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WETUMPKA, Ala. (AP) — Harley Ezelle gently rocked back and forth on a yoga ball in a meeting room at Tutwiler Prison as the woman next to her helped set her legs for maximum balance.
It was the second meeting of the Alabama Prison Birth Project, which is bringing certified doulas to the women's prison to support pregnant inmates. Eight inmates in matching white prison uniforms sat in a circle, while the trained doulas led the discussion. For Ezelle, the meeting was a rare opportunity to reflect on her first pregnancy - and prepare for a birth that promises to be bittersweet.
The Alabama Prison Birth Project is inspired by a program in Minnesota that pairs certified doulas - who help and encourage mothers during labor - with inmates during pregnancy and childbirth. Women who participate in the Minnesota program have dramatically lower rates of C-section and pre-term birth, saving the state money on medical expenses.
One of the most difficult things about being pregnant in prison is that you're doing it alone, Ezelle said. There's no partner or family member for support. The prison library has a couple copies of What to Expect When You're Expecting, but no baby name books or other pregnancy-related titles.
Pregnancy behind bars often feels like something she and her baby are doing alone.
"I'm hoping to learn everything I possibly can about the birth process and how to mentally deal with being pregnant and in prison," Ezelle said.
At any given time, there are about a dozen pregnant women at Tutwiler, said Clayton Wheat, director of operations for women's health services for Corizon, the company that provides health care in state prisons. He estimated that about 36 women give birth every year while incarcerated at the prison.
During the meeting, the doulas led expectant mothers through stress reduction exercises and used a book to explain the steps in a C-section. They also allowed the women to share their own stories of previous pregnancies, births and babies.
Right now, only guards and medical staff can accompany an inmate to the hospital and during birth. Ashley Lovell, executive director of the East Alabama Birth Village, the group spearheading the project, said she would like to see those rules changed so doulas can assist women during labor.
"When you're attending a birth, you should be allowed to squeeze hips, put washcloths on heads and feed ice chips," Lovell said. "Right now, no one except for nurses and doctors can touch her during labor."
Lovell has plenty of experience helping women through the pain of childbirth, but for the women of Tutwiler, the physical pain is just the beginning of a gut-wrenching process that ends a day or two later. That's when incarcerated mothers say goodbye to their babies and return to prison.
Most of the women participating in the group are far more worried about the pain of separation than the pain of childbirth, Lovell said. That's why she enlisted the services of a bereavement doula, Erin Brown, who helps mothers prepare to leave the hospital without a baby. Many of her clients are experiencing a stillbirth, but her strategies also apply to mothers who must leave a living baby.
In addition to staying with women during childbirth, Brown said doulas should be able to return to comfort a mother when she gives up her child.
"That's when they need you the most is after that separation," Brown said.
Postpartum mothers can also attend meetings with the Alabama Prison Birth Project to share their stories and get support as they complete their sentences away from their baby.
In the second meeting of the project, the doulas focused on how moms could bond with their babies in the short time they have with them. An inmate who had just given birth took the message to heart, and asked for skin-to-skin immediately after her child was born.
Tarra Barron is having her first baby in the fall, and serving a two-year sentence for drug possession. She said she found out she was pregnant when she was in county jail. She will be separated from her child for more than a year while she completes her sentence.
"It's kind of scary being in prison and pregnant, and doing it alone," she said. "Until this group happened, there was no one here explaining the birth process."
Lovell wants to increase the frequency of meetings from monthly to weekly - and work on a plan to accompany women to the hospital. But attending births is time-consuming and may require funding from grants or donations, she said. Improvements in outcomes for babies and mothers can save the state money, she said, but that's not the only reason to support pregnant women in prison.
"This is also about the babies who didn't commit a crime," Lovell said. "They are going through this stressful pregnancy through no fault of their own, and they are not given much time to bond with mom. We want to help women make a plan and maximize their time with the baby."
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