Mothers and Incarceration

Mass incarceration is a societal and public health catastrophe. Rates of incarceration in the U.S. have increased by 700% since 1970. Women are the fastest growing segment of the prison population, increasing at nearly twice the rate of men since 1985. Many women are pregnant at the time of their imprisonment, and most are in prison for nonviolent offenses, often drug crimes, for which rates of incarceration have increased tenfold since 1980.

The vast majority of women in prison are mothers of young children. “Imprisonment, especially of women, destroys the family network. When women go to prison, families most often fall apart.”^[1] Children of incarcerated parents bear the burden of crimes they did not commit and suffer enormous consequences. One young woman described her own experience, when her mother was incarcerated when she was eight years old. “When my mother was sentenced, I felt that I was sentenced… She was sentenced to prison – to be away from her kids and her family. I was sentenced, as a child, to be without my mother.”^[2]

Incarcerated pregnant women, more than any other population of pregnant women, need information and physical and emotional support during and after their pregnancies. These pregnancies are higher risk in part because of the problems that contributed to the women’s incarceration: poverty, lack of education, substance abuse, and inadequate health care.  The problems associated with incarceration are associated with higher risk pregnancies, negative birth outcomes, and infant and maternal health problems. Breastfeeding is difficult or impossible when mothers are incarcerated. Mass incarceration of women exacts huge emotional, social, and financial costs – on women, on families, and on society. As these numbers grow, we must recognize the costs to society if we do not offer appropriate and much needed care and programs for these women and their children.  Shortcomings in how we treat the incarcerated contribute to the inter-generational transmission of poverty and familial dysfunction and impose huge costs on the individuals involved and on our society.

Most incarcerated women have been victims of violent crime; the overwhelming majority have experienced physical or sexual abuse. They are often drug or alcohol dependent ‑ opioid and heroin use is largely to blame for the increase in women entering prisons ‑ but prisons are unlikely to provide treatment for addiction. As rates of opiate use have risen sharply in recent years, there has been a concomitant rise in the rate of Neonatal Abstinence Syndrome, a group of problems that occur in newborns exposed to opiates in utero. Infants with NAS have significantly longer hospital stays, but the use of mother’s milk with methadone is helpful in reducing the severity and duration of their symptoms. Several professional medical organizations encourage breastfeeding for women who are enrolled in methadone-maintenance programs.

Being able to pump milk for her baby can provide the incarcerated mother a significant connection to her infant and can instill a sense of purpose and pride. It promotes mother-baby attachment and has lifelong implications for the health of both. Breastfeeding can significantly improve health outcomes for mothers and babies throughout the lifespan and can reduce health care costs and rates of infant mortality. But the challenges for incarcerated women who want to breastfeed or pump are daunting and can be insurmountable.

Breastfeeding is the most precious gift a mother can give her infant. When there is illness or malnutrition, it may be a lifesaving gift; when there is poverty, it may be the only gift. – Ruth Lawrence, MD

1. Hotelling, Barbara A. (2008). Perinatal Needs of Pregnant, Incarcerated Women. J Perinat Educ. 17(2): 37–44.
2. Invisible Children Documentary. https://www.youtube.com/watch?v=qqFXxvAdQZ4.