Results revealed that fourteen of the fifteen women interviewed for the current study reported engaging in at least one of the active elements (i.e., support group or lactation) of the perinatal support program, and the majority expressed positive perceptions and satisfaction with their experience. Although childbirth education was ultimately found not to be available during the study period due to consequences of the COVID-19 pandemic, 13 women expressed being interested in participating if it were available to them during their incarceration. Lastly, 14 women reported they would have been interested in doula support services if it were available and would support its addition to the existing program.<\/p>\n
Perception of services currently offeredSupport group<\/p>\n
Among the women interviewed, 14 reported participating in at least one session of the support group. The remaining participant reported that she did not remember hearing about the group and did not participate. Those who did participate provided primarily relational reasons for attending, including having a safe place to share thoughts and feelings, having a similar experience with others in the group, feeling comfortable with the group facilitator, and meeting their needs for support. One participant reported attending to receive parenting education and coping skill development. Most women reported attending the group after being encouraged by another person, usually an incarcerated peer, though some were motivated to attend by a group leader or a relative.<\/p>\n
Of those who participated, most reported positive experiences, felt highly satisfied, and would recommend the group to other pregnant and postpartum people who are incarcerated. Largely, women found the support group to be a safe place to speak openly among peers with a shared experience. One woman described, \u201cI was in prison, I really didn\u2019t have anyone to talk to about it\u2026it was good, supportive, and nice to be surrounded by women who was probably going through the same thing I was\u201d (30-year-old, African American). Another said, \u201cit\u2019s a safe place for girls that are pregnant to talk amongst people that encountered [pregnancy and incarceration]\u201d (33-year-old, White). Others spoke specifically about how the support group provided an outlet for women to openly share their feelings and frustrations without repercussion. Women described the support group as a place to \u201cbe open, say how you feel and be a crybaby and it\u2019d be okay\u201d and stressed the importance of having \u201copen discussion outside the barracks\u201d and \u201cbeing able to be open and not worry what could come of it.\u201d Two women mentioned the support received from the facilitator influenced their decision to attend. One described the group facilitator as \u201camazing\u201d and \u201cvery helpful,\u201d while the other elaborated, \u201c[The teacher], whenever I came back here from having my baby, just showing that she cared just enough to come back and check on me, that helped a lot\u201d (26-year-old, African American).<\/p>\n
Two women felt neither satisfied nor dissatisfied with their experiences in the support group. One of these women shared similar positive views about the support group facilitator but also expressed that the topics of conversation in group were misaligned with her current needs. She stated the support group facilitator was, \u201cdown to earth\u2026genuine, not judgmental\u201d but added,<\/p>\n
\n\u201cI\u2019ve been clean before I went to prison\u2026all they [members of the group] wanted to talk about was their drug use and they were scared to get out and use again. I felt like that was one of the main and only topics we talked about, just since there\u2019s so many people that were still talking about getting high again and that didn\u2019t help me at all\u2026\u201d (30-year-old, White).<\/p>\n<\/blockquote>\n
The other woman also expressed mixed feelings about the group and stated that her favorite part was the opportunity to, \u201ctalk to other inmates going through the same thing\u201d but also added that, \u201cno one really talked\u201d (33-year-old, White), leaving her feeling neither satisfied nor dissatisfied.<\/p>\n
Lastly, the one woman who did not participate in the support group expressed that she would have been interested in the group and would have attended had she heard about it. Her interest in the support group mirrored those who did participate. When asked why she would be interested in attending, she stated, \u201cI was unprepared. It would\u2019ve been nice to get other mothers\u2019 opinions and stuff like that. Which, I did do that, but I had to do it on my own by going around and asking women who had kids\u201d (28-year-old, White).<\/p>\n
Lactation program<\/p>\n
Two women reported participation in the lactation element of the program. Twelve women remembered hearing about lactation but did not participate and one woman did not remember hearing about it and did not participate. Of the two women that participated, one woman reported being highly satisfied with the experience, while the other expressed ambivalence and gave several suggestions to improve the program. Both participants expressed that they would recommend the lactation element of the program to other postpartum people who are incarcerated and gave similar reasons for participation. Both chose to participate because they knew they wanted to breastfeed their infant and felt that breastmilk was best for their baby. One stated, \u201cI thought it would probably be a good idea\u2026I thought it was the best way to feed my baby breastmilk\u201d (32-year-old, African American). The other enrolled in the lactation program for, \u201csupport while being locked up and so my baby would be able to breastfeed\u201d (30-year-old, White).<\/p>\n
Although both women gave similar reasons for being interested in the lactation element of the program, the two women shared very different experiences. One described feeling very satisfied with her experience and did not offer suggestions to improve the program. She expressed,<\/p>\n
\n\u201cThe [guards] didn\u2019t give me any problems pumping\u2026they did what they was supposed\u00a0to. We had to go every three hours\u2026my pump broke and the [hospital] was good, they came and brought a [new] pump right over. It was very, really helpful\u201d (32-year-old, African American).<\/p>\n<\/blockquote>\n
In comparison, the other woman who participated reported a less positive experience and expressed several concerns with the pumping schedule, access to the pumping room and supplies to clean the pump, and logistical barriers experienced by the caregiver picking up the milk. She explained,<\/p>\n
\n\u201c[Pumping] is something you have to do on a schedule, and sometimes it is hard to get out of there [barracks]\u2026breastfeeding is on a schedule like every four hours type deal\u2026it was an issue trying to get out of the barracks, getting the guards attention when it came time to go breastfeed, to pump\u201d (30-year-old, White).<\/p>\n<\/blockquote>\n
Although she believed that being provided with a pump and pumping supplies was beneficial, she did express a need for more consistent stocking of supplies in the lactation room. She stated that at times,<\/p>\n
\n“We were out of stuff, we didn\u2019t know who to tell\u2026like we needed more soap to wash bottles with\u2026but when I ran out, I didn\u2019t know who to get in contact with, or request to get more of what I needed.”<\/p>\n<\/blockquote>\n
She also urged that caregivers should be able to pick up milk more than once a week, which was the limit per facility policy, and felt that it would be beneficial both for the mother and the infant. She emphasized:<\/p>\n
\n\u201cWhen the baby runs out, it really hurts her stomach to have to switch back and forth [between breastmilk and formula], so it would prevent the baby running out if they could let the people coming to pick up the milk pick it up more than just one time\u2026\u201d (30-year-old, White).<\/p>\n<\/blockquote>\n
Of the 12 women who remembered hearing about the lactation element of the program but did not participate, seven wished to participate but were ineligible per institutional policies, three were eligible to participate but declined, and two were ineligible and did not want to participate. Institutional policies that prevented participation in the lactation element of the program included Department of Human Service (DHS) involvement in infant placement following birth (n\u2009=\u20095), infant placement for adoption (n\u2009=\u20091), infant placement with a caregiver who lived out of state (n\u2009=\u20091), and COVID-19 restrictions (n\u2009=\u20091). Similar experiences were echoed by all women who were interested in lactation but unable to participate due to DHS involvement. One woman informed us, \u201cI wanted to [participate], but the rules are if your family member gets your baby, then you can participate in lactation. But if DHS get your baby, they don\u2019t let you participate\u201d (26-year-old, African American). Similarly, another woman described being denied the opportunity to participate in lactation due to DHS involvement despite obtaining a relative as an approved caregiver. She proclaimed,<\/p>\n
\n\u201cThe bad thing about the way the contract is written or whatever, it says if DHS is involved, they just don\u2019t participate [in lactation]. My aunt spoke with DHS and had everything already lined up and pre-approved so there was no reason why I should have been denied an application. She [my aunt] picked him up from the hospital. He never went into [DHS] custody or anything\u201d (35-year-old, White).<\/p>\n<\/blockquote>\n
The three eligible women who chose not to participate due to their personal choice to formula feed. One participant explained that she knew she wanted to formula feed out of concern for her emotional-wellbeing post-separation. She expressed,<\/p>\n
\n\u201cI knew I was going to have to leave her, it\u2019s just, more depressing knowing if I started breastfeeding her and then not being able to continue breastfeeding her. I decided to bottle feed for that reason because I did not want to get more attached knowing I was going to have to leave her\u201d (33-year-old, White).<\/p>\n<\/blockquote>\n
Perception of services not currently offeredChildbirth education<\/p>\n
Thirteen of the fifteen women interviewed expressed interest in attending childbirth education if it were available to them at the time of their incarceration. Most reported being interested in childbirth education to learn more about maternal, fetal, and infant health and well-being, with some noting particular interest in learning how to manage and cope with stress, prepare for childbirth, or access emotional support. One woman stated, \u201cit would have been helpful for me to know things that I could do just to help with stress and overall health of myself and my baby while incarcerated\u201d (28-year-old, White).<\/p>\n
Another, who was still pregnant with her first child at the time of her release, explained that her current pregnancy was unexpected, and she felt unprepared for childbirth. She said, \u201cI didn\u2019t find out I was pregnant until six and half months, doctors told me I could never have kids, I feel totally unprepared for this baby\u2026I don\u2019t know what to expect during birth\u201d (28 years-old, White). She added that she was due in eight days and knew very little about signs of labor and how the body prepares for childbirth. However, even women with multiple pregnancies reported interest in childbirth education, a sentiment exemplified by another woman who explained, \u201ceven though it was my fourth child, it felt like having a new baby every time\u2026every labor is different, and you\u2019ll experience something different with every single one of them, so the more you know, the better\u201d (35 years-old, White).<\/p>\n
Two women denied interest in the childbirth education component by expressing low perceived compatibility\u2014not with the content, but rather with practical elements of an educational group. For example, one woman explained, \u201cI was really really bad at waking up in the morning and while I was in prison, I\u2019d sleep all day and at night I\u2019d read a book\u201d (23-year-old, White). Another described that she, \u201cdoesn\u2019t normally do support groups\u201d (33-year-old, White).<\/p>\n
Doula support<\/p>\n
Fourteen participants indicated that if they were still incarcerated and would be giving birth in custody, they would be interested in the hypothetical doula support service component of the program and having a doula attending their birth. All participants were asked to rate the likelihood of enrolling in doula support services if it were available to them. Most women (n\u2009=\u200913) responded they would have almost certainly enrolled, one woman\u2019s response was neutral towards the doula service, and another woman\u2019s response indicated she would have been unlikely to use this service.<\/p>\n
Nine of the 13 women felt they would have enrolled because of the physical and emotional support the doula would provide during childbirth. One woman expressed, \u201cthere\u2019s nobody in the room with you but the guard\u2026they\u2019re not emotional or supportive, no one\u2019s gonna be there to hold my hand\u201d (26-year-old, African American). Another woman detailed how family members could not attend their delivery and the opportunity to have a trusted emotional support person would have contributed to a better birth experience. She stated,<\/p>\n
\n\u201cBecause you can\u2019t really have your family there with you, so that would help to have somebody that was there before [childbirth], and then if they were there with you, you kind of feel close to them. Even though you can\u2019t have family and support there, that would make a big difference\u201d (33-year-old, White).<\/p>\n<\/blockquote>\n
Others shared similar views and made statements like, \u201c\u2026you need that kind of support going into labor\u2026cause you don\u2019t have your family\u201d (23 year-old, White) or \u201cour husbands can\u2019t be there for the birth, our families can\u2019t be there for the birth, so having somebody there, other than a police officer or uniformed guard, would be nice\u201d (28 year-old, White).<\/p>\n
Eight of these 13 women highlighted the importance of receiving mental health and emotional support from the doula during the pregnancy and into the postpartum period. One woman explained,<\/p>\n
\n\u201cI feel like the [Department of Corrections] does not give pregnant or postpartum women the mental help that they really need\u2026I think that having somebody there that you trust would help tremendously with the birthing process and the postpartum afterwards. I feel like that\u2019s a really big issue in the program\u2026\u201d (28-year-old, White).<\/p>\n<\/blockquote>\n
Another woman gave similar sentiments, \u201c\u2026just to have someone there for mental support. You know what I\u2019m saying? Because you don\u2019t have that in there. They don\u2019t have steady mental health\u201d (33-year-old, White). One woman equated postpartum emotions to a nightmare and expressed the need for someone, such as a doula, to assist with emotional processing following childbirth, \u201cit is such a hard experience, to have someone there would be helpful, that\u2019s a really emotional rollercoaster\u2026whole thing is like a nightmare\u201d (35-year-old, White).<\/p>\n
Two women expressed feeling neutral about the doula service or unlikely to enroll. Among them, one woman felt uncertain about the doula being a \u2018stranger,\u2019 but felt that having a support person during childbirth was needed. She stated.<\/p>\n
\n\u201cI would be a little hesitant about it\u2026you need that kind of support going into labor\u00a0transition cause you don\u2019t have your family\u2026I guess they wouldn\u2019t really be a stranger\u00a0after meeting with her so many times, but I don\u2019t know\u201d (23-year-old, White).<\/p>\n<\/blockquote>\n
The other woman felt highly unlikely to enroll in the doula service and would not be interested in having a doula attend their childbirth. Although she agreed that incarcerated birthing people could benefit from doula support and services, she was personally not interested in doula support because, \u201cI\u2019d rather be my own support\u201d (33-year-old, White).<\/p>\n
Program needs and recommendations<\/p>\n
Nearly all women emphasized the need for additional support and advocated for a component within the program to provide continued mental and emotional support throughout the postpartum period, particularly after being separated from their newborns and the subsequent readjustment to the prison environment. One woman described,<\/p>\n
\n\u201cI would say better help with the postpartum after you come back\u2026they don\u2019t really help you with that in there [in prison]\u2026you\u2019ll have days where you\u2019ll be okay and then you\u2019ll have days where every little thing makes you cry and they sent me to mental health to talk to them and when I went down there, she didn\u2019t really talk to me. She just gave me a packet and sent me back to the barracks\u201d (26-year-old, African American).<\/p>\n<\/blockquote>\n
One woman shared her thoughts about having more frequent access to program staff throughout the week,<\/p>\n
\n\u201cI think just having somebody to come in and help you deal with the postpartum\u00a0depression or any concerns of the postpartum period would be a really big help to have\u00a0available to us\u2026I just feel like if you\u2019re having a really hard day\u2026you should be able to\u00a0go off and talk to somebody right then instead of having to wait a whole week for\u00a0somebody to come in and be able to talk about it\u201d (28-year-old, White).<\/p>\n<\/blockquote>\n
One woman, who did not give birth during her incarceration, expressed similar thoughts given her peers\u2019 experiences,<\/p>\n
\n\u201cWhile I was incarcerated, three of the girls gave birth to their babies and had to go back to prison and no support whatsoever, other than hoping and praying that whoever has their baby will send them pictures. They have no support or nobody to talk to about what it\u2019s like to have to leave your baby and be sent back to incarceration\u201d (28-year-old; White).<\/p>\n<\/blockquote>\n","protected":false},"excerpt":{"rendered":"Results revealed that fourteen of the fifteen women interviewed for the current study reported engaging in at least…\n","protected":false},"author":2,"featured_media":9641,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[74],"tags":[18,9471,19,9466,17,9470,9469,9468,9467,657,82],"class_list":{"0":"post-9640","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-technology","8":"tag-eire","9":"tag-gynecology","10":"tag-ie","11":"tag-incarceration","12":"tag-ireland","13":"tag-maternal-and-child-health","14":"tag-perinatal-support-programs","15":"tag-postpartum","16":"tag-pregnant","17":"tag-reproductive-medicine","18":"tag-technology"},"share_on_mastodon":{"url":"","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/9640","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=9640"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/9640\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/9641"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=9640"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=9640"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=9640"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}