This summer, Minnesota passed a first-of-its-kind law improving the treatment of pregnant incarcerated women. In addition to extending an existing ban on the use of restraints during childbirth for up to three days postpartum, the law also allows incarcerated women to have a doula.

Doulas are trained birth attendants who provide physical and psychological support during pregnancy and birth. Doulas have gained popularity in recent years. Doulas of North America (DONA), just one of a handful of training organizations, now boasts 6,500 members; in 1994, there were only 750. As the community and movement has grown, doulas have worked to bring their model of care to many different arenas. As a trained doula, I’ve participated in groups such as the Doula Project in New York City, which brings doula support to people having miscarriages and abortions. Other groups focus on providing low-income women with this kind of care, and a number have also tailored their work to support incarcerated women. 

Giving birth while incarcerated is not easy, says Rae Baker, a project coordinator with Project Isis* Rising, a Minnesota group that has been providing doula support to pregnant women in the state’s only women’s prison since 2011. Imprisoned women labor without the support of family or friends–they are not allowed to join them at the hospital. New mothers are separated from their babies when they return to prison–usually within three days after the birth.

Because Project Isis Rising has an established presence in the prison, the new law doesn’t change much about the way they practice. But it does provide a potential opening for two changes. One is possible state funding. Project Isis Rising, which is supported by foundations and donors, currently pays the doulas $1,000 per birth out of its budget. Second, the law may extend doula care to women giving birth in Minnesota jails. 

Project Isis Rising isn’t the only prison doula program in the country. I wrote about the Prison Birth Project, based in Western Massachusetts, for Colorlines in 2011 while reporting on the movement to ban shackling of pregnant women. For groups operating in states without laws like the new Minnesota one, their ability to provide doula services to women inside is wholly reliant on their relationship with prison officials, who could at any time decide to end their program. Baker’s group has a good relationship with the prison staff, but she’s happy that the new law means their program can’t be cancelled. The law also paves the way for future initiatives to get started without the years of proposals and lobbying officials that the original Isis Rising program required to get off the ground.

This new law is just another element of the wave of attention and momentum we’ve been seeing for state-level legislation protecting the rights of pregnant women in prison. When I wrote about the anti-shackling movement in 2011, only 14 states had banned the practice. In the three years since, six more states have followed suit. Issues that impact  jail and prison populations have a disproportionate impact on women of color, who are incarcerated at much higher rates than white women. According to the Correctional Association of New York, African-American women are incarcerated at three times the rate for white women. Latinas are locked up at almost 1.6 times the rate for white women.

In Minnesota, the current racial breakdown of the prison population at Shakopee, the one state women’s prison, is 62 percent white, 18 percent American Indian/Alaska Native, 17 percent black and 2 percent Asian Pacific Islander (4 percent of those above also identify as Hispanic). The overall population of women is 86 percent white, 5.7 percent black and 1.3 percent American Indian or Alaska Native. These numbers show a high level of overrepresentation, particularly for American Indian/Alaska Native women.

While Baker says that the biggest benefit to having a doula for incarcerated pregnant women is the additional emotional support, her group has been working with the University of Minnesota to track how having a doula might impact the medical outcomes. That research shows that before the doulas worked with women at Shakopee Prison, 63 percent of those giving birth C-section deliveries. With doula support in place, that percentage has dropped to 3 percent. These statistics played a key role in the passage of the law the first time it was brought forward.

Prison doulas also provide support to the mothers when they are leaving the hospital and being separated from their child. One doula shared this perspective from such a separation in a study by professor Rebecca Shafer titled "Doulas’ Perspectives about Providing Support to Incarcerated Women": "It was time to say goodbye. By then the baby was back [from being taken to the visiting room to meet relatives] and was being held by my client. She started sobbing, she covered her face with her blanket. She got dressed and the shackles were placed on her wrists, feet and a chain around her waist…she was wheeled out of the hospital and back to the facility. She cried all the way until she got in the van and I could not be a witness to her tears anymore."

The law passed unanimously through the Minnesota legislature in July and could signal a new pathway for improving the experiences of incarcerated pregnant women. Funding could definitely pose a challenge for other states without independently funded programs like Project Isis Rising. But considering that the majority of states still allow shackling of incarcerated pregnant women during labor, a doula for every birth in prison may still be a long way off.

*Post has been updated to reflect that the "Isis" in "Project Isis Rising" isn’t in all capital letters.