When the mother is in prison
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.
About Elvish, BSN, RN Guide
Elvish has 'a few' year(s) of experience and specializes in 'Community, OB, Nursery'. From '221B'; 37 Years Old; Joined Nov '06; Posts: 20,431; Likes: 22,606.Feb 10, '09 by cardiacRN2006What does happen to their babies? Do they just get churned into foster care?
Are they up for adoption? I wonder if the moms can come for them after they have been released, even if it's been several years.
How sad to leave thier babies after only a few hours...Feb 10, '09 by Elvish, BSN, RN GuideCardiac, it depends. Sometimes there is already a plan in place when mom comes in, as to who's getting the baby. This is what we prefer. Generally it's someone related to mom or the father of the baby. Social work checks out the family to make sure the environment is a decent one.
Sometimes if there is no plan, or no one willing to take the baby, the baby either goes into foster care or goes up for adoption. This is by far the saddest. We keep them in the newborn nursery until the county comes to get them. That really breaks my heart.
And sometimes the situation is such that any arrangements are temporary. We have moms come in w/ just a few days/weeks/months left on their sentence and just need someone to take care of the baby until she gets out. So it's kind of a toss-up.Apr 17, '09 by diane227Do they ever let the baby go with the mother to be taken care of within in the prison system? I worked for a short time at a woman's prison and they did not allow the mothers to keep their babies but I have heard of some prisons that allow the mothers to keep their babies with them. This used to be so sad for the women. It always broke my heart. After all, they may be in prison but they are still women and love their children (for the most part).Apr 17, '09 by Elvish, BSN, RN GuideQuote from diane227Diane, I wish they did this but they don't in my state. It would be so nice for all involved. It breaks my heart to to see these moms kiss their babies goodbye for the last time and whisper that *onelastthing* to them before they walk out the door in those shackles.Do they ever let the baby go with the mother to be taken care of within in the prison system? I worked for a short time at a woman's prison and they did not allow the mothers to keep their babies but I have heard of some prisons that allow the mothers to keep their babies with them. This used to be so sad for the women. It always broke my heart. After all, they may be in prison but they are still women and love their children (for the most part).Apr 25, '09 by prisonRN2007Elvish, I do admire your compassion and desire to treat offenders with respect and dignity, which is as it should be. However, and this very well may vary on a state-to-state basis, in my state, by the time an offender gets to prison, she had usually had umpteen chances, via probation, community service, outpatient treatment, etc, etc, particuarly for drug, alcohol, and traffic violations, as well as forgery, larceny, theft. These women are rarely poor misunderstood young things who made simple mistakes and got caught up by the long arm of the law; they are practiced in their street skills and know who to run a con, including always managing to end up in prison to have their babies. That's right, we see repeat pregnant offenders. In addition, zero prenatal care, out-of-control gestational diabetes, trich and chlamydia, you name it. I just can't quite find it in me to have much empathy for her when she's sobbing in front of me, saying, "You just don't know how much I want this baby!" and I'm thinking, "Yeah, right...that's why you've have two abortions, two drug-related miscarriages, and your three live births are all with DHS...and you're all of 25 years old." True story. I still am polite and respectful, but I'm also pretty jaded...and a strong proponent of mandatory sterilization. I'll grant anybody one mistake...but several? It's time to take a look at what isn't working.Apr 28, '09 by 2soxy2foxyi can see ur point there prisonrn2007. i mean, in my state it's pretty close to ur description - they've already had several chances by the time they go to prison...Apr 29, '09 by huxueqinaI think all mothers should be cared carefully just after delivering ,we should think of the babies ,they need the love from the mother !Apr 29, '09 by Elvish, BSN, RN GuideI agree, it is time to take a look at what isn't working....but the time she hits the door of the hospital to deliver, IMO, isn't the best time. I'm just trying to make the best I can of the 24-ish hours she has with her baby.
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