T wo guards stood outside the bathroom door, waiting as Brittany Seaver sat in a tub, naked and crying, hoping the warm water would ease the pain of childbirth. She had waited until her second hour of labor before asking a nurse to draw the bath, her preferred alternative to epidural drugs. Up until that moment, the two corrections officers, both women, had been silently observing Seaver from the end of the hospital bed as she gritted her teeth through each contraction.

It wasn’t their job to engage or offer assistance; they were solely there to make sure the 21-year-old prisoner wouldn’t try to escape. “I was sitting in the bathtub by myself, having labor by myself,” Seaver said.

Seaver had two other children, but during this delivery, a few months into a five-year sentence for burglary in Minnesota's only correctional facility for women, she was both intensely watched and eerily alone. She repeatedly asked to see her prison-appointed doula, Rae Baker, who is authorized to provide physical and emotional support — but no medical help — to expectant mothers.

Finally, three hours after Seaver’s initial request, the night watch commander of Minnesota Correctional Facility-Shakopee called Baker to tell her that Seaver was close to delivering at a nearby hospital. The commander told Baker that inmates are only allowed to have their birthing coach in the hospital room during the final stages of delivery. But Baker knew the rules. She had a right to be there all along.

At any given time, of the roughly 98,000 female inmates in state institutions, an estimated 1 in 25 reported that they were pregnant when admitted. A handful of correctional facilities across the country, in places such as California, Massachusetts, and Florida, have allowed the use of doulas, but Minnesota is the only place to implement the policy statewide.

When Baker arrived, Seaver was back in her hospital bed, writhing in pain. State protocol dictates that doulas can touch inmates during childbirth and up to three hours after delivery. So, while she could, Baker tried to provide physical comfort, holding Seaver’s hand, stroking her arm, rubbing her back, feeding her ice chips, and occasionally blotting her forehead with a cold towel.

She also offered Seaver a crucial piece of advice that she gives to all inmates during childbirth: Don’t look at the guards. “Focus on having a healthy baby,” Baker said. “Just remember, your situation is not forever.”

Nearly an hour after Baker arrived and as the sun began to rise, the baby was ready to come. A nurse asked the prison guards to retreat to a back wall to make way for the doctor. Seaver inched forward in the hospital bed to push. The doctor told her to reach down and pull out her baby girl.

Baker cut the cord.

Then the hard part began.

B aker, and every doula she works with, will tell you that the most painful part of any inmate birth isn’t the actual process of delivering the baby. It’s what happens two days later. What they call “the separation.”

The Minnesota Department of Corrections prohibits female inmates from spending more than two days with their newborns after delivery. (The limit extends to three days when a Cesarean section is involved). Baker had spent weeks lecturing Seaver on how to prepare for the moment of separation. She was unflinching about the realities: That as a mother, Seaver would replay the memories of those two days with her child in her mind for the remainder of her prison stay.

To make the most of those two days, Baker had coached Seaver on how to develop an immediate bond with her child. She emphasized the importance of Seaver keeping her infant close, having near-constant skin-on-skin contact. She also encouraged Seaver to breastfeed as much as she could. “It’s going to be the last time the baby is going to have your milk,” she said.

Ten states have prison nursery programs in certain facilities that allow incarcerated mothers to stay with their babies for a few months. In Washington state, that period extends to nearly three years. In New York, if an inmate is granted permission to be housed in a facility with a nursery, she can stay with her child for up to a year. Minnesota, however, has no such nurseries and does not allow mothers to nurse their infants after they leave the hospital. Breast pumps are also prohibited in Shakopee, so once the new mothers are returned to their cells, they have to find other ways of extracting the milk, including squeezing it out in the showers. If the women don’t sufficiently extract the milk, they risk getting a painful infection, known as mastitis.

Seaver barely slept during the 48 hours after she gave birth. She obsessively held and nursed her new infant, whom she named Jazzlynn. As mother and baby nuzzled, a rotating shift of corrections officers monitored the pair. Seaver’s ankle remained fastened with a polyester belt to either the bed railing or the nearby chair leg. Every few hours, Seaver asked to be unstrapped so that she could make a trip to the bathroom, where she changed sanitary pads and wiped away post-birth bleeding.

As Seaver and Jazzlynn’s two-day stretch together drew to a close, Baker returned to the hospital to help the mother through the separation. Two corrections officers placed metal chains around Seaver’s legs, ankles, wrists, and torso – a form of bondage referred to as a “lockbox” – in preparation for her van ride back to Shakopee.

When Seaver sat in a wheelchair, Baker covered the chains with a blanket. “I didn’t want people to see the shackles,” she recalled. A nurse pushed Jazzlynn in a bassinet down the hallway of the maternity ward as a prison guard pushed Seaver in a wheelchair towards the elevator. Seaver leaned toward the baby and kissed her on the cheeks one last time, a few tears dripping from her face onto Jazzlynn’s. Her baby was going home with Seaver’s mother, who was also the legal guardian for Seaver’s two- and five-year-old sons.

As Seaver cried, Baker told her that eventually everything was going to be okay.

I n spring 2007, Erica Gerrity, a trained doula and a freelance social worker, emailed fellow practitioners about an idea that she had to create an organization that offers doula services to pregnant inmates. Baker leapt at the opportunity. She had spent her teenage years writing letters to an incarcerated older cousin and felt a particular kinship with female inmates. For the next three years, Gerrity worked to persuade the Minnesota Department of Corrections to loosen their strict, no-contact policy with inmates and approve her pitch. In January 2010, Gerrity, Baker, and their fellow doulas at what later became The Minnesota Prison Doula Project taught their first parenting class.

During the first 11 months of the Doula Project, seven of the 11 women they worked with had c-sections. Over the next two years, only one of 29 pregnant women had the procedure, according to Rebecca Shlafer, a pediatrics professor at the University of Minnesota, who has been studying the program. Though Shlafer’s research provides no explanation for the drop, the doulas believe that their weekly maternity classes with inmates, in which women learn about their bodies and how best to advocate for themselves during childbirth, have played a role.

Pending approval, Shlafer also plans to have two University of Minnesota graduate students review inmates files at Shakopee in attempts to study the number of pregnancies, births, stillbirths, and miscarriages. Only a few states tally the outcomes of inmate births.

Last summer, the Minnesota Better Birth Coalition, a lobbying group focused on women’s health, contacted Gerrity to seek her help crafting a law that would reform how pregnant inmates in the state are treated. Gerrity aimed high. She requested prisoners have access to doulas and midwives, as well as breast pumps in their facilities. She also asked that corrections officers stop shackling pregnant inmates and performing strip-searches on expectant mothers, many of whom are searched, mid-contraction, as they leave for the hospital.

Officials at the Department of Corrections balked at most of Gerrity’s proposals. But they agreed to limit the use of restraints during birth. Twenty-one states and Washington D.C. have enacted some form of anti-shackling policy, but they vary widely. For example, pregnant prisoners in Connecticut can still be placed in leg irons up until the last trimester. In Louisiana, prison staff are prohibited from using electronic restraint belts on expectant mothers after the fourth month of pregnancy.

Minnesota also granted the right for prisoners, statewide, to pair up with a doula as long as the cost of those services doesn’t fall to the Department of Corrections. Much of Gerrity and Baker’s time now is spent fundraising. By July 1, doula services will also be offered to women in the state’s 84 county facilities.

B aker is in a rush today. She teaches two classes a week while holding about a dozen one-on-one counseling sessions with prisoners. All in all, she assists about 75 inmates. But Thursdays are the hardest. She is up at 6 a.m. in order to get her two-year-old, Vincent, to day care by sunrise (Baker also has two daughters). Her “Mothering Inside” class at the Hennepin County Adult Corrections Facility outside of Minneapolis begins promptly at 8:30 a.m. In 2014, 20 inmates in the facility reported that they were pregnant.

The doulas’ classes cover a wide variety of subjects, including nutrition and hunger, challenges in most facilities. At Shakopee, Baker often advises the women to supplement their daily “pregnancy packs” – comprising two packets of peanut butter, 1 packet of jelly, 2 slices of wheat bread, 2 cartons of milk (8 oz each), and 1 orange – with hard-boiled eggs from the prison kitchen rather than unhealthy snacks from the commissary. Women also have access to a daily regimen of vitamins; they can choose between a large, prenatal pill or a double dose of chewable, animal-shaped children’s tablets.

When it comes to labor, doulas have to prepare women in prison for the frustrating reality of not knowing when their due date is: Prison staff alert the doulas days, even weeks, in advance of upcoming trips to the nearby hospital. The inmates themselves, as well as their families, are not informed of the news until the morning of the appointment. Even mothers with planned c-sections aren’t told the exact date of the procedure until the morning of the operation. The Department of Corrections spokesperson, Sarah Latuseck, said the restriction prevents “outside persons” from planning and assisting escapes.

Baker also instructs women on the emotional turmoil that can follow childbirth, like postpartum depression, which is often exacerbated when mother and newborn live apart. Some inmates, Baker says, lose interest in attending group sessions as they settle into life behind bars without their child. Others, like Seaver, show up, but talk less and less.

Seaver shared few complaints during the first four months after Jazzlynn was born. Her mother would bring the baby a few times each month for a visit. But as Jazzlynn developed her ability to recognize faces, she grew less comfortable around Seaver. The bond that Seaver tried so hard to establish in the first two days of her life seemed to have faded.

When Jazzlynn was 14 months old, Seaver told her mother to stop bringing her to Shakopee. She couldn’t bear to watch her child throw tantrums whenever she was near her mother.

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“My little girl wanted nothing to do with me,” Seaver said.

During one Thursday class, nine women sat in a semicircle sharing their worries. Gerrity and Baker passed around strips of paper and asked each inmate to anonymously jot down her worst parenting fear. The notes were placed in a bowl and the women took turns reading each other’s anxieties aloud.

Kenyetta Taylor, a 43-year-old grandmother charged with drug possession, read: “I am scared that she won’t be able to make the right decisions when she is an adult as a result of my parenting.”

Gerrity then asked the class to discuss any other parenting problems that came to mind. The inmates explained that friends and relatives who used to make the trip to the facility could now only speak to them through a video monitor. The doulas were unaware that the visitation rules had been changed, and Baker suggested that the inmates write formal complaints to officials about their grievances.

Jena White, a 29-year-old inmate jailed on a trespassing charge, cried as she recounted how her daughter, who was two-and-a-half, sobbed through a televised visit. “It don’t even come in good. It only shows half of you,” White told the class. When asked about this restriction, a spokesperson said the facility plans to revise the rule by the summer to allow children under the age of 13 to have in-person visits.

I f a former prisoner is still “on paper,” or on probation or parole, the Department of Corrections forbids contact with any employee or volunteer working at Shakopee. “Corrections controls everything,” Baker said. So Baker was surprised to learn that Brittany Seaver had been released in June 2014 and was now two-months pregnant with her fourth child. Seaver, it turns out, wanted to hire Baker as her personal doula.

In September 2012, Seaver had successfully appealed her sentence on the grounds that a juror had discussed her case in a hallway outside the courtroom. As a result, her sentence was cut in half. Jazzlynn was 18 months when Seaver returned home. Before the appeal, Seaver hadn’t expected the reunion to occur until Jazzlynn was in kindergarten.

Seaver, now 25 and “off paper,” is earning a living as an esthetician at a salon. Jazzlynn remembers nothing about her trips to Shakopee as an infant. For her, Seaver has always been in her life.

Preparing for birth this time around was completely different. Baker told Seaver to eat a steady diet of fresh greens and pineapples, which, she believes, makes for speedier deliveries. It was advice she couldn’t give to Seaver before – certain fruits and vegetables were nearly impossible to find when Seaver was in prison.

In the early hours on February 11, Baker drove Seaver to the Mother Baby Center at Abbott Northwestern Hospital in Minneapolis at 3 a.m., where a large birthing tub with whirlpool jets awaited. Seaver’s mother and a midwife stood in place of the guards.

There was no one to ignore. Baker sat by her side.

It took 11 minutes for Seaver to deliver Serenidee Grace. Baker held Seaver from behind and whispered, “Look at your baby.”

Then Seaver cut her own cord.