The hospital in which I work has a contract with our state wherein all pregnant prisoners deliver at our hospital, regardless of home county. This population has a special set of needs to consider.
Prisoners get a very short hospital stay - for a normal vaginal delivery, the woman goes back to the prison the next day, most often in under 24 hours. For a Cesarean delivery, the woman goes back to the prison infirmary on post-op day two. This translates into a) a very short amount of time for mom and baby to be together; and b) a very short amount of time for discharge teaching.
We are a mother/baby unit and encourage rooming in anyway, but especially in the case of prisoners. These mothers are going to be leaving their babies - their flesh and blood - at the hospital. In my experience, they are the ones who don't allow the baby to be taken from their rooms for anything. And I do my absolute best to respect that, with the realization that this may be all the bonding time she gets with her baby for a very long time. It's not at all uncommon for these mothers to spend their entire hospital stay with their babies on their chest. I encourage these mothers to talk to their babies and tell them all they want to tell them, about life, love, about their families. Of course the baby's not going to understand it, but the sound of their mother's voice is a comfort that they are not going to have once mom goes back to prison.
Requisite to any prisoner in the hospital is the presence of at least one prison guard. I won't lie - at first I was unnerved by their presence but now I just take care of the patient as if the guard were not present. A large majority of my patients are nonviolent criminals and present no threat to me - and often the women convicted of violent crimes, I find after I do some digging, that they are not a threat to me either. They are just people. So sometimes, I have the guard step outside (or at the very least turn their back) to preserve some of this woman's dignity. I can deal with the guard taking notes about what I do while I'm in there. I know I'm doing a good job so that doesn't bother me. What does bother me is when the guard has the TV on full-blast or is talking loudly with the other guard in the room while the patient is trying to sleep. It really irritates me, as though the patient does not deserve to sleep. On the other hand, there are some wonderful prison guards that help with the baby, really talk with the patient, and treat them like human beings. Those guards I want to clone!
Anytime you are dealing with a patient that is a prisoner, there are numerous psychosocial issues: possible drug use, often a history of abuse, finding someone to take the baby after mom goes home. It's really important to have social work involved here - our hospital social workers are crackerjacks at digging into a situation and finding things out.
I don't usually care to know what the patient is in prison for. I don't care, and I certainly don't ask. It does not change the care that I give. But more often than not, they tell me. One patient I had was in for writing bad checks. One patient had a drug history, but was currently in jail for driving without a license (this was corroborated by the guard outside the room). More patients than I can count were incarcerated for drug charges, and most often it's marijuana. Sometimes I find myself annoyed that my tax dollars are going to shackle these women to the bed for these things, some of which I might have done too had I not had all the tools in my proverbial toolbox that I had.
Along with cramming their discharge teaching into the 16ish hours they might be in the hospital, there is one more thing I do. No matter what, I make it a point to tell these women that they are beautiful, inside and out. I also tell them that I believe in them and their ability to make it; that they are not defined by their mistakes. It may be the only time in their lives that they hear someone say that. I am not trying to portray myself as some angelic do-gooder, but so many people have helped me out when I needed it. I try to pass it on when I can. If it means giving back some dignity to someone that most people have written off, then that's what I do. And pray that that will ignite some spark and help these women get their lives turned around.
Sheesh...this turned out to be something far different from what I had intended. I just feel so strongly that prisoners who have had babies deserve the same care, consideration, and dignity that we give anyone else on our unit.