give your own hormones plenty of time and make that choice with full awareness of the potential side effects, including increased labor pain.  If you do use pitocin, give it at least four hours before you decide if it’s working or not.
5.  MAKE CAREFUL CHOICES ABOUT OTHER MEDICAL TECHNIQUES THAT SPEED UP LABOR.  While the medical techniques commonly used to speed up labor are helpful in some cases, they should be chosen with great care to make sure they’re not causing more harm than good: breaking the waters, balloon catheters, using forceps or vacuum extractors.  Epidural anesthesia can certainly slow labor (and, less often, it can also speed it up by helping the mother to relax).  The ultimate result of a rushed labor is often a cesarean.
There’s a terrific article by Henci Goer with more details here

The EBook is finished!


There’s another ebook in the works: Childbirth in a Nutshell. And a new film, too!

I’ve been loving my work as a childbirth educator in Northampton and also in the women’s jail. I’ve been going to lots of births as a doula, and learning so much every time! For example, one mom was really not hearing that “everything is okay, you’re safe, you’re doing great.” I went out on a limb and told her, “Look at me. If anything scary really does happen, I WILL TELL YOU. I promise.” I felt pretty bold saying that, but I’m glad I did, because she finally relaxed into the groove. Everything shifted. We worked together as a team with her wonderful family, and she had the VBAC she really wanted. Now, it’s entirely possible that that magic moment was also the instant that her epidural kicked in, and I deserve zero credit. I’ll have to ask her!


“Childbirth Education Essentials” workshop in Northampton, MA USA, SUMMER 2013

This unique, intimate one-day workshop for childbirth professionals and students explores what expectant parents and their educators REALLY need to know about pregnancy, birth, cultural/media influences, fear-busting, baby-bonding, and raising healthy happy kids. It’s an immersion in skill-building: teaching experientially, tailoring classes to specific populations, encouraging parents to cultivate deep responsibility, resisting commercial co-optation, and transforming institutions. $150.

Participants may choose to complete the “Start Teaching” packet ($100, available at the workshop) to become Certified Childbirth Educators. This is a very thorough but quick and inexpensive path to certification. CEE is a small, grassroots program, and our CBE’s are encouraged to also explore larger organizations with more infrastructure.

The CEE workshop is offered in Massachusetts and California regularly, and around the world as requested.
Childbirth anthropologist Vicki Elson, MA, CCE, CD has been a doula and childbirth educator in her diverse community for 28 years. For the past 19 years, she has been training childbirth educators for ALACE (Association of Labor Assistants and Childbirth Educators), Seattle Midwifery School, the Prison Birth Project, and the Massachusetts Midwives’ Alliance. Her award-winning film, “Laboring Under An Illusion: Mass Media Childbirth vs. The Real Thing” is shown in classrooms, community centers, conferences, and living rooms around the world. Her second film, with the working title “What REALLY Works For Childbirth” is currently in production.

The intense experience of childbirth has the potential to change lives. Vicki believes that gathering with neighbors in a live class is much more helpful than learning about birth from the internet or TV. She is concerned about overuse of obstetrical interventions in some places, and about lack of access to needed interventions in others. She is enthusiastic about distributing useful and accurate information AND easing information overload. Her mission is to prevent trauma, cultivate love, empower women and parents, and have more fun.
More information can be found here at

Vicki Elson, MA, CCE

What’s New




“Childbirth Education Essentials” workshop in Northampton, MA USA, SPRING 2013

This unique, intimate one-day workshop for childbirth professionals and students explores what expectant parents and their educators REALLY need to know about pregnancy, birth, cultural/media influences, fear-busting, baby-bonding, and raising healthy happy kids. It’s an immersion in skill-building: teaching experientially, tailoring classes to specific populations, encouraging parents to cultivate deep responsibility, resisting commercial co-optation, and transforming institutions. $150.

Participants may choose to complete the “Start Teaching” packet ($100, available at the workshop) to become Certified Childbirth Educators. This is a very thorough but quick and inexpensive path to certification. CEE is a small, grassroots program, and our CBE’s are encouraged to also explore larger organizations with more infrastructure.

The CEE workshop is offered in Massachusetts and California regularly, and around the world as requested.
Childbirth anthropologist Vicki Elson, MA, CCE, CD has been a doula and childbirth educator in her diverse community for 28 years. For the past 19 years, she has been training childbirth educators for ALACE (Association of Labor Assistants and Childbirth Educators), Seattle Midwifery School, the Prison Birth Project, and the Massachusetts Midwives’ Alliance. Her award-winning film, “Laboring Under An Illusion: Mass Media Childbirth vs. The Real Thing” is shown in classrooms, community centers, conferences, and living rooms around the world. Her second film, with the working title “What REALLY Works For Childbirth” is currently in production.

The intense experience of childbirth has the potential to change lives. Vicki believes that gathering with neighbors in a live class is much more helpful than learning about birth from the internet or TV. She is concerned about overuse of obstetrical interventions in some places, and about lack of access to needed interventions in others. She is enthusiastic about distributing useful and accurate information AND easing information overload. Her mission is to prevent trauma, cultivate love, empower women and parents, and have more fun.
More information can be found here at

Vicki Elson, MA, CCE

248 Women Speak: What REALLY Helped Us During Labor

We are 248 World Wide Women.

We are all ages.

Some of us gave birth vaginally, with and without drugs or anesthesia, and some by cesarean.

Some of us gave birth in hospitals, some at home, and one in the car.

Some of us breastfed our babies, and some of us bottle-fed.

Some of us are married, some single, some partnered with men, some partnered with women.

Some of us are raising our children, some of our children are being raised by others.

Some of us have grown-up children, and some of us have grandchildren or great-grandchildren.


We come from 7 different countries.

But we want to include the experiences of thousands,

from dozens of countries.


Join us! Tell your story here.

What REALLY Helped Us During Labor

Labor support from our spouses, partners, midwives, doulas (labor support professionals), doctors, nurses, and moms was the thing that helped us the most in labor. They didn’t have magical powers, but their love, gentleness, respect and encouragement made all the difference in the world.

Next came…water! A bath or shower really helped a bunch of us.

A whole lot of us loved moving freely, like walking, dancing, rocking, swaying our hips, climbing stairs, even crawling.

And loads of us loved to try different positions, like squatting, hands-and-knees, kneeling, standing, sitting on a big rubber “birth ball,” being on all fours with our upper bodies on a birth ball or other furniture, leaning over, side-lying, pulling or hanging on a cloth hung from the ceiling. Several of us loved sitting on the toilet – we hate to tell you this, but birth really does have a lot in common with pooping.

Lots of us felt good when we made a lot of noise. Moaning, chanting, humming, screaming, yelling, swearing, singing, roaring, oh, ah, and that thing that horses do with their lips.

As noisy as we were, a lot of us liked solitude. We just wanted to be left alone and not told what to do.

But we appreciated being reassured that everything was fine, since labor is so intense, and so unlike anything else.

Anything that helped us relax was great.

A number of us loved counter-pressure: somebody pressing as hard as they could on our lower backs or bottoms.

Focused breathing is a famous labor technique that many of us liked, though toward the end of labor it wasn’t always enough.

We did best when we kept a positive attitude of confidence, intention, determination.

A lot of us just decided to stop fighting it and surrender to labor, and then it felt easier, even if physically it got harder.

A lot of us were amazed by our intuition and instincts. How smart we were when we trusted ourselves and listened to our bodies!

Many of us prepared for birth by learning as much as we could from classes and books. We were inspired by great birth stories and videos. We liked understanding what was going on in our bodies, and we were inspired by other brave, strong moms.

Some of us were deeply grateful for epidural anesthesia, cesarean section, pain medications, and other medical interventions.

Those of us who made informed decisions are a lot happier than those of us who felt like our doctors or midwives didn’t respect our dignity, our capabilities, or our wishes.

Some of us got in touch with our wild animal nature. One of us roared “like a cave woman,” and it was great.

Some of us thought about the many generations of mothers who have come before us: if they can do it, so can we! We appreciate them more now.

We also loved massage and self-massage, although some of us felt so busy laboring that we didn’t want to be touched.

Some of us depended on our spiritual selves. We prayed or meditated or worked on staying in the present moment.

Some of us were glad we stayed home for a large part of labor, or even the whole thing (typically, with skilled midwives to keep us safe).

Some of us loved listening to music. Jazz, classical, mellow, or peppy!

Some of us liked heat or ice, darkness or sunshine.

Last but not least, some of us repeated mantras over and over:

If Mum did it, anyone can!

My baby’s size is perfect for my body. We birth easily.

Breathe in peace, Breathe out baby. Breathe in breath, Breathe out baby.

The only way out is through.


Sweet Jesus, help me!

This is happening, now. [attention to this moment instead of “what’s next?”]

Relax your face, relax your shoulders, relax your hands.

My butt hurts!

Keep the energy moving!

[to the baby:] Run for the light!

Adapting Childbirth Services for Incarcerated Mothers: Midwifery Today article

Adapting Birth Services for Incarcerated Mothers

[Article submitted to Midwifery Today Magazine, October 2011]

 By Marianne Bullock, CD, and Vicki Elson, MA, CCE, CD

Approximately 40,000 women who are incarcerated in the United States each year are pregnant.  85% of women in prison are mothers.  2/3 were their children’s primary caregivers prior to incarceration.

The number of women incarcerated in the U.S. has increased 832% in the past decade (that’s not a typo), in large part because of the “War on Drugs.”  More than 1% of U.S. adults are in jail or prison right now.  73% of incarcerated women are serving sentences for nonviolent crimes (property, drugs, prostitution), and many do not pose a flight risk.

When you go into a jail to serve mothers, you leave contraband items behind: sharp objects, glass, chewing gum, cellphones, notebooks with wire spirals, even plastic forks.  You cope with the security screenings, dress codes, and big metal doors.  And you leave behind whatever notions you once had about “good” and “bad,” or “teacher” and “learner.”

In many ways, working with incarcerated women is the same as working with any other population: it’s all about empowerment. In other ways, its vastly different, because incarcerated mothers lack autonomy and birth choices.

In our work with The Prison Birth Project (, 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 in our regional women’s jail, empowerment takes the form of advocacy, friendship, peer mentoring, and leadership development.  We offer childbirth education, doula services, and mothers’ groups.  We organize with incarcerated people around policy change.

For all mothers, giving birth has the potential for being traumatic.  But for incarcerated mothers, giving birth is inherently traumatic.  Mothers give birth under the supervision of an armed corrections officer (CO).  They are not allowed to bring their own food, clothing, or belongings.  Even going for a walk in the hospital hallway is at the discretion of the CO.  Many are handcuffed or shackled before, after, and sometimes during active labor. Vaginal exams and monitoring are done with the CO present.  Without the presence of a doula or advocate, mothers don’t know if their rights will be respected.

Hardest of all, they have to surrender their newborns after only a day or two together, and go back to jail.

We assume that every single client has experienced trauma.  If they’ve been jailed, they’re traumatized.  But there’s more. 57% of incarcerated women have experienced sustained physical and/or sexual abuse.  (There may be many more that do not report such abuse.)  Not surprisingly, given that history of trauma and the lack of support services available, 84% of incarcerated women have histories of drug addiction.  Poverty and illiteracy are also disproportionately represented in jail.

16-20% also suffer from diagnosed mental illnesses.  A generation ago, there were ten times as many beds per citizen in facilities for the mentally ill.  Now, jails and prisons, the only places where health care is mandated, are functioning as de facto mental health centers — only lacking adequate mental health care resources.

Effective care requires a space of absolute nonjudgment, awareness of local resources, and a willingness to emphasize good listening skills over advice-giving.

In fact, the whole caregiver-client relationship shifts in the work that we do. We cultivate peer-to-peer relationships.  We offer training for incarcerated and newly released women to take up leadership positions in our grassroots collective organization. They are designing and running programs, and helping to set the course for the future of the organization.  After all, they have the best perspective on what is really needed. They are the experts!

We all reap the spiritual and educational benefits of being equals. It’s rewarding to share information and explore issues. Love is love, whether or not we share a similar ethnicity, age, or life history.  We try to keep the love flowing out, so the sadness doesn’t flow in as much.  We start having fun, just like any bunch of women.

When we were learning to be doulas, our training emphasized being a liaison between mothers and their care providers.  But in doula work with incarcerated mothers, advocacy is a primary role. We advocate as needed, plus we teach advocacy skills to clients during pregnancy and postpartum. We try to expand the small number of choices that mothers have left to them.  We offer space for mothers’ voices to be heard in a system that might not believe that they are capable of making good decisions for themselves.

Incarcerated mothers obviously don’t have the option of homebirth, or of laboring at home and choosing when to come in to the hospital.  They go when they have convinced a CO and a medical staffer that they really are in labor.  The common scenario of “you’re still in early labor, go home and come back when it picks up” is complicated by strip searches, the use of restraints during transport, and the whims of whoever is on call.  We try to be there for transitions to and from the hospital, but we never know if we will make it in time.  Also, we can’t just pick up the phone and ask our clients what’s up.  Communications go through complex channels and are sometimes delayed.

Luckily, we have two wonderful nurse-midwives providing prenatal care at the jail, but they are part of a large practice. So, when women are in labor, they may not know the midwife on call.  The hospital staff may or may not be comfortable working with incarcerated people. Our role then often becomes helping care providers see clients as “human”.

We try to help laboring moms feel more in control.  We try to create a “bubble” that consists of the mom, her family (if they’re present), and her doula.  We help CO’s and hospital staff create a friendly atmosphere, but we try to let the mom decide who gets to be in her bubble.  It feels odd that we doulas are allowed to touch her, but her close family members are not.  We try to channel their touch, and offer suggestions for how family can participate in ways that are allowed under Department of Corrections protocols.

Of all the women who have ever received PBP’s doula services and then been released, only one has returned to jail so far. We believe that doula care is stopping a cycle of violence and trauma to mother and baby during delivery, and helping women to have the tools to make healthier choices. Other prison birth programs report similar decreases in recidivism.

Having a baby is a time of transformation for all of us.  And for women on the inside, sometimes it’s an opportunity to re-think and re-invent oneself, a catalyst for hitting the cosmic re-set button and starting fresh.  It’s an honor to witness this, and a delight to help facilitate it.  It’s the ultimate teachable moment.

“I’m never coming back in here.  I’m gonna do right by my baby.”

For women experiencing homelessness, starvation, or abuse, jail may feel like the safest place they could be while birthing. We honor that, and we try to make distinctions between personal choices and societal oppression.

We are proactive.  We provide evidence-based information to those who have power over our clients’ lives.  For example, our Department of Corrections used to give postpartum women a one-size-too-small sports bra and a suggestion to take cold showers until their milk stopped flowing.  Now there is a breastpump at the jail, and one mother just broke our record: she pumped five times a day for seven months, breastfeeding her baby in person at weekly visits (until the baby decided the bottle was easier).  The baby’s guardian lives nearby, and drives to the jail to pick up the frozen milk regularly.

Another example: Mothers using heroin are put on methadone until after their babies are born, at which time the methadone is tapered off.  (It can be dangerous to mother and baby to stop using methadone during pregnancy.)  We sometimes help women to communicate with their doctors when their dosages are too high or too low as their blood volume changes during pregnancy.  We sometimes find ourselves in the role of educating staff and even pediatricians about the value to the baby of breastfeeding while the mother tapers off her methadone.  (It seems to make Neonatal Abstinence Syndrome less frequent and less severe, perhaps because the low concentration of methadone in mothers’ milk helps the newborn through withdrawal.)

Many of us may harshly judge a mother who puts her baby in such a situation, but part of our mission is to recognize the the ways in which perceptions of incarcerated people are shaped by those with power and not by incarcerated people themselves. We have come to know so many mothers who have barely survived their own lifelong difficulties, and we are try to be more compassionate without being naïve. Some of the women at the jail are there for violent crimes, but they are no less deserving of care than the vast majority who are incarcerated for nonviolent or victimless offenses, or those who may even be entirely innocent. We are in the business of harm reduction.

We usually have more contact with our clients than their midwives have, and, since we are not government funded, we sometimes have more freedom to advocate on behalf of our clients.  If a postpartum woman is tapering off methadone, she is typically placed in a segregation unit, a lonely place where we may be her only visitors.  Here she is, having just given birth, missing her baby, going through withdrawal, living in terrible uncertainty about when or even whether she will see her baby again.  Here, empowerment takes the simple form of witnessing and listening.  We say, as we did in labor, “I’m with you” or “This will be over.” One of the most useful things a doula can do is take pictures of the baby and bring them to the mother postpartum.

In addition to doula care, we offer full-spectrum reproductive care.  This might include pregnancy options counseling.  We serve as abortion doulas or adoption support.  We help women with custody issues and interactions with the Department of Children and Families.  We offer support in the courtroom.

We offer weekly childbirth classes, to which postpartum moms are also invited.  We bring in lunch: fresh fruits and vegetables, whole grains, and real meat, cheese, poultry, and fish.  For women who aren’t doing well on the jail diet (typically inexpensive foods, heavy on soy protein and white flour products), this is most welcome.  For women who prefer processed foods or do not have kitchen facilities outside the jail, it’s an opportunity for nutritional education.

Childbirth classes are a little tricky in jail because there are issues (like custody, or survival) that overshadow everything you ever thought was important to teach pregnant people.  Sometimes the best “classes” are just being together.

It’s also tricky because you never know for sure if you’re going to see a woman only once or if you’ll see her every week for her entire pregnancy. It doesn’t matter.  Any respect and kindness – and food – that you offer will not be wasted.  There’s a suggested class plan at:  There are also some one-page handouts that you’re free to use.  One handout is what Vicki thinks pregnant women need to know if you only meet them once, and another is a postpartum guide specifically for incarcerated moms.

We also offer mothers’ groups for ALL mothers.  So far, more than 75 moms have participated in “Mothers Among Us,” PBP’s peer-led support group. MAU offers a safe place to be real and honest about the full spectrum of mothering experiences.  Both participants and facilitators are reclaiming their resiliency and strengthening their core selves.

“I have had an extremely difficult time in jail.  At this group I was comfortable for the first time.  The women of this group have brought me a long way.  They provide us with hope, faith, and compassion.  The group is open-minded and understanding. I am fortunate to have these women helping me to obtain the resources that I will need.  Also when I leave I will still be working with them.  Because of this group I know I have a chance to have a good, solid, nurturing bond with my children.”

We are building an empowered community that supports mothers through recovery and release.  We address issues of justice, oppression, healing, education, reunification with children, and leadership development.  We connect women with needed resources and information.

“Being incarcerated doesn’t make us bad people, and Mothers Among Us recognizes that.”

The average age of children with an incarcerated parent is 8 years old.  22% are under age 5.  In 2004 59% of parents in state facilities and 47% in federal facilities reported never having had a personal visit from their children.

“Then one of the girls in my ‘pod’ told me about this group.  My first reaction was doubt: ‘They won’t help me.  I won’t be welcomed.’  Wow, I arrived and they welcomed me.  The facilitators didn’t turn me away.  They actually listened to my story.  I shared about my daughter’s mental illness, her new diagnosis.  I didn’t understand it, and the PBP women offered to research this for me.”

Inside a jail, there is limited access to books, phones, or nature.  There is no access to the Internet.  We try to fill in the gaps.

“The great thing about this group is I’m able to share my feelings, my troubles, get feedback.  So I’m able to get better equipped to be a great mother when I return home and not bring all my guilt home to my children and my community.”

Most of us mothers make a straightforward transition, from person to pregnant person to parent.  Incarcerated mothers have many more stages to move through: moving between jail and the community, changes in access to their children, challenges with reunification with their families.  We try to ease those transitions, helping mothers to create not only birth plans but postpartum plans, safety plans, and relapse plans.

No matter what the custody situation ultimately becomes, we encourage bonding for both the mother’s sake and the baby’s.  We encourage the children’s caregivers to support mother-child connections.

As you can see, this is a time-intensive project.  Marianne Bullock and Lisa Andrews were 20-something moms nursing squirmy babies when they “envisioned a space for mothers to receive support and tell the truth about their experiences” during and after incarceration. They created a program based on their own experiences with the criminal justice system and reunification with family. They presented their program to the new women’s jail and it was accepted.  Within days they had their first client deliver.

Now they have expanded their volunteer partnership into a grassroots collective, supported mostly by private donations, plus a few grants.  PBP does not receive funding from any government sources.  In order to be sustainable, we have to put considerable energy into administration and fundraising as well as direct services and programming.

We can’t talk about PBP without talking about the context: the vast problems of mass incarceration, inadequate support systems, racial and economic disparities, domestic abuse, breakdown of communities.  But since we are doing something so concrete and so clearly effective, even for just a small sliver of the affected population, donors appreciate the opportunity to be part of it.  We have house parties and “Secret Cafes” and knit-a-thons.  Sometimes local musicians – from punk to classical — offer benefit events.  There is still a whole lot of volunteering going on, and food is donated.

Are you interested in helping incarcerated women in your community?  There are so many ways, large and small.  Ours is just one model.  Here are some ideas.

1.  Start a doula project in your local jail or prison. Organize incarcerated and formerly incarcerated mothers in guiding the project and providing services. Work with incarcerated folks, not on behalf of them.

2.  Tailor a childbirth class for incarcerated women. Movies are welcome, though many natural childbirth films need a little bit of cultural contextualization.  (“I know you might find it strange that this woman gives birth in her bathtub with her kids jumping in, but check out the way she moves in labor, and how she works with it when it gets hard.”)

3.  Raise money and volunteer for your local doula project — or PBP!

4.  Organize mothers’ groups ( is a GREAT resource). Learn how to run these groups from an anti-oppression framework, so everyone can be included.

5.  Be a mentor to mothers during incarceration and/or after release. Give your card to medical/jail staff and tell them you will offer free doula/midwifery services to women when they get out.

6.  Be a mentor to teens, pregnant or not.  Help them develop good decision-making and life planning skills.

7.  Network with programs that run outside the jail for people after release.  Hold an event to raise funds for people in transition.

8.  Research prison nutrition for pregnant mothers.

In the United States:

1.  See or for current campaigns regarding shackling and treatment of pregnant inmates.

2.  Research the causes of mass incarceration (see

3.  Research the effects of disrupted bonding on families.  So far, it appears that when fathers are incarcerated, role models are lost, but when mothers are incarcerated, families just fall apart.

4.  Research the disparate effects of this disruption on communities:  70% of  U.S. women in prison are African American or Latina, and this is the fastest growing sector.  (Only 29% of all U.S. 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.

5.  Research community-based alternatives to incarceration.  Some states have prison nurseries, which are cost-effective and successful, but they tend to be small and serve only a small number of families.

Marianne Bullock founded the Prison Birth Project based on her own experience with the criminal justice system. She has been working as a doula for 10 years. She lectures on prison and reproductive justice issues.  She is an Ada Comstock Scholar at Smith College, and mother to a spirited young daughter.

Vicki Elson made the film “Laboring Under An Illusion: Mass Media Childbirth vs. The Real Thing.”  Her next film will be about what REALLY works for labor.  She has been a childbirth educator and doula for 28 years, and a grandma for 8.  She offers a workshop called “Childbirth Education Essentials” and a low-cost, grassroots, streamlined certification program for childbirth educators.  She is a volunteer childbirth educator and doula with PBP.