May is reentry and criminal justice month of Generocity’s 2018 editorial calendar, and on Mother’s Day, we were reminded us of all the hidden work mothers do for their kids. So this week, we want to highlight the challenges of all of the moms who could not spend the holiday with their children because they are in prison.

Maternity Care Coalition (MCC) is a nonprofit that supports mothers in communities with high rates of infant mortality, high health disparities, high rates of poverty and changing immigration patterns. It also provides services to mothers residing in Riverside Correctional Facility in Northeast Philadelphia through its 30-year-old MOMobile at Riverside program.

MOMobile at Riverside not only supports approximately 100 women per year in its case-management program, but their children (about 150 per year) and caregivers while the mothers are in prison. This program is meant to help the mothers stay connected with their children and ensure that the reunification upon reentry is best supported.

We asked Colette Green, the director of behavioral health at MCC’s MOMobile, to tell us more about the program. Here’s what she had to say about its on-site doula services, advocating for mothers’ rights and what it’s like for women to give birth while incarcerated.

Green’s responses have been lightly edited for clarity and length.

What are some of the services that the MOMobile provides for women at Riverside Correctional Facility?

The MOMobile at Riverside Program offers:

Interactive educational groups in which women receive education on pregnancy, birth, child development, parenting skills, mother/child bonding and maintaining involvement with children during incarceration.

Health and nutrition instruction through the “Fit Beginnings” program to empower women to create healthy lifestyles for themselves and their children, including good nutritional habits and physical exercise.

Individual case-management to assist women in obtaining services, support and supplies for their children, maintaining a role in their child’s life and sustaining a positive relationship and open communication with their child’s caregiver when possible. They allow the women time to write letters to their children and mail them, which otherwise the women may not be able to afford to do and to make calls to their children and care-givers.

All Advocates [MOMobile staffers] are trained doulas and provide continuous physical, emotional and informational support to the mother before, during and following the birth, and advocate for them as needed during labor. They screen for postpartum depression at regular intervals and make referrals to mental health staff and MCC behavioral health consultant if they test positive for depression risk.

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Our Advocates manage the lactation program in the jail for women to pump milk if they were breast-feeding at the time of their incarceration or delivered while incarcerated and want to continue providing breast milk for their baby. Clients can pump three times per day with a hospital grade pump and are provided manual pumps that they can used in their cells at other times and overnight.

What services are provided for caregivers?

MOMobile at Riverside Advocates provide community support services to the child’s caregiver, including any items they may need for the children, such as cribs, clothing and diapers. Advocates also facilitate communication between the mother and the caregiver. They also assist with any barriers the caregiver may have to getting care for the child such as obtaining referrals and getting them to appointments.

Additionally, Advocates provide linkages to community support services for caregivers such as grandparent support groups. The staff also deliver breast milk for caregivers who are unable to come and pick it up.

Can you walk me through a typical scenario for a woman who gives birth while incarcerated?

When a woman goes into labor and is being taken to the hospital, the Captain on duty calls the 24-hour doula phone, which is manned by the Riverside MOMobile Advocate who is on-call. The Captain informs the doula of the hospital to which the woman is being taken and of any other relevant information. The doula meets the woman at the hospital.

Sometimes the client knows the doula because she has been enrolled in the MOMobile program at Riverside, but sometimes the woman is new to Riverside and had not yet met the Advocate, in which case the individual introduces themselves and explains the role of doula and asks the client if she wants the support (no client has ever refused the service.)

Other than the doula, the client isn’t allowed to have any family or other support person present. The doula stays with the client for the entire duration of the labor, explains the procedures that are taking place and any choices and/or decisions she can make, and supports her in advocating for herself throughout the process.

After the delivery, the doula encourages skin-to-skin contact for bonding and also helps initiate breastfeeding if the client choses to do so. The doula will also take some pictures of the mom and baby. The staff member will leave when the new mother is doing well and resting. The doula will meet with the new mother upon her return to the jail, discuss any postpartum issues and provide her with pictures of her baby. She will also set her up for the lactation program if she wants to pump milk for her baby.

How long does she stay with the baby? Are there any follow-up procedures after the mother has given birth?

Mother stays in the hospital for approximately 48 hours for a vaginal birth and 72 hours for a C-section, unless there are additional complications. After her return to Riverside, her Advocate meets with her immediately. As mentioned above, they will discuss any postpartum issues and provide her with pictures of her baby. She will also set her up for the lactation program if she wants to pump milk for her baby. The woman will also have a follow-up with the OB doctor.

What are some of the services that the MOMobile provides mothers after reentry?

MCC’s reentry services are one of the few programs in the country designed to provide comprehensive support focused on the needs of returning mothers. After women are released, the MOMobile at Riverside Program provides reentry case-management services to clients in the community (e.g. in their homes, recovery house, shelter, etc.) for up to one year following their release. Research has shown that the responsibility of caring for a baby or toddler can be an additional risk factor for recidivism and that reunification with a child is key to successful reentry.

To support women as they return to the community, staff provide continued assistance including connecting them with RISE [The Office of Reintegration Services for Ex-Offenders] and other reentry programs and helping them navigate probation and parole procedures and the child welfare system pertaining to child custody issues.

Staff also offer support with basic needs such as obtaining proper forms of identification and accessing public benefits, educational/vocational programs, housing and medical and behavioral health services for the client and her children. Staff also encourage clients to be involved in community events that advocate for returning citizens, such as the recent Women in Reentry Day and march on May 10 in Philadelphia.

What are the biggest challenges that the MOMobile at Riverside faces and how does the organization find targeted solutions for those challenges?

Nutrition in the Jail is challenging due to the limited opportunity to select specific food options for pregnant and nursing mothers. MCC advocated for an additional meal for pregnant and nursing mothers, which was approved by the jail.

Other concerns are lack of housing upon reentry; DHS involvement and difficulty regaining custody and — at times — severing parental rights; domestic violence; and substance dependency issues. Medication-assisted treatment for opioid use is prescribed at Riverside, but helping clients sustain their recovery during the transition from jail to the community is a challenge, and we have started conversations in regard to addressing this concern.

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