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Ep.105- Breastfeeding While Incarcerated: An Interview with Moira Tannenbaum

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Heather & Maureen: This is Maureen Farrell and Heather ONeal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way. So join us for another episode.

Heather: Welcome to the Milk Minute Podcast, everybody. We have a very special guest today.

Maureen: I’m super excited. This is, I feel like we don’t get to do like activism topics very much, but this is one and I just love it. So dear to my heart.

Heather: Same. So today we are stepping into the social justice space with a dear friend, colleague and advocate, Moira Tannenbaum, to discuss milk expression in jail.

Moira has worked in the perinatal space for 24 years and has seen it all. She’s a certified nurse midwife, IBCLC, and certified correctional health care professional, among many other esteemed certifications. We also need to recognize the incredible legislative and policy work that Moira has done in both Michigan and West Virginia on behalf of nurses and midwives.

When you find yourself facing injustice for people of childbearing age, and you ask yourself who the heck is out there trying to fix this? This is ridiculous. The answer is Moira Tannenbaum. Before we jump into our interview with Moira, we wanted to answer a quick question from one of our patrons, Sarah Kollment from Clermont, Florida.

She says, “While pumping, I always get more from one side. Does that mean on the slacker side when I nurse, I should also offer the strong side? I typically only feed from one side at a time and my son is nursing every two-ish hours. He doesn’t seem to act more hungry when he nursed on the slacker side and I know he’s better at milk removal than my pump, but a typical session is one ounce from one side in three to four ounces from the other. So I worry he doesn’t get enough from the slacker side. What’s up?”

Maureen: Yeah. My answer is let’s not make problems where we don’t have them. Yeah. So if baby’s gaining weight well, they’re not showing you signs that they’re hungry after eating off of your slacker, they’re probably fine. Not every meal for them is going to be the same size. Just like you have snacks sometimes and you have dinner sometimes.

Heather: Yup. It’s all good. As long as baby is gaining weight and wetting appropriate diapers, which is usually about six a day, we don’t have a problem.

Maureen: I hope that helps. I hope that reassures you.

Heather: Yes. And also everyone, basically everyone has a slacker side. So, you know, if it was a problem for everyone with a slacker side, it would be a problem for everyone. And nature just doesn’t work like that.

Maureen: No, I mean, we were just talking today. I was pumping and Heather was like, you’re not getting anything from that side. I was like, yeah, that’s my slacker. It’s going to give us

Heather: Give it time, give it time.

Maureen: A half ounce after 20 minutes, it’ll be fine.

Heather: Well, Sarah, you go on with your slacker boob and enjoy your day.

Hey everybody, Heather here with some good news for you. If you’ve been wanting a lactation consult with me, but you’re not really sure how to go about it, I finally can take some insurance. So if you have Blue Cross Blue Shield, Anthem, or Cigna PPO, there’s a very good chance that you can get your visits a hundred percent approved with me.

So if you fill out the short form, it’ll take less than two minutes in the show notes with your insurance information we’ll know in as little as five hours if you’re approved and then we’ll throw you right on my calendar. And then we get to hang out and guess what? It’s not just one visit. I can see you prenatally.

I can see you before you go back to work. I can see you when you start solid foods. I can see you through weaning. I mean, we got this whole journey covered. So shout out to those insurance companies for valuing this as work and I’m here for you every step of the way. So click the link in the show notes to learn more about my private consults and make sure that we can get you what you need. I look forward to working with you. Bye.

So thank you Moira for coming on to The Milk Minute today. We are thrilled to have you.

Moira Tannenbaum: Thank you so much, Heather and Maureen. Yeah. You really are speaking to causes that are very close to my heart with social justice and activism and knowing that there’s things that we can do and trying to combine efforts and find out what people have already done.

What’s already going on instead of just sitting home, feeling like the world is going to end. So that’s the space I inhabit.

Heather: Good. Perfect. We’re there with you and it’s very nice to have these people around you, you guys, because it gives you a little bit more of a positive spin on the world at large.

Maureen: And it always helps me at least feel like I’m less alone when there’s these really big problems that feel hard to solve because those feel really isolating.

Heather: Sure. Well, if you don’t mind, Moira, we would like you to please start by setting the stage for our listeners. So if you could, would you mind describing the type of jail environment where you work and your role there, and then maybe help us by highlighting the differences between jail and prison and maybe some possible circumstances you would encounter there as a healthcare worker?

Moira Tannenbaum: Sure. Okay. Well, so I work in a jail and jails and prisons are the two main components of the places where people are incarcerated. There’s also something called a lockup, which we don’t need to get into today. So jails are shorter term entities. People are often in jail because they’re awaiting sentencing or they’re sentenced to such a short term that, you know, the government puts them in a jail to serve out their term rather than going through a prison.

Prison is for people who are already sentenced for something that they’ve been accused of and convicted of. So when you think about prison people, they’re generally there for longer time, and there’s a lot less turnover in the population. So we actually get to know people that you’re incarcerated with, whereas in a jail, it might be different people from day to day.

So that has a big effect on programs that are offered, services that are available.

Heather: I didn’t even think about that. I really didn’t. That thought has never crossed my mind, but in prison you actually get to notice those nerves cause you’re around them all the time and that they might be more likely to get funding for programs. That’s crazy to even think about.

Maureen: So I think when most people hear the term “nurse- midwife”, they think of someone working just in the birth space, if they even know what it is. I think we both even had many people tell us like, “Oh, you’re a midwife? I didn’t think people did that anymore.” So I’d love to take a minute if you could help us understand the scope of practice of CNMs and just help us understand what else they can do other than just be at the bedside of a birthing parent.

Moira Tannenbaum: Absolutely. Okay. So the scope of practice of CNMs or certified nurse midwife, and also it’s the scope of factors for our parallel midwifery credential called certified midwives, which are still a much smaller number, but our scope is care of women from adolescence through the end of life.

In a broader sense it’s care of people who were born with the cervix, care of people who were assigned female at birth, care of people who were assigned male at birth and are transitioning or have transitioned to female with what we call gender affirming care. So we do primary care, which means we can be the person you see for most healthcare, and then we can refer as needed.

For example, if I’m taking care of somebody and I realized she has higher blood pressure, I can monitor her blood pressure and put her on anti-hypertensive medicines, medicines to control blood pressure. And then if that’s not working, I can send her to a specialist in that field, but I can be the one that gets that care going and partners with this person for care throughout their lifespan.

So, absolutely we’re not just in the birthing space. We are in every space that has women or people, you know, people assigned female at birth in it. And I think all the time of something that Heather Clark told me, and she’s the incoming president of the American College of Nurse Midwives. She and I were working on a project last year, year before, and she said, “You know, you go on midwifing those people at the jail. That’s what you need to do.”

And so I think that, yeah, the jail is mostly men, but I am, I’m hired as a nurse, but in my head, I’m a midwife in my head. I’m all these other things that I am. And I am there empowering people and providing evidence-based care and uplifting and doing advocacy and navigating this very constraining environment. I’m using my white privilege with people who were mostly not privileged, not white, but I’m doing all this because of who I am as a midwife.

Heather: Well, how did you come upon working in a jail? Where did this passion stem from?

Moira Tannenbaum: Yeah, so years ago I was working in a small town in West Virginia that had a women’s prison nearby. And my colleague and I got the contract to provide the care for the incarcerated people who were pregnant and all of them. So we did GYN care and we did prenatal care and birth and postpartum. And this was super eye-opening for me because my previous experience with incarcerated people had only been years prior when I was a labor nurse and taking care of people who were in labor and were incarcerated.

And then also when I was a nurse and working on a step-down unit from a medical intensive care, sometimes we would get incarcerated men and they were shackled to the bed and had guards with them. So, you know, I always had that awareness of, oh my goodness, these are what’s going on here? These people are sick, but they’re chained to the bed.

They’re shackled to the bed. You know, how, how is this even doable? So when caring for the incarcerated, pregnant people, I was so struck with, you know, at first it seems like there was a big barrier. Like there they were in my exam room and they had a guard with them and, you know, maybe might be handcuffed or had what looked to be like scary tattoos, like indicating different things.

I felt a whole lot of barrier and otherizing, and then one day that just all broke down when a woman I’d actually been scared of had her baby and she wasn’t in a program that would let her stay with her baby. And so postpartum her baby was taken from her and sent to foster care. And she came in for a few days, postpartum visit in our office and she looked at me and she just started sobbing and I held her and she cried until we were both soaking wet and the guard just let it happen.

And then after that I thought, oh my God, things have to change. This is, this is just not okay. So at that prison at the time, there was a program that kept some women and their children together. And we can possibly link to this and the resources for afterward, but there are programs. So these model programs in some states in the US.

So that pregnant incarcerated women who meet certain criteria are able to stay with their kids postpartum. And that means they’re providing all the care for their kids and they’re doing the things they would do at home within the confines of the prison.

Heather: Wow. That’s incredible. And you know, to be honest with you, I’m going to guess that about 99% of our listeners did not know that breastfeeding, pumping, milk expression in general, while incarcerated was even a thing or that it was even an option for people to stay with their babies.

So is pumping and milk expression a thing for the most part, if people are postpartum and would like to provide that? I guess, can you just help us understand the scope of the issue? Is this something that affects like one person a year or is it much more than that?

Moira Tannenbaum: Yeah. So it is much more than that. You know, statistics can be hard to come by, but one commonly cited statistic is that people who are incarcerated, who are female, about 3 to 4% of them are pregnant at any given time. So correspondingly, a lot of them are postpartum also. So you know, of course, many people want to provide milk for their baby.

That’s why we have the, the whole Milk Minute Podcast, right? But as far as postpartum women who are incarcerated, being able to provide milk it’s all over the map. So first of all, it needs something that you need is for women to have that plan when they’re pregnant or to know that it’s an option and to be empowered, because I would say that the default in most prisons is you’re not going to do it.

But then, you know, supposing you have a really active prison doula program, or really active community health workers who come there, or nurse practitioners working at the prison who are super pro breastfeeding. In some settings, a lot of the women who are guards have breastfed and they’re there as a support.

So it’s really all over the map. So when you look at postpartum women providing milk, it’s a small percentage of them who actually have their child with them. So the ones who had their child with them, the child is with them all the time that they can breastfeed on demand as it’s called, you know, unless, for example, they’re meeting with their parole officer right then and there, you know, if one of the other inmates is holding their baby.

But then a much larger group of women, postpartum, childbearing people and postpartum are providing milk and having it transported out of the prison which can be either by family members or there are volunteer groups that come to the prisons and pick up the milk. And that, of course, anything with correctional facility involves a whole lot of security and screening and procedures, but that’s an option too. And then there is a group that is not offered any of that and that their option is only to hand express milk and dump it and hope that when they go home, they have a little supply.

And that is often a situation at jails where there’s just not the program in place. And so the occasional people who come through are, hand expressing and dumping it down the drain and hoping to have a supply when they get home.

Maureen: Wow. So we have a really big scope of what’s happening here and I guess you know, those partially influenced by funding and how long people are staying in these facilities. But essentially, you know, I want our listeners to understand that incarcerated individuals are stripped of a lot of rights. You know, you don’t go in there and get to make choices about yourself any longer. So can you help us understand Moira, what rights in general incarcerated people are able to maintain in regards to their body autonomy? Like do, is it one of those situations where like the fetus has more rights than the incarcerated person or does the baby had a right to breastfeed? We, we, one of our patrons had a question. “I wonder how feeding on demand works incarcerated. I’m not sure what rights they have, but I can only imagine they’re only allowed specific visitation with children.”

Moira Tannenbaum: Yeah. And we did sort of talk about that one already, which is that for those small percentage of postpartum childbearing people who have their baby with them, they can breastfeed on demand. Because if you think about that, those programs are set up for people to take care of their own kids.

They’re not set up for like handing off the kid and you’re in some prison work program that prisons are definitely not staffed with you know, childcare facilities built in for the most part, unless they might be for the staff children. So you’re looking at people who can breastfeed when their baby needs to breastfeed.

But as far as bodily autonomy, not so much. If you are, first of all, you have absolutely no choice about who your healthcare provider is when you’re incarcerated. you see the prisoner jail staff healthcare people when you’re there. And if you needed to get referred into the community, for example, follow up on, you know, you were pregnant and you tripped and broke your ankle and you’re supposed to see orthopedic people for a follow-up, you don’t get to go to the person you saw when you were outside incarceration. You see who they have a contract with. So you’re starting over with generally brand-new people to you. And then as far as fetal autonomy, there are many states where women don’t have the ability to choose whether they’re going to continue a pregnancy or not. And so that extends to the correctional facilities in those states.

Heather: So let’s clarify that, I don’t want to just gloss over that. So let’s dig in just a little bit more without getting too political. And can you help us understand specifically what happens when you are pregnant and incarcerated say early in pregnancy, or you find out you’re pregnant while you’re incarcerated and, and you, so you’re saying that if you find out and you don’t want to continue your pregnancy, you may not have the option to terminate the pregnancy based on the state that you were incarcerated in. Is that correct?

Moira Tannenbaum: That’s correct. Because if you look at, for example there’s, there are some states nowadays that have essentially banned abortion procedures, but pregnant people in those states can tap into some resources and leave the state and get an abortion in other states. But if you were incarcerated, you’re not leaving the state to get healthcare in another state.

That’s just not happening. Barring, you know, everybody who works in corrections knows that there are extraordinary circumstances that come up and that’s a whole different subject for a different podcast series. But for the most part if you’re in one of those low abortion rights states and you find out you’re pregnant when you’re incarcerated you don’t have choices.

Heather: So, do you witness any coercion to keep the pregnancy while they’re there? Or is it just not talked about, and it’s like an understood thing that like, yep. You’re going to have this baby and then we’re going to take it from you and it’s going to be formula fed. Or is it like, okay, so we’re going to force you to keep this pregnancy and here are your options for feeding your baby and visitation?

Moira Tannenbaum: Well, I work in a state that does have abortion rights, although there are restrictions like so many other states have. And so in the setting that I work in, incarcerated, pregnant people do have the choice to choose an elective abortion if they want to. There are a bunch of hurdles to jump over, just like everything else, if you’re incarcerated. And it is involved coming up with people who were pregnant every, every inmate gets a case worker, they might not know who it is, but it’s something that you can look up in the system and tell people, oh, your caseworker is so-and-so.

So this is who you should contact. And so at the setting I work in, people have a caseworker and I have known many, many pregnant people who choose termination and I’ve known many pregnant people choose to keep the baby or you know, which if they’re incarcerated and going to give birth while they’re still incarcerated, that will mean placing the family with foster care or a family placement.

But it’s, I have not seen any coercion one way or the other, as far as that goes. I have seen what you see in any healthcare setting, which is staff making life difficult because people have their strong biases just like in any other setting. And so I’ve seen staff who express a lot of distaste for somebody who wants to choose to terminate, to have an abortion, but I haven’t seen staff get in the way.

Maureen: Have you ever seen medical staff just gloss over the fact that pumping would be possible for people who are separated from their babies and not offer it up on the table?

Moira Tannenbaum: Okay. I’m sorry. I’m about to cry because when I started at this jail, there was a healthcare provider there who was openly hostile to the idea and felt that it was like a cushy treatment and that people shouldn’t do it.

And that it didn’t matter if you said the baby has rights, that was just not even on the table. And I don’t work with that person anymore. And so the setting I’m in doesn’t get that many pregnant people. I haven’t seen healthcare providers say, Hey, is this something that you’re going to do postpartum?

We can set you up with a container and you can pump and dump, but I haven’t seen people say you can’t do it either. So if you look at the variously empowered people and what their priorities are as healthcare providers, you could imagine that depending on which healthcare provider you’re seeing that day, different choices are going to be offered to you. That’s like in any setting, right.

Maureen: I’m sure this then basically comes down to the motivation of that person and their previous education as to whether or not they advocate for themselves in this process to get, you know, access to a pump or access to whatever they need to hand express, or…

Moira Tannenbaum: Yes, I have a lot of thoughts in that around that. And this is a reason that when you’re talking about a prison and not a jail that the prison doula initiatives can be so important. Doulas come into the prison and work with the incarcerated pregnant people and help them learn about options. Just as doulas in the non-incarcerated world do.

So people may not have realized that pumping for their baby would be an option, but prison doulas bring that message.

Maureen: Right. Well, I have so many follow-up questions. I just have one though that came to mind. You’re working in a jail. We know that people spend less time in a jail than in a prison. Do you find, do you think in general, there are a lot of people then who come into jail pregnant and leave before they give birth. And so we’re not seeing that continuity of care then because of the average stay in a jail is just a few months.

Moira Tannenbaum: Yeah. Well, continuity of care is a big issue but as an issue with incarcerated pregnant people too. Because back when I was working to provide care on the outside. “On the outside”, is jail and prison lingo for anything that doesn’t happen in the correctional facility.

So when I was working on the outside, providing care for incarcerated women in prison all the time we got people transferred to the prison because maybe they were in a jail and then they were sentenced to prison. And so they’d had prenatal care elsewhere and we had to review their records and it would be like, okay, she’s in the waiting room.

Here’s 50 pages for you to look at. So, you know, that’s scary looking at, trying to look these 50 pages of records and hope that you don’t miss something. And, but that is definitely an issue for incarcerated pregnant people is changing providers when they weren’t planning to and something getting missed.

And if you look at the fact that so many pregnant incarcerated people are high risk because of history of abuse, history of substance abuse, history of lack of access to healthcare. It’s really frightening when you think about things getting missed, because simply because of transferring providers that much.

Heather: Well, and also reasons for going to jail versus prison, you know, like a lot of the, correct me if I’m wrong. Okay. But when people go to jail, it’s for like theft, right? And for, you know, breaking and entering or

Maureen: A lot of people go to jail for stealing formula for their babies. It’s misdemeanors.

Heather: Right. You get enough misdemeanors for stealing food, for example, to provide for your family, you know? So that’s one thing. And then there’s like, I think just in general, people think, oh, people that are incarcerated would be a safety issue for their own baby. Like, just because you would steal something means you’re more likely to harm your baby. So you should not be able to provide breast milk, you know, like you’re unsafe to be a mother. And I think we just need to take a minute to separate safety issues as a parent from acts that people commit or circumstantial reasons. Is that correct?

Moira Tannenbaum: Yes, absolutely. No, that is, that is so valid. And I think this is somewhat akin to what you see if you’re working in a hospital with NAS babies that neonatal abstinence syndrome babies. Babies who are withdrawing from their mothers’ opiate use or as we talked about when Kelly Lemon was on this show, mothers who were in medication assisted treatment therapy and their babies maybe withdrawing from those drugs.

So people have an attitude like, oh, that mother made choices and now she’s a risk for her child. And I really don’t view it that way at all. Like you said, people who’ve stolen money, stolen formula or, you know, mismanaged and taken somebody else’s money to buy formula. That hardly means they’re a danger to their kids.

And so looking internationally, the US incarcerates far more people, far more pregnant people, far more women, than any other country on the percentage basis. And so why would we have that many dangerous mothers in this country? You know, it just doesn’t make sense. So most things that people have done that have got them incarcerated aren’t a harm to their child.

Maureen: Something else our country really struggles with especially in the correctional facility world is systemic racism. We incarcerate a lot of black and brown and indigenous people. So I imagine the issue with racism and must be really severe in these facilities. Can you help us understand how systemic racism plays a role in the care that pregnant patients and breastfeeding inmates receive? Do you see any really big challenges as a midwife and lactation consultant regarding that within the prison system?

Moira Tannenbaum: Yeah, so we know that black folks are way overrepresented in the incarcerated population and bypass folks in general. So when you look at the effect of systemic racism prior to incarceration, lower access to healthcare, chronic conditions that are exacerbated or caused solely by systemic racism and distress that so many people are under.

Then you put that in a higher stress environment and a lower resource environment like corrections and everything is just magnified. And there is an under supply, not only of healthcare providers of color behind bars, but also staff of color behind bars. And so you may have a situation where you have a largely black women population being cared for by largely white male guards.

And that’s not to say that some of them are lovely and caring people because they are. But as far as representation, being with people who look like you, that so often not the case. And I have to stay, I could walk into any hospital and tell you that I’m hearing racist attitudes here and here and here and here and that’s no different behind bars. I hear that, the same thing.

Maureen: Okay. So let’s change gears a little bit and maybe talk about some good things. Let’s talk about what are the major benefits of breastfeeding while incarcerated, and an add on question to that, do we have any factual studies and data about the outcomes of these breastfeeding dyads that start in jails or prisons?

Moira Tannenbaum: So I was working hard to try to find data and found a lot of reports and that kind of thing. So there are so many variables because of what was the length of the program and so on and so on. But all of the programs, all of the people I’ve talked with in preparation for this podcast who’ve worked in programs where mothers, childbearing people and babies were staying together.

What everybody points to is the lower recidivism and recidivism is that fancy word for being incarcerated after you’ve already served a sentence. So many, many people who weren’t even necessarily in favor of babies and mothers staying together said, wow, it really made an impression on me to see that these mothers really cared about those babies and would do everything to continue their life, together outside of incarceration.

So that’s a huge benefit right there and not rocket science, is it? Keep them parent and a baby together and let the parent provide with their own body, that nutrition to grow the child. Like what’s not to love with that? Right.

Heather: Well, and also some of the biggest risk factors for postpartum depression and anxiety are the same stressors that people experience who are incarcerated, you know?

So one way to kind of eliminate the PPD and PPA is by keeping them together and breastfeeding and supporting with programs and education and just letting generally having anyone there.

Maureen: Yeah. And I’ll say I’m really glad to hear these programs insist. I didn’t know about them before you had told us. And I think it, you know, recognizing they’re only serving a very small amount of incarcerated people, but that following the trend, that we’re also starting to see more in the foster care system too. We’re realizing that the goal of these programs is to reunite families and keep them together. And that has better long-term outcomes for these children then to keep them apart. And I really hope to see more of that just across the board in this full, you know, state run child system.

Moira Tannenbaum: Absolutely. No, and I think, I mean, some just on a tangent, some interesting research I read recently, which is probably not news to anybody like my daughter who works in a head start program, is that the benefit of taking low-income women and giving them a cash benefit every month, that then the, instead of spending money, investigating them for alleged you know, reports to child protective services that most families just need some more money in order to be able to provide.

And when you are reporting, oh, this child came to school in dirty clothes. Well, maybe there was no laundromat. Maybe there was no money to wash the clothes. Maybe there was no laundry detergent. Maybe they didn’t have more clothes. So it’s the basics that most people aren’t bad people and most parents are stressed and you give them a little bit of help rather than locking them up or investigating them. And you’ll see amazing benefits.

Heather: I just want to say that it makes me so happy to hear somebody that works in the jail, say something so positive. Like most people are good people. Most people are good parents. Where I think a lot of people that work within the system, you know, feel otherwise.

Maureen: They get really jaded and you know, that’s a symptom of being overworked, right? They see how many patients a day? And you get 10 minutes with each of them? You’re not going to see their best side. Yeah. They’re not going to see your best side.

Heather: And I’m guessing, whereas that you are able to maintain this positive attitude because you’re active in the reform. You know, you’re actively working on policy and there’s a light of hope within you and you share it with everyone that you’re around. So tell us more about this hope, what kind of reform do you hope to see? If we were to wave a magic wand, what would be better in this world?

Moira Tannenbaum: Well, so reforming first of all, I’m a big, big believer in not incarcerating so many people to begin with. So waving my magic wand, I would have restorative justice, which is a movement that’s at least several decades old.

And it’s rather than locking up people and saying, you’re a bad person, you did something wrong. You’re going to be behind bars. And then meanwhile, the person who you harmed by doing something bad, all they get is like the feeling of revenge or maybe like happy that you’re locked up or maybe that doesn’t make them happy at all, but it doesn’t address the two parties.

It locked one up and it ignores the other one. Restorative justice has three components to it, which are encounter, repair, and transform. And without getting off into way more of a tangent, I would like to see restorative justice be the law of the land. As it is, it’s in some counties. I don’t think there’s any states that have universal restorative justice, but that’s my big magic wand.

So my smaller magic wand is reforming things like locking people up for unpaid parking tickets. Supposing you’re in an area with crazy shortage of parking, any city is often this and supposing, I mean, I’m going to just throw out some incarcerated people that I’ve known. Personally, I see their faces. Somebody who had to go into the city all the time and take care of her elderly grandmother and there was never any parking in the neighborhood. So she would park someplace and feed the meter and come back and boom, have a ticket because she stayed longer with her needy elderly grandma. And she didn’t have the money to pay for the tickets. So she kept getting notices and just ignored them cause she was a busy student, mom, worker, caring for an elderly grandparent and then one day, boom, she’s in jail or a lot of unpaid parking tickets.

And that’s crazy that, you know, that kind of thing. There had to be a different way to handle that one. When I’m waving my magic wand, I would say, well, locking people up for things like not paying bills is not helping because you’ve removed their ability to earn money, to pay the bills in the first place. You’ve made them pay for their incarceration, lose their income while they’re incarcerated, incur extra charges, like now they have to pay somebody to take care of their kids or walk their dog or many other things like that. Get behind on their bills. All those things aren’t helping. So my magic wand would encompass all that.

Maureen: Thank you so much for bringing that up. I think a lot of people don’t realize that essentially being poor is criminalized in this country in a lot of ways. We have modern day debtors’ prisons and that most people in jails and prisons are not there for violent crimes. They’re there for the consequences of substance use disorder, of being poor, of not having adequate resources to take care of themselves or their children. And these are all things that we have the solutions to and yet we have to figure out a way to implement them on a systemic basis.

Moira Tannenbaum: Yes. And when you look at further, at who’s locked up, the percentage of people who have aged out of foster care and are incarcerated, and then the percentage of women who have sexual abuse in their background is staggering. Absolutely staggering. And if I could share, do we have time for me to share a story? Absolutely.

So a woman I worked with recently had no criminal background, none, but she had a traumatic birth in recent years. And she was in some crowd scene situation fairly recently. And some, some criminal activity possibly was going down and she’s a black woman, a white male officer yelled at her, drop it.

And she didn’t know what he was talking about. She tells me, so she clutched her purse to her chest because she was scared and he yelled drop it. And the next thing she knew she was handcuffed. So as she told me all this later, when she was in jail, that triggered some stuff from her birth because she’d had a traumatic birth and as she tells it she was a black patient, obviously in a virtually all white provider setting and something traumatic happened. And she feels that people came into her room and were yelling at her afterward and telling her that she couldn’t report this thing. And those were white authority figures. So 18 months, two years passed, and then she’s out in public and a white male authority figure is yelling at her and she just went into flashback, trauma mode and didn’t know it was happening. She was reliving her birth trauma.

So, okay. She ends up incarcerated and of course it’s all full of white male authority figures. And I saw her fairly early on in her time and she was talking a lot about the trauma and I was working with her on some things she could do when she was experiencing trauma, but she continued to experience trauma at the jail and so she got into higher and higher security because she would have these flashbacks or these episodes and started getting violent. And this is somebody who’d had her own business and was in her early thirties, late twenties. And I’m just like how did we do this? How did our society get this far off track?

Maureen: Yeah, it’s, it’s really a system that, I mean, again, this is a whole other podcast, but the incarceration system in this country is a system created, you know, basically private entities make money off of it and they do not help reform or heal anybody in that.

Moira Tannenbaum: You’re not getting about; you’re not getting about money. When you look at the astronomical growth of the for-profit healthcare entities that provide care in the jails and prisons, there’s some very wealthy companies doing that. And when you look at the people who provide food services in the jails and prisons have also giant for-profit companies, rather than, you know, local companies, cause there’s definitely jails and prisons that have food provided by local companies and local people might have more control.

Heather: Oh, well, on one hand, it’s like if they’re all owned by private companies, you’d think that maybe groups that are very pro breastfeeding, pro milk expression would be able to come in and have a more reasonable conversation with less bureaucratic red tape to get through than if it was all government owned, you know, if you could work on them on an individual basis. I mean, is that pretty much how it goes? And it’s just like this, this owner of the prison is more immutable to breastfeeding and this one’s not.

Moira Tannenbaum: You know, I mean, that’s such a good question because I did a lot of research for this into, you know, the microenvironment, different places. And I mean, when you look at the large companies that provide healthcare, okay, they’re for profit privately owned, but they all work with an individual jurisdiction, you know, a state prison, a county jail, and so they are subject to the rules of that state prison or county jail. And, and they’re also to be considered as the national accrediting body for jails and prison healthcare. And they have standards also, but everything is really subject to local control unless there’s state rules, like the states that had the model prisoner programs for prisoners and their babies. So it’s so many like little company policies.

Heather: Well, you know what makes me mad about that is that we can have public hospitals that make their own rules and they don’t have to comply with the state regulations, right? So like Fullscope advanced practice nurses at the state level, the state says you’re independent and the hospital says, well, even though we’re a state hospital that’s publicly funded, our rule is that you’re not Fullscope and that you can’t admit your own patients. And so it seems very backwards. Like how can it be one way, but not the other way?

Maureen: Well, I think the reality is that we can never forget is we’re working with a population of people here that has very few advocates and the people who are loudest in this space are the people who are making money from it. And their goal is generally, I’m going to make generalization, not to help the people in prison or in jail, but to run it in a way that makes their company money.

Moira Tannenbaum: Yeah, I notice that all the time, when you look at certain infant formula companies that also make diabetic products. And so it doesn’t take rocket science to realize, oh, if we push infant formula, then we’re going to get more customers for our diabetes medicines, years down the pike since we know that there’s a direct correlation between formula use and diabetes. So yeah.

Heather: Oh my gosh. Well, you know, obviously we have a long way to go, but we are so thankful that there are people like you working within the system because there’s a lot of people that I think are advocates for it, but they’re not working within the system every single day.

So it’s such a gift to have somebody like you on the inside. But for other people that would like to help on the outside, can you give them some tangible things that they could do if they have a friend or a loved one that’s incarcerated or going to be incarcerated, who are currently expressing milk?

Moira Tannenbaum: Yes. In fact, I made quite a list, so I’m going to shuffle things up just a second and pull up my list with priority items. So,

Heather: I love lists of priority items. Okay.

Moira Tannenbaum: Yes. So I mean, first and foremost one thing to remember is that we’ve talked about on the show, I mean, the tremendous stigma and barriers that people who are incarcerated face.

So if you have friends or family who are going to be incarcerated, let them know that you’re there for them. People beat themselves up so badly and have such often such self-hatred for just being incarcerated. When, as we’ve seen, there are direct things, a pipeline of foster care to incarceration pipeline, sexual abuse to incarceration pipeline, drug addiction incarceration pipeline, and those things are out of people’s control.

So let your friends or family know that you’re there for them. There’s some very specific, easy to do. I mean, sometimes people don’t know they’re going to be incarcerated. You went out on Saturday night and you had one drink too many and you and your partner started yelling and throwing things. And then one of you was hauled away to jail and it was you. You didn’t know you were going to be incarcerated. But if you knew you were going to be incarcerated, if you knew you had those unpaid parking tickets and they were coming for you, you might have some notice or you might have like a surrender date.

You’re going to turn yourself in on March 17th and it’s only March 1st. So maybe your friends can help you line up a couple things that will be helpful beforehand. Maybe you can secure some health care, like go to the dentist before you get incarcerated. What about having a couple of counseling sessions and learning some coping strategies?

You know, because I see people all the time who were anxious to be incarcerated. It’s very hard. Just imagine a lot of people only sleep well in their own bed and now you’re going to be someplace with like dozens of other people around you and cold cement and a different bed and not enough covers, and you’re going to be cold and it will smell bad and you eat bad food before going to bed. I mean, all those things, one cup of tea that you like to have at home, all those are going to be gone. So it really behooves you to learn some coping strategies. So if you can help your family or friend focus on some things like that before getting incarcerated, it’s a big help.

Remind people, basic things, memorize some phone numbers, you won’t always have access to some piece of paper that you wrote phone numbers on down on. Memorize your top three phone numbers. None of us anymore knows numbers guys. We just have them saved in our cells. Find out about the rules, where your loved one is going to be incarcerated. How what’s the process of commissary on this? Commissary is the common term for the accounts that people have to buy items when they’re incarcerated, there’ll be like a jail or prison store.

So you don’t just walk in and hand them a 20 because you’re incarcerated. You don’t have cash. So people can pay money to be on your account and you can buy necessities like special shampoo or snacks or things like that. And it’s important to know what the rules are.

Everybody who’s incarcerated in general gets a little rule book out of, you know, what are the rules around here, but only members can learn that too. So you can go on the website at the jail or prison and figure out what their guidelines are. What are the rules for visiting? Having contact with the outside world while you’re incarcerated is huge.

And you need to know, like, if you’re sending packages, how to get your packages through security, what are the rules? You don’t want to be annoying that jail or prison staff, because they are overworked and underpaid, understaffed, they’re forced to work many double shifts. So you wouldn’t want to mess their day up when they were already having a tough day to begin with.

Most of them are just honest people trying to make a living just like everybody else. I’m going to turn the page now on my giant list, there’s going to be some rustling. So most people, you know, if you’re incarcerated, there’ll often be a lawyer involved, either a paid lawyer or a public defender. If you’re talking about somebody who’s breastfeeding and incarcerated or pregnant incarcerated, their lawyer might not know local resources supposing as happens.

Somebody is a month postpartum and they’re going to go to jail or prison. They’re breastfeeding or they’re pumping, exclusively pumping, partially pumping. How are you going to make sure that can continue behind bars? You as the family or friend member can look up, what are the rules for the state? What are the rules of the facility?

How can you get them some good information? Because the lawyer or public defender may be able to run with this if you just get them the info. So some places to check with are your state breastfeeding coalition, local WIC offices, if there’s a prison doula initiative, any kind, you can look up whatever resources are specific for your area and help the person. Give those to your friend or give them to their lawyer if they have your permission to talk with them.

And then figure out the visitation system. I mean, if your family or friend member is going to prison, that may be quite a long ways away. I mean, people might have to drive 500 miles in some states prisoners are moved around. This seems to happen more to male prisoners because there are more male and more prisons that can take men, but it can happen that women prisoners get moved as well.

So supposing you were all set to be driving 30 miles on a Sunday, and now it’s going to be hundreds of miles away. Can you and somebody else carpool? Was there a way to share resources? Is there somebody that you know that you can stay with when you’re in that distant location, visiting your incarcerated family or friend?

And I think that’s my top one. I could probably go on all day because I’ve seen so many cases of, “oh, if only x had happened.”

Heather: Well, thank you so much. Yeah. Thank you so much. I would love to actually turn that into a pdf that you can download.

Maureen: I have one thing to add to that list because I had actually been to jail before. I was arrested at a protest. Oh, many years ago now. The biggest thing for myself and also from other people I was talking to was consistency from support systems on the outside. A lot of people are like, oh yeah, I’ll call. And that lasts for a week, a month, maybe two months. But the way that time passes and when you don’t have a lot to distract you is really different. You know, people in there are counting on your communication and your consistency and knowing that you, that they have a consistent form of communication coming once a week, every day, whatever. It can really help people stay sane and stay healthy. So if you make a commitment to somebody who’s going to be incarcerated, be consistent. And if you cannot be consistent, communicate clearly about that.

Moira Tannenbaum: I cannot emphasize that enough. That is such a good point, Maureen. Yes.

Heather: And then also if somebody is watching your baby for you, waiting for you to get out, it would be very nice if those consistent correspondence, however you’re doing it, would include updates about the baby, you know, pictures of the baby, because that’s going to help. I mean, our brains are very smart and that will help continue to bond so when you get out of jail, it’s less of a leap for you to get back with your baby.

Maureen: And that helps. People have a narrative about themselves when they’re going to be incarcerated. And it’s very easy to feel like you’re not worthy. You’re not good enough to be a parent anymore. So helping somebody keep that clear communication and understanding what’s happening with their child and keeping them in the loop helps them keep some confidence there and understand that other people believe in them. They want them to be involved and that helps them, you know, increase their chances of actually being involved in that child’s life when they’re out.

Moira Tannenbaum: That’s such a good point. And I think, you know, when one more thing to think about is, I mean, a lot of women are incarcerated when their children are old enough to know what’s going on.

I mean, this applies to a lot of men also. And so having a family out there, not doing a narrative of oh your mom is bad, so she’s locked up. At the same time I knew of one incarcerated woman who said, oh, well I told my son, I was going for some training. And you know, then she was gone for four months, that’s pretty rough.

Because you know, this kid was seven and he, I think was going to figure it out. But you know, that’s also part of being a supportive family member is, you know, without burdening children with oh, society is unfair and, poor black people get locked up or, you know, people with substance use disorder get locked up.

There should be some way to help children stay in contact with their parent when these kids are old enough to do so. If you’re the baby, you can get your shipment of milk from your mother or your visitation where you can breastfeed once a week. Cause that is a thing, there are babies that can come to a prison or jail and breastfeed once a week and keep breastfeeding. So there’s so much that we can do once we set the stigma aside. Yeah.

Maureen: Well, I’m going to take this list from the recording and make something that we’ll put out for free and people can print it out and have it as a resource so they can be supportive.

Heather: Yeah. And you can download that straight from the link that we’ll put in the show notes. And also in the show notes, we’re going to put all of the organizations and charities that Moira is about to plug. And Moira tell us who is helping people. Give us some organizations and charities that you want to lift up.

Moira Tannenbaum: Would you believe that there is an organization that has been fighting for incarcerated women since 1845?

Well, I know isn’t that crazy? I was so tickled. So the Women’s Prison Association has been fighting for incarcerated women since 1845. I mean, here’s the scary thing is we’ve been locking up women in the US since then. To say nothing of, you know, during the time of enslavement, what was happening then.

But so this is an amazing organization and I’ll be really happy to give you the link. And then Prison Justice International, which is one of the big advocates of restorative justice that we talked about earlier. Those are two organizations and I have several others and some really interesting articles, for example, about the Model Prison Programs, mean model prison, being, you know, parents and babies get to stay together, but we’ll definitely throw some good links out there. I hope.

Maureen: Yeah, we’ll put them right in the show notes. You guys can follow the link to our website and everything will be there. And you can go as far down this rabbit hole as you want to, and hopefully come out the other side ready to advocate.

Moira Tannenbaum: Yes. I love that. I mean, having just recently had dinner with somebody who works for one of those volunteer milk transport organizations, like yes, there’s so much that we can do from the outside.

Maureen: Well, I’m happy we found a good place to end here. A place of action makes me feel really good.

Heather: Yeah, me too. I’m thinking Moira. It was so nice to just hang out with you on this wonderful morning. And we thank you so much for coming in and parting all of your wisdom and your hope and your action. And I just love the life that you’ve built and what you stand for. So thank you so much for coming on the podcast.

Moira Tannenbaum: Heather and Maureen, I’ve been looking forward to this for so long and it was a joy and I will see you back on the podcasts.

Heather: All right. Bye-bye.

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Maureen, I knew I was going to like talking to Moira about this. I just did not know that it would make me want to cry for half the time and tug at my heart strings like that.

Maureen: Yeah. I, I deeply appreciate Moira coming on and also being super prepared. I feel like she just made the most of this hour.

Heather: She did. She has been putting this off because she wanted to do such a good job with it. We were ready to go in like November and she was like, wait, I just want to do a couple more things. I have a couple more resources. I need to talk to a few more people. And I was like, yeah, Moira, you do whatever you need to do and we will be here for it whenever.

Maureen: Well, this was perfect. Really. And I know that there are a lot of other aspects to this that maybe we’ll dig in deeper in another episode about just like the healthcare and all of that. There’s, there’s a lot to talk about. Moira wants to come back and talk about it. So we’re going to see if we can make that happen.

Heather: Absolutely. And if you were incarcerated expressing milk, please email us and let us know your story. We would love to hear it. We would love to read a firsthand account from you and give you all the praise you deserve for overcoming obstacles within the system.

So thank you so much for all of you that made it through the entire episode. Even if you don’t have any loved ones or friends that have been incarcerated, this is very important for all of us to know, because it affects our life.

Maureen: Yeah. And, and really the way I see it, you know, and I, I think this is pretty real as if we’re living in this country and we pretend this problem doesn’t exist, then we are complicit in.

Heather: Right.

Maureen: So I hope this brought some awareness. I hope everybody out there can figure out a way that even just one time they can be an advocate, even if it’s just talking to one person or when you’re at Thanksgiving dinner and Uncle Bob says this a really shitty thing about, you know, black people in prisons, you can be like actually.

Heather: And if really, all that you feel compelled to do is donate to one of the charities listed in the show notes, that’s enough for today. You know, just thank you for listening. This is the first step and stay tuned because hopefully as all things do, they will change. Hopefully for the better.

Maureen: Well, I would really like to head over to our you know, Award Alcove.

Heather: Yes. I’m there. I’m sitting there right now.

Maureen: I have a question though, since we’re not in the alcove anymore, what do we call this? Do we still mentally go there for awards?

Heather: It actually looks more like a padded wall.

Maureen: I’ve been calling this, the studio.

Heather: It’s studio awards?

Maureen: Sort of a closet. It’s awkward. It has no air circulation, which is lovely for recording quality, but it gets smelly.

Heather: Sorry.

Maureen: For me because I’m breastfeeding and deodorant doesn’t work.

Heather: Oh, I thought you meant I was smelling.

Maureen: You are not. I am, which is fine. It’s just, I’m just letting y’all know.

Heather: I don’t smell anything. Maybe that means it is me.

Maureen: Anyway. Let’s, we’re going to go. We might, let us know. What do you think we should call the new space? Tell us if you think we should name this and our awards differently, or if we’re just staying under the stairs for awards. If you’re just joining us, we used to record in a tiny alcove under the stairs, and it was hilarious and also small. Anyway, now we’re in a beautiful new studio. That’s what I’m calling it.

Heather: But originally our award segment was called Award in the Alcove.

Maureen: And that’s what we’re calling it today.

Heather: Unless you tell us otherwise. So now you’re all caught up.

Maureen: Today’s award goes to one of our patrons, Lisa Critchfield and she was saying she was very discouraged at the beginning of her breastfeeding journey and had a lot of difficulties, but they’re still going strong at 14 months and she really never saw that in their future.

Heather: That’s amazing. Lisa, we’ve been with you on this journey, girl. We have been on the Patreon talking to you and getting to hang out with you and your baby and our live Q and A’s. And I just have to say, I knew you’d make it.

Maureen: Absolutely. We believe in you so much and we’re so happy to hear that you’ve made it this far and you will keep going.

Heather: Lisa, we’re going to give you the Beyond Belief Award.

Maureen: That’s really cute, Heather.

Heather: Yeah, we did it. We came up with one.

Maureen: I know. I love that because you have gone far beyond where you believed you could and I think you will continue to do so. Okay. Thanks for listening to the Milk Minute Podcast today, everybody. I really think this was an important episode and I hope you guys share it.

Heather: The way we change this giant system, including the system of jails and prisons is to tell our friends, educate our children, our spouses, and our healthcare providers.

Maureen: If you found some value in today’s content and you want to see more like it, we would really appreciate if you would consider joining our Patreon. For as little as $1 a month, you can support us in making more episodes, just like this. And if you can’t do that, please tell a friend.

Heather: If you could share this episode with somebody, it might change their life.

Maureen: And we’ll see you next week, guys.

Heather: Bye-bye bye.

Moira Tannenbaum: I wanted to give a shout out to three incarcerated, pregnant women and postpartum women who had a big impact on me. For the first two I’m just going to do their initials. And this is T and H who were both in West Virginia. And then here in Michigan, I wanted to give a big shout out to Caitlyn. Caitlyn inspired me with this idea of just pumping and dumping to save your supply because that’s what she did.

And then she came back to serve out her sentence after she was done breastfeeding. And I met her, you know, like late at night when I was making rounds for something else. And there she was and we were staring at each other and I’m like, oh my God, you’re the same woman that I saw at the beginning of labor.

And, you know, I’m going to get really emotional talking about this, but it’s just so incredible that she, one encounter with her when she was just trying to keep her milk supply going was enough to fuel the light in me to try to preserve this option and learn more about it. So big shout out to Caitlyn. I hope you’re hearing this, that I hope you’re well.

Heather: That’s incredible. Great job, Caitlyn. Your ripple effect has taken hold.


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