During the past year, the UNC Center for Maternal and Infant Health (CMIH) has been investigating perinatal health in the criminal justice system. As part of the North Carolina Perinatal Health Strategic Plan, with some resources from the UNC School of Social Work, we have been exploring the needs and experience of this important population.
In a desire to share what we have learned with our clinical partners, and come together to have a conversation and understand more about how we can best serve these women, an initial meeting was convened. The objective was to better understand the practices and policies in place that affect these women when they come into our care, and identify strategies to strengthen the existing system. Clinicians with experience and responsibilities working with incarcerated women during the perinatal period were encouraged to join along with other stakeholders with an interest in this topic.
What resulted, was an initial gathering in August 2017 of a group of individuals from a broad range of disciplines that came together based on their shared interest in perinatal health and incarceration in North Carolina. The group convened again in December 2017 and plan to continue to meet to address this issue. This group is also looking to organize a daylong summit to explore and highlight this important maternal and infant health concern.
Some members of this group came together to write a letter to the North Carolina Department of Public Safety after learning that women had been shackled while giving birth. As a result, in March of 2018 the North Carolina Director of Prisons signed a policy that no longer allows women to be restrained during labor and delivery–read more HERE. HERE is a video about shackling with working group members from SisterSong.
In May of 2018, the working group convened the Perinatal Incarceration Learning Summit. This one-day event brought together members of the working group as well as professionals from across from other states to learn about each other and with each other, build trust and coalition, and to think forward to possible next steps. The day’s agenda was meant to capture many aspects of pregnancy and incarceration through sessions that included Mass Incarceration and Understanding Carceral Systems, Reproductive Justice (RJ) and Activist Strategies, Learning from Those with Lived Experience, Maternity Care Quality and Content, Best Practices and Programs in Other States and Next Steps.
This group continues to meet to enhance the health and wellbeing of incarcerated persons and their children.
Click HERE for a special series by NPR titled “Discipline and Women in Prison.” There are multiple reports from a recent investigation that reveal how women are punished more often than men in US prisons and information about what some are doing to address the disparity.
In December 2019, members from this committee met to discuss the need for a specific bail fund for pregnant persons in North Carolina who are being held pretrial. In March 2020, this fund was created under the leadership of Kristie Puckett Williams from the ACLU of NC and Andréa “Muffin” Hudson from the North Carolina Community Bail Fund of Durham.
Click HERE to read more about how to promote and support this fund.
If you are interested in learning more about this work please email Megan Canady at email@example.com
Agencies Participating in the North Carolina Perinatal Health and Incarceration Working Group
The Appalachian District Health Department covers Alleghany, Ashe and Watauga Counties. Our mission is to promote safe and healthy living, prevent disease, and protect the environment. Our strategic vision is to work with local, state, and federal partners for collaborative planning and implementation for an integrated public health system that invests in prevention, safeguards the public’s health, and assures access to quality healthcare. With both direct clinical care and community health initiatives seeking to improve conditions of historically marginalized groups, AppHealthCare desires to ensure relevant staff and providers receive training and technical support related to serving incarcerated prenatal and postpartum populations.
The North Carolina State Center for Health Statistics is responsible for data collection, health-related research, production of reports and maintenance of a comprehensive collection of health statistics. We provide high quality health information for better informed decisions and effective health policies. Our goal is to improve the health of all North Carolinians and their communities.
NC Child is a statewide non-profit working to make NC a better place to be child and raise a child. Our interest in the incarceration project is two-fold: reduction in infant mortality and the prevention of discrimination during pregnancy.
The UNC Center for Maternal and Infant Health aims to improve the health of women and infants by providing quality collaborative care, translating evidence-based strategies into practice, and developing new approaches to complex problems. During the past year, the CMIH has been investigating perinatal health in the criminal justice system. As part of the North Carolina Perinatal Health Strategic Plan, with some resources from the UNC School of Social Work, CMIH convened the initial meetings for the current working group in an effort to better understand the practices and policies in place that affect incarcerated pregnant and parenting women and to identify strategies to strengthen the perinatal care available. CMIH continues to coordinate meetings for the working group, oversee email communication about meetings updates, and maintain a webpage for the working group.
March of Dimes fights for the health of all moms and babies. We’re advocating for policies to protect them. We’re working to radically improve the healthcare they receive. We’re pioneering research to find solutions. We’re empowering families with the knowledge and tools to have healthier pregnancies. By uniting communities, we’re building a brighter future for us all. March of Dimes understands and appreciates the importance of prenatal care for all women and also recognize the link between lack of prenatal care and premature birth. Premature birth is the number one killer of babies, which is why we are fighting to reduce prematurity in a number of ways, including advocacy and coalition work.
Project CARA: Care that Advocates Respect/Resilience/Recovery for All
Our mission is to decrease barriers and the stigma that prevent pregnant women with substance use disorders (addiction) to getting quality obstetrical care as well as access to the substance use treatment that they deserve. Our role is twofold: the first is being an advocate for our clients and the unique challenges pregnant women (particularly with substance dependence) face while incarcerated. The second is we are dedicated to educating those who interface with pregnant women with substance use disorders in the judicial system about the disease of addiction in pregnancy and the special/specific needs of this population.
WakeMed is committed to improving the health and well-being of our community by providing outstanding and compassionate care to all. WakeMed will be the provider of choice and the preferred partner for quality health care and community health by: collaborating with physicians, employees, volunteers and others to engage, educate and guide our community to take charge of their health and well-being; transforming patient care delivery through high-quality, coordinated services for the best value; and ensuring we are the best minds and biggest hearts. We are located in the heart of Raleigh and we care for incarcerated pregnant women in our hospital for delivery and/or pregnancy complications. We also care for the infants in our NICU and Newborn Nursery. Our interests include fair and equal treatment of the incarcerated women and their infants including the ability to labor without wrist restraints, order meals (as our standard for everyone is a choice in a meal selection), pump breast milk after returning to prison and send the milk to the newborn, and setting clear guidelines from the state regarding the newborn as once the paperwork is cleared legally for a family member or foster care for the infant, so that the Prison will no longer be able to enforce their rules of visitors for the infant in the hospital.
The WakeMed team, Donna Lane RNC-OB, Manager L&D, Ryah Koprowski MSW, Dr. Kathleen Foster OB/GYN, and Jaime Oxholm JD, are interested in improving the health and wellbeing of women giving birth across our community, including incarcerated women.
The Wake County Human Services Prenatal Clinic provides prenatal care for the uninsured and underinsured pregnant patients of Wake County. The WCHS prenatal clinic currently provides prenatal care to those pregnant patients who are incarcerated and are appointed to receive care at our facility (Sunnybrook location). We also have a staff member, Adonna Simpson Lewis, from the Education department of our facility, who provides prenatal, childbirth, women’s health and limited parenting education, depending upon the inmate’s incarceration status. Adonna works with the Maternal Health Social worker at the prison to schedule the sessions, which occur twice a month and average between 10-20 women per session.
Our Children’s Place of Coastal Horizons is a statewide program that serves as North Carolina’s leading advocate and educational resource focused on children of incarcerated parents. Our work includes: educating professionals, especially those working with children; supporting the relationship between children and their incarcerated and returning parents; and, identifying and promoting policies, programs, and practices which improve the outcomes for these children.
SisterSong is a reproductive justice organization (training, advocacy, policy and culture shift). Sistersong’s mission is to strengthen and amplify the collective voices of indigenous women and women of color to achieve reproductive justice by eradicating reproductive oppression and securing human rights. SisterSong is launching our prison abolition anti-shackling public education awareness campaign this year. Our plan is to: increase the awareness of shackling practices (local, state and in ICE detention centers); tell the stories of the communities members who have been most impact by the practice via photo documentaries and storytelling; explore opportunities to support making changes to the administrative policy at the state level; partner with other mass incarceration abolitionist groups to engage in culture shift and policy change work around the prison industrial complex.
NC Staff: Ash Williams, NC Coordinator, They/Them/Theirs Omisade Burney-Scott, Director of Strategic Partnerships and Advocacy, She/Her/Hers
NARAL Pro-Choice North Carolina works to support and protect access to the full range of reproductive health care options and the ability for each North Carolinian to make the reproductive decisions that are best for them and their family. We advance our mission through advocacy, community education, and civic engagement. We work with policymakers to defend against anti-choice attacks and advocate for policies that protect and advance reproductive rights. We also work to educate and inform our community about the impact harmful anti-choice legislation has on North Carolinians’ reproductive rights and health, and the ability to access comprehensive reproductive health care. Finally, we help elect candidates who support reproductive health and rights, and we work to actively defeat anti-choice opponents. We see our role as providing advocacy and resources related to the full range of reproductive health care for people who are incarcerated, including access to birth control, emergency contraception, safe abortion, and support and management of miscarriages.
The UNC Health Care- Women’s Care provides a full range of health care services in inpatient and outpatient settings to meet a women’s needs throughout the span of her life, from general wellness and preventive screening to the most sophisticated specialty care. We are located on UNC Chapel Hill’s Campus and provide care to pregnant and incarcerated North Carolinians in the form of delivery and/ or pregnancy complications. We are interested in participating in discussions of harm reduction for incarcerated women – reducing shackling on L&D, timely access to care for incarcerated women and fair treatment of both the women and their infants.
Planned Parenthood South Atlantic is an affiliate of Planned Parenthood Federation of America, the nation’s leading nonprofit sexual health provider, educator, and advocate. Planned Parenthood South Atlantic (PPSAT) provides high quality, nonjudgmental care and education, including annual exams, lifesaving cancer screenings—like Pap tests and clinical breast exams—STI testing and treatment, and abortion care in health centers located throughout North Carolina, South Carolina, Virginia, and West Virginia. Planned Parenthood South Atlantic is committed to providing care, no matter what.
Other participating agencies include:
Policies, Laws and Legislation
- Mothers Behind Bars: A state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women and the effect on their children https://www.nwlc.org/sites/default/files/pdfs/mothersbehindbars2010.pdf
- State Standards for Pregnancy- Related Health Care and Abortion for Women in Prison https://www.aclu.org/issues/prisoners-rights/women-prison/state-standards-pregnancy-related-health-care-and-abortion
- House Bill 594: Healthy Mother, Healthy Child https://www.ncleg.net/Sessions/2017/Bills/House/PDF/H594v1.pdf
- Health Services Policy & Procedure Manual https://files.nc.gov/ncdps/div/Prisons/HealthServices/CC_ContinuityPatientCare/cc4.pdf
- Inmate Maternity Leave Policy and Procedures http://www.doc.state.nc.us/dop/policy_procedure_manual/f2300.pdf
- Parenting Programs Policy and Procedures http://www.doc.state.nc.us/dop/policy_procedure_manual/e2300.pdf
- Handbook for Family and Friends of Inmates http://www.doc.state.nc.us/Publications/2006handbook.pdf
Shackling of Pregnant and Postpartum Incarcerated Persons
- Pregnant inmates still being shackled in Massachusetts, report finds http://theprisonbirthproject.org/wp-content/uploads/2016/05/Breaking-Promises_May2016.pdf
- The Shackling of Incarcerated Women: A Human Rights Violation Committed Regularly in the United States https://ihrclinic.uchicago.edu/sites/ihrclinic.uchicago.edu/files/uploads/Report%20-%20Shackling%20of%20Pregnant%20Prisoners%20in%20the%20US%20%28Final%201.8.14%29.pdf
- Best Practices for use of Restraints with Pregnant Women and Girls Under Correctional Custody https://www.nasmhpd.org/sites/default/files/Best_Practices_Use_of_Restraints_Pregnant(2).pdf
- Shackling of Pregnant Women in Custody https://www.plannedparenthoodaction.org/uploads/filer_public/54/56/5456be64-1916-4745-8508-5c890e78edcc/anti-shackling_legislation.pdf
- A National Analysis of Shackling Laws and Policies as They Relate to Pregnant Incarcerated Women http://journals.sagepub.com/doi/full/10.1177/1557085117737617
- Overlooked: Women and Jails in an Era of Reform https://www.vera.org/publications/overlooked-women-and-jails-report
- Women’s Mass Incarceration: The Whole Pie 2017 https://www.prisonpolicy.org/reports/pie2017women.html
- Incarceration, Maternal Hardship, and Perinatal Health Behaviors https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161663
- Health Care for Pregnant and Postpartum Incarcerated Women and Adolescent Females https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Health-Care-for-Pregnant-and-Postpartum-Incarcerated-Women-and-Adolescent-Females
- Women’s Health Care in Correctional Settings https://www.ncchc.org/womens-health-care
- Options for Pregnant Inmates https://nccriminallaw.sog.unc.edu/options-for-pregnant-inmates
- The Effectiveness of Parenting Programs for Incarcerated Mothers: A Systematic Review https://link.springer.com/article/10.1007/s10826-017-0900-8
- Public Opinion Strategies (National survey from Justice Action Network) https://www.politico.com/f/?id=00000161-2ccc-da2c-a963-efff82be0001
- The Prison Industrial Complex Map http://correctionsproject.com/wordpress/wp-content/uploads/2015/07/whatIsPIC-e1437215871385.jpg
- Jailcare: Finding the Safety Net for Women Behind Bars https://content.ucpress.edu/chapters/13079.ch01.pdf
- Association for Justice- Involved Females and Organizations https://www.ajfo.org
- National Resource Center for Justice Involved Women http://cjinvolvedwomen.org
- American Psychology Association http://www.apa.org/advocacy/criminal-justice/shackling-incarcerated-women.pdf
- Dream Corps- #cut50 https://www.cut50.org