Who is the Most Important Person in the Room?

Not too long ago, we had a very interesting birth.  Actually, all of the births are interesting and you never know what new protocol has been instituted at the hospital regarding inmates.

Many times, the inmate is not taken to the hospital where we usually go for their births.  An ambulance is only called for them if the Nurse in the Medical Department of the jail is concerned about getting her to the hospital in time.  Normally, they go in a squad car with the Deputy.  Understandably, taking an inmate out of the jail and into an unsecured environment is a safety risk for everyone involved.

If the inmate goes by ambulance, the EMT’s can make a decision to go to a closer hospital.  This can become interesting if we, the doulas, have not been told of a hospital change.  In this case we do a lot more driving trying to find our mom!

Recently, one of our doulas did the “find the right hospital” in the early morning light.  After she got there, the inmate was so relieved to see her.  She was afraid that the doula would not know which hospital to go to.  Thankfully, she was there and was able to support her.  The inmate was precious in her very fast birth.  Heather, the doula, was stroking the inmate’s shoulder.  The inmate put her hand up as if to say stop touching me.  Heather apologized and the inmate said, “No!  I want you to keep doing that.”  Heather put her hand back on her shoulder.  The inmate reached up with her hand and then tilted her head as if she was trying to get even closer to Heather’s hand.

For many inmates the comforting touch of a doula is the only nonviolent contact they have experienced in months.  Many are coming from less than steady relationships on the outside.

After the birth, if the mom is addicted to drugs, then time is spent waiting to see how the baby reacts to being out of the womb and not having drugs going into their system.  There is a procedure the nurses do each hour to test how baby is doing.  At a certain point, in all cases of addicted babies, they are taken to NICU so they can be monitored more closely. 

This mom was addicted to drugs. She cried and held her baby tight. She kept apologizing to the baby for taking the drugs and making him sick.  It is not as if they found out they were pregnant and then started taking drugs.  They were addicted long before they were pregnant.  Just as any disease, addiction is very hard on the body, the baby, and extremely hard to stay clean.  This is not an excuse; it is the facts of this terrible disease.

The baby did end up having to go to NICU.  Before Heather left, she could see the signs in the baby that he was now feeling the affects of not having the drugs in his system.  This is a radical departure from what the baby had been experiencing in the mothers womb.

So, why my question, WHO IS THE MOST IMPORTANT PERSON IN THE ROOM?  In this case, because of some confusion, the hospital staff was not sure about when to take the mom to NICU to see her baby and how many times they could.  By this time there was a new doula that was now working with the inmate postpartum, everything is different from the protocol we are accustomed to.  And we are in a hospital that we rarely go to. 

The doula, Cheryl, was texting me asking questions on certain policies and what the procedure would be.  It was at this time I learned a very valuable lesson.  Everyone wants the best for the mom who is an inmate.  You, as the doula want the best, and also the hospital wants the best for their patient (the inmate) and now their new patient, the baby.  But many times things do not turn out the way you as the doula want them.

Being a doula, and “standing your ground” and saying I will not be moved and I want Plan A to be done NOW does not help the inmate who is the mother. The most important person you are working with in the room is the nurse.  She is doing her job. She is the medical professional on scene.  There may not be a written policy for inmates.  The nurses can also be questioning what to do too.

In situations like this, instead of “standing your ground” and saying it WILL be Plan A, work WITH the nurse and the staff, not against them.  You want to let them know that you recognize they want what is best in this situation and you want to help them and the new mother with this plan.

It is at this point, if you fight to get your way with the hospital you may loose your right to be a doula and to help her.  Remember why are you there.  It’s to help the mother, the inmate.  To help her bond with her new baby.  To help this baby get the best start in life.

If you spend this time fighting, and loose the privilege of being with the inmate, who will be there for the next inmate that is giving birth?  That is the question you need to ask yourself.

 We have found that many times, that if we don’t try to change the policy of the jail or the hospital, just our presence alone has changed many different situations and policies.  I believe this is the reason why the jail we work with and the hospital and caregivers, have been more on the cutting edge of incarceration reform than many other institutions in the county.

Care for the mother first.  You will be surprised how much you can influence the circumstances around you.

****Disclaimer: This blog is from the perspective of a jail, not a Sate or Federal prison.  Protocol will vary from initiation to institution.

How Do You Talk To The Pregnant Inmate About The Baby's Father?

In most of the births you attend, asking about the baby’s father is not difficult.  But in jail, to show respect to the inmate, it can be challenging. Finding that place in your conversation with her to ask the personal question can be like walking on glass.  Especially if there are other inmates close by that can hear her answer. 

On our intake form that we use for each inmate in our childbirth classes, there is not even have a place to write down the partner’s name.  We wait to ask this in person.  Many times we do not ask because we don’t need to know.  But if it comes to where we know she will be giving birth while incarcerated, this is something we do need to identify.  She will be answering questions with DCF/CPI, or whatever County organization you have that will be involved in placing the child with a family member after the birth.

So why is this question difficult?  In many cases, they do not know who the father is.  Some of the inmates that are will be working with are prostitutes and accidently got pregnant.  In some cases, a woman has been with so many men at the time of conception that she says she will have to wait to see the race of the baby and she can cut the list of men of who it may be down to a few.  For many, this is embarrassing to acknowledge. 

This question is important to ask because in many of the cases, the mother looks to you for guidance as to where the baby should go after she is born.  No, it is not your responsibility to find her a place for her baby.  But you may have to help her understand who she might think would take the best care of her baby.  Many times it can’t be the father because he is also in jail or maybe unfit to parent. 

We had a case of a mom that was pregnant with twins.  She wanted the boyfriend to have the babies.  In our conversations with her over a couple of months discussing this, we strongly encouraged her not to give the twins to him.

He did not have a job.  He did not have a place to live.  He did not have a car and his driver’s license had been suspended.  It was obvious this was not a stable place for them to go.  She was sent to prison and the day she got to prison, she had the babies.  If it had just been while she was with us.  But giving birth at a different facility and a different county so quickly after she had arrived, some of her information did not get checked out completely.  The babies went to the boyfriend.

Not long after he got his daughters, he killed on of them – baby shaken syndrome.  

This completely changed a part of each doula that works in our organization forever.  All of the what ifs…………  We mourned for that precious little girl.

Because of this happening to one of “our” baby’s, we knew we had to change.  We started asking that question sooner than later. We asked the important questions if she planned on giving the baby to the father after she gave birth.  Important questions such as: 

*Does he have a good support system to help him with the baby?

*Does he have a safe place to live?

*Does he have a job?

*If he has a job, who will watch the baby while at work?

*Has he been in jail?  If yes, do you think this would keep him from

    being allowed to have the baby with him.

These questions are not for us to have to give government agencies or to anyone.  They are questions to help the inmate start thinking of a safe place for her baby to live.  If the person she has chosen is the father of the baby, she needs to have gone through the thought process of the best place for her baby to be loved and to thrive.

These babies are precious, just as all babies are.  And my hope is that this information will help you if you need to guide her in finding a safe place where her child will not be abused.

In a typical jail who are the officers?  I look forward to sharing my opinion with you in my next blog.  Meanwhile go towww.birthbeindbars.com website and www.facebook.com/birthbehindbars and discover more stories.

****Disclaimer: This blog is from the perspective of a jail, not a Sate or Federal prison.  Protocol will vary from initiation to institution

Can You Really Talk About What You See And Hear In Jail?

You just left the jail and a friend calls you on your cell.  You can’t WAIT to tell her what just happened!  No.  Wait.  Can I talk about this?  Well why can’t I?

Well, it is a matter of security and the safety of me, the inmate, the deputy that is with the inmate and the hospital staff.

The longer you work with the jail population, the more you will be asking yourself this question.   As much as I know the rules, I still have to catch myself on what I say.  You are with a population that the majority of people you are with have never even entered a jail to even visit someone.  People are always asking you questions.  Some you can answer, some you cannot.

I remember I was with a very well known doctor and he was telling his employees what I do and that I go with the inmates when they give birth.  He stopped and said, “Now what hospital do you to go to be with the inmate?”  I froze.  We are not allowed to tell where they give birth.  It is a security issue.  And I have this doctor in front of me with his employees around him and trying to figure out how do I answer this without insulting him for not answering.  Finally I said, “Well doctor, I would like to tell you, but then I would have to kill you.”  That broke the quietness and people giggled – including the doctor.

So what is private?  What are you allowed to talk about?  This is a general list and will be different from jail to jail.

The names of the inmates we are working with.

The place where they give birth.

The name of the caregiver the inmates see prenatally and also for the birth.

You do not put on social media that you are leaving for the hospital to go be a doula for an inmate.

You don’t put on your Facebook page you just came home from a 30 hour birth with an inmate and put her picture on your page

You can’t teach a class and tell someone so many details about one of the inmates that it just may be very easy to know whom this inmate is.. 

The part that can be very difficult is with social media and emails.  As we know nothing is private.  Once it is out there, it is out there.  FOREVER!  The jail has not told us we cannot put on social media about the inmates, but that falls under not giving out information about the inmate.

Our organization has a Facebook page and we are on Twitter.  But the rule that we follow is nothing is ever said while the inmate is still in the hospital.  The hospital is not a secure place.  This is one of the reasons some jails do not let doulas in.  We are not a secure person.  I believe that you really have to gain that trust with the jail to be allowed to be a doula for an inmate.  We write about a class after it has happened. We write about a birth after the inmate has returned to the jail.  We have a policy in our organization that no one is allowed to talk about the jail on his or her personal social media.  All of our staff signs a policy and procedure paper just on social media and what is allowed and what is not.

But what CAN I say?  There is information you can give.  And when people hear what you do, they are going to ask questions.  After the class or birth has happened, you can talk about it in general terms just as you would any client.

I often have people want to know if they all take drugs for their birth since they could at the hospital.  And I answer them honestly.  And the answer is no.  We have more women have natural birth that are in jail than we do with our clients on the outside.

I am often asked so what are they in there for?  Did they kill someone?  We are not allowed to ask the inmate what they are in jail for.  But if you know the name of the inmate, it is public knowledge what their crime is.  You just have to click on the Internet and you can find out.  But who ever you are talking to will not be able to do that because you did not give them the name of the inmate.

Much of what you realize you should or should not be saying on what you see at the jail is just common sense.  In some cases, you work closely with the Deputies.  Just as you would not want someone to criticize your work, you do not want to criticize their work. 

One of our doulas said it best.  I just don’t tell anyone anything.  This way I know I won’t hurt anyone with my words.  I think we also learned that in kindergarten, didn’t we? 

How Do You Talk To The Inmate About The Babies Father?

 I look forward to sharing my opinion with you in my next blog.  Meanwhile go to www.birthbeindbars.com website andwww.facebook.com/birthbehindbars and discover more stories.

****Disclaimer: This blog is from the perspective of a jail, not a Sate or Federal prison.  Protocol will vary from initiation to institution.

How Do You Prepare A Doula Or Childbirth Educator For Their First Jail Visit?

You have been going to the jail to teach childbirth, parenting or other classes for a few years.  We do not realize it, but we have become so used to the jail environment; the slamming doors, being searched, and waiting for what at times seems like a life time for a door to open so you can get from point A to point B. But, if this is your first time, it can be (and is) very intimidating. Your new educator or doula needs to be prepared, and you can help her.

When someone starts teaching with our organization, we first have an orientation meeting with us at our office. They receive a binder that includes all of the subjects we teach, any materials we give to the inmate, plus the policies and procedures they must follow at the jail and at births, and the importance of confidentiality outside of the jail when talking about the work they do.

To help him or her retain all of the information we give them, people in the organization receive a jail manual that contains all of this information.

We also share with them a few things they may see at the jail and sounds they will hear. You also want to make sure they do understand the dress code for the jail. 

The first time they go with us to the jail, we let them know ahead of time, this is a time for you to take everything in.  We let them know they will not be teaching or be involved in conversations with any of the inmates. For you, this class will be two classes.  One you are talking almost constantly to your new educator and the other the class you will be teaching to your inmates.

All of the things that you do without even thinking, you need to explain in as much detail as you can literally from the time you step in the building.  For us, it starts with what we are allowed to bring in of personal nature.  And where do you put your car keys?

Explain how they have to sign in.   Why in the world is it important to write clearly? (The answer is one of the “just in case” problems that could happen in the jail, a lock down and they need to know where all people are in the jail)  I don’t know about you, but if something happens in the jail, I want them to be able to find me!

I believe one of the most important things that she will need to know is where to stand and wait and near what door.  It is important that she knows how important it is to be out of the way of the deputy.  The deputy’s first priority is not to make sure you get to your programs room and to have the pregnant women in there for you ASAP.  They are there keeping you safe and keeping the jail safe.

This is a subject that I believe that is the hardest to teach anyone new that comes into the program.  They are not waiting for you to come and get the girls in there in your room as soon as you get there.  This is one of the things you have to look at from their perspective.  They are having to move inmates. 

Each time an inmate is moved, it has to go into the computer.  The girl has to come out of her cell/pod.  Each girl has to be searched.  Another deputy has to walk them to the room you are in.  This process could take 10 minutes and I have seen it take 30 minutes.  That means your class time was just cut almost in half.  Explain to the new educator that you have to think on your feet.  You may have to completely change what you were going to teach.  

Is it a different world?  Yes.  It is the inmate’s world. And in the inmate’s world are the Deputies. Deputies that are underpaid overworked and understaffed watching out for your safety, their safety and the inmate’s safety. 

Again, you have been doing this for a few years.  For the new person you just brought on your team, it is a whole new world to her.  And she has to learn it now. 

Can you really talk about what you see and hear in jail? I look forward to sharing my opinion with you in my next blog.  Meanwhile go to www.birthbeindbars.com website and www.facebook.com/birthbehindbars and discover more stories. 

****Disclaimer: This blog is from the perspective of a jail, not a Sate or Federal prison.  Protocol will vary from initiation to institution. 

Is it Ever Appropriate to Cry in Jail?

Going into the jail is almost like entering a different world. There are so many rules to follow. There are so many doors to buzz so you can open it just so it can slam and lock behind you.  Your classroom is full of young pregnant girls. Each one has stories that you thought could not be possible. They grab at your heart.  There are times they almost make you sick. 

You want to cry.  But you can’t.

When a woman cries, it is almost an automatic action that another woman reaches out to hug her and hold her.   But in jail, you can’t do that.  You are not allowed physical contact with an inmate at any time.

You want to cry with them. But you need to stay strong so the girl can continue talking to you.  She needs to share.  And if she wants to, she needs to cry.

But there are times you just want to cry.  Maybe it is the smell of the building.  The yelling you hear from one pod to another. (It is never quiet.) The story a woman just told you about being abused since she was 2.  Or hearing a woman say she has no idea who the father is because she is a prostitute.  Or a woman has so many boyfriends, she has to wait till the baby is born and can get an idea who the father is by the race of the baby.

When we go to the jail, two of our team goes each time.  Thankfully, when one of us is having a difficult time holding it together, the other one of us is able to help the one that feels like she cannot take it.   We hold our emotions until we get to the car. 

Having the other educator or doula with you helps when you need to debrief right then.  Once you talk it out with your team member, and hear her talk about the situation, it helps you to handle the situation better.

Attending a birth of an inmate is always difficult because you have to word everything different than you would for someone on the outside.  She will be leaving her baby.  She may never get to see her baby again because of loosing parental rights, adoption, or she knows she will be going to prison for a long time.

Hearing her talk at her birth between contractions, she is sharing her heart, spilling everything out because she believes you to be a safe person.   You stay with her for hours after her birth to help her bond with her baby.  She is crying as she holds her baby close. 

You need to stay strong so she can have time with her baby and not be thinking about you crying. You come back the next day to spend more time with her to answer any questions she might have.  To help her breastfeed the few hours she is with her baby.  And she cries more.  You need to stay strong for her. 

A couple of years ago, we had a birth with an inmate that had spent most of her pregnancy in jail.  We got to know her very well.  She made the decision as it got closer to her due date to surrender her baby for adoption.

Because of the emotional state the mom was in, it took 3 doulas to help her have the baby, be with her postpartum, and then to sign papers for surrender and walk out with the Deputy.  Each one of us that was part of her birth wanted to cry the entire time.  We knew we could not.  She cried.  She held on to us (when they are at the hospital, we are allowed to have physical contact with them). She would cry.  Then sing to her baby.  Talk and laugh with us and then go back to crying.  With each doula, it took so much out of each one of us.  All three of us said that when it was time for us to leave, we all cried when we got to the car.

So, is it ok to cry?  If you want to put HER first, no, you cannot cry.  This is not about you.  When you are helping an inmate in her pregnancy or her birth, it is always all about her.

How do you prepare a doula or childbirth educator for their first jail visit? I look forward to sharing my opinion with you in my next blog.  Meanwhile go to www.birthbeindbars.com website and www.facebook.com/birthbehindbars and discover more stories.

****Disclaimer: This blog is from the perspective of a jail, not a Sate or Federal prison.  Protocol will vary from initiation to institution.