As the number of incarcerated women around the U.S. continues to skyrocket, some correctional facilities have started adapting to meet the needs of an increasingly gender diverse population.
A pilot program at the Cook County Jail aims to address the needs of pregnant women entering the criminal justice system, who make up between 3% and 10% of all women admitted to jails and prisons according to a 2023 study by the American Academy of Psychiatry.
“Mass incarceration has unfortunately increased exponentially—and even more so incarceration of women,” said Cristina Gonzalez del Riego, who works as a program manager and doula for Start Early, an Illinois nonprofit that provides early childhood development to families as well as at-home care and doulas.
When Cook County Jail officials approached Start Early to create a doula program for expecting mothers, Start Early began coordinating with other agencies to provide outreach to women who were incarcerated.
“Without this partnership, connecting with moms would be a lot harder,” said Gonzalez del Riego. “We work as an intermediary for home visiting and doula sites and agencies throughout Illinois.”
In 2018, Start Early began working with six community-based organizations around the Chicago area to provide ongoing care to pregnant women who were expected to be released around or before giving birth. Since beginning services in July of 2019, Start Early has facilitated doula and at-home services for 37 mothers, some of whom are still receiving services.
By connecting women with local agencies, the program has enabled doulas to continue working with them after their release to provide postpartum support. Pregnant women are referred to the agencies for services and are given programming options that they can choose to participate in.
“Once women see us in action, many of them will sign up,” said Lanise Washington, who works as a doula through Marillac St. Vincent Family Services, one of the organizations that works with women in Cook County Jail.
Washington assists women as they make birthing plans, provides educational resources and connects women with therapeutic and addiction services.
“We discuss what they would like in terms of labor and delivery,” said Washington, who advocates for women to ensure that their pregnancies go as smoothly as possible.
Many mothers are released prior to giving birth, but for those who will remain in jail or face custody issues, Washington also provides guidance and support as women select caregivers for their babies.
“We would go over what’s to come after birth,” said Washington. “If they were going to continue to be incarcerated, then the person who they chose would come to get the baby. I would be there until they figure out where the baby’s going.”
Washington has also taught prenatal, postpartum and parenting classes, where she educates women on the importance of taking vitamins and staying hydrated.
“Vitamins are important because there’s no special diet for pregnant women in jail,” said Washington.
Unlike many clinical birth workers, doulas’ responsibilities include advocacy and assistance, and doulas continue to work with mothers after giving birth. The presence of a doula during pregnancy has been shown to increase positive birthing outcomes, improving the health and safety of both mothers and their babies.
“Seeing doulas work with moms who have criminal justice involvement seems like a good match,” said Olivia Soja, Cook County Jail’s program manager. “They can offer a sense of empathy and compassion that is often needed in the criminal justice system.”
The best place for soon-to-be moms is outside of correctional facilities, according to Dr. Jane Gubser, DOC Programs Officer at Cook County Jail.
“Through Sheriff [Thomas] Dart and the Cook County Sheriff’s Justice Institute, we’ve been advocating for pregnant women to not be detained unless they really needed to be,” said Dr. Gubser. “Our pregnant population has significantly gone down—occasionally there’s one or two pregnant women in custody.”
Cook County Jail has developed the Individualized Assessment for Strategic Assignment, a framework for assessing the needs of individuals as they enter the criminal justice system and formulating an individual program based on their needs.
“We’re advocating for alternatives like electronic monitoring—and then doulas continue to work with women in the community” said Dr. Gubser. “It’s a resource that women can access that they might not have otherwise thought of.”
Each year, approximately 100,000 people circulate through the Cook County jail, making it one of the country’s largest pretrial detention sites. Between 5-6% of these bookings are women, meaning that more than 300 women are often detained in Cook County Jail on any given day, according to CCJ statistics.