The Benefits of Prison Nursery Programs: Spreading Awareness to Correctional Administrators Through Informative Conferences and Nursery Program Site Visits

Analisa Johnson

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Over the past forty years or so, the United States has seen a steady increase in incarcerated individuals, with 2.2 million people currently in prisons and jails nationwide, according to an organization called The Sentencing Project, which provides updated statistics on prisons and the criminal justice system (2). In particular, the number of incarcerated females has risen dramatically, at a rate fifty percent higher than that of men since the early 1980s (The Sentencing Project 4). As recently as 2015, there are nearly 112,000 incarcerated women across the nation (The Sentencing Project 4). While there is a plethora of healthcare issues that women face when locked up, one of the most concerning is that of reproductive health, specifically pregnancy and birth in prison. Roughly one in twenty-five women entering prison or jail is pregnant (Yager). As a result, the number of babies born behind bars has also grown at an alarming rate. It is estimated that up to 2,000 infants are born to incarcerated mothers each year, only to be taken from them a scant twenty-four hours after birth and placed either with a family member, or more often, in the foster care system (Sufrin). Current scholarly sources have proven prison nursery programs—which allow mothers to keep their infants with them while they serve out their sentences—to be a very effective method in dealing with the issue of incarcerated mothers. Nevertheless, despite this fact, there are only nine nursery programs currently operational in America. In order to make prison nursery programs more prevalent, we need to better educate correctional administrators on the effectiveness of nursery programs so that mothers, babies, and the nation as a whole can benefit. I propose addressing administrators through an informative presentation at the American Correctional Association’s annual conventions as well as sending correctional administrators without prison nurseries to successful facilities across the nation to experience firsthand the effectiveness of such programs. If we take the time to study this issue and better educate individuals on the effectiveness of prison nursery programs, we can begin to improve the prison healthcare system, which is currently failing many women and children alike.

When it comes to women’s healthcare in the prison system, there are many areas that are lacking in adequacy, but several of great importance include the prenatal care and unsafe birthing practices of incarcerated mothers. According to the journal article “Timing of Conception for Pregnant Women Returning to Jail,” “[a]pproximately 6% to 10% of women entering jails are pregnant” (Clarke et al. 133). This is a significant increase over the past four decades, mostly due to the fact that the number of incarcerated women has increased dramatically. In an article entitled “Perinatal Needs of Pregnant, Incarcerated Women,” Barbara A. Hotelling discusses the lack of quality healthcare provided to expectant mothers behind bars. Despite adequate healthcare being mandated to all inmates through the Eighth Amendment to the Constitution, women still make up a lesser percentage of total incarcerated individuals than men, which is used by correctional staff to justify providing scarcer healthcare and rehabilitative programs for incarcerated women (Hotelling). Not to mention the fact that prisons aren’t subject to any sort of external review, which doesn’t encourage the improvement of healthcare services, especially if they are seen as costly endeavors (Hotelling). As a result, many incarcerated women face unnecessarily high-risk pregnancies. Another practice that increases the risk of complications in pregnancy in prison is the custom of shackling female inmates during labor, delivery, and postpartum. This practice is both degrading and inhumane and can pose a problem for healthcare providers in case of an emergency. In an official position statement made by the Association of Women’s Health, Obstetric & Neonatal Nurses condemning the use of shackles on pregnant women, the board of directors’ note that the unnecessary practice can interfere with the ability of nurses and health care providers to deliver the proper care and treatment (AWHONN). Only eighteen states in the U.S. currently ban the shackling of expectant mothers in prison while they give birth (ACLU). The remaining thirty-two states are left to their own devices, in some cases shackling mothers with no regards to the recommendations of nurses and other health care providers. This poor treatment of female inmates and lack of proper health and prenatal care is cause for concern. When looking at the nine states that currently operate prison nursery programs—California, Illinois, Indiana, Nebraska, New York, Ohio, South Dakota, Washington, and West Virginia—all but three have laws in place that prevent the shackling of inmates while giving birth (Sufrin). Prisons with nursery programs seem to better understand the necessity of protecting incarcerated mothers and babies throughout the pregnancy and delivery than other prisons. I believe that we should consider the positive effects that implementing prison nursery programs has on the correctional facilities themselves, as providing better healthcare seems to be one key component.

Before attempting to spread awareness of prison nursery programs we must first understand exactly what they are and how they service incarcerated mothers. Prison nursery programs offer women who become incarcerated while pregnant the option to keep and parent their child while they serve their sentence. It can be a rigorous process to get into these programs; with limited spots available, prospective mothers must have a nonviolent conviction, no record of child abuse, and be roughly within eighteen months of completing their sentence—which is the maximum amount of time a child can stay with his or her mother behind bars (Stein 11). When mothers do get into these programs, there are many benefits to be had while behind bars, for both themselves and their child. For starters, mothers are provided with parenting classes, support groups, substance abuse counseling, and complementary day-care services to attend these classes. Many prisons also provide high school and college courses for those mothers who have not yet completed their education (Wertheimer). Lastly, vocational programs are also offered, which aid in the job search once the women are released from prison. These enrichment and rehabilitative classes are an important part of reintegrating these women back into society upon their release from prison. As a result of the work put in while serving out their sentence, many of the mothers have been shown to have a reduced recidivism rate once they are released. According to a study conducted in the article, “Recidivism after Release from a Prison Nursery Program” by Lorie Goshin, Mary Byrne, and Alana Henninger, the recidivism rate within three years of women exiting prison nursery programs was found to be a mere 4.3% for a new offense and 9.4% for a parole violation. An astounding 86.3% of women remained in the community three years following their release from a prison nursery program (Goshin et al., “Recidivism”). This is a proven positive for both the mothers and their children.

In addition to prison nursery programs providing mothers and babies with the tools necessary to succeed upon leaving prison, they have also been proven to foster the imperative mother-child attachment bond, which bears a positive effect on children later in life. In the article “The Price They Pay: Protecting the Mother-Child Relationship Through the Use of Prison Nurseries and Residential Parenting Programs,” Anne E. Jbara discusses the emotional and cognitive benefits of the mother child bond. Jbara notes that the attachment bond is crucial to a child’s psychological development; even in instances where a mother is reunited with her child at two to three years of age—before a child can actually remember their mother’s absence—severe psychological trauma can ensue later in life (Jbara). Jbrara goes on to quote The American Psychological Society, which found that “…infants who bond securely with their mothers become more self-reliant and have higher self-esteem as toddlers” (Jbara). This is remarkable evidence showing the importance of the bond between mother and baby at such an early age. Furthermore, in the article “Preschool Outcomes of Children Who Lived as Infants in a Prison Nursery,” by Lorie Goshin, Mary Byrne, and Barbara Blanchard-Lewis, a study was conducted examining the long-term effects of early childhood life in prison on infants ages one to eighteen months. This data was compared to that of children who were separated from their mother due to incarceration. Goshin, Byrne, and Blanchard-Lewis found that “[c]hildren who spent time with their mothers in a prison nursery had significantly lower mean anxious/ depressed and withdrawn behavior scores than children who were separated from their mothers in infancy or toddlerhood because of incarceration” (Goshin et al., “Preschool Outcomes”). This is promising evidence for the effectiveness of prison nursery programs, and shows that there are not only benefits to be had in the short term, but also in the long-term development of children as well. Still, the mother child attachment bond is not merely something beneficial if fostered, but can actually produce detrimental effects on the child later in life if not nurtured: “Studies have shown that children who fail to sufficiently bond with their mothers are more likely to suffer from developmental delay, an inability to connect with others, and a greater likelihood of being convicted of a crime later in life” (Jbara). Clearly, mother-child separation is neither good for the child, the mother, or the state, who would not only be putting more children into foster care but also more individuals into incarceration, two avenues paid for by the government.

Despite all of the benefits previously discussed stemming from the employment of prison nursery programs, it is quite alarming that there are only nine currently operational in the United States. Furthermore, what I have found to be most disturbing is the number of women’s correctional facilities that reported being uninformed on what prison nursery programs even were or that they proved to be beneficial. In a study conducted by Julie Campbell and Joseph R. Carlson, out of twenty-eight women’s correctional facilities interviewed across the United States, only eight had nursery programs (which proved to be 100% of all nursery programs in the country at the time). Out of the remaining twenty, a stark 50% had never heard of the programs before or had very little information on them (Campbell et al. 1096). This data is troublesome and proves that we need to be advocating for the expansion of prison nursery programs across the nation, providing more information to the source itself—women’s prisons—who are currently largely uninformed in this area about the many benefits that prison nursery programs have to offer.

In order to make the benefits of prison nursery programs more widely known, we need to provide increased education of these programs to women’s prison facilities throughout the country. One way in which to do this is through an informative presentation given at The American Correctional Association’s (ACA) Annual Congress of Correction conference. Although little research has been conducted showing the effectiveness of conferences and talks on spreading information and boosting implementation of the ideas presented, much research has been done on the effectiveness of professional development and its benefits in education. We can look at these statistics and apply the findings to our case, which presents a similar necessity—present information to be implemented in a different setting at a later date. According to the journal article, “What Makes Professional Development Successful? Strategies That Foster Curriculum Implementation,” by William R. Penuel, Barry J. Fishman, Ryoko Yamaguchi, and Lawrence P. Gallagher, which discusses the effect of professional development on the implementation of an inquiry science program called GLOBE, “[p]rofessional development is widely believed to be required for supporting implementation” (Penuel et al. 922). This illustrates to us that by simply providing new information and teaching techniques through professional development, these techniques were more likely to make it into the classroom than if not offered through professional development. Thus, we can conclude that by presenting information on the benefits of prison nursery programs at the ACA’s Congress of Correction conference to current correctional administrators, we can expect to see an increase in the number of prison nurseries across the country.

When marketing the benefits of prison nursery programs, it is imperative to recognize that not all states or correctional facilities are created exactly the same or possess the same resources. As a result, being able to take and customize the information presented at the ACA’s annual conference is an important step in the augmented adoption of prison nursery programs across the country. We can see clear differences in the nine prison nurseries currently operational, as none are exactly the same, each with its own individuality. For instance, while many nursery programs are similar in the sense that they allow nonviolent offenders to keep their newborns in a well-stocked facility, many differ in the number of days that infants are allowed to stay, anywhere from thirty days at the South Dakota Women’s Prison to three years at the Washington Correctional Center for Women (Women’s Prison Association 10). Additionally, the capacity of these nursery programs varies considerably; facilities across the nation can accommodate anywhere from five mother/infant pairs at the Decatur Correctional Center in Illinois and the Lakin Correctional Center for Women in West Virginia to no limit on capacity at the South Dakota Women’s Prison. Most programs, however, tend to waver in the twelve- to eighteen-month range (Women’s Prison Association 27–29). Clearly, these differences can make it challenging to present a universally applicable model of how to implement prison nursery programs in new correctional facilities. Therefore, in order to get the highest rate of employment of prison nursery programs, there should be some flexibility presented at the conference so that attendees form different states feel that they are able to take the information presented and customize it to add a prison nursery program to their correctional facility’s repertoire as opposed to completely uprooting their current structure in order to accommodate nursery programs. This was also a found to be significant marker for implementation in the GLOBE study on professional development, as it was discovered that “[f]or both protocol use and preparedness for student inquiry, the opportunity to ‘localize’ GLOBE—that is, to plan for how to tailor its implementation to local circumstances of teachers’ classrooms—was a significant predictor of the extent to which teachers implemented these aspects of the program” (Penuel et al. 950). As it follows, not all schools and teachers are the same, and so the ability to customize the information and techniques presented through professional development programs is important. Hence, from the findings presented here in this study, we can gather that the more flexible the information provided to states concerning the gritty details of these programs, the more likely that they will be implemented in the future.

In addition to an informative presentation, I propose that there also be a panel discussion. This would include correctional officers as well as mothers currently in the program and mothers who have successfully completed the program to discuss their individual experiences, give testimonials and answer questions that attendees may have. Research has shown that lively panel discussions have proven to leave a longer lasting impact on attendees, rather than merely a non-interactive speech. Additionally, it allows conference attendees to hear various perspectives on the positives and negatives of prison nursery programs from essentially the experts in the field: those who run and live/have lived in a prison nursery. Bernadette Melnyk examines in her book, Evidence-Based Practice in Nursing and Healthcare, the benefits of utilizing panel discussions to distribute information. Melnyk states of panel discussions that “[t]his type of presentation format is especially effective in convening colleagues from various clinical settings to disseminate information […]” (358). Furthermore, “[l]istening to a number of different views enriches the session for the audience” (358). As I’ve previously discussed, not all prison nursery programs are the same, and thus, not all experiences living in and running a prison nursery are exactly the same. Some programs are bigger than others, possibly making the day for officers more hectic and the nights for mothers prolonged, with more crying infants in the mix. These are all things that will have a bearing on the program, and by including different perspectives in a panel discussion, conference attendees can get a more holistic view of the day-to-day life and operations in prison nurseries. By including a panel discussion, we also gain the opportunity for ample question and answer time: “[q]uestions from the audience are taken as a means of delving further into particular areas of interest or understanding the panelists’ views better” (358). Oftentimes, audience members will have questions about the information being presented or want to know more about a certain experience or topic. Through having a panel discussion, women and officers of different backgrounds and experiences with be available with a plethora of experience to answer any questions that may come up. Thus, a panel discussion is a positive means of making conference attendees more receptive to the idea of opening up nursery programs in their correctional facilities, and as a result, opening up opportunities for mothers who find themselves pregnant behind bars.

While giving an informative presentation and having a panel discussion at the ACA’s Annual Congress of Correction conference will prove highly beneficial in spreading awareness of prison nursery programs, to really make sure that correctional officers and administrators are prepared to implement these programs, the second part of my proposal is that we send officers from prisons without nursery programs to prisons that have a program in order to see first-hand the benefits and ask any clarifying questions. This will allow correctional officers and administrators the opportunity to get a first-hand look at successful prison nursery programs across the country and how they have gone about helping expecting women in prison. Although giving an informative presentation at the ACA’s Congress of Correction conference is a proven effective method of disseminating information to a widespread audience, by allowing officers and administrators to see the benefits of these programs up close, the hope is that they will be motivated to implement them in their own prisons. Looking back at the GLOBE study on the effectiveness of professional development in spreading information, it was found that “[a] common criticism of professional development activities designed for teachers is that they are too short and offer limited follow-up to teachers once they begin to teach” (Penuel et al 929). In order to mitigate this problem, we need to supplement the knowledge gained at the ACA’s Congress of Correction conference with site visits to successful prison nursery programs. Through this mentor type program, facilities without nursery programs can get the advice and help that they need from facilities with prison nursery programs in order to start their own nursery programs.

Now that we’ve seen the benefits of an informative conference on the implementation of prison nursery programs across the country, I’d like to take a moment to address what many are probably questioning; the potential costliness of these programs on prison facilities. While it may seem as if implementing prison nursery programs across the country would be a costly endeavor, what I’d like for us to consider are the costs of putting children in foster care comparatively. On average, according to the report, “Children in Foster Care” by Amanda Fixsen, the total financial cost for one child to remain in foster care per year in Oregon is about $26,600 (Fixsen 3). Conversely, in her article entitled “Prison Born” in The Atlantic, Sarah Yager discusses the findings of Joseph Carlson, a professor the University of Nebraska at Kearney who evaluated Nebraska’s prison nursery program. Yager speaks of Carlson’s findings: “[h]e calculated that nursery supplies, staff salaries, and medical expenses would total about 40 percent less each year than foster care for the babies who would otherwise end up there, and predicted more-significant savings from a decline in recidivism.” One of the most prominent gains to prison nursery programs is, indeed, a drop in the recidivism rate of these women. This is not only a positive for the mothers and their children, but also for the prison system as a whole, which would benefit greatly financially with less people in the system. Clearly, we can see here that while somewhat rapidly increasing the number of prison nursery programs across the country may result in some extra money spent, we will reap the benefits in the long run, both financially and socially.

Clearly, the benefits of prison nursery programs for mothers, infants, and the population as a whole are astounding. Not only will the costs pay for themselves down the line and provide incarcerated mothers with better healthcare, but they will also receive the rehabilitative programs necessary to succeed in society once leaving prison. Additionally, mothers completing nursery programs have been proven to have a reduced recidivism rate versus the general inmate population, which means less taxpayer dollars going towards constructing and staffing new prisons. While it seems obvious that more of these programs should be implemented nationwide, in order for this to happen, education demonstrating the benefits of these programs must be more widespread. Once we take this step in the right direction toward providing better care to incarcerated mothers, I believe that we should consider how to improve our flawed prison system as a whole and provide better care to all inmates. As a result, I believe that this will lead scholars to consider in the future the ultimate question of whether we want our prison system to be punitive or rehabilitative in nature—a rehabilitative system being more in line with the prison nursery program approach. As we can see, this approach is already proving to be beneficial even in small scale, and we can infer with a more rehabilitative prison system in the future, these benefits will only grow. While there are many reasons that could cause an expectant mother to be in prison, I’d argue that it’s much better to focus our efforts on rehabilitation, an argument that I hope other scholars will take the time to study.

Annotated Bibliography

American Civil Liberties Union Foundation. “ACLU BRIEFING PAPER: The Shackling of Pregnant Women & Girls in U.S. Prisons, Jails & Youth Detention Centers.” American Civil Liberties Union Foundation, American Civil Liberties Union Foundation, https://www.aclu.org/files/assets/anti-shackling_briefing_paper_stand_alone.pdf.

This source was used to show the number of states that ban the shackling of women when giving birth. These figures were then compared to the states that have prison nursery programs to see if having a nursery program lowered the likelihood of shackling women.

The Association of Women’s Health, Obstetric and Neonatal Nurses. “Shackling Incarcerated Pregnant Women.” The Association of Women’s Health, Obstetric, and Neonatal Nurses, The Association of Women’s Health, Obstetric, and Neonatal Nurses, August 2011, http://www.jognn.org/article/S0884-2175(15)30763-2/pdf.

This source was used to corroborate the negative impacts that shackling can have on women during labor and delivery, including the ability of healthcare providers to perform emergency care if necessary.

Campbell, Julie, and Joseph R. Carlson. “Correctional Administrators’ Perceptions of Prison Nurseries.” Criminal Justice and Behavior, vol. 39, no. 8, Aug. 2012, pp. 1063–1074. SAGE, doi: 10.1177/0093854812441161.

This source was used to demonstrate the fact that many correctional administrators did not even know about the benefits of prison nursery programs and, as a result, backed up the claim that with increased education, more prison nursery programs could be implemented.

Clarke, Jennifer G., Maureen Phipps, Iris Tong, Jennifer Rose, and Melanie Gold. “Timing of Conception for Pregnant Women Returning to Jail.” Journal of Correctional Health, vol. 16, no. 2, Mar. 2010, pp. 133–138. SAGE, doi: 10.1177/1078345809356533.

This source was used to show the percentage of women entering prison or jail pregnant.

Fixsen, Amanda. “Children in Foster Care.” A Family for Every Child, A Family for Every Child, November 2011, http://www.afamilyforeverychild.org/Adoption/AFFECreportonchildreninfostercare.pdf.

This source was used to demonstrate the total cost per child per year in foster care.

Goshin, Lorie S., Mary W. Byrne, and Barbara Blanchard-Lewis. “Preschool Outcomes of Children Who Lived as Infants in a Prison Nursery.” The Prison Journal, vol. 94, no. 2, 2014, pp. 139–158. SAGE, doi: 10.1177/0032885514524692.

This source was used to prove that the long-term effects on children who spent the early years of their life in a prison nursery with their mother resulted in less anxiety and depression compared to children who were separated from their incarcerated mothers.

Goshin, Lorie S., Mary W. Byrne, & Alana M. Henninger. “Recidivism after Release from a Prison Nursery Program.” Public Health Nursing, vol. 33, no. 2, Mar./Apr. 2014, pp. 109–117. Wiley Online Library, doi: doi/10.1111/phn.12072.

This source was used to show the low recidivism rate of mothers who completed their sentence in a prison nursery program. This source also showed the high percentage of women who remained in the community three years after being released from a prison nursery program.

Hotelling, Barbara A. “Perinatal Needs of Pregnant Incarcerated Women.” The Journal of Perinatal Education, vol. 17, no. 2, 2008, pp. 37–44. PubMed Central, doi: 10.1624/105812408X298372.

This source was used to show the poor quality of healthcare being provided to incarcerated mothers. This source also demonstrated that while the Eighth Amendment guaranteed healthcare to all inmates, it was often inadequate and ill monitored.

Jbara, Anne E. “The Price They Pay: Protecting the Mother-Child Relationship Through the Use of Prison Nurseries and Residential Parenting Programs.” Indiana Law Journal, vol. 87, no. 4, 2012, pp. 1825–1845.

This source was used to support the necessity of the mother-child bond for both mother and baby, as it is crucial for cognitive development and self-esteem of the child and lowers rates of depression in mothers.

Melnyk, Bernadette. Evidence-Based Practice in Nursing and Healthcare. Lippincott Williams and Wilkins, 2005.

This source was used to corroborate the benefits to be had from a panel discussion in disseminating information and boosting likelihood of later implementation on the part of conference/panel discussion attendees.

Penuel, William R., Barry J. Fishman, Ryoko Yamaguchi, & Lawrence P. Gallagher. “What Makes Professional Development Effective? Strategies That Foster Curriculum Implementation.” American Educational Research Journal, vol. 44, no. 4, 2007, pp. 921–958 SAGE, doi: 10.3102/0002831207308221.

This source was used to establish the effectiveness of profession development at encouraging implementing of the practices taught. This information was then used to support the assertion that an informative conference on the effectiveness of prison nursery programs would result in great implementation of prison nurseries.

The Sentencing Project. “Fact Sheet: Trends in U.S. Corrections.” The Sentencing Project, The Sentencing Project, March 2017. http://sentencingproject.org/wp-content/uploads/2016/01/Trends-in-US-Corrections.pdf.

This source was used to provide facts on the number of prisoners currently in the system, as well as the number of females imprisoned in the United States.

Stein, Deborah J. “Babies Behind Bars: Nurseries for incarcerated mothers and their children.” Children’s Voice, vol. 19, no. 4, Jul./Aug. 2010, pp. 10–13, https://search-proquest-com.ezproxy.bu.edu/docview/866359865?accountid=9676.

This source was used as background information to show how long a child can stay with his or her mother behind bars. This source also demonstrated to rigorousness that mothers go through to get into these nursery programs.

Sufrin, Carolyn. “Incarcerated women and reproductive healthcare.” TEDx, 1 Jul. 2012. https://www.youtube.com/watch?v=WNx1ntLyI2Q.

This source was used to show the astounding number of infants born to incarcerated mothers each year. This source also demonstrated the number of prison nurseries that have laws against shackling.

Wertheimer, Linda. “Prenatal Care Behind Bars.” NPR, 5 Nov. 2005. http://www.npr.org/templates/story/story.php?storyId=4990886.

This source was used to demonstrate the rehabilitative opportunities provided to mothers in carrying out their sentences in prison nurseries.

Women’s Prison Association. “Mothers, Infants, and Imprisonment: A National Look at Prison Nurseries and Community-Based Alternatives.” Women’s Prison Association, Women’s Prison Association, May 2009, https://www.prisonlegalnews.org/media/publications/womens_prison_assoc_report_on_prison_nurseries_and_community_alternatives_2009.pdf.

This source was used to illustrate the various differences that can occur between prison nursery programs in different states.

Yager, Sarah. “Prison Born.” The Atlantic, Jul./Aug. 2015, https://www.theatlantic.com/magazine/archive/2015/07/prison-born/395297/.

This article was used to corroborate the fact that prison nursery programs, though they seem like an expensive endeavor, will pay off later on in reduced costs and lower recidivism rate of the mothers.

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