Kim was in her first trimester of pregnancy when she arrived at the Davidson County Jail in Nashville, Tennessee, in 2010.
Kim, who asked to use a pseudonym to protect her family’s privacy, had nursed her two older children and wanted to ensure her third baby wouldn’t miss out on the benefits of breastfeeding. She’d also met a woman at the jail who had given birth while in custody and had been allowed to pump and send breast milk to her newborn. So Kim began asking jail and medical staff about doing the same.
“At first, they gave me the runaround,” she told Rewire, “but I kept pushing the issue.”
It was not until she was in the hospital after giving birth that she was able to get her answer, Kim says. “I told the doctor, ‘I wanna nurse my baby,'” she recalled. He gave her an electric breast pump.
After being born, Kim’s son stayed in her room at the hospital, enabling Kim to nurse him whenever he was hungry. Two days later, Kim was sent back to jail while her newborn went to her mother’s.
Kim wasn’t allowed to keep her breast pump with her. Instead, it was kept in the jail’s clinic. Any time that Kim needed to pump, she walked to the clinic to do so. In some jails, even simple visits to clinics require passes and escorts, practices that often delay movement and cause missed medical appointments. However, Kim recalls, that wasn’t an issue for her. “Whenever I needed to go, I could go,” she said. Her breast milk was placed in the clinic’s freezer and, once a week, her mother picked it up. Kim was also granted two special hour-long visits where she could nurse her newborn.
This lasted for three weeks. After that, Kim was no longer allowed to pump or nurse. While she was breastfeeding, the jail’s medical staff provided her with breast pads to prevent her from leaking onto her clothes. Once she was no longer allowed to pump, they gave her bandages to bind her breasts, theoretically to stop the flow. “That didn’t work,” she recalled.
Kim isn’t alone. The issue of breastfeeding behind bars briefly made headlines in August after 33-year-old Monique Hidalgo sued the New Mexico Department of Corrections for the right to breastfeed. The judge ruled that Hidalgo, who gave birth while incarcerated, had the right to pump and send breast milk to her newborn. The American Academy of Family Physicians recommends breastfeeding for at least 12 months, while the World Health Organization recommends two years. But as Kim’s experience demonstrates, many mothers behind bars across the country are denied that length of time—or the opportunity to breastfeed at all.
In Oklahoma, which has the nation’s highest rate of women’s incarceration, 30 women gave birth in custody in 2015; that number rose to 40 in 2016. Among them was a 22-year-old who goes by Cookie, who had twins in the spring of 2015 while incarcerated at the Mabel Bassett Correctional Center, the state’s largest female prison. “I was told by nurses and guards that I was not allowed to breastfeed,” she wrote in a letter to Rewire. She was also not given anything to help dry up or manage her unused milk supply, nor was she provided any information about what to expect. “It hurt like hell,” she recalled. “I put pads [sanitary napkins] in my bra to soak up the breast milk.”
Two other mothers had similar experiences. Chrystal Tite was 36 weeks pregnant when she entered Mabel Bassett. “I was not told anything,” she wrote in a letter to Rewire. She said that she did not breastfeed during the two days she spent in the hospital with her newborn “for fear the separation would be more painful.”
But even if she had wanted to, the Oklahoma Department of Corrections does not, according to its press office, allow mothers to nurse their newborns even in the hospital.
Two days later, Tite was returned to prison. Her newborn was sent to the family that would adopt him. Inside the prison, Tite said that she was not given anything to address her leaky breasts. “It hurt so bad and reminded me of having to leave my baby in the hospital,” she wrote. “I was in pain in my breasts full of milk and not knowing where my baby was at. It was two weeks before I knew the adoption went through.”
Like Tite’s baby, Courtney Pratt’s newborn was adopted shortly after birth and, like Tite, Pratt chose not to breastfeed in the hospital without knowing it was against policy anyway. “I couldn’t bring myself to start something so intimate and have to stop,” Pratt, who had breastfed her nine older children, wrote in a letter to Rewire.
Two women who are currently pregnant at Mabel Bassett told Rewire that they too have not been told anything about breastfeeding either in the hospital or after returning to prison.
“Breastfeeding has many health and psychological benefits for mothers and infants,” said Dr. Carolyn Sufrin, a medical anthropologist, OB-GYN, and assistant professor at Johns Hopkins School of Medicine. From 2007 to 2013, Sufrin served as the OB-GYN at the San Francisco county jail, an experience that she chronicled in Jailcare: Finding the Safety Net for Women Behind Bars.
For the infant, Sufrin said, breastfeeding leads to a lower risk of infections during the first year and a lower risk of developing chronic disease. For the mother, it decreases the risk of serious postpartum hemorrhage and diabetes. Breastfeeding also strengthens the mother-baby bond. “Denying a newborn breast milk is excessively punitive,” she said.
The San Francisco jail had already established a breastfeeding program several years before Sufrin arrived. Sufrin credits one of the jail’s lieutenants (who is now in a higher administrative position) for taking up the issue and implementing the program. From what Sufrin understands, that lieutenant didn’t encounter administrative resistance. It was simply that no one had thought the program was possible.
According to San Francisco jail policy—which does not extend to other California institutions—a new mother was allowed to breastfeed her newborn at the hospital. Back at the jail, she was given a hand pump and breast milk storage bags. She was allowed to pump milk in her cell at any time. The bags of milk were picked up four times a day by the nurse who was dispensing medications throughout the housing units. The milk was stored in the clinic’s freezer until the baby’s caregiver picked it up.
“I’ve seen it happen and it works,” Sufrin said. If the caregiver did not pick up the milk, she added, regular pumping enabled the new mother to keep up her milk supply, which can dry up after a few days without nursing or expressing. Also, during Sufrin’s tenure, the jail increased mother-baby in-person breastfeeding visits from twice to three times a week.
Terry Rather, public relations officer at the San Francisco Sheriff’s Office, confirmed that the breastfeeding program is still in place, providing mothers with individual pumps and allowing caregivers to pick up the milk. But, she added, “it’s been years since we’ve had a mother give birth while incarcerated.” The jail no longer has a set number of mother-baby visits. Instead, the number of visits is decided on a case-by-case basis.
Sufrin strongly believes that breastfeeding programs can be replicated in other jails and prisons. But to do that, there has to be someone willing to champion the program. That may include assuring staff that new mothers don’t view breast pumps as potential weapons, but simply as a way to nourish their infants.
After that, she explained, “policies need to be written and, on the logistical side, there needs to be protocol for how milk is labeled and stored.” There also needs to be support for breastfeeding complications; in San Francisco, Sufrin arranged to have a lactation consultant regularly visit the jail to answer questions and provide support.
Oregon’s sole women’s prison has a similar program through its health services for women whose babies were in custody. Meanwhile, in Washington, new mothers who are accepted into the Residential Parenting Program can live with and nurse their babies for up to 30 months. They are supplied with a breast pump as well as breast cream and breast pads. But not every mother is accepted into the program; those not in it are still provided with a breast pump after birth. According to the prison’s official memo, they are also given containers to store milk and blue ice packs. Milk is stored in the clinic’s freezer; the baby’s caregiver has two weeks to pick it up. A lactating mother can lose her pumping privilege if she tests positive for an illegal drug.
In this way, security often overrides maternal instinct. In the New Mexico decision, the judge allowed prison officials to take away Hidalgo’s “right” to breastfeed if she violated prison rules. Less than two months later, Hidalgo tested positive for buprenorphine, an opioid medication that helps relieve withdrawal symptoms. Officials rescinded her access to pump and send milk to her baby.
But this doesn’t happen everywhere. Sufrin noted that in the San Francisco jail, breastfeeding and pumping were under health-care protocol. “We never use health care as punishment,” she stated. Even if a woman violated the jail’s rules and was punished, she could still pump in her cell.
Still, Sufrin reminded Rewire, jail remains an environment where custody and control remain the primary concerns. In Jailcare, she described a new mother whose “intimate encounter with her baby in the hospital nursery was inhibited by having one arm chained to a wheelchair and a guard towering over her. Care (as the enabling of breastfeeding) and violence (as constraining its possibility with chains) graphically coexisted in this moment.” It’s a tension that often exists in women’s penal institutions.
This was graphically illustrated for Maya Schenwar, whose sister gave birth while incarcerated at Illinois’ Logan Correctional Center. At first, prison officials refused to allow Schenwar’s sister to pump and send milk to her newborn. The sisters pushed until the administration relented. But, says Schenwar, what actually happened was “like a case study in how prison policies don’t allow humanitarian measures to play out.”
First, the pump was kept in the prison’s medical unit. For the first few weeks after birth, Schenwar’s sister was kept in that unit and so access wasn’t an issue. Then she was moved to her own cell while the pump stayed in the medical unit. Prison policy dictates that movement between units require a staff escort. “The guards were not educated on why this was important,” Schenwar explained. “They’d think it was funny or they’d ask, ‘Why do you need to go to the medical unit?'”
This was further complicated by the logistics of picking up the expressed milk. Logan is a three-and-a-half-hour drive from Chicago, where Schenwar lives. They bought a cooler to keep the milk cold during the long drive back.
But prison protocol interfered. Halfway through one visit, not long after her sister gave birth in 2013, a prison staff member came to their table. “He plopped all these bags in front of us,” she recalled. Schenwar asked if the bags could be kept in the freezer until the end of the visit. (Once breast milk has been thawed, it needs to be consumed within the hour and can’t be refrozen.) The answer was no.
Then the guards went on break. Just as guards are required to escort incarcerated people as they move around the prison, they are also needed to escort visitors to and from the visiting room. The break meant that Schenwar—and the bags of slowly defrosting milk—were stuck in the visiting area until the break ended. “We were sitting there for hours,” she said. “It was really sad to watch them melting.”
However, even when her sister’s milk didn’t reach the baby, Schenwar said that her sister still felt a sense of connection as she pumped and looked at photos of her newborn. “It was a good beginning of an experiment,” Schenwar reflected. “But all of the restrictions made it clear that this was not sustainable. It raises the inevitable question, ‘Why does she have to be in there at all?'”
The sisters’ efforts established a protocol. The next woman who gave birth was able to pump; Schenwar’s sister was called in to show the new mother how to operate the pump. But that’s not always the case: Kim noted that, though one mother who had given birth before her had paved the way, she had to continually advocate for that same right. Another mother, who gave birth before her, had been denied. So were the mothers who came after her. (The Davidson County jail no longer houses women.)
“They shouldn’t be denied that right because they’re in jail,” said Kim, whose son had just turned 3 when she came home. “That’s a natural-born right. It’s not something that you have to earn. If a woman gets pregnant, she should be able to nurse the baby she gave birth to. It shouldn’t be no man to dictate whether that should be okay or not.”
So does this mean that advocates should fight for a new mother’s right to nurse her baby, or that they should fight for alternatives to incarceration that keep them together?
“I don’t think the two are mutually exclusive,” Sufrin said. “While working on bigger system changes, this is something to implement that has an impact on an individual mother’s life.”
She also adds that a breastfeeding policy is easier and faster to implement than legislation that creates alternatives to incarceration. “This is something to provide while we work towards bigger system change and as we work to keep more moms out of jail,” she reflected.