BOP: Publications

The Federal Bureau of Prisons protects society by confining offenders in the controlled environments of prisons and community-based facilities that are safe, humane, and appropri- ately secure, and which provide work and other self-improvement opportunities to assist offenders in becoming law-abiding -- citizens. Cultural Anchors/Core Values nBureau family The Bureau of Prisons recognizes that staff are the most valuable resource in accomplishing its mission, and is committed to the personal welfare and professional development of each employee. A concept of “Family” is encouraged through healthy, supportive relationships among staff andorganization responsiveness to staff needs. The active participation of staff at all levels is essential to the development and accomplishment of organizational objectives. n Sound correctional management The Bureau of Prisons maintains effective security and control of its institutions utilizing the least restrictive means necessary. thus providing the essential foundation for sound correctional management programs. n Correctional workers first All Bureau of Prisons staff sham a common role as correctional worker, which requires a mutual responsibility for maintaining safe and secure institutions and for modeling society's mainstream values and norms. Promotes integrity The Bureau of Prisons firmly adheres to a set of values that promotes honesty and integrity in the professional efforts of its staff to ensure public confidence in the Bureau's prudent use of its allocated resources. n Recognizes the dignity of all Recognizing the inherent dignity of all human beings and their potential for change, the Bureau of Prisons treats inmates fairly and responsively and affords them opportunities for self- improvement to facilitate their successful re-entry into the community. The Bureau further recognizes that offenders are incarcerated as punishment, not for punishment. n Career service orientation The Bureau of Prisons is a career-oriented service, which has enjoyed a consistent management philosophy and a continuity of leadership, enabling it to evolve as a stable, professional leader in the field of corrections. nCommunity relations The Bureau of Prisons recognizes and facilitates the integral role of the community in effectuating the Bureau’s mission, and works cooperatively with other law enforcement agencies, the courts, and other components of government. n High standards The Bureau of Prisons requires high standards of safety, security, sanitation, and discipline, which promote a physically and emotionally sound environment for both staff and inmates. Contents

VOL. 3, NO. 1 nSpring 1992 ¨ © 3 The Female Offender: 3 A Profile of Female care of the Pregnant A Prologue Offenders Offender J. Michael Quinlan Sue Kline Anita G. Huft, Lena Sue Fawkes, A statistical overview charts the growth and W. Travis Lawson, Jr. and changes in the Federal female All aspects of pregnancy are affected by 4 The Log offender population. incarceration, which creates dilemmas Correctional notes and comments for medical staff. The 5-South Unit at MCC New York 37 Linking Inmate Community Corrections Families Together 54 “Constants” and and Female Offenders Bobbie Gwinn “Contrasts” Turning Up the Lights Alderson’s L.I.F.T. program helps solve David W. Helman one of the major problems for incarcer- The Older Female Offender Managers must be aware of the ways in ated mothers—separation from their which such factors as the “dependency children. response” affect their female populations.

11 A Journey to

Understanding and Change ¦ Women’s Spirituality Ann D. Bartolo in Prison Guylan Gail Paul ¢¡ Equality or Difference? Though incarcerated, women can learn to Nicole Hahn Rafter feel a sense of freedom that changes the way they see themselves. This question has remained a constant in the history of incarcerated women in America. ¦§¦ Women’s Prisons: Their Social and Cultural Environment 59 The Cycle: From Victim 20 The Alderson Years to Victimizer Anne Sims Esther Heffernan Crista Brett Similarities and differences between The first female inmates in minimum- and high- Many women inmates come from Federal security facilities. backgrounds of abuse, and need to be institution for given the tools to form less violent women was for relationships in the future. many years run as a “grand experiment.” ¡§ Canada’s Female Offenders £¥¤ HIV, AIDS, and Jane Miller-Ashton the Female Offender The Canadian Federal system has developed innovative options for W. Travis Lawson, Jr., imprisoned women. and Lena Sue Fawkes A look at a growing problem for prison administrators. 2 Federal Prisons Journal

Federal Prisons

J. Michael Quinlan Published quarterly by the Director Federal Bureau of Prisons From the editor Thomas R. Kane The Attorney General has determined This issue of the Federal Prisons Assistant Director, Information, Policy, that the publication of this periodical is Journal was a long time in plan- and Public Affairs Division necessary in the transaction of the public ning and production. As we have Dan Dove business required by law of the Depart- discovered, there is little available Chief, Office of Public Affairs ment of Justice. on the subject of female offenders Peter Jones in prison; we hope this issue will Opinions expressed in this periodical are Chief of Communications not only fill a gap, but stimulate not necessarily those of the Federal further research and reporting. Bureau of Prisons or of the U.S. Depart- ment of Justice. Our thanks to the wardens and staff Doug Green Editor members (and inmates) at four institutions the Federal Prisons Ann D. Bartolo Journal visited in fall 1991: the Guest Editor Federal Prison Camp, Alderson, Kristen Mosbæk Design Studio West Virginia; the Federal Medical Design and Art Direction Center, Lexington, West Virginia; the Federal Correctional Institution, Editor’s Advisory Group: Marianna, Florida; and the Metro- Joe Holt Anderson politan Detention Center, Los Senior Editor, National Criminal Justice Contributing artists: Bob Dahm, Fred Angeles, California. Our photogra- Reference Service DeVita, Michael Hill, Sherrell Medbery, phers received complete coopera- Tim Teebken. tion, and we were able to cover the John J. DiIulio, Jr. Professor of Politics and Public Affairs Cover photo: Foreman Denise Thomas full range of activities in institu- and Director, Center of Domestic (left) instructs an inmate worker, tions from minimum to maximum and Comparative Policy Studies, UNICOR cable factory, Federal Medical security. Thanks as well to all the Princeton University Center, Lexington, Kentucky. The contributors from both inside and factory manufactures cable for the outside the Federal Bureau of Dennis Luther Department of Defense. Photo by Craig Prisons. Warden, Federal Correctional Institution, Crawford/U.S. Department of Justice McKean, Pennsylvania Photo Section. Our next issue will be non- Patricia L. Poupore thematic; the issue after that This publication was printed at the Director of Communications and will focus on “management and UNICOR Print Plant, Federal Correc- Publications, American Correctional leadership.” We invite short (two- tional Institution, Sandstone, Minnesota. Association page) contributions from any of our readers, whether or not they work Dr. Vicki Verdeyen The Federal Prisons Journal Chief, Psychology Services, Mid- welcomes your contributions and letters. for the Bureau. Please send your Atlantic Regional Office, Federal Bureau Letters may be edited for reasons of submissions to the address listed of Prisons space. Please contact: at the left.

Federal Bureau of Prisons Office of Public Affairs 320 First Street, NW Washington, DC 20534 202-307-3163 Spring 1992 3

The Female Offender A prologue

J. Michael Quinlan changes, but will that force us to make similar changes with male inmates? Our society, which has periodically Will the men ask for the same treat- wrestled with women’s issues, is only ment? Will we lose control if what we beginning to accept as fact that many give the women, we then have to give women function differently, manage the men? There are no easy answers to work and personal life differently, and these questions. communicate differently than men. It is all too likely that the perceived In the Bureau of Prisons, we are importance of the issues surrounding continuing to examine our programs women in prison will lag behind those and services for women. Last year, we affecting women in other sectors of sponsored a successful “Issues Forum” society, but I am hopeful that this on the female offender for correctional special issue of the Federal Prisons policymakers. This special issue of the Journal will help enhance synergy Federal Prisons Journal represents among corrections professonals, who another attempt to examine the can sharpen the focus on issues relating really mean treating all inmates the spectrum of issues involving women to women prisoners. same? Or, rather, does it mean that inmates. We hope to raise the aware- their needs should be met at the same ness of those—both administrators and Historically, women offenders have level as those of the male offender— line staff—in a position to make a been compared not just to male even if through “different” programs difference. I would like to acknowl- offenders, but to society’s expectations and services? edge the hard work of Ann D. Bartolo, for all women. Whether the woman Chief of the Female Offender Section, offender was considered to be “fallen” Our staff, who want to do the right Correctional Programs Division, and or overly “liberated,” she stood outside thing and at the same time follow good guest editor of this issue, in assembling the traditional roles of mother and correctional practices, try to treat such a comprehensive and thought- housewife. The criminal justice system women prisoners “the same” as they do provoking collection of articles. was often given the task of bringing her incarcerated men. But all too often, back to “higher standards.” despite the great dedication of our staff, We are moving toward an enhanced even employees with years of experi- level of focus upon women inmates. The war on drugs, increasing prison ence have trouble working effectively Years from now, a new generation of populations, and crowded prisons have with a female population. Well- criminal justice administrators will again heightened the public interest in meaning staff who have been success- look back on our efforts. If they find a corrections. The increasing number ful in all-male facilities have used their solid foundation to build upon, and a of women sentenced to prison, the proven skills in facilities for women serious attempt to address the issues of addicted pregnant offender, and the sad and have come away bewildered, the time—our time—we will not only phenomenon of drug-addicted infants wondering: Why is this so difficult? have been leaders for today but will have raised public awareness of the have established a model for the future. female offender. Perhaps this suggests that a change in our approach to the differences I hope the articles in this issue will With the rapidly increasing numbers between men and women inmates is increase your awareness and stretch of female offenders—in June 1992, needed. Gender-specific treatment may your understanding of the complex 7.4 percent of the Federal Bureau of suggest “special” treatment to some— issues surrounding female offenders. n Prisons’ total offender population—we and so we fear we may create a have also seen an increase in litigation monster by attempting to create aimed at forcing “equal treatment” for “special” treatment. Experience tells J. Michael Quinlan is Director of the women. But does equal treatment us that perhaps we need to make Federal Bureau of Prisons. 4 Federal Prisons Journal

and more willing to express emotions The 5-South Unit at leads to a unit in which there are more MCC New York complaints, louder voices, and greater demands on staff. Marcia Baruch When a staff member walks into the Surrounded by Chinatown, Little Italy, unit, he or she is hit with a rush of taxicabs, and people traveling back and activity and a barrage of languages. forth to work is the Metropolitan 5-South is a microcosm of New York. Correctional Center (MCC) New Not only are there blacks, Hispanics, York—a building comfortably tucked whites, and Asians, but there are away in the heart of downtown subgroups of each. Hispanics are Manhattan. Those who walk past represented by Colombians, Puerto hurriedly see just another co-op— Ricans, Dominicans, and Cubans. pleasant in appearance with good Black groups include Afro-Americans, security. Few are aware that the Nigerians, and a variety of other officers patrolling the building are not African groups. There is no culturally protecting the tenants of another mixed unit like this one anywhere else apartment building but guarding one of in the Bureau. the Federal Bureau of Prisons’ “high- rise” detention/correction centers. lllustrations by Michael HIII This accounts for the immediate answer that question by answering this cultural and communication barriers— About 900 inmates, most of them one: What is it like to be a female frustrating for the inmates who must awaiting trial, live in this building in incarcerated at MCC New York? live together as well as for staff nine separate housing units—each with members who must ensure that the its own personality and problems. One A typical day for a female on the unit is inmates receive proper care. A visitor of these units is more likely to produce to wake up, dress, eat, and remain on may be approached by several inmates shivers in officers when they are given the unit. Since there is an understand- complaining (in their own languages) it as a new assignment. It is not the able concern regarding male and of aches, pains, or weight gain due to segregation unit or a unit housing the female inmates mingling in the prison, lack of exercise, and demanding most dangerous criminals. It is 5- the majority rules—males have the “When can I see my kids?” “When can South, a unit with about 120 females— privilege of leaving their unit with a I get what I need in the commissary?” the only female housing unit at MCC pass or reporting to a daily work detail, “Can you get in touch with my New York. During a recent roll call I while females must be escorted, and lawyer?” “Can you help me?” It is a observed an officer as he was informed their movement is limited. While the unit in which the inmates are forceful that he would be working on 5-South. male inmates can be transferred to in their requests, which require extreme He handled the news eloquently; he another facility at Otisville, New York, patience to understand and respond to. rolled his eyes, put his head down on that has more activities, females must the table, and groaned to no one in remain at MCC New York until they What are most of their requests and particular, “Oh no!” are sentenced. This leads to greater complaints about? Where the male restlessness, agitation, and depression. inmates seek out counselors on issues Why is 5-South considered to be one of Some say women have a natural regarding phone calls and visiting, the most difficult units to work on, or capacity to show their emotions more according to 5-South’s Unit Manager, just to walk on? We might be able to than do men—just as it is okay for Katherine Cant, female complaints them to cry in daily life, it is okay for center around issues such as a lack of them to cry in prison. Perhaps a combination of being more confined supplies. “They never have enough their family, specifically their underwear or uniforms, and the children and the guilt they feel commissary doesn’t sell specific over leaving them with others. feminine items.” Ms. Gant also According to Dr. Leslie believes that additional staffing is Knutson, a staff psychologist needed on the female unit because at MCC New York, “Many of more time is necessary to handle the the women discuss the way females’ problems. they were abused in relationships and blame the men in their lives from a severe Since MCC New York is a holding for manipulating them to get involved facility where the women are taken in illegal situations. They feel they are disorder that produced self-destructive immediately after arrest, they have not pawns in their relationships and are behavior and pseudoseizures. Because yet made provisions for child care. As compelled to do what their boyfriend of the seriousness of their illnesses, many of them are sole caretakers, a or husband tells them to. Their depres- four of these inmates were put on a typical problem entails attempting to sion becomes more apparent as they watch more than once. contact child welfare or other appropri- verbalize their perceived victimiza- ate agencies to ensure proper guardian- tion.” The hospital staff are also very familiar ship of a child. Furthermore, a woman with the complaints of the female who is pregnant needs additional care, At times their depression is so deep inmates. According to Douglas Reed, attention, and assistance. Whereas a that they have to be placed on a suicide Hospital Administrator, “There is a complaint from the male unit generally watch (generally, they can be removed large number of female medical takes 5 to 10 minutes to handle, a from a watch rather quickly since they complaints, most of which center counselor on the female unit may are verbal about their feelings; the fact around minor aches and pains, gyneco- require 30 to 40 minutes to work out that they can vent their emotions leads logical problems, and sleep distur- just one problem. to a quick resolution of their crisis). bance. In fact,” states Mr. Reed, “one- This, however, is not the main reason quarter of sick call, on a routine basis,” The psychology staff also deal with for suicide watches among women at is made up of women. Mr. Reed inmates’ complaints and concerns and MCC New York. While many suicide believes that this results from two note the differences between those watches among men occur almost factors: the women are seeking medical presented by males and females during immediately upon incarceration as a assistance that is not readily available therapeutic sessions. result of their reaction to their arrest, to them outside prison, and are seeking Generally, males a little extra attention. Unfortunately, discuss their fears this extra attention takes up much of and problems over the physician assistants’ time—more of being incarcer- been incarcerated for their time is spent on 5-South than on ated, perhaps a time. Most of these any other unit. Furthermore, health care indicating a loss women have deep for women is more expensive than that of power and psychological problems provided for males. The Bureau’s independence. that are exacerbated by hospital facility at Springfield, Mis- Female the stress of prison life. souri, can evaluate the general inmates talk In 1990, out of 10 laboratory work for all inmates but more about females placed on a cannot do so for some female tests, suicide watch at MCC which must be sent to more costly 1 New York, 7 had local laboratories. serious psychological problems, such as psychosis, 2 - were suffering from severe Despite the stress of living on 5-South, If Shakespeare had seen 5-South he for the courts in some probation and many of the women are friendly and would never have suggested “Frailty, parole cases. talkative. They are helpful to other thy name is woman.” He would have inmates who are experiencing prob- emphasized the toughness and strength Nationally, the Federal Bureau of lems. The women who make up the that make these women survivors. Prisons solicits through the competitive suicide watch team will express much Despite their surroundings—Wall bid process (in accordance with the concern over a troubled inmate and at Street, the South Street Seaport, and Federal Acquisition Regulations [FAR] times continue to watch over her even the Brooklyn Bridge—they are living and the Competition In Contracting Act when the official watch has been in a confined space and adjusting to a [CICA] of 1984) for publicly and terminated. In an attempt to adjust to variety of culturally diverse individuals privately run CCC’s to provide their isolation and emotional depriva- as roommates, possibly for months. supervision and residential services. tion, some females form symbolic Their toughness mirrors that of the These contracting procedures have “families” in which they nurture other officers who must face the daily enabled the Bureau to contract with “family members.” Other inmates challenges of this unit. Working on 198 privately operated facilities and 62 actually take on the role of mother, 5-South requires perseverance, patience, public facilities (operated by State, father, sister, brother, or child, as well creativity, and diligence to maintain county, or local governments under as extended “family” members. This order in a potentially turbulent environ- Intergovernmental Agreements) by the type of role-playing—an unhealthy ment. end of 1991. Of the private facilities, form of dependency—is unique to 139 are nonprofit and 59 are for profit. female institutions. Marcia Baruch is Chief Psychologist at In addition, 350 local and county jails the Metropolitan Correctional Center, have Intergovernmental Agreements Many women take advantage of the New York. with either the Bureau of Prisons or the programs designed by staff at MCC U.S. Marshals Service to house Federal New York to help them to adjust to offenders. their initial time in prison. Women can work in the kitchen during the mid- Community Corrections With the implementation of sentencing guidelines and a trend toward a more night shift when there is little or no and Female Offenders movement in the institution. The conservative approach in the use of education and recreation departments Rita D. Hardy-Thompson community corrections programs for also provide special programs: drama, prerelease preparation, the percentage arts and crafts, English as a Second Community Correction Centers of prerelease inmates in our centers has Language, and exercise. The psychol- (CCC’s) are more commonly referred decreased; however, the number of ogy department has created several to as “halfway houses.” However, these direct short-term, low-risk commitment women’s groups—drug abuse groups, facilities have expanded beyond the and supervision cases has increased. groups for mothers, and a general traditional halfway house to become a therapy group. The hospital staff, in an viable sentencing option in their own Women tend to commit less serious attempt to respond to the increasing right. CCC’s are used by the Federal crimes and have less serious offense needs of the female population, has Bureau of Prisons in three ways: to histories than men—and therefore begun to provide monthly educational provide transitional services for receive shorter sentences; often, direct sessions on medical issues such as inmates nearing their release date from placement in a CCC is recommended AIDS, breast exams, and a variety of Federal correctional institutions back by the court. As of December 1991. others. into the community (usually the last 30 there were 4,096 offenders in CCC’s to 90 days of the incarceration period); nationwide. Of these, 595 were female as an option for direct commitment offenders: 17 percent direct court of inmates serving relatively short sentences who pose no public risk; and as an additional supervision resource Spring I992

commitments, 30 percent supervision In early 1990, the Bureau’s Executive enhance release preparation for cases, and 53 percent institution Staff approved the establishment of a females. The Community Corrections transfers. residential program for pregnant Branch of the Bureau of Prisons has inmates within a 50-mile radius of compiled special guidelines for Because there are fewer prison each correctional institution housing developing contract facilities that facilities for women, an incarcerated females. A policy statement has since specifically address female offender woman is ordinarily placed farther been developed to outline the criteria issues: parenting, substance abuse, from her home and family—about 160 and procedures for placing inmates in career counseling, money management, miles farther than a male inmate, on this program. The inmate must be and so on. The first such contract of average. This distance between a pregnant upon commitment with an this kind is being solicited in the female offender and her family often expected delivery date prior to release, Milwaukee area and is projected to be causes transportation problems and must have community custody status awarded in 1992. Once this pilot deprives the resident and her children prior to transfer to a CCC, and must program is operational and its level of of regular visits. The Bureau of agree to placement and full participa- success can be determined, the Bureau Prisons, seeking to increase female tion in the program. The Community of Prisons intends to establish this kind offenders’ preparedness for release, has Corrections Branch has begun the of CCC nationwide to assist female begun to develop specialized services solicitation process for residential offenders in establishing or and programs for women in CCC’s, center contracts nationally. maintaining community Research has found that placing ties, and rebuilding their increased emphasis, through group and CCC programs have grown much family units in proximity individual counseling, on such areas as more diverse in recent years. How- to their release areas. self-esteem, parenting skills, substance ever, the Bureau of Prisons continues abuse prevention, and money management, as well as on education and vocational training, will help female inmates return to society as productive citizens.

The Bureau has also began to address the needs of pregnant inmates through CCC placements. In February 1990, the Community Corrections Branch initiated a pilot CCC with the Mothers and Infant Together (MINT) program in Texas to provide pre- and postnatal services and programs for pregnant inmates. The success of this program was a major factor in the decision to establish alternative residential programs for pregnant inmates nationally.

Volunteers of America Regional Correctional Center, Minneapolis, Minnesota, operates under contract with the Bureau o f Prisons. Federal Prisons Journal

for both males and females has also a special kind of caring for the dying. meant an increase in the resources Turning Up the Lights We are alike in many ways—mostly devoted to program evaluation. During women, probably sitting in a circle, Angela Church fiscal year 1991, more than 1,200 sharing a belief that people should be onsite inspections were performed at allowed to die with dignity....” “Turn up the don't want to CCC’s by Bureau contract oversight go home in the dark.” specialists. The inclusion of their The Hospice movement was started in —Last words of O. Henry, American oversight has enhanced the overall 1967 by Dame Cicely Saunders, when short story writer performance of all CCC contract she opened the Saint Christopher’s facilities; the information gathered Hospice in London. The first Hospice On a Sunday morning it was an- during these evaluations (measuring in the United States began in 1974 in nounced in chapel services at the the degree of compliance with contract New Haven, Connecticut. The move- Federal Correctional Institution in requirements—inhouse programming, ment has committed itself to providing Lexington, Kentucky, that a Hospice counseling, staffing, food service, support and care for people in the final group would be started. The Hispanic safety, and so on), when analyzed by stage of terminal disease—believing inmates, who sat off to the side with Bureau researchers, supports the that, through personalized service and an interpreter, giggled nervously and conclusion that there is a need for a caring community, patients and looked at the chaplain as if she had said specialized female CCC’s nationwide. families can attain the necessary state something a little off center. Later that of preparation for death. day, the interpreter stopped the The rate of female offender incarcera- chaplain in Food Service and said, tion is increasing faster than that of In corrections, beyond the “I want to apologize to you, Chaplain. males. Recognizing the difference in increases in the overall I translated something very wrong female and male offenders’ needs, the population, a number of in the service this morning. I Bureau is continuing to develop special factors have encouraged thought you told us there was programs and services for females. The the development of going to be a Hostage group increasing acceptance of community Hospice programs: the started here.” corrections as an alterative to tradi- aging of the popula- tional imprisonment—as well as the tion, increased Thus began the experiences short sentences given most female sentence lengths, of the Hospice volunteer offenders—warrant the increased and the growing companions to the terminally attention that the Bureau is giving to number of inmates ill women incarcerated at community corrections programs for who are medically “at Lexington. In a way the translation was women. risk,” due to serious substance abuse, not all wrong; the volunteers have HIV infection, and other problems. “become captive” to the belief that no Rita D. Hardy-Thompson is a commu- one should go home in the dark without nity corrections specialist with the Recently, one of the Hospice patients, a the light of compassion. Five inmates Federul Bureau of Prisons. young woman, celebrated a birthday. and four community volunteers have Her disease had left her with a childlike committed their time and talents to nature. She repeatedly told everyone meeting the needs of women who are her birthday was coming. The Hospice dying in prison. volunteers planned a surprise party to which the hospital unit would be “We are not different,” said Terry Green, Hospice volunteer trainer, “from the group that met in living rooms 15 years ago, when a small group of people gathered to talk about Spring 1992

invited. Other inmates would play right kind of sweater. Much of the the patient smiled and said, “Beautiful! guitar and sing. The nursing staff kept work was done by the volunteer in her Please send it to him and tell him I love the secret as the young woman went home, but she often brought the pieces him.” After she died the sweater was from one to the other saying, “Does and sat in the woman’s room knitting. sent from the prison chapel with a note anyone know about a party? Did you explaining how it was made. By return know my birthday is coming?” Finally When the woman was taken to the mail came thanks and a box full of yarn the hour arrived. She was invited to local hospital outside the prison, she that might be used for others. visit another patient’s room; while they was close to death. The volunteer came talked, a room was decorated with to her one day and roused her. She It’s necessary for Hospice volunteers banners and party favors made by the pulled from a shopping bag a sweater and staff alike to come to grips with volunteers. When she was led into the of earth tones. “Finished!” she ex- their own mortality and feelings about room, her face reflected her joy as her claimed as she death. They must learn to understand lips moved to the words of “Happy touched the the stages of death and dying and Birthday” being sung by all. develop their communication skills, both verbal and nonverbal—especially When the volunteers met later to reflect labored their listening skills. on the celebration, they were moved by the knowledge that this might be this A special concern is that woman’s last birthday celebration. professionalism in the “There was a feeling of happiness,” said one volunteer, “and there was this insurmountable sadness too. She had a wonderful birthday and I’m glad we had a part in making it special.”

Another patient had turned her back to her door and faced the wall. She seemed to have given up. The community volunteer noticed a sack of yarn by her bed; she had ordered it to make a sweater for her husband. “It’s no use now,” she said, “I know I’m going to die and it’ll never be knitted.” The volunteer asked if she could do it for her. The woman rolled over to face her—“You would do that for me?” Patterns appeared and the two women put their heads together to choose the

The author (left), with Hospice volunteers—both inmates and community members. Games are important for the Hospice workers as well as the patients. Federal Prisons Journal

correctional setting, and the “distanc- ing” between staff and inmates that it implies, at times makes it difficult for staff to show the compassion they feel. Without a way to express these feelings, staff who have close, pro- longed contact with dying inmates risk burnout.

The duties of the Hospice volunteers are varied. They commit to visiting the patient at least twice a week—more if needed. They are on call for emergency situations. They help by writing letters, reading, playing games, and listening. One volunteer gives manicures to help the patients feel better about their appearance. One volunteer arranged to have a photograph taken so a patient could send it to her children. The volunteer was there before the photog- rapher arrived to help the woman fix her appearance for her first picture to release had been submitted and she She made the flight to her homeland be sent home in years. awaited a decision. As she waited, the without incident. When the plane Hospice workers stood with her; her life touched down she checked her appear- When a patient would not leave her sustained by oxygen tubes and the will ance, then asked the nurse to remove room her Hospice worker was called to see her sister in another country one the oxygen tubing; she walked by the nursing staff. She lay depressed last time. Volunteers were called unassisted into the arms of her family. and saddened that her children were far repeatedly to sit by her side during the Two months later she died peacefully away—voicing the guilt so many long nights; she would hallucinate and at home. “When I watched her go mothers in prison feel: Why should she imagine herself home. The volunteers through that sallyport door it was as if leave her room when she had been such soothed her with the hope that soon she part of me went with her,” said one of a failure as a mother? Her Hospice would be with her family. the inmate volunteers. “I had been companion was able to listen and given the great privilege of knowing a respond; before the end of the visit they The compassionate release was granted. woman of strength and faith. Her life were walking hand in hand up and A surge of hope caused Maria to draw touched mine. The facts of compassion down the hospital corridor. inner strength. Her hair, makeup, nails, I shared with her are small compared to must be done; her sweatsuit must be the lessons she taught me.” Sometimes, an inmate will be granted a pressed. The Hospice workers leapt into compassionate release to spend her last action. There was joy in the preparation, Death is never easy to deal with. For days at home with her family. Maria but the workers also knew they were those in prison it is even more difficult was such a woman. The request for her preparing her for her final journey. due to their isolation. The Hospice When the morning arrived, Maria, a group gives the women in prison an wheelchair, portable oxygen, an entourage of Hospice volunteers, and staff made their way to the sallyport door. Spring 1992 ¡

opportunity to say “goodbye” by means They will not die alone, but will be of a memorial service. On one occasion embraced by a group of caring indi- The Older Female Offender: 20 white helium-filled balloons repre- viduals who bring a commitment to Suggestions for senting those who had died were meeting the needs of others. Correctional Policymakers suspended over the altar in the Chapel. At the end of the service 150 women “I was scared at first,” says one of the Joann B. Morton filed into a courtyard in the pouring volunteers, “scared that I would say the rain and watched as the balloons were wrong thing, do the wrong thing, act Being old, being female, or being an released. The wind and rain threatened the wrong way. But now I look forward offender can all have negative implica- to whip them to the ground, but they to being with these women. They teach tions in our society. Combined, they began to rise, higher and higher, until me more about life than about death.” provide challenges for corrections one woman cried, “Look, they’re over now and in the future. Consider the the wall! They’re free.” Angela Church is a chaplain at the following: Federal Correctional Institution, The seed of Hospice is taking root at Lexington, n“Annie,” 72, a small, frail woman the Federal Correctional Institution in with scraggly white hair, crouched Lexington. As it flourishes it will against the wall as a group of boister- ensure compassionate concern for Mary Joe Powers, Registered Nurse, ous young women came down the hall. women who may die in prison. It will and Richard Price, This was her first week in prison and call forth the best from those LPN, provide she was terrified. Everything was new. inmates and noninmates-wh She was afraid that the fast-moving inpatient care volunteer. It will celebrate tht younger women would cause her to life of these women and give for geriatric fall. She knew people at home who had them dignity stroke victim. suffered broken hips and were never as human the same. She was confused by all the beings. noise and the instructions she had received; humiliated by the strip search and other intake processing; sore from trying to sleep 12 Federal Prisons Journal

mattress; upset because she had trouble age group (Feldman and Humphrey, you will have some idea of the diver- finding her room and had been repri- 1989). By the year 2030 forecasters sity among older people. manded by an officer. Above all, she expect 65 million people aged 65 and had an overwhelming dread of dying in older. Older women this stark, friendless place. Within the 65 and older age group the One way to define aging is chronologi- number of women is growing faster n The warden read the incident report cal. Using years, aging persons can than the number of men (Kart, Metress, and put it down with a sigh. What were be defined as: “older,” 55 and older; and Metress, 1988). Older women they going to do with “Mary”? Mary “elderly,” 65 and older; “aged,” 75 and make up some 60 percent of older had been in and out of mental hospitals older; and “very old,” 85 and over and prisons most of her adult life. She had a long history of assaultive behavior and at 60 showed no signs of mellowing. According to the report, this time she had hit her roommate with her cane and threatened to kill the officer who intervened.

These two cases illustrate the extremes correctional personnel face in dealing with older female offenders. They do not represent isolated instances. According to a recent study, women 50 years of age and older make up some 4 percent of the female inmates in this country (American Correctional Association [ACA], 1990). In 1990, the number of women 55 and older in State and Federal prisons was less than 1,000 (ACA Directory, 1991), but the (Lesnoff-Caravalia, 1987, p. 379). But Americans; as age increases the graying of the American population as chronological age is only one facet of percentage of women in the general well as mandatory sentencing, harsh aging, which can also be defined in population also increases. Life expect- public attitudes, lack of community terms of the physical, emotional, ancy for both Caucasian women and alternatives, increasing numbers of social, and economic changes that minority women averages 7 to 8 years women being incarcerated, and the come with advancing years. longer than that of men. Among longer lifespan of women will ensure minority populations the gap between that this number continues to grow. The rate at which these changes occur the longevity of men and women is This article will review some relevant and how people cope with them are the widest among Native Americans facts about aging and women as well as result of a complex interaction involv- (Lesnoff-Caravaglia, 1987). Longevity factors to be considered in program- ing heredity, lifestyle, socioeconomic does not, however, increase the quality ming for incarcerated older women. conditions, and access to medical of life; older women often outlive their services (Yurick, Robb, Spier, and support systems (see chart). The population of the United States as Ebert, 1984). Older people are an a whole is becoming older, with those extremely diverse group with widely Additionally, menopause, breast cancer 65 and older being the fastest growing varying needs. Compare the level of (the prevalent malignancy among functioning of your elderly relatives women; see Lesnoff-Caravaglia, 1987), with other older people you know and Spring 1992

as well as sensitivity in dealing with them, will help overcome some of the debilitating aspects of prison for older women. All staff—particularly medical staff—who work with this population nMore older women—particularly minority women—live below the should have training in gerontological health issues. Staffing patterns should nOlder women often “fall through the cracks” of medical and financial also reflect that supervising older support programs, as well as private insurance programs. women is often more time-consuming

nOlder minority women are more likely to be ill and need medical care. for a variety of reasons, including visual and muscular impairments that nOlder women make up three-fourths of all nursing home residents. slow them down. Staff must also confront their own fears of aging and nOlder women have a higher incidence of certain debilitating diseases, prejudices about older women. Not including strokes, visual impairments, hypertension, and diabetes. everyone can work effectively with this n Osteoporosis, a degenerative bone condition, causes women to be three to group. five times more likely to suffer from hip, back, and spine impairments. n Programming and supervision will nOlder women are portrayed more negatively than older men, categorized by have to be individualized to meet the stereotypes such as unattractive, ineffectual, unhealthy, asexual, and broad range of needs of this diverse group. Individual program planning is particularly critical in prerelease nMiddle-aged women find it more difficult to enter or reenter the workplace; they are viewed as “over the hill” at an earlier age than are men. preparation—women’s needs vary, as do community resources. Additional nAlthough older women outnumber older men, most research on older people lead time will be necessary in has focused on the impact of aging on men and ignored older women. prerelease planning for older women,

Sources: Lesnoff-Caravaglia, 1987; Kane, Evans, and Macfadyen, 1990; Yuric, et al., 1984; Mummah and Smith, 1981): to help with placement in residential I facilities for the elderly or in nursing homes, if needed.

and hysterectomies can cause dramatic female offenders. Combining what is nPhysical plant designs will need to physical and psychological upheavals known about aging and older women accommodate persons with a range with which women must cope. Finally, with issues relevant to female offenders of disabilities (this applies to male many women need encouragement to has serious implications for correc- institutions as well). Wheelchair take an active role in controlling their tional programming. While the vast access, color distinctions between lives (“Fighting for the rights,” 1991). majority of older womefloors, nd doorframes, n are reason- floors, walls, and doorframes, comfort- Keeping older women active and ably healthy, active people, lifestyle is able places to sit, and handrails will aid involved is critical in preventing a significant factor in how well one those who have limited mobility. Older dependency and helplessness. ages. Unfortunately the lifestyle of women need privacy and quiet space many female offenders is not condu- as much as or more than do younger Older women in prison cive to a viable old age. Incarceration women. Vulnerable older women, such Both older offenders and women also encourages dependency and as “Annie,” may need protection from more aggressive younger women. offenders are often referred to as passivity. Some of the immediate programmatic implications are: “forgotten.” Older women in prison are nThe use of outside consultants and almost totally overlooked, even among volunteers who have specialties in nStaff selection and training are the limited number of studies on gerontology will greatly enhance the critical. Awareness of medical and other factors involving older women, ¢¡ Federal Prisons Journal

ability of correctional personnel to deal The list above is only a beginning. constructively with older women in Older female offenders, even in small prison, as well as assist their transition numbers, pose many challenges for to the community. The network of correctional personnel. Now is the time service providers for the elderly, such to start addressing them, as well as as local Councils on Aging, can be considering alternative sanctions or invaluable in improving services for timely release of those who pose no older women. threat to themselves or the community. Acting now may avoid a costly nCreativity in modifying work and correctional crisis in the future. other activities to accommodate the interests, needs, and capabilities of Joann B. Morton, D.P.A., is an older women will also be necessary. associate professor in the College of Work and other programs—which are Criminal Justice, University of South not only critical to feelings of self- Carolina. worth but also, in many systems, mean time off of one’s sentence for participa- References tion—must be accessible to the elderly. 1991 ACA directory of juvenile and adult correctional departments, institutions, agencies. nInternal systems of rewards and and paroling authorities. 1991. Laurel, Md.: punishments must be reevaluated in American Correctional Association. light of what is effective for older female offenders and their long-term Feldman, R.H.L., and Humphrey, J.H., ed., 1989. well-being. The use of traditional Physician Assistant Charles Glass Advances in health education: Current research. volume 2. New York: AMS Press, Inc. lockups and loss of privileges may be (left), Federal Correctional Institution, counterproductive. Yet the “Marys” in Marianna, Florida. “Fighting for the rights of older women inmates.” this group must be handled as effec- AARP Highlights, July/August 1991, p. 1, 8. tively as possible under the circum- must be aware that it is all too easy to Kane, R.L., Evans, J.G., and Macfadyen, D., ed., stances. Flexibility and creativity are attribute symptoms of illness to old age 1990. Improving the health of older people: A essential. and ignore serious medical problems. world view. New York: Oxford University Press. Continuity of medical care upon nMedical services should not only release will require additional effort. Kart, C.S., Metress, E.K., and Metress, S.P., be gender-sensitive but be planned to 1988. Aging, health, and society . Boston: Jones Liaison with community health meet the needs of older women. This and Bartlett Publishers. providers will ensure accessibility to includes special diets, as well as medications and other services that Lesnoff-Caravaglia, G., ed., 1987. Handbook of physical therapy to counter osteopor- some older women will need. applied gerontology. New York: Human Services osis and other potentially debilitating Press, Inc. conditions. Regular mammograms, pap nIssues of loss, including death, also Mummah, H.R., and Smith, E.M., 1981. The smears, and other diagnostic work must be considered when working with geriatric assistant. New York: McGraw-Hill should be conducted in accordance this age group. Women will need legal Book Company. with prevailing community standards. assistance with matters such as wills An “ounce of prevention” will have and living wills, as well as spiritual The female offender: What does the future hold? 1990. Laurel, Md.: American Correctional long-term benefits. Many older women guidance and solace. When a death Association. are reluctant to assert themselves with does occur, it can be traumatic for both medical staff, or will simply agree with staff and other inmates who may have Yurick, A.G., Spier, B.E., Robb, S.S., and Ebert, instructions received without clearly worked closely with the older woman. N.J., 1984. The aged person and the nursing process (2nd ed.). Norwalk, Conn.: Appleton- understanding what is happening. Staff Counseling, crisis intervention, and Century-Crofts. closure in the form of a funeral or memorial service can be helpful. Spring 1992

The author (left), with Hospice volunteers—both inmates and community members. Games are important for the Hospice workers as well as the patients. Federal Prisons Journal

A Journey to Understanding and Change

Ann d’Auteuil Bartolo and refresher training to recreational staff and hire staff who specialize in female I have had a unique opportunity these last recreation—providing aerobics and 2 years, as Chief of the Female Offender exercise classes geared to women’s Section, to visit local, State, and Federal interests, and walking and jogging facilities housing females, and speak to programs that encourage them to release many practitioners involved in their tension and control their weight. administration. I have listened to the concerns of dedicated and knowledgeable nThe average female offender is more administrators and line staff, as well as receptive than the average male offender women offenders. By making use of their to programs and services offered by the shared knowledge and experiences, the chaplaincy staff. We must ensure that Bureau has improved programs and chaplains assigned to female facilities are services for the women in its custody. I open to an all-inclusive spirituality and would like to outline briefly some of the provide family-oriented services in which areas in which women offenders’ needs women can join with their children in differ from those of men. worship. nOne of the most significant differences nMore than 80 percent of women in the management of male and female inmates are single parents. The children inmates involves medical needs. Women are ordinarily cared for by the inmate’s have different medical needs and mother. The construction of facilities concerns than men, the most obvious reasonably close to where most inmates being gynecological care. Given the live will help maintain family ties. differences in diagnostic procedures, medical care is clearly more expensive These are a few of the issues surrounding and time-consuming for women—and It is important that we provide a female- the care and custody of women offend- there are the added issues of care for designed therapeutic model within the ers—a population that is increasing at a pregnant inmates and placement of prison setting that addresses these issues, faster rate than is the male population. newborns. We must train medical staff as well as a community support group The following articles, written from in female health care by providing that assists women leaving prison. several different perspectives—the orientation and refresher training and academic community’s, corrections hiring staff who specialize in obstetrics n Educational and vocational programs professionals’, and the women’s them- and gynecology. must be staffed and equipped comparably selves—do not “solve” these issues, but to those in male facilities. Most female I believe they will inspire both thought nWomen tend to react differently to offenders are high school dropouts; most and action. n their incarceration than men, and thus have poor employment histories and require different psychological services. lack skills that enable them to support The woman offender is more prone themselves and their children. Life Ann d’Auteuil Bartolo is Chief of the to depression—commonly related to skills classes, parenting classes, and Female Offender Section, Federal separation from her children, guilt over “reunification” programs for women Bureau of Prisons, and Guest Editor of her incarceration, poor self-esteem, and prior to their return to the community this issue of the Federal Prisons Journal. a history of abuse or neglect. A large need to be high priorities. number of women offenders have a history of alcohol and substance abuse. nRecreational programs are important tension-relievers at all facilities, but female inmates have different prefer- ences and tend to use different exercise equipment. We must provide orientation

16 Federal Prisons Journal

¡ ¢¤£ ¢§¦§¨©¡ § § ¨ £©¡ © ¢¤¡ ¡ ¢¤ !!©¢¤ © ¢¤"$#%!&¨'¦§¡ £( !! ¢" ¥ The American Prison From the Beginning...A Pictorial History. ¥ Spring I992 17

Equality or Difference?

Nicole Hahn Rafter nMy third example concerns pregnancy and birthing. If a female convict in one Over time, women in U.S. jails and of these early prisons was pregnant, she prisons have been incarcerated under had to deliver the baby alone, in her cell. enormously varied conditions. However, nThe first stage began about 1790, Predictably, infant death rates were very when the very first State prisons were one question has remained constant: founded, and continued to about 1870. high. Male convicts did not have to whether these women should be treated During this period, women were subjected contend with such problems. like male prisoners or differently. to essentially the same conditions as male inmates. As the decades passed and more female The current situation is complicated, prisoners accumulated, they were re- nThe second period covered the century however, by the growing realization that from 1870 to 1970, during which the moved to separate quarters, perhaps a outwardly “equal” treatment often means emphasis fell on differential treatment—on small cell block in a corner of the prison less adequate care for women. It does so providing care designed to meet what were yard or—toward the middle of the 19th because the standard is set on male terms thought to be the special needs of women. century—to a separate unit just outside that overlook important gender differ- the wall. Removal brought some advan- nThe third period began in 1970 and ences. Today, we are seeing a search for continues into the present. It has been tages. The women convicts were no new policies that can achieve equality characterized by a reaction against longer so isolated from other members while taking gender differences into differential treatment and a swing back of their own sex, and they were less account. The chart at right shows broad toward the idea of equal treatment. vulnerable to sexual exploitation. historical shifts in policies. But removal also took a toll. The further First period nMy first example concerns isolation. the women were located from the center Let me clarify some of the problems Alone in a sea of men, the women were of the prison, the less access they had to inherent in the first period’s straightfor- surrounded by members of the opposite whatever opportunities were available to ward equal-treatment approach. When sex. This created privacy problems, and the male convicts, such as medical advice the first State prisons were founded at the meant that they were more lonely than and services, religious services, and end of the 18th century, there were (as their male counterparts. It also made opportunities to exercise in the yard. The there are today) many fewer female than women more vulnerable to sexual isolated women’s units had no kitchens. male convicts. With only 1, 3, or 10 exploitation by “guards” and male Food was carried to them from the men’s female prisoners, States had no need for a prisoners. quarters, often just once a day, usually cold. And if the warden did not hire separate women’s institution. They began nA second example, concerning prison a matron to supervise the women’s by operating just one prison or peniten- personnel, also shows how apparent quarters, female inmates had no protec- tiary to which all felons were sent, equality created harsher conditions for tion from one another. There are records regardless of sex. In these early institu- the few women in these early institutions. of some wild fights in these early tions, women were often celled next door All the staff were male—not only the women’s units. to men. Outwardly, they received the guards but the physicians and chaplains. same treatment. But this ostensible Visitors from the outside, like the guards In sum, during this first stage in women’s equality in fact meant more difficult on the inside, identified more closely prison history, from roughly 1790 to circumstances for women, as three with the male than the female convicts. 1870, the policy was to treat female and examples will illustrate: For visiting physicians and chaplains, as male convicts alike. But because the for members of their broader culture, norms were set by male officers with women belonged on a pedestal; thus, if a reference to the needs of the far larger women “fell,” she fell farther than any man, and must consequently be far more depraved. Physicians and chaplains therefore often steered clear of the women, giving more attention to the male convicts. ¢¡ Federal Prisons Journal

number of male convicts, outward identify—white women found guilty of equality in fact produced inferior misdemeanors or (more frequently) conditions for incarcerated women. offenses against chastity. The new women’s reformatories held these minor Second period offenders on long sentences—terms equivalent to those imposed on felons in This situation began to change about the State penitentiaries. 1870, as the ideal of rehabilitating prisoners took hold. Interest grew in Thus, differential treatment carried its reforming female as well as male own set of liabilities: convicts. However, due to the “separate spheres” doctrine—according to which nWomen imprisoned in female reforma- men are best fit for public work, while tories were forced into a “true woman” women are inherently better at dealing mold of domesticity that infantilized and with domestic tasks, children, and other ill-prepared them for self-support in an women—the job of reforming female industrializing society. criminals was relegated to other women: nMoreover, minor female offenders middle—class reformers. were now held on very long sentences— much longer than those to which male This task was welcomed by late 19th- misdemeanants were subjected. century feminists, who threw themselves into the task of establishing separate nAnd, of course, males were never sent women’s reformatories. These middle- to State prisons for violations of chastity. class feminists succeeded in the often were sent to positions as domestic The women’s prison system became a very difficult job of persuading all-male servants, where they could be supervised means of enforcing the double standard legislatures to fund separate reformatory by yet other middle-class women. of sexual morality. prisons for women. When the new reformatories opened, these reformers In short, the regimen of the first separate Third period frequently became the administrators. penal institutions for women was The ideal of differential treatment of infantilizing: inmates were treated as male and female prisoners prevailed The reformers established the principle wayward children rather than responsible through the 1960’s, a persistence that women in prison must be treated adults who, after release, would have to illustrated by a 1960’s recommendation entirely differently than male prisoners. live independently. The reformers did not that a certain women’s prison develop Copying the mode1 of the juvenile face the fact that most of their charges a dairy industry. Milking cows, the reformatory, they built the new women’s would have to support themselves. formulator of this policy argued, is an prisons on the cottage plan. Inmates lived Alderson—the first Federal women’s excellent activity for women prisoners, in relatively small “cottages,” or indi- prison—was built during this period. since women have a natural affinity for vidual units, where they could be Like its State counterparts, Alderson udders! supervised by motherly matrons. adhered to the principle that women should be treated differently than men. The women’s movement of the late Programmatically, the new women’s 1960’s brought a reaction against such reformatories were designed to rehabili- Differential treatment manifested itself talk, however, and renewed demands for tate by inculcating domesticity. While in sentencing practices as well as in equal treatment of male and female the programs included outdoor work, architecture and programs. The reformers inmates. The tide began to turn against inmates were mainly trained to sew, who founded the State reformatories for cook, and wait on tables. At parole, they women had little interest in dealing with felons—serious offenders who were also often black. The reformers preferred to direct their rehabilitative efforts toward minor offenders with whom they could ¢¡ Spring 1992

domestic training. Instead, advocates male needs uppermost in mind. Deliber- insisted on programs that would prepare ately differential treatment, alone, also released women for real-world jobs and spells inferior treatment, for it reinforces self-support. the gender division of labor.

Another signal of the shift back to the Today, policymakers are seeking ways to ideal of equal treatment was a wave of go beyond both the equality and differ- litigation against differential care. For ence models. I want to stress “beyond.” example, in the 1960’s female inmates The move is emphatically not toward began using the courts to challenge merely combining the two approaches, sentencing laws that made them liable to for the result would be to compound their longer terms than men who had similar individual disadvantages. Rather, the records and conviction offenses. search is for a way, or ways, to transcend the traditional approaches by developing We are all familiar with aspects of this a new model. drive toward equal treatment. But many people are unaware that it has been This new model will no doubt borrow accompanied by a growing perception the best elements of the two older that equal treatment usually means less approaches. But it will also have to find ways of avoiding their inherent draw- adequate treatment. Inferior care is the Law library, Federal Correctional Institution, rule because today, as in the first stage, Marianna. Florida. backs. As yet we do not know what the the ideal of equality does not take gender new model will look like. We do know differences into account. Two examples that merely extending the older ap- constitutes the major hardship for illustrate this new awareness: proaches will perpetuate a tradition that incarcerated women. The studies began to form on the day the first State n show that separation is also devastating One concerns law libraries. Incarcer- prison received its first female convict. for the children, who must keep in ated women are finally being given law That tradition, whether based on the idea contact with their primary parent if they libraries as adequate as those available to of similar treatment or different treat- are not to suffer severe psychological incarcerated men. But because women ment, has been one of automatically damage. Thus, although male and female have no tradition of “jailhouse lawyer- condemning incarcerated women to ing,” they are less skilled in using legal prisoners are both separated from their inferior care. n resources. Thus, several recent court children, this situation affects them decisions have ordered not only adequate differently and has different social consequences. law libraries, but legal training for female Nicole Hahn Rafter is a professor in the prisoners, so that their level of access to College of Criminal Justice, Northeast- the courts will in fact equal that of males. Beyond the models ern University, and is the author of These decisions recognize that equality Partial Justice: Women, Prisons, and Today, the two major historical themes involves parity—actual as well as Social Control (Transaction Publishers, apparent equivalence. of equal and differential treatment are flowing together. Those involved 1990, 2nd edition). A version of this nA second, very different, example of with planning for female prisoners are article was presented at a Federal Bureau of Prisons “Issues Forum” in the need to recognize gender differences trying to deal with both considerations June 1991. concerns children. Unlike incarcerated simultaneously. men, most women in prison leave behind children who are solely dependent on This confluence signals an awareness them. Every study of this matter con- that neither approach works well on its cludes that separation from children own. Outwardly even-handed treatment produces inferior treatment for incarcerated women because the norm is still set by male administrators, working with 20 Federal Prisons Journal Spring 1992 21

The Alderson Years

Esther Heffernan endure the belittling of my part in Alderson, West Virginia, the first every accomplishment resulting Editor’s note: Professor Heffernan’s Federal institution for women, from years of devoted labor...[and article is an excerpt from a larger work, opened in 1927, predating the it is] unjust to give you, a new- “Banners. Brothels, and a ‘Ladies founding of the Federal Bureau comer to the whole problem, sole Seminary’: Women and Federal Correc- of Prisons by 3 years. At that credit and picture me as a danger tions.” first presented at the Conference time, the few Federal wardens to prisons. on the History of Federal Corrections in operated largely independently; March 1991. The full paper traces the it was not until several years In turn, in his memoirs, Bennett attrib- influence on corrections of the Progres- after the founding of the new utes the passage of appropriations for sive movement and the struggle for agency that directors Sanford Alderson to President Calvin Coolidge’s women’s suffrage; this excerpt examines Bates and James V. Bennett recommendation in his State of the the early years of Alderson and the were able to exercise effective Union Address, with no mention of repercussions of that experience on the control over the wardens. One of Willebrandt’s role. Bureau’s institutions for women through the most independent-minded World War II. wardens was Mary Belle Harris In the critical years from 1925 to 1929, of Alderson. while Willebrandt remained at the James V. Bennett, for 27 years director Department of Justice and fought for the of the Federal Bureau of Prisons, in his needed appropriations, Mary Belle Harris memoirs, begins the chapter “Women developed her “grand experiment” at Behind Bars” with the statement: “No Assistant Attorney General Mabel the new institution at Alderson, West one has really known what to do with the Walker Willebrandt played an important Virginia. At a cost of $2.5 million (with few women who are condemned to role in laying the groundwork for the the aid of male prisoners brought from prison, least of all the federal govern- Bureau of Prisons. By the end of her Leavenworth and Atlanta and housed in ment.” He comments later that with the tenure in the Department of Justice, an adjoining camp), 14 cottages (segre- “leniency,” “mercy,” and “favorable denied the Federal judgeship that she had gated by race), each containing a kitchen treatment” that women receive in the expected as a reward for her competence, and rooms for about 30 women, were courts and corrections, he is led “to commitment, and loyalty, Willebrandt built in a horseshoe pattern on two tiered wonder why the public paid so much watched the political influence of women slopes. Administrative buildings and attention to such a relatively insignificant wane and her contributions be attributed cottages were named in honor of Kather- sector” of crime and corrections. to others. In 1929, in response to an ine B. Davis, Mabel Walker Willebrandt, editorial recommending that the newly Ellen Foster, and Elizabeth Fry—all The early publications of the Bureau of formed Bureau be taken out of her important figures in the history of Prisons reflected that “insignificance.” jurisdiction, she wired Attorney General corrections. Bureau staff, inmates. and programs were William D. Mitchell: exclusively identified as male, with the According to Eugenia C. Lekkerkerker, few exceptions in which women (3.9 I think you owe it to me to make a writing in 1931, “it is undoubtedly the percent of the prisoners in 1930) were statement of facts...that it is due largest and best equipped reformatory designated a “problem.” With the solely to my labor and vision that that exists.” However, she voiced some creation of the Bureau in 1930, women the prison bureau is reclassified concerns that have a familiar ring to moved into a new status in Federal into a scientific major bureau.... contemporary observers: the heterogene- corrections. As a monument to my hard ity of the population—rural South to work...a first offender’s reform industrial North, “white and colored, atory has been established at Indian and Mexican, Chinese and Chillicothe...a modern women’s Japanese women”; the nature of Federal institution established at Alderson...and industries started at Leavenworth...1 can no longer 22 Federal Prisons Journal

offenses, which brought “a large number his famous 1928 report on “The Federal of drug addicts into the reformatory”; Penal and Correctional Problem” for the and “the difficulty of contact with the U.S. Bureau of Efficiency (the ancestor communities from which the women of the Office of Management and come, with their families and other Budget), described Alderson as “a social relations.” Despite the myth that complete and self-sufficient institution Alderson opened its doors with capable of adequately caring for all moonshining women from the hills Federal women prisoners for some years of West Virginia, in the first year of to come.” He praised the “modem” operation before its formal “opening” on facility as representing “the best thought November 14, 1928, 174 women had in penological methods.” been sent to Alderson from State prisons and jails, 119 of whom were drug law In Bennett’s discussion of the need for violators, while only 1.5 had violated specialized Federal institutions for men, prohibition laws. A.H. Conner, in his he noted that Alderson’s cottage plan testimony in 1929, commented that “70 “permits the individual treatment of to 80 per cent...were coming suffering women” with “their segregation into from social diseases” so that “we can groups and cottages, by classes or types.” not use them around the dairy and the However, he added a cautionary note that kitchens and until they are cured they can became a major point of dispute and a not be put at any hard physical labor.” and individualized treatment under the continuing issue in the Bureau: “Will [the Hospitalization rather than industry joint watch of the staff and the inmate Federal Industrial Institution for Women] appeared to be the first need at Alderson. members of the Co-operative Clubs. Bird be able to handle successfully all the and Tree Clubs, pageants and plays, women who are committed to it?” Mary Belle Harris, in her autobiography athletic teams, and well-censored movies I Knew Them in Prison (1936), describes enlivened leisure hours after the Claudine SchWeber’s excellent research the development of an individualized women’s work on the farm, on the on the early history of Alderson summa- classification system, the institution cottages and grounds, and in Alderson’s rizes the key issues for a woman’s of inmate self-government with Co- garment industry. Harris quotes an institution after the creation of the operative Clubs, and her insistence that inmate as saying: “This is the goin’est Bureau of Prisons: the “warders” in each cottage be included place I ever saw.” With an annual in decisionmaking and the classification Country Fair, which exhibited the works After 1930 Alderson’s relations to process. Educational classes were begun of the cottages and industries and the its superiors were characterized (segregated by race for the 20 percent wares of the farm, Harris brought the by continual conflict from which “colored”), ranging from English and local community, as well as the members few areas were immune. In part, arithmetic to table service, elementary of the Advisory Board, into her open the struggle flowed from the agriculture, stenography, and typewrit- institution. Bureau’s push to consolidate its ing, and capped with Bible study and authority and to limit institutional elementary and advanced Americaniza- In fact, the “excellent treatment” and the autonomy. In part, it flowed from tion (developed for immigrants, the latter “wonderful buildings” for the women the fact that “in many instances, stressed civics and home economics). offenders led Representative William F. the only point in the whole system Kopp in the 1929 hearings (in addition to where the [Bureau] met any Determined that drug addicts were not calling Alderson a “women’s seminary”) resistance was at [Alderson].” “hopeless,” Harris emphasized the need to wonder “whether or not it would rather Most important, the men at the for withdrawal under medical supervision unfit them for meeting the world—when Bureau disagreed with the women you send them back to the household of Alderson’s contention that as a duties of ordinary homes...they might women’s institution it should be lose courage and want to get back to Alderson again.” However, Bennett, in Spring 1992 23

A few years ago, there was a sentimental outcry against doom- ing the inmates of correctional institutions to the drudgery of the kitchen and of domestic service. My experience here and in other institutions has been that most women are greatful [sic] for the opportunity to learn how to keep house well.

She concludes by noting there is a good defense for training women “and men, too, for that matter,” in basic household skills.

In her regular reports in Federal Offend- ers from 1930 to 1940 (the last issue to include Warden’s Reports), there is no direct mention of the nursery at exempt from many policies and example of the process. In Federal Alderson, and only an occasional practices that had been devised for Offenders 1933-34, Warden Hill of reference to the number of births, three the largely male inmate population Lewisburg Penitentiary proudly reports in 1940 and a “birth of triplets to a of the system. Whereas Alderson’s on the new policy that “this is possibly colored inmate” in May 1937. Nor do correctional superiors in the the only prison in the United States her memoirs touch this dimension of 1920’s included a powerful where every prisoner who has ever Alderson’s programs. Lekkerkerker’s woman, Willebrandt, who agreed entered it has been required to appear description of Alderson in 1931 includes with the women-oriented ap- before such a Board.” Superintendent mention of a “fine maternity cottage.” proach, leadership of the Bureau Harris (who fought the title of warden But only in later Bureau of Prisons of Prisons during the 1930’s was until 1937), in her section of the report, descriptions of Alderson (1942 and composed of men who did not. notes that at Alderson, where this had 1957), where it is noted that “the Conflict was inevitable. been the practice since the opening of presence of babies in the cottages adds the institution, not only does each new to the homelike atmosphere,” do babies Ironically, the “women-oriented” commitment come before the Board, and classes in child care become integ- approach of Alderson in classification, but every woman in the institution is ral to the perception of Alderson as a specialized programs for drug addiction, reviewed every 3 months! In Federal “women’s institution.” However, forms of inmate self-government, unit Offenders 1935-36, Harris comments according to Virginia McLaughlin, management, and cottage-style open that Alderson’s classification process is Alderson’s fifth woman warden, in the institutions became the pride of the “shaping its activities to conform with late 1940’s, Helen Hironimus, Alderson’s Bureau of Prisons—but only when they the general classification program of the second warden, accompanied her annual became Bureau policy and were insti- department.” reports with pictures of babies to remind tuted in male institutions. The early the Central Office that the babies were introduction of Classification Boards in Interestingly, regarding those aspects uncounted “inmates,” lost in the cost- the Bureau provides an interesting of Alderson that were truly “women- accounting of the Bureau. Elizabeth oriented”-the cottage-centered kitchens Gurley Flynn, in her inmate’s view of and the presence of a nursery-Harris Alderson in the 1950’s, mentions that the was either relatively silent or somewhat defensive. In Federal Offenders 1930-31 she commented: 24 Federal Prisons Journal

babies remained in the cottages with their Harris argued that, with inmate coopera- mothers for a few months, a shorter time tion and skillful handling by staff, with than a year or two earlier, but that “the very few exceptions—when the good of parting of mother and child, especially the institution overruled the needs of the if she faces a long sentence, was woman—Alderson’s open institution heartrending.” could handle all commitments. She questioned the assumption in Alderson’s In the 1960’s, Federal judges were enabling legislation that some women surprised at the number of babies born were not “reclaimable,” and denied the at Alderson, but were concerned that a need for a separate facility for “desperate difficult pregnancy might mean a 50-mile and incorrigible” women. Nevertheless, trip on mountain highways to the nearest as Bates describes in his memoirs, in the specialized hospital. But, according to newly opened Federal Detention Farm at Virginia McLaughlin, the end of the era Milan, Michigan, “a small section of the came when “two high-powered social cell block at Milan has been completely workers came down from [the Depart- sealed off from the rest of the institution ment of Health, Education and Welfare] and contains twenty-two cells for and said ‘prison is no place for a child’.” women.” In the Federal Offender for Between the forces of centralization 1933-34, Bates notes that “they can be in the Bureau of Prisons, which had adequately guarded by armed officers difficulty handling a “woman’s institu- and housed in the more traditional type tion,” and a “child-saving” perspective The laundry was one of the few “industrial” of steel cells” with a “matron and number jobs available for Alderson inmates. that included “saving” a child from an of warders” to “assist the Superintendent inmate mother, Alderson lost its babies. in guarding these women.” The issue was exemplified in the conflict While Sanford Bates in 1936 described over whether there was a need for a In the intervening years, as reported by Harris’ administration as “one of the maximum-security Federal facility for the warden of Milan in Federal Offend- outstanding accomplishments of the women. Harris’ description in 1936 of ers 1940, in addition to the “problem Federal penal system,” Bennett, by 1970, Alderson’s “five rooms of reinforced women” the Bureau used the institution characterized Harris’ tenure as one concrete” in the Reception Center and for “informers...narcotic addicts, consti- whose aim was to make Alderson “as “two small barred cottages” for a tutional psychopaths, and homosexuals nearly as possible like an old-fashioned possible 48 medium-security women, who were found troublesome elsewhere.” girl’s school.” Bennett attributed to with accompanying anecdotes on her In 1936, a transition year from the himself the creation of women’s open handling of “resisters and smashers” and administration of Sanford Bates to James institutions and experimentation in self- “molls,” was in reaction to Bates’ Bennett, Bennett called for a maximum- government. Alderson’s “remote decision in 1933 that: security institution for women: “We need location” was viewed as “a problem for to specialize our institutions for women Sanford Bates and the rest of us” trying The conviction of a number of just as been done for men.” Citing the “to develop a realistic rehabilitation women during the past year for fact that Alderson was overcrowded, with program for women.” Significantly, serious and desperate crimes or for more than 200 women boarded out at Harris’ effort to demonstrate that women aiding gangsters and racketeers has non-Federal institutions under contract, were as capable as men left her vulner- made it necessary to provide a he mentioned that a new jail was planned able to Bates’ and Bennett’s argument special place for their incarceration for Terminal Island in California, which that women inmates should be treated in an institution of the maximum would accommodate 24 women in a wing “like men.” security type. The Federal Indus- of a facility built to house 600 men. trial Institution for Women at Despite his call for specialization, the Alderson was not designed and is new maximum-security institution as not equipped to handle women who Bennett described it would house are desperate and incorrigible. ¤§¦ Spring ¢¡£¡¥¤

request for three new institutions—one a women’s facility in the Southwest: “It is an extremely expensive and undesirable situation to be forced to transport these women all the way to Alderson.” In 1937, more than 1,267 Federal women offenders had been committed from the courts, with 400 sent to Alderson and the rest to State institutions.

A Congressman inquired whether the new women’s institution would “be along the line of the Alderson Reforma- tory, with cottages?” Bennett replied: “It will be more in line with a maximum- security institution.” All of the 25 long- term problem women would be taken out of Milan (where they had no exercise space and little employment) and the “drug-addict population” would be divided between Alderson and the new custodial institution. Bennett admitted that “certain women’s organizations feel we are discriminating against women ...not only the approximately 250 The issue was one of principle: prisoners, because there are no facilities, women who come from western comparable with the facilities at Lexing- districts at a considerable saving in I do not believe that a maximum ton and Fort Worth, for handling women transportation costs but also accept security institution for women is addicts.” those most difficult cases originat- necessary, and I feel that it would ing in other sections of the coun- be a decided letting down of our When the new Federal Reformatory for try...unregenerate keepers of standard if such an institution were Women officially opened on October 10, houses of prostitution, gangsters’ proposed. I am convinced that we 1940, in Seagoville, Texas, it was an “molls,” and confirmed drug users. have made a demonstration here open institution. With a capacity for 400 which has set a standard for the women, situated on farmland, it was Harris fought back. In her “Report of the country, and that it would be built on a cottage plan similar to that of Superintendent,” following Bennett’s considered a set-back if we should Alderson. It appears that Harris had . “Introduction,” she responded: depart from the policy so far won—and Bennett lost. How did it adopted here and in well conducted happen? It seems that the time has come, state institutions for women. which was anticipated when this The records are scanty. A 1958 brochure institution was built, to plan for an However, her argument was weakened on Seagoville indicated that the first institution west of the Mississippi, by her request that the courts select cases warden (Helen Hironimus—Harris’ built like this on the cottage for Alderson “in which there is the long-time friend and assistant) “good- plan...to care for a population of greatest possibility of reclamation.” By naturedly begged, cajoled, and browbeat 500, and with cottage facilities for implication, the other women would be her Washington superiors into giving her 300 at the outset. contracted to the States. funds for the progressive development of

In 1938 Bennett approached the House Appropriations Committee with a 26 Federal Prisons Journal

its plant.” However, it appears that the “one or more of the following: music, “great coalition” of Progressive women’s sewing, knitting, dressmaking, weaving, clubs that had helped bring Alderson into laundry work and nursing.” being may have been rallied again. In Federal Offenders 1936-37 H,arris The next year at the appropriation described the great celebration in hearings, a Congressman raised the May 1937 of the 10th anniversary of question: “What was the reason for Alderson’s founding. Key participants having women at Terminal Island? Was in the earlier victory, Mabel Walker there any effort to move them to any Willebrandt and Julia K. Jaffrey, as other place?” Bennett responded: “Yes, well as the chair of the Public Welfare sir. We are moving these women to Committee of the General Federation of Dallas. We put them at Terminal Island Women’s Clubs, gave speeches. Bennett simply because we had no other place to was present. In other “Reports” Harris put them.” With the closing of Terminal describes Eleanor Roosevelt’s visits and Island and Seagoville in 1942, some of interest in Alderson. There is some the women were put in non-Federal indication from the nature of the ques- institutions, and the others joined the tions at House Appropriation Hearings women at Alderson. that the “heavy artillery” the women’s clubs were able to muster had affected Fifteen years after its founding, Alderson members of the Appropriation Commit- was once again the only Federal institu- tees as well as the Director of the Bureau tion for women offenders. Ironically, of Prisons. during World War II, the “ladies seminary” performed the function that during By 1941, when 104 women were at World War I transformed former brothels Seagoville, the members of the House first parole board, moved from assistant into Federal detention centers for women. Appropriations Committee quizzed to warden. In March 1942, Seagoville With the passage of the “May Act,” Bennett on a $5,000 item for fencing— became a Federal Detention Station for patterned after the World War I antivice was it to keep cattle or people in? Japanese, German, and Italian families. legislation, as a contribution to the war Bennett replied that it was to keep cattle Amy Stannard remained as administrator, effort, Alderson became the temporary in and people out. The Congressmen but the women staff and inmates returned “home” for several hundred women appeared somewhat startled to discover to Alderson, and the Federal Reformatory arrested for prostitution in military areas. that the women were doing the farming: for Women ended its short career. In 1945, it was reported that 52 percent “But they drive the tractors?...They bring of the women committed to Alderson that home the cows and do all the regular Terminal Island’s first life as a men’s year suffered from venereal disease. farm work?” Bennett replied in the facility with a “wing for women” also Perhaps the situation can best be de- affirmative. came to an end with World War II. In scribed as providing a final twist to the 1940 Bennett reported to the members of end of an era for women in Federal But the history of Seagoville as a the House Appropriations Committee corrections. n woman’s institution was short-lived. In that Milan’s “notorious cases” had been 1941, with the retirement of Mary Belle transferred to Terminal Island. The Harris, Helen Hironimus returned to removal of the women from Milan Esther Heffernan is Professor of Sociol- Alderson as warden. Amy N. Stannard, brought the number of women at ogy at Edgewood College, Madison, who had been a member of the Bureau’s Terminal Island to 56. According to the Wisconsin. warden’s report in Federal Offenders 1940, while vocational training for the men was limited, vocational training for women was “progressing nicely,” with all of the women inmates enrolled in Spring 1992 27

HIV, AIDS, and the Female Offender

the U.S. and worldwide. At least one 150,000 Americans had been diagnosed drug, AZT, may slow the progression of with AIDS, two-thirds of whom have the HIV infection. In addition, there are since died. The CDC estimates that by In 1990, the number of reported Ac- medications to treat certain opportunistic the end of 1993, 390,000 to 480,000 quired Immunodeficiency Syndrome diseases to which people with AIDS are Americans will have been diagnosed (AIDS) cases among women in the U.S. susceptible. with AIDS—with between 285,000 and exceeded 15,000, an increase of 34 340,000 deaths. percent from 1989 and approximately 9 Nevertheless, the Centers for Disease percent of all adult AIDS cases in the Control (CDC) estimates that a million The disease is no longer primarily the U.S. As the AIDS epidemic approaches Americans are infected with HIV, most affliction of well-defined risk groups, its second decade, both the number of of them with no symptoms and no according to the National Research new infections with HIV (the Human knowledge that they are carriers. Another Council. In particular, heterosexual Immunodeficiency Virus that causes the 7 to 10 million people around the world transmission is on the rise: though it still disease) and the number of full-blown are also infected, according to estimates accounts for a relatively small percentage cases of AIDS are expected to continue by the World Health Organization of U.S. cases, it is the predominant mode rising sharply for the next few years in (WHO). At the end of 1990, more than of spread in most countries. Among

Fred DeVita 28 Federal Prisons Journal

American heterosexuals, sexual partners nAssays of more than 16,000 blood of IV drug users and people who have samples collected in health centers at 19 multiple partners remain at greatest risk. United States universities revealed an Some additional facts: HIV seroprevalence rate on campus of 0.2 percent (1 in 500 students)-within nBy the year 2000, 25 to 40 million the range found in other national surveys. people will be infected with HIV While no HIV infection was found in internationally, according to projections more than half of the schools, one by the World Health Organization. school had a rate approaching 1 in 100. nAIDS is rising sharply among Ameri- Seroprevalence increased with age, can women, especially poor blacks and reaching 1 percent in students over 40, Hispanics. The death rate from AIDS and was 25 times higher in men. Because among women aged 15 to 44 quadrupled many students still have misconceptions between 1985 and 1988, and undoubtedly about the modes of HIV transmission, will continue to rise. By the year 2000 and because some high-risk behaviors the number of new cases among women (such as sex with many partners) are worldwide will begin to equal the common on campus, HIV may spread number of newly diagnosed men, further in this population. according to WHO estimates. As of 1990 about 700,000 infected infants had been Epidemiology of HIV born worldwide. About 10 million infection in women infected infants will have been born by According to data published by the CDC, the year 2000, according to WHO data, as of January 1989, 52 percent of women and there will be millions of uninfected diagnosed with AIDS in the United orphans whose parents have died from States are intravenous drug users: 30 AIDS. About 6,000 infected American percent were exposed to HIV through women gave birth in 1989 alone (one- heterosexual contact, and 11 percent third of babies born to HIV-positive received HIV-infected blood or blood mothers in the United States became products. The transmission category for infected). the remaining 7 percent is “undeter- nAIDS is not just a disease of young mined.” A significant trend noted people. Those over age 50 account for between 1982 and 1986, however, is the about 10 percent of all U.S. cases. AIDS- hundredfold increase in the percentage of related symptoms are more likely to be female cases classified as heterosexually misdiagnosed among these older people infected partner. Overall, the rate of transmitted, which has increased an because doctors may assume that they are transmission from men to women was additional hundredfold since 1986. not at risk. 27 percent. Three independent factors significantly increased the risk of About half of the women with AIDS in nTo identify risk factors for the trans- transmission: full-blown AIDS in the the U.S. are aged 30 to 39; 90 percent of mission of HIV from men to women, a men, the practice of anal intercourse, and adult female cases occur in women aged European study group analyzed 155 a history of sexually transmitted disease 20 to 50. CDC data underscore HIV’s couples recruited from six European in the woman. Couples with none of disproportionate impact on minority countries. Couples were included only these risk factors had a transmission rate populations. Although 17 percent of all if the men were infected first and the of 7 percent; couples with two or three women in the U.S. are black or Hispanic, women had no risk factors other than an risk factors had a rate of 67 percent. The blacks and Hispanics account for 73 authors concluded that the risk of male- to-female transmission of HIV varies considerably and depends on the couple’s clinical and behavioral characteristics. Spring 1992 29

percent (52 percent and 21 percent, At 9 of the 10 correctional facilities, It is assumed that these children were respectively) of reported AIDS cases women had higher rates of HIV infection born to infected mothers and were among women. This number reflects the than men. The difference was greatest infected themselves during the perinatal prevalence of intravenous drug use in among prisoners under age 25, with 5.2 period. (While the exact methods of some black and Hispanic communities, percent of women in that age group perinatal transmission remain unknown, particularly on the east coast. Although testing positive, compared with 2.3 both transplacental and postpartum most States have reported adult female percent of the men. Minority groups also transmission have been suggested by AIDS cases to the CDC, more than half had higher rates of infection: 4.8 percent case reports.) The relative risk of HIV of these cases have been reported from overall, compared to 2.5 percent of white infection to the fetus of an infected the northeastern States—half in New inmates. No major difference in HIV woman is not known. In an early study York alone. infection rates was found between of infected mothers who had previously prisons and jails. delivered infants who developed AIDS, Fifty-nine percent of women with AIDS 57 percent (6 of 14) of babies born reported to the CDC have subsequently subsequently were also infected. In died, compared to 50 percent of men. contrast, no babies born to women AIDS has a significant impact on Although impregnated by artificial insemination mortality patterns for women in areas showed evidence of HIV infection after where HIV infection is common; it has most States have 1 year of followup. (Because these were now become the leading cause of death small studies, it is important to empha- for women aged 30 to 34 in New York reported adult female size that the risk estimates are varied and City. AIDS cases to the CDC, uncertain.)

The virus that causes AIDS may be more more than At this time, outcomes for the newborn common among prison and jail inmates, cannot be predicted by the clinical especially women, than previously half of these cases status of the mother during pregnancy. thought, according to a study based on have been reported Infected babies have been born to testing of nearly 11,000 inmates entering women who are HIV-positive but have 10 prisons and jails between mid-1988 from the northeastern not developed symptoms, as well as to and mid-1989. The study, conducted by mothers with AIDS. A mother with the Johns Hopkins School of Public States—half in New AIDS can also deliver a baby with no Health and the Centers for Disease York alone. evidence of disease. Transmission from Control, found that rates of HIV infection an infected woman to older children or to ranged from 2.1 to 7.6 percent for male other household members who are not inmates, and from 2.5 to 14.7 percent her sexual partners has never been among females.* documented. In April 1992, 12 percent of HIV- positive inmates in the Federal Bureau of HIV infection and AIDS in *Earlier studies indicated HIV infection rates Prisons were women. However, the rate as high as 17.4 percent among inmates from the of infection among women was higher— correctional facilities New York City area, but far lower rates elsewhere. 1.52 percent, versus .9 percent for males. While the crisis atmosphere surrounding The names of the prisons and jails in the more recent study were not released, but were said to AIDS in prisons and jails seems to have represent all areas of the country. The findings Transmission during dissipated, the disease remains a serious were reported in the Journal of the American pregnancy issue for correctional administrators. Medical Association. Concern has shifted significantly from The vast majority of adults with HIV short-term matters such as fear of casual infection are in their reproductive years. transmission to “long-haul” issues such According to CDC data, the risk factor as housing, programming, and medical for about 78 percent of the children who care for prisoners who have HIV have AIDS in the U.S. is a parent with infection. AIDS or in an AIDS risk group. 30 Federal Prisons Journal

As the population ages, and as determi- 3 “Since 1979, have you ever had nate sentencing and strict sentencing sexual relations with a person at risk for guidelines continue, inmates will age Some symptoms AIDS—someone who injects drugs, a within our facilities. We will see more gay or bisexual man, a hemophiliac, or a and more women of childbearing age of HIV infection are person from Haiti or Central Africa?” If who are infected. The historic differences similar to those commonly yes, further history should be taken on between the Federal offender versus the clinical status of the person at risk, offenders within State, city, or county seen in problem the type of sexual activity involved, the systems have become blurred by the duration of the relationship, and the use issue of drug trafficking. These offenders pregnancies— and type of contraception. tend to be less well educated, predomi- fatigue, anorexia, weight 4 “Have you had any anonymous sexual nantly urban, and from depressed partners or partners that you did not socioeconomic backgrounds. The loss, and shortness of know well who may possibly have been frequent victimization of female offend- in AIDS risk groups?” Many women do ers also increases the risk for hetero- breath. Health care not know the risk status of all their sexual sexual disease transmission. workers caring for partners. The question is most relevant if the patient lives where HIV infection is Although during its first appearance pregnant women in HIV common. within the correctional setting, AIDS victims were predominantly white risk groups must assess 5 “Have you tried to become pregnant homosexual or bisexual males, hetero- these women carefully for through artificial insemination since the sexuals and minorities are being infected late 1970’s? If yes, where?” Again, this in increasing numbers. In society, the signs of HIV infection. question is most relevant if the patient disease currently has a greater impact on lives where HIV infection is common. the IV drug user population than on the 6 “Have you received a transfusion of homosexual community. In the Bureau of blood or blood products since 1979?” If Prisons, a considerable percentage of yes, ask when, where, and how much however, are not so easily identified. A present and future inmates will come blood. The risk is higher if a woman comprehensive patient history will help from backgrounds of IV drug use, or will received transfusion before 1985 in an identify some women at risk. Appropriate have had intimate contact with IV drug area where HIV was common. users. questions can be inserted into the social, sexual, and medical portions of the 7 When applicable, “are you from Haiti Although current data suggest a roughly history. These sensitive matters may then or Central Africa?” 1-percent seropositive rate of HIV be documented in a way that maximizes 8 “Is there any other reason why you confidentiality. infection (a composite infection rate, think you might be at risk of exposure to slightly less for males and slightly more 1 “Have you ever been tested for HIV?” This question may lead to the for females, using current Bureau antibodies to AIDS virus? If so, what was patient’s revealing an additional possible monitoring standards), this still exceeds the result of your test? When and why risk factor, such as providing health care the estimated seroprevalence within the were you tested?” to people with AIDS or HIV infection. at-large population of .005 percent. The question also gives the woman a 2 “Since the late 1970’s, have you ever chance to express her fears about AIDS Evaluation injected drugs into your body with a so that the health care worker can needle? If yes, have you shared needles Intravenous drug users in treatment evaluate her needs for information. with other people?” If a woman is or has programs and those who have the been an IV drug user, a history of the physical signs of IV drug use are at risk type of drugs used and the extent of drug for HIV infection. Other women at risk, use and needle sharing should be obtained. Spring 1992 31

Even when such histories are taken, not they died within weeks of diagnosis. all women at risk will be identified. HIV infections Some symptoms of HIV infection are Many women are unaware of the drug Initial diagnoses among women, similar to those commonly seen in use or unsafe sexual activities of their October 1988 problem pregnancies—fatigue, anorexia, current or past sexual partners. weight loss, and shortness of breath. Health care workers caring for pregnant Clinical issues women in HIV risk groups must assess The signs and symptoms of HIV infec- AIDS-related these women carefully for signs of HIV opportunistic infection. tion are the same for women as for men, infections with one notable exception: women without PCP rarely develop Kaposi’s sarcoma (KS), or KS Counseling women the most common AIDS-related malig- 31% with HIV infection nancy. Women with AIDS most fre- Kaposi’s Counseling issues differ for women quently develop pneumocystis carinii sarcoma depending on whether they are pneumonia (PCP), the most common uninfected but at risk for HIV infection, AIDS-related opportunistic infection. seropositive but asymptomatic, or have Sixty-six percent of women diagnosed symptomatic HIV infection or AIDS. with AIDS as of October 1988 had PCP as their initial diagnosis; 3 percent had nWomen at risk should be counseled on KS as their initial diagnosis. The remain- The signs and symptoms of HIV infection how HIV is transmitted and how to avoid ing 31 percent had other AIDS-related are the same for women as for men, with or minimize their exposures. Programs opportunistic infections without PCP one notable exception: Women rarely designed to meet the needs of women at or KS. develop Kaposi’s sarcoma (KS), the most risk who are or may become pregnant common AIDS-related malignancy. should make the HIV antibody test Few studies have been published on understandable and readily available. The aspects of HIV infection that may be CDC recommends antibody testing for unique to women. However, some Pregnancy, which is associated with women at high risk but emphasizes that studies have revealed a high percentage many women are unaware of their risks. changes in cellular immunity, may affect of women with gynecological disorders The most important part of any such both the natural history of HIV infection as well as very high maternal morbidity program is identifying women at risk and and mortality rates. Whether these and the development of AIDS-related disease. One study followed 15 HIV- educating them to prevent exposure to findings were related to HIV infection or (and transmission of) HIV infection. The to other patient characteristics (such as positive women, asymptomatic at childbirth, for 30 months after their best way to prevent transmission of HIV IV drug abuse and poverty) has not been to infants is to prevent its transmission to deliveries. During the follow-up period, adequately addressed. Another study women. reported that women with clinical five of these women developed AIDS, seven developed related symptoms, manifestations of HIV infection had a nThe concerns expressed most fre- greater tendency to be inaccurately and only three remained asymptomatic. Still, while there remains a theoretical quently by seropositive women are fear diagnosed, despite numerous medical of becoming ill; fear of transmitting HIV evaluations; given the preponderance of risk that pregnancy could accelerate progression of HIV disease, controlled to their sexual partners and children; infected males, HIV infection in females difficulty in communicating with studies following both pregnant and non- had simply not been deemed statistically potential sexual partners and in remain- relevant until recently. pregnant seropositive women are needed to answer the question. ing sexually active; and not being able to bear children for fear they will become A number of case reports discuss women infected. who develop AIDS-related opportunistic infections while pregnant. These women’s diseases progressed rapidly; 32 Federal Prisons Journal

The CDC recommends that seropositive have had to deal with the problems women avoid pregnancy until more is associated with poverty—inadequate known about HIV transmission during The CDC recommends housing, poor nutrition, lack of health pregnancy. This recommendation is often care and child care—long before their difficult to accept. Childbearing is a life that seropositive women diagnosis. All of these problems are goal for many women; the potential loss avoid pregnancy until exacerbated by the diagnosis. of that option can be devastating. Even more difficult is the situation of a woman more is known about Women who have symptomatic HIV who is already pregnant and then learns disease and AIDS are often part of that she is infected with HIV. Although HIV transmission households already dealing with the transmission to the infant is neither during pregnancy. disease: their children and sexual inevitable nor predictable, its likelihood partners may be infected. When AIDS is high. Infected women in late preg- This recommendation is affects an entire family, the psychosocial nancy and those in early pregnancy who needs are extensive. do not elect to have an abortion will need often difficult to accept.... extensive counseling and support. AIDS is a complex, challenging, and Infected women tragic issue. It is even more challenging nThe issues that women who have in late pregnancy and for incarcerated women. The HIV symptomatic HIV infection and epidemic will continue to influence the AIDS must deal with overlap those of those in early pregnancy custodial and medical missions in asymptomatic seropositives and women who do not elect correctional facilities for the foreseeable at risk. Fear of transmitting HIV to others future. This mandates that the correc- is a major concern. Unlike women in the to have an abortion will tional system stay abreast of develop- other groups, those who have symptom- ments in this area. National population atic HIV infection and AIDS must deal need extensive projections over the next 10 years with grief over the loss of their previous counseling and support. notwithstanding, correctional populations body image, sexual freedom, and will continue to rise. The demographics potential for childbearing. They must of those at risk tell us that AIDS will be a also come to grips with the imminent significant part of correctional medicine loss of their own lives. Grief and other through the coming decade. n emotions triggered by an ARC or AIDS support, as gay men can. Very few diagnosis can be profound. programs have services designed for women with AIDS. W. Travis Lawson, Jr., M.D., is Associate Women who have symptomatic HIV Warden of Clinical Programs and Lt. infection and AIDS experience a unique For some women, being diagnosed with Lena Sue Fawkes, U.S.P.H.S., C.R.N.A., social isolation. Although women were symptomatic HIV disease or AIDS is the M.S.N., is Quality Assurance Coordina- among the first persons diagnosed with first indication that their sexual partners tor at the Federal Medical Center, AIDS, they are still not widely perceived are infected and that these partners are Lexington, Kentucky. as at risk for AIDS, which is seen as a therefore probably IV drug users or “man’s disease.” Moreover, women with bisexuals. The anger and sense of AIDS are a diverse group with no betrayal add to the emotional crisis parallel community to look to for provoked by the diagnosis.

Because most women with severe HIV disease are in their childbearing years, many already have children. A major concern of such women is care for their children if they become disabled or die. Many infected women are also poor and Spring 1992 33

A Profile of Female Offenders in the Federal Bureau of Prisons

Sue Kline

In the decade 1981-91, the number of females in Bureau of Prisons custody steadily increased. In 1981, slightly more than 1,400 women were held in Bureau facilities. By 1991, women inmates numbered more than 5,000, representing a 254-percent increase during the 10-year period. The rate of growth for males during the same period was 147 percent, from 24,780 in 1981 to 61,208 in 1991. In June 1992, the Bureau held 5,103 females in its facilities—7.4 percent of the 68,779 inmates then being housed.

The female prison population grew at a faster rate than the male population in 7 of the 10 years between 1981 and 1991. While the number of female inmates has been increasing, the proportion of the population they represent has also been on the rise. In 1981, females made up 5.4 percent of the Bureau’s inmate population. By 1991, they represented 7.6 percent of the inmates. By comparison, in State prison populations, the proportion of women in 1991 was 5.6 percent.1

The 5,103 women in Bureau custody in June 1992 were housed in 13 facilities—6 of which were all-female facilities, while the other 7 included both male and female units, primarily in detention facilities. The largest all-female facility is the Federal Medical Center, Lexington, Kentucky, the primary medical center for female inmates, where more than 1,800 women (36 percent of all females) are held. The next largest all- female facility is the Federal Prison Camp, Alderson, West Virginia, cur-

Recreation area, Metropolitan Detention

Center, Los Angeles, California.

¢¡¤£¦¥ § 34 Federal Prisons Journal

rently housing 809 females, or 15.2 The next most common identifiable The latest offense-specific information percent of the female population. offenses in 1981 were drug offenses for females housed in State institutions Alderson was the first institution for (26.0 percent), robbery (11.8 percent), shows them most likely to be housed Federal female offenders; it opened in and white-collar offenses (7.6 percent). for a property or violent offense (81.9 1927 as the Federal Reformatory for percent). These 1986 figures from the Women. The offense profile of males in 1991 Bureau of Justice Statistics (BJS) show shows that the majority of them (55.8 that only 12 percent of women housed in In 199 almost 64 percent of females percent) were also being held for drug State facilities were there for a drug- were serving time on a drug-related offenses. The next most common related offense.2 offense—most commonly for the identifiable offense for men was robbery manufacture or distribution of illegal (12.2 percent). The male population also The female population housed in BOP drugs. The next most common identifi- saw a decrease in the proportion of facilities as of June 1992 had characteris- able offenses were property offenses robbery, property, white-collar, and tics similar to the male. The majority of such as larceny or theft (6.3 percent), and immigration offenders between 1981 and inmates were white and not of Hispanic extortion, bribery, or fraud offenses (6.2 1991. Both males and females showed origin. The distribution of ages was percent). The offense type of today’s increases in the proportion of drug similar for males and females, the female offender differs from that of the offenders, and a small increase in the average age for males (37.3) being female offender of 10 years ago. In 1981, proportion of arms, explosives, courts slightly higher than that for females (36). the largest number of women were being and corrections, and national security The latest figures from BJS show that held for property offenses (28.2 percent). offenses. State inmates are noticeably younger

Federal prison population Offense of inmates by sex (%) 1981 1991 Female Male Female Male

Robbery 11.8 24.2 4.4 12.2

Extortion, bribery, fraud 5.1 5.2 6.2 4.9

D.C. offenses N.R. N.R. 3.4 2.2

White-collar offenses 7.6 3.4 2.6 1.3

Courts or corrections 1.2 0.7 1.3 0.8

June ‘92 5,103 63,676 7.4 National security 0.0 0.0 0.1 0.1

Data for 1981-1991 are for September of each year. N.R.: Not reported separately. Percentages may not add to 100 due to rounding. Data are for September of each year. 1981 data includes 16 unsentenced female Inmates and 101 unsentenced male inmates. The offense listed is the one with the longest sentence length. Spring 1992

than those in Federal prisons. In State State of residence. The other top States Notes prisons in 1986, 72.0 percent of males were California (11.1 percent), Texas 1. “Prisoners in 1991,” BJS Bulletin, NCJ-134729, and 73.0 percent of females were under (9.8 percent), New York (9.2 percent), May 1992. 3 the age of 35. Males and females in and Illinois (3.5 percent). The top five 2. “Women in Prison,” BJS Special Report, NCJ- Federal prisons did differ in their security States of residence for males are Califor- 127991, March 1990. level assignments. Most females (75.1 nia (12.3 percent), Florida (11.3 percent), 3. Ibid. percent) were classified as either mini- Texas (8.9 percent), New York (8.4 mum- or low-security, but only 49.8 percent), and Illinois (3.7 percent). percent of males were. Males were more Top left: An inmate in her room, Metropolitan than four times as likely to be classified Results from an in-depth survey of Detention Center, Los Angeles. Bottom left: as high-security. Federal inmates, conducted in conjunc- Dental clinic, Alderson, West Virginia. Top tion with a BJS survey of State inmates right: A staff member assists with a computer In June 1992, every State in the union in 1991, will soon provide us with more class, Federal Medical Center, Lexington, was represented by females incarcerated detailed comparisons for males and Kentucky. Bottom right: Parenting class,

in Bureau facilities. More than 91 percent females across systems. Lexington. of females had as their place of residence a U.S. State, territory, or the District of Columbia, leaving 8.8 percent as non- Sue Kline is a research analyst in the U.S. citizens. More than 11 percent of the Federal Bureau of Prisons’ Office of female inmates had California as their Research and Evaluation.

Inmate characteristics Inmate characteristics June 1992 June 1992

Female Male Race (%) Female Male

26-30 19.2 16.8 Black 39.1 32.5

36-40 18.9 17.8 Asian 1.2 1.1

46-50 8.0 8.7 Ethnicity (%)

56-60 1.9 3.1 Non-Hispanic 75.1 73.8

Older than 65 0.6 1.1

Percentages may not add to 100 due to rounding. Federal Prisons Journal

Residences of women in Bureau custody

Alabama 100 H a w a i i Michigan 112 North Carolina 148 Utah 9 Alaska 11 Idaho 6 Minnesota 39 North Dakota 1 Vermont 8 Arizona 93 Illinois 181 Mississippi 39 Ohio 127 Virginia 137 Arkansas 28 Indiana 35 Missouri 100 Oklahoma 71 W ashington 43 California 560 Iowa 32 Montana 9 Oregon 35 West Virginia 74 Colorado 26 Kansas 17 Nebraska 23 Pennsylvania 102 Wisconsin 37 Connecticut 18 Kentucky 37 Nevada 27 Rhode Island 16 W yoming 10 Delaware 4 Louisiana 67 New Hampshire 9 South Carolina 36 G u a m 4 Dist. of Columbia 117 M a i n e 1 3 Jersey 63 South Dakota 7 Puerto Rico 21 Florida 592 Maryland 99 New Mexico 23 Tennessee 105 Virgin Islands 12 Georgia 154 Massachusetts 21 New York 473 Texas 504 Non-U.S. citizens 450 Spring 1992 37

Linking Inmate Families Together The L.I.F.T. program at FPC Alderson

Bobbie Gwinn infant back into the institution was as parents are not unimportant, but major discontinued at the behest of social traumas involving bonding, parenting, The parenting program at Alderson has service agencies, which regarded the and separation are much more common deep historical roots. The facility was presence of children in a prison as among incarcerated mothers. Some dedicated in 1927 as the first Federal unhealthy. Today, concerns for bonding, correctional practitioners support the institution for female offenders. parenting, and related matters are ever- theory that the resolution of issues Throughout Alderson’s history, manage- present for incarcerated mothers. The surrounding parenting is important to ment has attempted in various ways to attempt to resolve these concerns has rehabilitation and may promote a decline strengthen family ties and promote been evident in Alderson’s past programs in recidivism. parenting skills, and the children of and policies, which have evolved into our inmates are central to that concern. present program—Linking Inmate In 1986, the U.S. Congress appropriated Families Together (L.I.F.T.). funds for the continuation and develop- Earlier in the prison’s history, babies ment of parenting programs at four were delivered in the institution hospital One concern regarding inmate manage- Federal Correctional Institutions housing and remained in a nursery on the institu- ment has been how to determine what female offenders—Pleasanton, Fort tion grounds until age 2. During the early services and facilities are appropriate Worth (the only such program for males), 1970’s, expectant mothers began to be for incarcerated mothers and Lexington, and Alderson. Prior to that sent to maternity wards at community their children. The issues funding, Alderson operated a “Sesame hospitals; the practice of bringing the surrounding male inmates Street” program in a small trailer

adjacent to the institution visiting room.

¢¡¤£¤¥ £¤¦¨§ © © Federal Prisons Journal

Although small, the program was popular with the inmates and their family members. Upon receiving the parenting funds appropriated by Congress, Alderson constructed a Children’s Center.

In January 1987, prior to program startup, the Federal Bureau of Prisons’ Office of Research and Evaluation conducted a survey to determine the likely usage of the Children’s Center. The survey was voluntary; 256 inmates (30.5 percent of the population) were selected at random. Analysis revealed that 75 percent of the inmates using the visiting room felt that their children were not comfortable and that the visiting room was too crowded, restricting privacy and activities for children. Sixty- one percent of the inmates surveyed were from 400 miles away or further; two- thirds of these were not receiving visits. With the survey completed, the parenting program was developed to be sensitive to the needs of both inmates and their children, as well as correctional services staff.

From the beginning, the organizational structure has centered on an advisory staff committee and an inmate steering committee. The inmate committee represents the various ethnic groups at the institution, and remains active with 10 members. Trained inmate volunteers, from a list of 25, work in the Children’s Center during Center hours. In addition to the Center itself, a playground area was constructed; its design included areas for imaginative play and fitness.

The parenting program includes not only Top: Michael Vincent, Project Director, Children’s Center activities, but social Catholic Community Services, with the service and educational courses. The author. Left: The outside visiting area has education component has always been play equipment for the children. Right: An inmate volunteer, one of 35 to donate time during weekends. popular and well attended, with many classes offered on a regular basis. Exploring Parenting and Parenting From a Distance are the two core courses; other workshops include prenatal care information, diet, nutrition, family nutrition, parenting skills, and community resources for family life. Also included are skills for family support—budgeting, setting priorities, coping with change, and other life skills. The social services component deals with crisis intervention and helps address such concerns as facilitating visitation, child placement, legal issues, and support services.

L.I.F.T. has successfully operated since September 1987. Alderson’s Education Department coordinates the program and contracts with a local social services agency to staff it. Careful selection of qualified staff has made L.I.F.T. activities almost problem-free. An early- childhood educator is responsible for classes and training, while a licensed social worker handles crisis intervention.

The program has benefited hundreds of short- and long-term inmate mothers and their children. Visits occur in less crowded surroundings, and the area allows parents to participate in more constructive activities with their children. While incarceration is a fact of these women’s lives, communication skills and projects help reduce their isolation and separation. The Alderson program has proven to be a very positive link in getting inmate families together. n

Bobbie Gwinn is Supervisor of Education at the Federal Prison Camp, Alderson, West Virginia. 40 Federal Prisons Journal

My experience with the L.I.F.T. program

Norma Zambrana Now I was learning about situations normally be found in the nursery at of abuse and ways to guide children, home. The Center provides high chairs, I am a native of Bolivia. I arrived at offered in a positive light. Intrigued, I cribs, playpens, and a multitude of toys FPC Alderson in March 1989. For the began to put into practice the principles to appeal to all age groups. first year, all I could do was cry over being taught and found that my small the 8-year sentence I had received for son responded beautifully to the I realized that this opportunity was distribution of drugs. I am a naturalized creative offerings his mom was helping me blossom in my trials, and I citizen of this country with three producing as a result of her classes. began telling others. I became a leader children—two sons and a daughter. My to the women at Alderson, encouraging youngest son was just 8, and the family Armed with renewed spirit, I attacked them to “get involved” and do some- had suffered financially throughout the several projects. But what was the most thing constructive with their time. I conviction process. Thankfully, he was rewarding was the blessing I received began working at the Federal Prison living with relatives in Alabama. The as a volunteer in the Children’s Center. Industries garment factory, where I possibility of visiting with my little boy On weekends, I was able to work with started out sewing, but graduated to wasn’t even a consideration due to the other incarcerated mothers’ children, repairing the sewing machines. It is a distressed financial circumstances of using the skills I learned in the parent- skill that I plan to take with me back the family. ing classes. The L.I.F.T. program into the community. sponsors and staffs this center to I was so devastated by my incarcera- accommodate the many children of My work at the Children’s Center tion and the concerns over my family inmates and offers an opportunity for helped my emotional attitudes im- that I was placed under a “suicide the visits to be great fun for both mensely, but in the background there watch” in the county facility. That children and moms. was always the longing to be with my was a difficult year in which self-pity small son. Finances would not permit ravaged my waking hours. After Birthday cakes are prepared in the the expense of a trip to Alderson, West absorbing my grief for those many small microwave oven—made espe- Virginia, from Alabama. Last summer, months, I had no more tears—only a cially for and by the child. Creative my son was picked as one of 10 new determination to do something juices flow while painting, working children to participate in the L.I.F.T. positive with my situation at Alderson. with modeling clay, playing with Summer Camp Program. My joy knew I marched to the Education Building building blocks, listening to music, no bounds as my son was transported and signed up for every available and watching carefully selected videos. to the camp with all the costs fully course. “Growing Up Again,” offered Sometimes, there are small animals or underwritten by Catholic Charities. by the L.I.F.T. (Linking Inmate items of similar interest, such as The week-long camp gave both of us Families Together) program, was the turtles, to amuse the children. the opportunity to renew our bonds and first course I was able to attend. share in many delightful activities. It is not unusual to see the little Laughing, hugging, sharing special I entered the class skeptical of learning families grouped around tables treats: the experience has carried me much, viewing the opportunity as more working with beads or string art. One through many, many days with won- entertaining than productive. Much to mother of a very small son enjoyed derful memories. I am a new person, a my amazement, I realized that some giving the 6-month-old a bath in the better mother, and a more worthwhile things about the way I had raised my sink in the bathroom and then reading human being. I attribute these qualities two older children were wrong. I to the sleepy, powdered, and sweet- to the work done for me, personally, by came from the old school, the Spanish smelling baby in the Center’s version the training and caring I have received heritage providing strict guidelines for of “Granny’s rocking chair.” There is from the L.I.F.T. program. My life will my children’s upbringing. I didn’t even a changing table, a fresh supply of never be the same. n allow my daughter to date! diapers, and paraphernalia that would ¢¡£¡¥¤ Spring 4 l

Women’s Spirituality in Prison

Guylan Gail Paul

It is important for the reader to understand “spirituality” in its broadest sense. Spirituality is not simply a person’s relationship with God, but also to others and to him- or herself. It encompasses all of our relationships. Too often, women come into the prison system broken, betrayed by men, grieving over the loss of their role as caregiver to their children, estranged from parents, less educated than they want to be, traumatized by incest or sexual abuse, not knowing how to put themselves back together, not knowing God or having any idea that a journey to God is a journey to wholeness.

Maria Harris, in her book Dance of the Spirit, speaks of seven steps of women’s spirituality: n Awakening to the God spirit within and without. n Discovering, or achieving self- knowledge. n Creating—shaping our own image of God, our own spirituality. n Dwelling—“Be still and know that I am God”—until we discover that God dwells within. n Nourishing—practicing spiritual disciplines that nourish ourselves. n Traditioning—passing on the faith through ritual, song, community, and person. n Transforming—facing brokenness through stories from scripture and being reborn into a wholeness that incorporates

all of life’s experiences.

© ¥ Harris’ seven steps are one way of ¦¥§¢¨ expressing a woman’s spiritual journey from isolation and brokenness to relationship and wholeness. These steps are not discrete but overlapping and inter- 42 Federal Prisons Journal

twined. They give us a good model from woman’s language, moved to the which to understand the spiritual jour- idea of relationship as seen in the neys of women. Old Testament, and finally incorporated Jesus’ command- If chaplains want to help incarcerated ment—to love your neighbor as women make this journey, they must yourself—as a new dimension of understand other psychological aspects relationships. and needs of women and integrate these factors into the journey. A woman’s life experiences will affect her idea of what God is Language is an important clue to like. For example, if her God ministering to the spiritual needs of concept is perceived through the women. Women need different language memory of a father who was as well as different images and symbols often drunk, a wife-beater, and to express their spirituality. They may abused the woman physically or express their journey to wholeness as a sexually, her understanding of journey home to self and God. Women the imagery of God the Father may be may best explore the meaning of their different from others who have a positive lives through the imagery of weaving image of fathering. In that case, the together the different parts of their lives; chaplain may need to help the woman the good and the bad are integrated into develop a concept of God by using an acceptable pattern. When these mother imagery. If the chaplain can hear women speak to a chaplain about with sensitive ears and adapt the situation decorating the chapel, they are saying, to the inmate’s needs, the woman can be “I need to create a holy space in which awakened to the God spirit—and the I can be at home with God.” When they chaplain and the inmate will have express the need for a quiet room in achieved a new relationship with one which to pray, they are longing for a another. The spectrum of religious observances at the dwelling place. When they say, “We Federal Medical Center, Lexington, Ken- need to have a Woman’s Day celebra- Relationship is another critical concept tucky. Top: Daily Islamic prayer. Bottom: tion,” they are expressing a deep need for for women. Personal relationships help Jewish inmates and a volunteer perform a ceremony using a shofar, or ram’s horn. ritual that becomes a transforming event. define a woman’s existence. She needs to have a chaplain with whom she can form It’s important, as often as possible, to a safe relationship. It is helpful, though hope, universality, imparting of informa- speak to women using images and not necessary, to have a woman chaplain; tion, altruism, “corrective recapitulation” symbols that resonate with their experi- the inmate may trust a woman more of the primary family group, develop- ence. One of my best sermons used the when she begins to talk about the hurts in ment of socializing techniques, imitative unlikely imagery of toilet training— her life—especially those hurts related behavior, interpersonal learning, group something most women take responsibil- to men. If she can find a safe place in the cohesiveness, catharsis, and existential ity for—to express how basic the Ten chaplain’s office to share her broken factors. These therapeutic factors are Commandments are to living in the world feelings and lack of self-esteem, she can found not only in secular therapy groups, without “creating a mess” in our personal begin to believe that it is safe to share her but in scripture study and prayer groups. relationships. I was able to separate the pain with a psychiatrist or a trusted Ten Commandments into groups that friend—or even risk sharing in a group. Group relationships are important in a reflected our different relationships to woman’s journey to wholeness. Prayer God, to others, and to self. This sermon According to Irvin Yalom, in his book and scripture study groups may be the was successful because it began by using The Theory and Practice of Group first support groups that she begins to Psychotherapy, 11 factors in group attend, as she examines her life story in therapy foster healing: instillation of Spring ¢¡£¡£¤ 43

cal understanding of relation- particular prison, the chaplain may need ships and the spiritual issues to introduce them or become an advocate that emerge. for them.

I used a meditation, from If a woman does not move out into these Carolyn Stal’s book Opening to other groups, spiritually oriented groups God, based on the story of Jacob become the only place where she can talk and Esau. The meditation was as a member of a community and attempt designed to help women identify to integrate all the aspects of her life. people in their lives toward And talk she does! Women talk to make whom they need to make a sense of what has happened to them, to conscious effort toward recon- exchange ideas, to deal with the pain and ciliation. The Jacob-Esau story guilt they feel being separated from their also pointed out such concerns children. The telling of their life stories as the fears we face before brings healing. attempting reconciliation, the length of time it will take, and the need Then they need to get busy again, to give for the cooperation of the person with of themselves to causes beyond them- whom we want to be reconciled. selves. Chaplains can channel such activities into church-related events that One inmate identified an estrangement help build self-esteem: helping plan she had all but forgotten about, a cousin worship services, introducing a dance who used to be one of her major support- liturgy, decorating the sacred space with ers. Another was able to talk about her homemade banners, singing in the choir. struggle with a father who was not ready In so doing, inmates discover that they to forgive her. As we discussed each have skills and leadership abilities that woman’s experience of the meditation, I are appreciated. As Howard Clinebell could clearly see Yalom’s therapeutic says in his book, Basic Types of Pastoral Top: Lexington's New Life Gospel Choir. factors come into play; the other women Care and Counseling, the church’s Bottom: During a sweat ceremony, Native would console her and help her under- mission is to be an “abundant life center, Americans purify themselves with smoke from stand her experience.* a place for liberating, nurturing, and wild sage. empowering life in all of its fullness, in In these spiritually oriented groups, a individuals, in intimate relationships, and relation to the stories in her Bible, Koran, woman can be accepted for who she is in society and its institutions.” or Torah. These stories bring hope of right now, with a vision of who she can forgiveness, second chances, renewal of be in relation to God, self, and others. If the church is successful in its mission, relationships; here she begins to hear the She begins to talk and learn group skills. women can begin to feel a sense of stories of other women and realize she is From there, she may move with more freedom while incarcerated that changes not alone. confidence to other groups—Alcoholics their orientation toward all their life Anonymous, parenting, and so on. If experiences. This relates to Clinebell’s Women often can relinquish control to these groups are not available in a definition of liberation: “...the freedom to another person more easily than can men. become all that one has the possibilities of becoming.” Guided meditations based on scriptural *I see another interesting phenomenon operating passages can be introduced in study in guided meditations—a movement toward groups as a new form of prayer that “androgynous wholeness.” This can be defined as Understanding the uniqueness of women a balance between one’s vulnerable, nurturing, in their spiritual journeys to wholeness— women easily relate to. The chaplain can feeling, “feminine” side and the rational, assertive, interpret these dream-like experiences analytical, “masculine” side. Letting the holy spirit their needs for a woman language, much as Freud did: to further psychologi- bring images to mind constitutes the “feminine” Continued on page 48 side and the cooperative analysis of the images as symbols constitutes the “masculine.” 44 Federal Prisons Journal

Women’s Prisons Their social and cultural environment

Anne Sims Services. Indoor/outdoor visiting areas are also provided. There is no fence This article describes the differences in around the facility. the institutional cultures of women confined within the Federal Bureau of The second female area is a Medium/ Prisons. The focus is on both the physical High-Security Women’s Unit. In this and social environments, according to the unit, 54 rooms are located on three security level of the inmate and the triangular tiers. Each room contains a facility she is in.* bed, a toilet, two lockers, a television, dresser, and a chair. Common laundry, I have worked for more than 3 years shower, and telephone areas are also as a case manager in the female units at located in the unit. The housing unit is the Federal Correctional Institution, totally enclosed by two parallel perimeter Marianna, Florida. I interact with inmates fences, and contains the same functional on a daily basis, and am responsible for offices as the camp. There is a secure advising them about their sentencing area for visitors, as well as for recre- information, as well as for inmate ational activities. The staff complement classification, programming, and release in the unit includes a unit manager, case planning. On a less formal basis, I listen manager, two counselors, and 24-hour to their problems and provide counseling correctional officer coverage. Above: The author counsels a high-security and crisis intervention. In this article, I inmate. Right: An education class meets at will discuss typical staff/inmate relations, Marianna’s minimum-security prison camp. Staff/inmate relations psychological characteristics, frequency and psychological and types of visits from the community, characteristics educational/vocational participation, and separate, self-contained areas. The main release planning—all in relation to their institution is rated medium-security and I worked at the camp from June 1988 physical surroundings and cultural and houses male inmates. until July 1990; my caseload consisted social situations. of about 130 inmates, with average ages The other two areas are for women. One ranging from 26 to 30. Most camp Physical environment is a Federal Prison Camp (FPC) with a offenders (64 percent) were serving capacity of 296 minimum- and low- sentences from 1 to 5 years for drug- First, let me describe the Federal Correc- security females. Inmate housing is related offenses. Crimes involving tional Institution, Marianna, Florida. extortion and bank fraud followed in Marianna, opened in 1988, has three provided by two modules, with two living units per module. The second level frequency, with 19 percent. At least in each unit has 19 two-person cubicles; three-quarters of these women were first- * ‘The Bureau of Prisons manages and houses the bottom floor has 18 two-person time offenders, with the remainder only inmates based upon the degree of supervision having minor prior histories, such as required. Security needs are determined prior to an cubicles. All cubicles contain two beds, inmate’s commitment and are rated by the seventy two lockers, a desk, and a chair. A misdemeanor offenses or probation of the offense, length of sentence, prior criminal telephone is located on each level for violations. history, and other management variables. Security inmate use, and each unit has a TV/ levels are categorized as “minimum,” “low,” These women have little, if any, experi- “medium,” or “high.” Once an inmate is designated multipurpose room, laundry rooms, and to an institution, the assigned security level may toilet/shower facilities. The two modules ence with prison and are initially rise or fall, depending upon the inmate’s conduct also have offices in each unit for a case uninformed about this new cultural and time remainmg to serve on her sentence. Some manager and counselor. Adjacent to the environment. To most, it is a tremendous institutions, such as medical centers, must be shock when the reality of “doing time” capable of accommodating inmates across the housing units are buildings for Adminis- security level spectrum, and are thus referred to tration, Receiving and Discharge sets in. In my experience, this hits as “administrative” security level facilities. (Records), Commissary, Food Service, hardest when they actually see their Education and Recreation, Federal Prison Industries, Pastoral Care, and Psychology sentence computation sheet reflecting their release date. Tears and mild depression are common, but usually subside as the inmate interacts with staff and peers and becomes involved in the programs available at the institution. Once the inmate is more integrated with her surroundings, she is not unlike a person one would meet outside of prison. She is usually willing to talk freely with staff about her crime, and openly expresses remorse for using bad judge- ment and placing hardship on her family. She is generally eager to use institutional programs to improve her education and vocational skills, as well as her emotional stability.

These women tend to suffer from anxiety and depressive disorders as a result of their situation. They are more likely than men to participate over the long term in group discussions led by a staff member, involving topics such as stress management, assertiveness, and family relationships. Most women display a genuine commitment to these groups and are motivated to take what they have learned back to the community. They display few inhibitions when discussing their experiences with their peers and are eager to gain as much information as they can from these self-help groups.

From July 1990 until earlier this year, I worked in the the Medium/High-Security Marianna Women’s Unit. With a population of about 85 females, this unit consists of medium- and high-security convicted felons, with most ranging in age from 31 to 35. Almost three-fourths are serving sentences of 10 years or more; another 10 percent have a life term. Half of the unit’s inmates were convicted of drug violations, with robbers the next largest group at 25 percent. The remaining 25 percent were 46 Federal Prisons Journal

convicted of crimes involving violence, children, but on the grandparents, weapons/explosives offenses, property mothers, and sisters who are left with the offenses, and more serious white-collar burden of child-rearing. It is not unusual offenses. for the children’s fathers to be confined as well. Probably the most significant characteristic apparent to me when I started in this FPC inmates can apply to participate in unit was the women’s general lack of the furlough program. Inmates who have trust and unwillingness to talk with staff. the lowest form of custody, are within 2 Many of these women had been incarcer- years of a firm release date, and have ated before, either in State or in other demonstrated responsible behavior while Federal facilities, and had considerable incarcerated can be allowed the privilege experience with how staff and inmates of a temporary stay in the community to interact. It took about 6 months for me to reestablish family ties in preparation for begin to feel trusted. Essentially, the eventual release. Furloughs may also be inmates were getting to know me, and I granted during emergency situations, them. My philosophy (and the Bureau’s) such as a death in the family. I have in working with inmates is to treat them never felt more helpless than when I tell as I would want to be treated, but many an inmate a loved one has died, espe- inmates found that hard to understand cially when the death was unexpected. Camp inmates are generally eager to use and had to acclimate. institutional programs to improve their education and vocational skills. The women in the FPC may also receive In comparison to the FPC, it is more pre-approved visits in a supervised difficult to work in this setting, because visiting room on Saturdays, Sundays, and there are more personality disorders to As is the commitment to self-help holidays. About one-third of the camp deal with. A significant percentage of the groups, the seeking out of staff for crisis population receive visits, averaging one inmates may be described as having intervention can be a short-term means visit during a weekend per month. Visits defensive and paranoid characteristics, by which the inmate learns to cope with are very important during an inmate’s which could be the result of their longer her environment. Because these women confinement—this keeps them in touch histories of criminal behavior. Many face a long period of incarceration, any with the outside world, especially with have psychological problems because of type of goal-setting can be problematic. their children. Some inmates fear that their past histories; for example, they Denial—a defense mechanism—is also a their children, especially the very young, may have been abused—physically, common characteristic of these women; may not know them when they return emotionally, or both—in their homes. they believe their crime is really not as home. Even worse, the children’s sense While about 10 percent of these women bad as everyone thinks it is (if they admit of time makes it difficult for them to do participate in the self-help groups to it at all). This way of thinking is also think their mothers will ever be back. offered by staff, their commitment to reflected during release planning, which using this information seems related to will be discussed later. In the Medium/High-Security Women’s the population participation rate. Of 10 Unit, visits from family, friends, and enrolled in a group, 7 may only be Visits and family contact attorneys may occur in a supervised enrolled as “a way to do time.” As one During confinement, hardships surround- visiting room on any weekday. Over a 3- individual described her feelings to me, ing an inmate’s family, and especially month period, only 14 inmates out of the there is little variation in day-to-day her children, are unfortunate conse- total population of 85 received visits— activities. quences of incarceration that add to the and about one-fourth of these were from burdens on both the inmate and the lawyers. For many inmates’ families, community. I believe a good estimate distance and the cost of travel prevent of the proportion of unmarried female them from seeing these women. For most inmates who have children is 90 percent. Thus, the hardship is not only on the Spring 1992 47

inmates who are concerned about their relatives, and especially their children, the distance makes the realities of spending time in prison even more difficult. One feels especially helpless when there are difficulties with child placement, and court actions and social workers must make decisions that affect the whole family, instead of the mother (and perhaps the father) who is incarcerated.

Educational/vocational participation Fewer than half of the camp inmates have earned a high school diploma at the time of commitment. Bureau policy mandates enrollment in a GED program if an inmate is without a high school education. College courses are only Marianna Warden Joseph P. Class (left) and Associate Warden Garland Jeffers make daily available through correspondence study; rounds. The high-security facility includes an automated data processing factory, which the participation rate is only 10 percent provides job assignments that also contribute to vocational training. of the camp inmate population. Other courses in English as a Second Lan- both the women’s units, it is not difficult ment and a residence, if necessary. There guage, Adult Basic Education, and to see the great feeling of accomplish- is much anxiety during the planning Horticulture, as well as a Cook Appren- ment these women display when they not period prior to CCC placement: during ticeship Program, have enrollment rates only earn their GED’s, but go on to learn this time FPC inmates consult with staff of about one of every four camp inmates. additional skills. to discuss their “prerelease jitters.” If A data processing factory, part of Federal drug abuse was a problem prior to Prison Industries, is also available as a Release planning commitment, the inmate knows that it voluntary work assignment, and offers an will be a problem for the rest of her life, opportunity to take a vocational skill Finally, as the offender nears a mile- making her struggle to return to society back to the community. stone—being within 12 months of her release from prison—it is time to take a more difficult. Another concern is telling future employers about their conviction In the Medium/High-Security Women’s serious look into residence and employ- history. More often than not, however, Unit, on the other hand, more than half of ment. To assist her in adjusting to the the women are anxious to begin a new the inmates have a GED or high school transition from confinement to living in life. The success rate for female offend- diploma, as well as some college educa- society, placement in a Community ers returning to the community appears to tion. Education participation in this Corrections Center (CCC)—or halfway be high, and most are determined never unit is about one-fourth of the inmate house—is considered. to see prison again. For those who do population and involves the same courses return to prison (I offer a “guesstimate” described for the camp. As with the Depending upon the inmate’s offense, of less than one-fourth of the camp camp, an automated data processing past history, and institutional adjustment, inmates), most do so because, for one factory provides a job assignment that the length of time spent in a CCC may reason or another, they were not moti- also contributes to vocational training. In vary from 1 to 6 months. Most camp inmates are placed in a CCC anywhere vated enough to succeed or still lacked from 4 to 6 months prior to release. the maturity to make the right choices. During this time, the inmate reestablishes family relationships and locates employ- 48 Federal Prisons Journal

In the Medium/High-Security Women’s from page 43 Unit, one exception to this pattern is the Spirituality inmates’ need to discuss with staff their relationships, sacred space, and feelings about returning to society. Many opportunities for service—are key are self-assured and believe they will not elements in helping chaplains effec- have any problems finding a job, which tively minister to incarcerated may be related to their general attitude of women. Responding to these needs denial or defensiveness regarding their helps women grow in their relation- criminal offense. The normal placement ships to God, and in their relationships time in a CCC for these women is 60 to other inmates, staff, and to them- days, in comparison to as long as 6 selves. months for the camp inmates. The success rate in the community that I Working with women is a challenge, have observed for medium/high-security but it is exciting. Incarcerated women inmates is about the same as for the camp are appreciative, loving, helpful, and inmates. Of the 10 medium/high-security nurturing, as exemplified by the often- women I have processed for release, I heard statement, “Chaplain, take care know of 3 who have returned to prison. of yourself. Get some rest; we need Conclusion you.” Our ministries will be rewarding As in all Bureau institutions, staff members and successful if we as chaplains are in (here, Unit Manager Mike Pettiford) make As every experienced prison administra- constant touch with our Helper, who tor knows, there are pronounced differ- themselves available for questions from inmates. teaches, enables, and enlightens us in ences between minimum- and medium/ our own spiritual journeys. n high-security inmates. This certainly holds true for female inmates. Obviously, camp inmates are apparently the result of these differences directly correlate to the geographical location, rather than lack The Reverend Guylan Gail Paul is length of the inmate’s sentence, and seem of family ties. When it comes time for chaplain at the Federal Prison Camp, to affect the development of trust in staff- release planning, the degree of participa- Danbury, Connecticut. inmate relationships. The camp inmate tion is greater from the camp inmate than who has been incarcerated before, is the high-security female, who one would References released, and returns again because of think would require it more. Clinebell, Howard, Basic Types of Pastoral Care

a violation is more likely to have the and Counseling: Resources for the Ministry of ¥§¦©¨ ©¥ attitude of the higher-security inmate. These differences are not construed as Healing and Growth. ¢¡¤£ Press, Likewise, some newly committed insurmountable, but are used by staff as Nashville, Tennessee, 1984, p. 28. medium/high-security inmates may management information. If we can Harris, Maria, Dance of the Spirit: The Seven display the same open and trusting understand why these differences occur, Steps of Women's Spirituality. characteristics as most minimum-security perhaps it can give us more insight into New York, 1991. inmates. how to offer all women inmates more Stal, Carolyn, Opening to God: Guided Imagery opportunities to learn to be responsible Meditation on Scripture Individuals and Groups. The Upper Room, Nashville, Tennessee, 1977, It is interesting to note that medium/high- for their behavior, while assisting them in pp. 107-109. security females are older and apparently becoming functional members of society better educated, yet camp inmates are and maintaining or reestablishing their Tarr, Del, “The Role of the Holy Spirit in Interpersonal Relations,” in The Holy Spirit and more oriented toward goal-setting and family relationships. n Counseling Theology and Theory, Marvin T. long-term commitments. The enhanced Gilbert and Raymond T. Brock, editors. frequency and types of visits received by Hendrickson Publishers, Inc., Peabody, Anne Sims is now Case Management Massachusetts. 1985, p. 24. Coordinator at the Federal Correctional Yalom, Irvin D., The Theory and Practice of Institution, Marianna, Florida. Group Psychotherapy, 3rd edition. Basic Books, Inc., New York. 1985, pp. 3-4. Spring 1992 49

Care of the Pregnant Offender

Anita G. Huft, Lena Sue Fawkes, and W. Travis Lawson. Jr.

Women face many choices once they are pregnant. Even deciding to find out if she is pregnant can be an overwhelming experience for some women. Whether to continue the pregnancy, how to manage it, and how to select a particular childbirth method largely depend on the knowledge, attitudes, and disposition of people close to the pregnant woman.

While medical literature provides detailed guidelines on monitoring the fetus and performing appropriate medical interventions during labor and birth, there are few guidelines addressing the psychological issues associated with childbirth.

Pregnant women in prison face unique problems. Stress, environmental and legal restrictions, unhealthy behavior, and weakened or nonexistent social support systems—all common among female inmates—have an even greater effect on pregnant inmates.

Maternity care in the prison setting is based on the following values and assumptions: nPregnancy is a healthy state in which biological, psychological, emotional, and intellectual adaptations to one’s surroundings increase the likelihood of a healthy birth. nEvery pregnant woman has the right of self-determination regarding her body and its functions. nEvery woman has the right to physical safety and access to certain health care services. Ensuring the safety of the

Sherrell Medbery ¢¡ Federal Prisons Journal

pregnant woman within the constraints relative or friend, depending on factors of custody may warrant expanding her such as support systems in prison, the movement privileges and access to inmate’s self-esteem and problem- certain health care services. Staff access solving skills, the presence of an intact to previous health care records may be family on the outside, and the imminence restricted. Violent or self-destructive of release. women must be evaluated to ensure they are competent to select health care Women who expect to give up their choices. infants after birth do not experience bonding in the same way as mothers who Prison and the experience know they will keep their babies. In of mothering addition to losing freedom, privacy, and self-esteem, inmates must also cope with All of the “tasks” of pregnancy are losing a child and an identity as a mother. affected by incarceration. Women in The ability to sacrifice one’s own needs prison are placed outside the normal for another’s is tested during the mother- mothering experience in four ways: ing experience. Whether the nurturing nStress—Incarcerated women experi- Physician Assistant Herminia Galang role is innate or learned, most women ence higher than normal levels of stress. provides prenatal counseling to an inmate identify childbirth with infant care. at the Metropolitan Detention Center, Los They have a higher incidence of compli- Removing the mothering role from the Angeles, California. cations during pregnancy, labor, and woman in prison may trigger feelings of delivery. Many have not practiced good dependence, a loss of self-esteem, an health habits throughout their lives. education and physical development are inability to focus on the future, or self- Infants of incarcerated women are more available during pregnancy, pregnant destructive behavior. likely to have life-threatening problems women will not take advantage of them if at birth, contract serious illnesses, and be they do not receive support from their For the medical staff, helping to resolve exposed to a negative social environment inmate peer groups. Limited health care the issue of the placement of an infant as they grow into childhood. facilities or staff sometimes warrant the after birth is based on accurately assess- ing the infant’s potential family environ- n Restricted environment—Adaptation immediate transfer of a pregnant inmate to a civilian hospital at the onset of labor. ment and the psychological state of the to pregnancy is limited by the prison mother. environment. Mandatory work, struc- But that inmate will then miss the tured meal times, and lack of environ- presence of a support person. These limitations may place certain mothers at Preparation for care includes teaching the mental stimulation may decrease the mother decision-making skills. Counsel- likelihood of individualized prenatal risk for longer labor, may induce some in labor not to seek care soon enough, and ing should emphasize developing an care. For instance, pregnant inmates identity during pregnancy and strategies receive standard clothing that often may increase the discomfort of labor and the need for medical intervention. for coping with the loss of the infant. does not fit well. Alternatives for special After the birth, the mother will need clothing (e.g., stockings and shoes) may n Altered maternal roles—Maternal counseling in making or accepting the be dictated by availability within the identity depends on rehearsal for the decision to place the infant for adoption institution or by what family and friends anticipated role after birth. Women in or temporary guardianship. are willing to supply. In addition, Federal prisons do not directly care for disciplinary action or other restrictions their infants after birth. Developing a Plans for the female inmate’s maternity may interfere with the offender’s maternal role therefore depends upon and nursing care should therefore be adaptation to pregnancy. plans for placing the infant after birth. guided by interventions to reduce stress, The inmate can place the infant either for nAltered social support systems—Even to decrease environmental restrictions. to if ideal opportunities for nutritional adoption or for guardianship. She may choose to maintain a maternal role “in absentia” or relinquish that role to a ¤¦¥ Spring ¢¡¢¡¢£

promote a healthy lifestyle, and to develop decision-making and coping skills for resolving infant placement problems and assuming a maternal role after the birth.

If the inmate is successful in coping with pregnancy and childbirth, she may have learned the skills necessary to successfully cope with her remaining period of imprisonment. Comprehensive maternity care for the pregnant inmate is one component of a supportive prison environment for the female offender.

The clinical dilemma Recognizing that a small percentage of pregnancies have poor outcomes, doctors introduced the concept of “high-risk The Federal Medical Center in Lexington, Kentucky, is uniquely capable of offering care for high-risk pregnancy” into clinical medicine. Early inmates. Here, a physician from the University of Kentucky Medical Center monitors a fetal heartbeat. identification of high-risk pregnancies allows doctors to intensively monitor all stages. Moreover, the patient at “low A single major medical condition, or for females. The concept of “high-risk risk” can receive more routine care, several minor conditions, can indicate a pregnancy,” for example, is well under- unless something changes her status to less than favorable birth. Such pregnan- stood by the certified specialists the high risk. The central question, however, cies must be termed high-risk, and these Bureau utilizes as local consultants. is “How do doctors recognize ‘high-risk’ patients cared for in specially designed pregnancies?” and staffed centers. All facilities can prudently meet the challenges of monitoring high-risk Some high-risk factors can be recognized That many individuals within the Federal offenders. Appropriate budgetary at the time of the first office visit; others system have “at risk” characteristics resources can be allotted during the develop or become evident in the latter increases the importance of prioritizing— institution’s strategic planning process. months of pregnancy or during labor. allowing individuals at lesser risk to be treated at the institution or in the commu- The social network Within the unique setting of the Federal nity, and those at significant risk to be during pregnancy Bureau of Prisons and similar correc- treated at a referral facility for more Misguided advice about pregnancy tional systems, a majority of pregnant intensive care. impedes access to and use of prenatal patients would meet at least some criteria care for low—income women. Low- for being high-risk. Within the correc- The Federal Medical Center in Lexing- income women—less educated, often tional setting, medical staff recognize as ton, Kentucky, is uniquely capable of exploited-are less likely to comply with “high-risk” the female with such demo- offering medical care for high-risk prenatal health care advice. The prison graphic characteristics as: minority, inmates. Lexington has an accredited population is an “invented family” of older than 35 years, previous history of hospital closely affiliated with the whom the pregnant woman is a member. chemical dependency, previous history physicians and services of the University Membership in this subgroup is often of multiple abortions or miscarriages, of Kentucky Medical Center. In addition, attained through an inmate “mentor,” previous history of sexually transmitted Lexington has the capability to house who offers advice and makes recommen- diseases or pelvic inflammatory disease, inmates of all security levels. However, dations regarding acceptable practices and so on. access to obstetric and gynecological during pregnancy. care is available at all Bureau institutions 52 Federal Prisons Journal

Convenience is often cited as a reason Satisfaction with pregnant women rely on peers or other maternity care sources for advice, rather than professional health care personnel. The prison A patient’s satisfaction with her medical subculture is a unique mix of racial, care is often cited as an ideal indicator of religious, and social customs and the quality of that care. By examining the practices that, blended with institutional components of satisfaction with mater- routines, organizes the activities of nity care, accurate quality assurance inmates, both within and outside the indicators can be developed. system. A prisoner’s reference group includes family, friends, and acquaintan- Nonincarcerated patients are often afraid ces, who serve as a resource for accept- that voicing dissatisfaction with their able information, including medical maternity care will adversely affect that advice. This group plays a major role in care. The female inmate is even more the pregnant woman’s interpretation of fearful: she is in a controlled environ- symptoms, self-diagnosis, acceptance of ment in which every action may affect the need for clinical appointments, use of her well-being. Even though pregnant self-remedies, evaluation of treatment, Assistant Health Services Administrator Z.Z. prisoners may complain about prenatal and belief in professional explanations. Fort with an inmate at the Federal Prison care, they are equally negative in their Camp, Marianna, Florida. description of pregnancy and birth The health and lifestyle choices of experiences. Part of this negative attitude may be due to a transference of feeling pregnant inmates are determined by This list suggests a pattern for dialog regarding their care to feelings regarding prison subcultures as well as inherited with the patient. Initial and followup their birth experience. For quality cultural practices. A thorough assessment visits should include this information, in control, it may be better to measure the of factors affecting pregnancies should this order, to spark the patient’s attention frequency and total amount of satisfying include identification of groups and and allow the practitioner to explore conditions rather than to measure patient persons to whom the patient turns for factors that may influence her compli- responses directly. information. While such networks can ance with medical advice. The physician detract from the quality of health care, should frankly and clearly explain the Conditions for positive pregnancies and they can also reinforce medical advice. consequences of noncompliance—but in childbirths include: Knowing which is the case will help a nonthreatening manner, emphasizing the health care practitioner use prison physician-patient cooperation for a nParticipation in decision-making. resources in the broadest sense possible. successful pregnancy. Areas of information concerning which nA high quality of explanations given to the mother (especially for delivery patients turn to their networks for advice Physicians should ask about important by Caesarean Section). The explanations include: medical issues such as substance abuse of what could be expected are similar and high-risk sexual practices in their nDiet and nutrition. to the actual experience, and the woman initial assessments of the pregnant client. nActivity and hygiene. receives emotional help from the physician and nurses. nHarmful substances or practices to Studies suggest that health education avoid. should be vigorously extended not only nThe nurses’ responsiveness to the to the pregnant prisoner, but to her woman’s pain. nRemedies for the discomforts of reference groups. Peers should be viewed nA short time spent waiting on pregnancy. as allies, not liabilities, in the reinforce- appointments. nWhen to seek advice about professional ment of good medical advice. Routine medical care. counseling and education by health care “Patient dissatisfaction” is a state of providers should dispel misinformation displeasure or disagreement with the nInformation on labor and delivery. and the stress it causes for pregnant inmates. Spring 1992 53

maternity care the patient actually experiences compared with the care she Pregnant in prison: An inmate’s experience had expected. The stress the pregnant inmate experiences as a result of unmet My name is Dana Johnson. I am Thava was one of the warmest, nicest, expectations increases her risk of health incarcerated at a Federal Prison Camp and sincerest persons who I had met problems during pregnancy, labor, and in Bryan, Texas. I have a story to since being incarcerated. We hit it off birth. Assuring the quality of maternity share that I hope will touch people’s from the start. We talked and I told her services in prisons should therefore lives. how I felt at the time, which wasn’t include measures to increase patient too great. She gave me some thought- satisfaction. I came to prison pregnant. I thought ful words. It was then that 1 realized I that it was the end of the world, but it had someone to talk to. As the days The halo effect—“satisfaction with care wasn’t. The psychologist and chaplain passed, Thava did so much for me. must make satisfaction with delivery”— counseled me and gave me advice. She set up my doctor’s appointments does not hold up. Most studies collecting They told me about a program where I and had films that I could watch—the data within 2 months after delivery tend could spend time with my child and subjects included mothers using drugs, to rate the delivery experience and form a mother/child bond. The name the birthing process, breastfeeding, maternity care very highly. Satisfaction of the program is MINT, which stands and so on. Thava was a hardworking with care decreases, however, when for Mothers and Infants Together. I and dependable woman. She was even women are interviewed more than 2 was excited to be leaving and spend- in the delivery room when I gave birth months after delivery. ing time with my child, even if it was to my precious son. (I’m not from for a short time. They explained that I Texas, but Illinois, and my family Team delivery of services would spend 2 months with my child couldn’t come.) She also bought my Women experience pregnancy in a after it was born. I had previously son clothes to wear back to the MINT variety of settings and receive care spoken with other inmates who told program. She was the greatest! When from health professionals in a variety me about their experiences being my son was a week old, he had bad of ways. Health care delivery facilities pregnant in other institutions and stomachaches. Thava would come at become part of the social network of the spending only a few hours with their any hour, day or night, to take him to pregnant woman; the outpatient clinic children. But not me, because I was the doctor. She made sure that he had is a social system in itself. The profes- here at FPC Bryan. It was then that I milk and Pampers. I don’t know what sionals who staff the outpatient clinic realized how lucky I was to have the I would have done without her. represent various disciplines and clinical MINT program available to me. experiences. I am grateful for having the opportu- To make a long story short, I left nity to spend 2 months with my son The formulation of an obstetrical Bryan on July 2 and went to the and establish a mother/child bond. treatment plan for pregnant inmates is the Community Corrections Center When my son turned 2 months old, it responsibility of several different health (CCC) in Fort Worth, Texas, where was time for us to say our farewells. care workers. The way such individuals the MINT program is located. I was 8 Thava took us to the airport and waved work as a team affects the success of the months pregnant when I left and my at us until we were gone. I got a treatment plan, and ultimately the health due date was August 8. One month furlough, which I am also grateful for, of the mother and infant. away! Just like any other institution, I and got to see my 2-year-old daughter, had to get to know everyone there. I who I hadn’t seen in 10 months. I The attending physician or chief obstetri- was scared at first, but the staff knew finally had my family together, even if cal physician serves as team leader. He or my situation and helped me in more it was for only 5 days. she can make medical diagnoses that ways than I could imagine. I was prioritize treatment. Other health care introduced to a staff member who I I am back in Bryan, Texas, finishing needs can be met (as deemed appropriate didn’t know would have such an my time. My son is now 6 months old. impact in my life—I’ll use her first Programs like the MINT program help Continued on page 58 name only. mothers in prison and their children. n 54 Federal Prisons Journal

Bob Dahm Spring 1992 55

“Constants” and “Contrasts” Managing female inmates

David W. Helman public. Nonetheless, the record shows that prison officials of the past had The reader of this article must surely substantial latitude to make up the rules agree that, on this topic, there is potential as they went along. for the author to get himself into trouble. Addressing distinctions between the This situation surely dismayed the sexes on any issue is usually fraught with benevolent civil servant, who felt that controversy, and the management of doing a good job meant treating inmates female versus male inmates is no decently and with impartiality. The exception. absence of some basic principles of management usually left him or her to I risk antagonizing traditionalists in the the changing political and philosophic corrections business, who argue that whims of a superior, the legacy of a “inmate management is inmate manage- predecessor—or to simply do whatever ment” and that the same administrative he or she wanted. principles and practices are required regardless of the population. We all agree The big loser was, of course, the inmate. that fundamental principles of manage- Violations of what we now consider ment guide modem corrections. Nonethe- basic civil and human rights were so Basic principles of managementensure that less, others maintain that rigid adherence there will be “constants” in how inmates are numerous that many civil servants turned to standard tenets of management in treated. Here, Randy Ream, Camp Superin- activist reformers and were joined by administering today’s diverse inmate tendent, Marianna, Florida, makes his daily concerned citizens from various walks of populations can inhibit flexibility and rounds. life to help bring about change in the innovation. Proponents of this perspec- corrections system. tive believe that there must indeed be This may strike the reader as a “safe distinct considerations in managing Central to the evolution of this system harbor.” Before being critical, however, I different segments of our inmate popula- was the gradual implementation of a ask the reader to glance again at the title tions-particularly when administering feature critical to the success of all of the article. In what follows I trust there male and female institutions. modem organizations—basic principles will be due consideration for both of management to which organizational “constants and contrasts” in managing We all know prison administrators policy and culture required administra- men and women committed to our care. who hold these divergent views. While tors to adhere. This ensured that there maintaining clear distinctions in philoso- Principles past and present would be guiding principles to help phy and practice, they generally share prison administrators manage—and one set of characteristics-they are Correctional practice has gradually “constants” in how inmates were treated. experienced, opinionated, and outspoken. evolved through this century to its Thus, the author’s dilemma. current state in which fundamental The constants principles guide practices in managing At no time has the diversity of our inmates. Such was not always the case. I weighed both perspectives before nationwide prison population been as In the past, practices in dealing with committing thoughts to paper. As it turns great as today. This diversity takes the inmates were glaringly disparate among out, I think both viewpoints are right. form of increasingly varied cultural, individual prisons, correctional systems, Each has merit; combined, they shape racial, and ethnic demographics, chang- and governing jurisdictions. Wardens much of today’s thinking in correctional ing offense behaviors and security could often act with autonomy—in some management. requirements, expanding health care cases impunity—in day-to-day inmate needs, and a rate of incarceration of management. The lore of correctional women greater than that of men. history is laden with tales of autocratic rule—accounts that have often been embellished to attract the moviegoing 56 Federal Prisons Journal

Despite these factors, prison adminis- Corrections to establish nationwide trators are today attempting to apply management standards are a hallmark in constant principles to daily management, the profession’s history. With the Bureau regardless of the populations they serve. of Prisons, as in many State and local Many such principles are common to agencies, strategic planning centers on all successful organizations, public or the constants of sound management. private, human services or industry. All such principles, albeit broad in scope, The contrasts have direct impact on inmate manage- To explore the contrasting management ment practices. variables in administering female as opposed to male inmates, we must return Foremost among modem organizational to the issue of population diversity. With principles is the need for a continuity of the constants as our baseline, there must mission that is understood by all employ- be appreciation of the diverse character ees. A healthy system of communication of our populations when making manage- both up and down the hierarchy is critical ment decisions. Culture, race, ethnicity, in support of the mission. It is essential Culture, race, ethnicity, and religious belief religious belief, social history, and that a sense of pride and professionalism must all be taken into account when making gender must all be taken into account. At combine with a qualified workforce that management decisions. Here, Islamic inmates times, these variables can affect how we is well trained. Employees must have prepare for prayer at the Federal Medical employ the constants. The ability to opportunities for career advancement Center, Lexington, Kentucky. understand and adapt to this distinction is and their leaders must have integrity. arguably critical to the effectiveness of the administrator who moves from one Additional management principles are staffing; an inmate discipline program setting to another. emerging as constants to join those based on due process, fairness, and already mentioned. These include the impartiality; and high standards of To address what I consider to be several importance of long-term planning and the sanitation and safety. Equally high notable contrasts, I draw primarily on use of up-to-date information systems in standards must be maintained in such my work at the Federal Prison Camp in evaluating programs and developing critical care areas as food services, health Alderson, West Virginia. During my planning strategies. Participatory care, and chaplaincy programs. The tenure there the institution was known as management continues to gain favor with constant that demands increased attention the Federal Reformatory for Women and employees, and broader contacts with in times of continuing crowding is the later as a Federal Correctional Institution; community officials, media representa- constructive involvement of inmates in in its early years the facility was named tives, and the general public are consid- institution programs. Skill development the Federal Industrial Institution for ered to be of great benefit. Not surpris- through meaningful work activities, Women. From the opening in 1927 ingly, promoting an understanding of the education, recreation, and counseling through today, Alderson has had as its agency mission is being linked to its past; programs are central. mission the care and custody of female accordingly, we are seeing increased offenders. Alderson’s history is rich and attention to the history and culture of Affirmation of these constants of its contributions to corrections and corrections. correctional management occurs on Bureau of Prisons culture are many. several fronts. Legislative initiatives, Several Alderson administrators have Finally, there are constants that most judicial review, and sound written been among the most principled and directly affect our management of policies help establish these basics, while dedicated professionals that corrections inmates and form the core of training the increased prominence of professional has known. programs: sound institution security; organizations such as the American individualized classification; adequate Correctional Association helps ensure ongoing attention to and focus on issues in corrections. The successful efforts of the Commission on Accreditation for Spring 1992 57

Foremost among the contrasts is the role The experienced case manager, having Alderson and institutions like it have examined hundreds of presentence played in managing inmates through investigation reports, might suggest a custody and security. As a general rationale for this condition. Females who principle, the least amount of “hard- make their way to prison have been ware” deemed necessary is used in socialized more toward dependent managing inmates. Rather, the first line relationships, as opposed to life activities of defense has been emphasis on a safe, that promote independence. One is likely productive “prison community” environ- to find limited work histories and early ment, with reliance on healthy staff- school dropouts. Meaningful job training inmate relationships as a primary means is unlikely, health care neglected, and the of supervision. self-discipline that derives from military experience much less common. Histories Remote location is a factor in security of abuse of various forms at all ages are (although in its early years, when rail not exaggerated; high levels of depen- operations were more efficient, Alderson dence on prostitution and drugs are was not considered as remote as it is common. The result is that dependencies today). It can be argued that female of varying forms are actually sought out inmates respond to the remoteness Physican Assistant Jim Harvey checks blood in the prison community to “replace” differently than males. With regard to counts on a DT60 analyzer at the Federal those the inmate has experienced prior propensity for escape, there appears to be Prison Camp, Alderson, West Virginia. to incarceration. greater intimidation due to the foreign surroundings, a tendency to form ties— This has clear implications for the not always healthy—within the prison This perspective does not alter the administrator’s application of the community that deter interest in escape, importance of security and control as constants. In disciplines such as health and less external support for escape a correctional “constant”; Alderson’s care, case management, counseling, and attempts. history of managing some of the psychology services, staffing levels Bureau’s most difficult offenders bears guided by male institution standards may These factors are certainly of less this out. It does affirm that application of well prove inadequate. In turn, decisions relevance with male inmates. Yet we the constant should require thoughtful regarding inmate programs and resources have all too often seen efforts to apply consideration of the distinctions between can be greatly affected by the female traditional male inmate security standards the male and female response to incar- dependency response—which brings us to female populations. Rarely does the ceration. to the next contrast. newly assigned Alderson captain, usually male and with limited experience with A second distinction rests in the varying The importance of aggressively develop- female inmates, not experience consider- “dependency response” of the sexes ing programs that promote community able discomfort in viewing the security when incarcerated. As we know, the and family ties—particularly with features—or lack of them, before male response is generally—I emphasize children—cannot be underestimated. One Alderson became a minimum-security “generally”—guided by the “do your merely has to examine the visiting room camp in 1990—at such an institution. It own time” adage, making an effort to rolls to understand who suffers the would be difficult to tabulate how often manage one’s own affairs and keeping greater abandonment when incarcerated. proposals have been advanced for double a distance from staff. Such is generally Also, single parenting occurs nationwide fences, secured cottages, high mast not the case with the female population. to a greater extent among women, lighting, and pass systems—usually not Myriad relationships with fellow inmates particularly in the increasing populations based on need but on what the proposing and relentless, often pillar-to-post of minorities and the disadvantaged. official has become accustomed to in demands on staff can be commonplace. male institutions. The open physical environment promotes this sort of interaction. 58 Federal Prisons Journal

Without doubt, many women in prison their day-to-day application can differ from page 53 have been ill-suited to parenting. in female institutions as the administra- Pregnant Nonetheless, the nurturing bonds tor faces several realities. Sick calls will between mother and child more often be longer, physical and mental health by the team leader) through interdiscipli- than not remain strong during incarcera- concerns more frequent, the need for nary contributions to the treatment plan. tion. I am not suggesting that male specialized medical care in the commu- While this model is common, it depends inmates do not experience a similar nity more common, and histories of upon the availability of staff and the response. My point is simply that the medical and dental neglect more patient’s needs. The use of other health sheer numbers of female inmates who chronic. care professionals to manage treatment have young children awaiting their planning and intervention may represent a return, combined with the “dependency Likewise, commissary operations will better use of resources. response” and abandonment that comes baffle the newcomer to women’s with incarceration, can prove a substan- prisons. In light of constants developed A holistic, health-oriented model is the tial management concern in the female to control male inmates’ personal framework that guides the delivery of setting. property, the volume and nature of health services to pregnant inmates in items stocked in the women’s commis- Federal correctional facilities. The coordi- The potential impact is clear. Innovation sary can indeed be troubling. Cosmetic nator for maternity health services super- is required to establish programs that and personal hygiene items usually vises the activities of staff physicians, promote successful adjustment on provoke the greatest anxiety for the consulting physicians, physician assistants, release by strengthening family relation- security-minded traditionalist. While social workers, and nurses. Referral to ships. With visitors often traveling great strict oversight is needed to limit the specialized services is performed as distances to the few women’s prisons, proliferation of items on the shelves, the required by the patient’s needs and expanded visiting room hours, child care male guidelines are not likely to prove institutional policy. programs, and innovative procedures are suitable for control in the female called for. Telephone programs take on setting. The patient is an integral part of the added importance, as do parenting treatment team’s setting of health care classes, counseling services, and Applying the “constants” goals and determination of treatment plans. chaplaincy programs. When a patient is allowed to work with the I have presented several correctional medical team in setting goals, compliance management issues involving contrasts with treatment is likely to be greater. n Furlough programs have proven critical between female and male institutions, in to fostering family ties and release the context of the clear “constants”— planning for appropriate inmates nearing proven principles and practices—of release. However, furloughs are less Anita G. Huft, Ph.D., RN, is employed by managing all correctional institutions. Women’s Health Care Services and is a used today, even in cases where they For the administrator, it is important to may well be indicated—again, probably consultant to the Federal Medical Center acknowledge that distinctions between (FMC), Lexington, Kentucky. Lt. Lena Sue a management response transferred from female and male populations do exist. male inmates to the female population. Fawkes, USPHS, CRNA, MSN, is Quality Appreciation of these distinctions can Assurance Coordinator at FMC Lexington. have a significant effect on the manner Two additional institution operations in W. Travis Lawson, Jr., M.D., is Associate in which these constants are applied in Warden of Clinical Programs at FMC which contrasts exist are medical and the correctional environment. n mental health care programs and Lexington. commissary operations. With regard to References these key correctional functions, the David W. Helman is warden of the incoming administrator’s motto must be, Standards for Obstetric-Gynecolologic Services, 7th Federal Prison Camp, Duluth, Minne- Edition, 1989, The American College of Obstetricians “Be Flexible!” While the constants of sota. He served at Alderson from 1972 and Gynecologists.

providing high-quality medical and

¥ ¦¨§ © ¤ ! #"$ $ %$ &$"' (*)*$&$+-, + ./)* to 1987 as case manager, drug abuse ¢¡¤£ mental health care remain the same, program director, case management 0*1*1*2-3 The American College of Obstetricians and coordinator, executive assistant to the Gynecologists. warden, and associate warden. Spring 1992 59

The Cycle From victim to victimizer ¢¡ Federal Prisons Journal

4,000 women are killed due to domestic This system of reward and punishment is violence. One-third of all women who similar to the experience of gambling. leave an abusive relationship will be A very strong bond is Slot machines use the principle of assaulted again by their abusive partner created between victim intermittent reinforcement, where a (Kaufman and Zigler, 1987). Many person pulls the arm and is either female inmates have been victims of and victimizer— rewarded with money or punished with domestic abuse as adults, and have no money. A person can develop all witnessed spousal abuse as children. In so strong that hostages kinds of ideas about this process. They one study of children who murder, more have tried to stay with can believe that a certain slot machine is than 75 percent had been exposed to lucky or “hot.” They can believe that a violence and abuse, especially sexual their hostagetakers after reward will surely come on a specific abuse during childhood (Lewis et al., time or day, or that God will grant them 1985). Child abuse and neglect are the terms of release have the money for good behavior. These thought to be on the increase due to drug been negotiated, belief systems help people convince abuse (Hackett et al., 1988). Drug abuse themselves that they are in control of a by parental figures is likewise thought to and abused children and chance phenomenon, even though they be a factor in the disinhibition of vio- aren’t. Once the behavior is learned, it is lence in the family and neglectful wives have lied about difficult to extinguish—the chance of behavior (Gropper, 1984). For every their injuries to protect winning is always there. If they don’t win reported case of child abuse, it is on the first or second pull, maybe they estimated that as many as 10 go unre- their abusers. will on the 15th. ported (Wolock and Horowitz, 1984). Women in a battering relationship Many inmates have abuse in their attempt to keep it in the honeymoon backgrounds. In a study of women suggested that memories of a traumatic phase—behaving in ways that will be inmates who were given prison terms for situation are “burned in” more deeply rewarded and avoiding behavior that will killing their children, each had a history and affect behavior more directly than be punished. Many times, however, the of severe rejection, neglect, or abuse. memories developed under normal punishments and rewards are not linked Many inmates with a history of severe circumstances. This may help explain to behavior, even though the victim may alcohol abuse reported receiving little the strength of a victim’s emotional choose to believe they are. Victims may parental affection and remember being response—even though it seemingly develop inferences about the victimizer’s seriously punished. They also reported defies logic. This bond has been labeled behavior in an attempt to feel in control. severe parental conflict in their families the “Stockholm syndrome” in hostage These inferences can have “magical” or of origin (Gayford, 1975). events, and “traumatic bonding” when superstitious qualities, and have little to discussing spousal or child abuse (Van do with the victimizer’s actual behavior. Some of the psychological effects of der Kolk, 1989). Many victims work to read every mood long-term spousal and child abuse are of the victimizer in an attempt to avert similar to the effects of being taken The cycle of violence punishment. Women and children who hostage. A very strong bond is created Lenore Walker (1980) has described a have been abused tend to be acutely between victim and victimizer-so cycle of violence in families—a tension- aware of other people’s thoughts and strong that hostages have tried to stay building phase, an explosive battering feelings and unaware of their own with their hostagetakers after the terms of phase, and a calm and loving phase that thoughts and feelings. They have learned release have been negotiated, and abused some call the “honeymoon phase.” Any over time that survival depends on children and wives have lied about their abuser tends to give intermittent rein- pleasing others. injuries to protect their abusers (Dutton forcement to the victim. Sometimes the and Painter, 1981). Researchers have abuser may be kind and rewarding to the victim, and other times may attack. (A positive reward may be something as simple as allowing the victim to live.) Spring 1992 61

When an individual is victimized, she begins to lose any sense of self-efficacy in the abusive situation. This loss carries over to other situations. Many abused women believe they are helpless to escape or unworthy of escaping, and think they have no value to other people (Dutton and Painter, 1981). Some believe that their faults cause the abuse, not the abuser’s faults.

Reliving victimization Traumatic events can be reenacted in many ways. Individuals may experience nightmares and intrusive memories of the traumatic event. They may avoid places, events, or people who remind them of a traumatic occurrence. People may also deliberately reenact traumas in an attempt to master them; such reenact- ments can take the form of harm to others, harm to self, or revictimization. For example, if a man was sexually molested as a young boy, he may sexually molest other young boys when Bessel van der Kolk (1989) described behavior has been labeled “learned he reaches maturity. In this way, he gains some physiological changes that can helplessness.” It is easy to see how, control over a frightening event by being occur in victims of trauma. When an when a person has lived in a situation of the perpetrator instead of the victim (Van individual has been traumatized, she chronic abuse, the motivation to avoid der Kolk, 1989). tends to experience chronic physiological rearousing conflict may become so hyperarousal. Behaviorally, victims great that she will choose a course of Rape victims have been known to walk demonstrate deficits in learning novel action without thinking through the in dangerous parts of town in an attempt behavior, may experience chronic consequences. to provoke another attack. They uncon- subjective stress, and may have increased sciously hope to prevail in this attack so tumor genesis and immunosuppression. Hyperarousal can also have a paradoxical they won’t continue to feel victimized. Chemicals in the brain, such as serotonin, effect. Occasionally people (and animals Women who have been victims of norepinephrine, and endorphins, may be too) will become “addicted” to stress and violence tend to reenact their abuse as unbalanced as a result of hyperarousal. seek greater and greater levels of stress to victims; men who were victims tend to obtain release. High levels of stress tend reenact their abuse as victimizers. Many Research with animals and humans has to activate natural opoids called endor- prostitutes have histories of sexual shown that when an organism is overly phins—probably most familiar as the molestation as children, and prostitution aroused it will persevere in familiar substance causing the so-called “runners’ appears to be a behavioral reenactment behavior even when the familiar is self- high.” Once a person has adapted to one of that molestation. Unfortunately, the destructive. If you put an animal in a level of stress, she or he must seek a woman is never able to master the trauma cage with no means of escape and shock greater level of stress to get the same and it repeats itself over and over. it, it will probably cower in a comer. If endorphin high. This theory has been you repeat this procedure numerous applied to people who self-mutilate, times, then open the cage door, chances using the reasoning that mutilating one’s are the animal will remain in the comer. This unwillingness to attempt new 62 Federal Prisons Journal

body increases the level of stress, and References endorphins would thus be released. To Dutton, D., and Painter, S.L. (1981). Traumatic test this theory, researchers blocked the The choices we make bonding: The development of emotional attach-

opoid receptors in the brains of subjects. ments in battered women and other relationships of

£¥¤ ¡ ¦¨§ © § The result was a reduction in mutilation now in corrections intermittent abuse. ¢¡ pp. 139-155. attempts (van der Kolk, 1989). will affect the coming Fagan, J., and Wexler, S. (1987). Family origins of violent delinquents. Criminology, vol. 25, no. 3, pp. The challenge for generations....We who 643-667. correctional workers Freeman, M.D. (1979). Violence in the Home. work with female inmates Famborough, England: Saxon House. People who have been victimized tend to

view the world more pessimistically. may have contributed to a Gayford, J. (1975). Wife-battering: A preliminary

! "# $&%'()+* ,- . $&*¥ study of 100 cases. Traumatic bonding is an extremely few more children vol. 15, pp. 243-244. powerful bond—and highly resistant to

change. Abused women often do not and a few more women Gropper, B.A. (1984). Probing the links between

23* 4565 drugs and crime. /10 U.S. Department of have the same freedom or capacity for Justice, November 1984, pp. 4-8. problemsolving and decisionmaking as achieving stable, loving

women who have never been abused. Hackett, G., McKillop, P., and Wang, D. (1988). A => relationships. tale of abuse: The Steinberg trial. 798 :<; :<8 8 December 12, 1988, pp. 56-58. Education and therapy are proven tools in the care of traumatic stress reactions. It is Kantrowitz, B., Wingert, P., King, P., Robbins, K., and Namuth, T. (1988). An epidemic of family important to help abused women inmates violence. /1*5?5?* * @ December 12, 1988, pp. 58- work through the traumatic content of Many victims have learned that violent 60. their lives, and explore the ways in which confrontation is the way to win an Kaufman, J., and Zigler, E. (1987). Do abused

they have constricted their thinking and argument. They need to be given skills to . %$

children become abusive parents? ACB1*

"6 $'%3(

type of attachment behavior they have progress. Ultimately, they must come to Biopsychosocial characteristics of children who . %6$ later murder: A prospective study. A9B1*

experienced—the only type of bonding to understand what constitutes a healthy

"# $&%6¢6(¢J KL. - %& KLC¥ CM5N¥O5 P no. 10, pp. 1161 which they have been exposed—is love. relationship, rather than simply moving 1167. They need to be given the tools to form from one battering relationship to another. Van der Kolk, B. (1989). The trauma spectrum: The

less violent, more stable relationships in interaction of biological and social events in the "6¥$&%96(

the future. The choices we make now in corrections genesis of the trauma response.

tion. Victims need to be educated about female inmates may have contributed to a maltreatment as a social problem: The neglect of

. %$U "# $&% the effects of violence on their offspring; few more children and a few more women neglect. ACB1* of Orthopsychiatry, vol. they cannot be expected to be good achieving stable, loving relationships. n 54, pp. 530-541. parents without the proper tools. Many of these women have never had proper child care models; the type of parenting they Crista Brett, formerly Employee Assis- have seen and experienced is often tance Program Coordinator for the extremely destructive. Federal Bureau of Prisons, now works for the Bureau of Indian Affairs in Wyoming. Spring 1992 63

Canada’s Female Offenders New options in the Federal svstem

Jane Miller-Ashton The Task Force was one of five set up by were serving their sentences in provincial the CSC to review such fundamental institutions. There were, as well, about In March 1989, the Commisioner of the correctional issues as substance abuse, 200 women under community release Correctional Service of Canada (CSC), mental health, and community and supervision. The number of women Ole Ingstrup, established a Task Force on institutional programs. The results of offenders is generally stable, and Federally Sentenced Women, in collabo- these task forces are being used by CSC represents 2 percent of the total Federal ration with the Canadian Association of to more effectively address the needs of offender population in Canada. Elizabeth Fry Societies (a nonprofit, offenders in their efforts to become law- private-sector organization which works abiding citizens. Issues and concerns with, and on behalf of, women in conflict Several long-standing and unresolved with the law). The Task Force included In April 1990, the Task Force on issues have placed women, due in part to women inmates, as well as members Federally Sentenced Women submitted their small numbers, at a disadvantage in from a broad range of relevant commu- its final report, which called for a new the correctional system: nity agencies, women’s groups, Aborigi- approach to meeting the unique needs of nal [native] organizations, and Govern- Federally sentenced women. nThe geographic dislocation of many ment departments. A large number of women from their families, cultures, and women participated in the Task Force At the time of the completion of the communities. and decisionmaking was conducted by report, about 260 Federally sentenced nThe “overclassification” of many consensus. women were incarcerated in Canada, women, and the lack of significant about 50 percent of whom were accom- opportunity for movement within a range modated at the only Federal prison for Prison for Women, Kingston, of both institutional and community women, a maximum-security institution Ontario: main cell block facilities and programs. built in 1934 in Kingston,

Ontario. Most of the

nThe lack of sufficient programs and services that respond to the unique needs of women. nProgram inequities that result from placement of women in provincial institutions, which are often not geared to the needs of longer-term offenders. n The difficulty of effective prerelease planning. n The uniquely disadvantageous situation experienced by Aboriginal women who, at about 16 percent, are overrepresented in the Federal prison population, and are particularly isolated Above and left: from their cultures and communities. Inmates can earn permission to spend Over the years, these problems have been up to 72 hours once every 2 months at examined by a variety of task forces and a private family commissions, and considerable effort has visiting house on the been made to improve the situation for grounds of their Federally sentenced women. Nonethe- institution. less, major problems have persisted. Numerous and recent recommendations to close the Prison for Women emerged, nThe hardship of mother-child separa- nThe paucity of community-based challenges under the Charter of Rights tion expressed by incarcerated women, services for Federally sentenced women. were launched, and pressures for two-thirds of whom are mothers, and nThe high need for culturally sensitive substantive change continued to mount many of whom are single parents of programs and services. from concerned lobby groups. children under 5 years of age. nThe high priority placed by Federally n The extensive histories of physical or Given this background, the mandate of sentenced women on their desire to be sexual abuse experienced by 80 percent the Task Force was to examine the closer to home. of Federally sentenced women, and 90 correctional management of Federally percent of Aboriginal women under nThe evidence that successful program sentenced women from the commence- Federal sentence. directions for women offenders include ment of sentence to warrant expiration, those that focus on self-awareness and and to develop a plan to guide this nThe high incidence of self-injurious self-esteem, promote community process in a manner responsive to the behavior among women at the Prison for involvement and adherence to commu- unique needs of this group. Women, and its relationship to past nity norms, use tools validated for histories of abuse. Findings women and Aboriginal peoples, and nThe relatively high incidence of provide in supportive environments The Report of the Task Force on Feder- substance abuse as part of the offense or programs responsive to the needs of ally Sentenced Women was based on offense history of the women and their women, with less emphasis on static insights gained from extensive consulta- expressed need for more comprehensive security measures. tions and from several research projects. substance abuse programs. Pertinent findings included: nThe high need for educational and vocational training geared to the development of marketable skills. Spring 1992 65

Recommendations CSC policy respecting the social, cultural, and religious differences of The Task Force made eight short-term individual offenders and addressed the recommendations geared to improving special needs of female and native the immediate situation at the Prison for offenders. Finally, the plan brought a Women. In large measure these recom- disadvantaged group within a long- mendations have been fully imple- standing CSC policy of regionalization, mented. In addition, an 1l-bed mini- enhancing program opportunities for mum-security institution for Federally women and bringing them closer to their sentenced women was opened during the families, communities, and cultures. course of deliberations. The locations recommended by the Task The Task Force’s longer-term plan Force report for the regional facilities incorporated a societal understanding of were based on proximity to the home women’s and Aboriginal people’s communities of the majority of women experience of disadvantage. It was based from a given region, and on the availabil- on the belief that a holistic women- ity of community resources generally centered approach to the treatment of found in larger urban centers. Federally sentenced women is required to address the historical problems, and is Facility description predicated on principles of empower- The Elizabeth McNeil House, an 11-bed The Task Force recommended that ment, meaningful choices, respect and minimum-security facility for women in regional facilities be developed and dignity, supportive environments, and Kingston, Ontario, opened in March 1990. shared responsibility. The plan placed operated premised on a program philoso- high emphasis on the need for Federally phy that approximates community norms, sentenced women to recover from past 4. Develop a community release strategy focuses on extensive use of community trauma, and to develop self-esteem and that would expand and strengthen expertise, and is geared to the safe self-sufficiency through programs and residential and nonresidential programs release of Federally sentenced women services designed to respond to their and services for women on release. at the earliest possible point in their needs. It stressed the need for physical sentences. Program delivery would be 5. Respond to the needs of the few environments that are conducive to based on gender-sensitive assessments women from remote or northern parts of reintegration, are highly interactive with and individualized plans developed by Canada by negotiating agreements for each woman in conjunction with a staff the community, and reflect the generally them to remain in their home areas under low security risk of these women. person (primary support worker) and a Territorial/Provincial jurisdiction. community worker assigned from a The plan included the following recom- private-sector agency. The Task Force plan was situated within mendations: the Canadian Federal Government’s Programs should be holistic, culturally 1. Close the Prison For Women. ongoing efforts to achieve equality for sensitive, and responsive to the needs of women and Aboriginal people, and was 2. Establish four Federally operated women. Primary programming would fundamentally rooted in the mission of regional facilities for Federally incarcer- focus on counseling and treatment— CSC, which respects the dignity of ated women. including sexual, physical, and substance individuals, the rights of all members of abuse recovery; educational, vocational, 3. Establish a Healing Lodge, which society, and the potential for human and skills development; leisure activities; would serve as an incarceration option growth and development. It was consis- family visitation; onsite residence of for Federally sentenced Aboriginal tent with CSC’s strategic objectives to children; and spiritual services. Self- women. provide a safe, humane environment that sufficiency and community responsibility promotes health and well-being and encourages positive interaction between staff and offender. Further, it honored 66 Federal Prisons Journal

would be fostered through daily opportunities for living skills acquisition, and through the positive support of staff who are skilled in counseling, communications, and negotiations, and are sensitive to women’s and cross-cultural issues.

It was recommended that the regional facilities be situated on several acres of land and be built to modem environmental standards that foster wellness, including considerations of natural light, fresh air, color, space, and privacy. Living areas would be cottage-style, with 6 to 10 women per cottage. A central core area for administration would contain flexible program space May 1992: Official announcement of the location of the new Healing Lodge facility for for recreational, social, spiritual, and Aboriginal women at Maple Creek/Nekaneet, Saskatchewan. Left to right: Royal Canadian Mounted Police officer; John Oakes, Nekaneet Band Councillor; the Honourable Doug Lewis, counseling activities. The facilities would Solicitor General of Canada; Doug McAlister, Mayor of Maple Creek; Chief Gordon Oakes, be designed to maximize mother-child Nekaneet Band; Geoff Wilson, Member of Parliament; RCMP officer. interaction and family visits.

The Task Force report suggested using The physical space and programs for the opment and operation of programs and dynamic rather than static security Healing Lodge would reflect Aboriginal services in both the facility and the measures wherever possible, to reflect culture. The needs of Aboriginal women community. the supportive orientation of the facili- under Federal sentence would be ties. An unobtrusive perimeter security addressed through native teachings, Membership for the Regional Advisory measure, for detection purposes only, ceremonies, contact with elders and Councils would be drawn from local may be added to what would otherwise children, and interaction with nature. private-sector groups and individuals be a boundary fence surrounding each Program delivery, as in the other facili- who have expertise and interest in facility, built to community standards. ties, would be premised on individualized women’s issues and criminal justice. One cottage (or part of a cottage) in each plans, a holistic approach, an interactive With respect to the Healing Lodge, the facility would require enhanced static relationship with the community, and a Regional Advisory Council would take security features, but staff support to focus on release preparation. The Healing the form of both an elders’ council and a higher risk women would be the pre- Lodge, however, would at all times connection to a local native community. ferred approach. operate from a unique cultural perspective, placing a high value on spiritual Councils would evaluate existing The Task Force recommended that the leadership, as well as on role modeling programs, identify gaps in services, and Healing Lodge be developed and and the life experiences of staff, with recommend additional programs and operated according to native traditions more traditional professional expertise services. They would also monitor the and staffed by Aboriginal men and providing an important but largely continuity of programs between the women. The Lodge would be designed in supportive role. facility and community and make consultation with Aboriginal people, and recommendations on how continuity would require, in addition to standard could be improved. Finally, councils CSC administrative requirements, a Regional Advisory Councils would play an educational role in their connection to a nearby native community The Task Force report recommended that local communities so that the facility and and the support of an elders’ council. Regional Advisory Councils be established in association with each regional facility to advise the CSC on the devel- Spring 1992 67

the women released from it are seen as an integral part, and a responsibility, of the community.

Community release strategy As envisioned by the Task Force report, the community orientation of the regional facilities would facilitate the development of individualized release plans, assisted by a community support team. The team, composed of CSC staff and community workers, would work closely with each woman to ensure that needed services would be available on release.

This effort would be supported by new, enhanced residential and nonresidential opportunities for women. There would be an increased need for specialized The Healing Lodge Planning Committee, a unique partnership composed of Aboriginal women, services, including Aboriginal halfway native elders, and Correctional Service of Canada staff. houses and community-based treatment residences, as well as alternate accommo- The Government had made significant dations such as satellite apartment beds operational input to the planning and development of the regional facilities, the progress toward achieving the closure of and private home placements. Services the Prison for Women and establishing purchased from community residential Healing Lodge, and the community the five new facilities. A three-step facilities would include employment strategy. selection process was implemented, the counseling, substance abuse treatment, first of which was the minister’s July and living skills programs. In December 1990, an External Advisory Committee was established to provide 1991 announcement. Implementation advice on the overall initiative. The committee includes members from The Correctional Service of Canada In September 1990 the Government Status of Women Canada, the Canadian subsequently developed selection announced its acceptance of the major Association of Elizabeth Fry Societies, criteria; communities were given an recommendations of the Task Force. and the Native Women’s Association of opportunity to submit proposals based on Included in the announcement were plans Canada. those criteria. Forty-four communities to close the Prison for Women by fall were assessed by members of the 1994, to establish the five new facilities, Location selection National Implementation Committee, and to expand and enhance community which also included a staff member from services and programs for Federally During the months following the Government’s announcement, an unpre- Status of Women Canada. A report was sentenced women. The cost is estimated submitted to the Solicitor General in to be about CAN$50 million. cedented number of communities expressed an interest in having the facilities early December 1991; later that month he located in their areas. In July 1991, the announced plans to locate the Atlantic In October 1990, the Commissioner of facility in Truro, Nova Scotia, and the Corrections announced the creation of a Solicitor General, the Honourable Doug National Implementation Committee to Lewis, announced that the new facilities oversee the initiative—including all would be located within 100 kilometers of the major centers of Halifax, Montreal, Toronto. and Edmonton or Calgary. 68 Federal Prisons Journal

Ontario location in Kitchener, Ontario. Announcements for the Quebec and Alberta facilities are expected in the near future.

There is no requirement for a regional facility in British Columbia because Federal women are now accommodated in a new Provincial facility for women in that province. This agreement was negotiated prior to the Task Force report.

With respect to the Healing Lodge, the Solicitor General announced that this facility would be established in the Province of Saskatchewan. This centrally located prairie Province is home to many Native women. The Healing Lodge Left: Vocational trades training. Right: Committee subsequently developed Playing ball at the Prison for Women, culturally sensitive selection criteria to Kingston, Ontario. help determine the location for the Healing Lodge. Operational plan Conclusion In March 1992, 23 Saskatchewan In addition to determining geographic The undertaking in Canada is in keeping communities (many of them joint locations, the National Implementation with many parallel initiatives taking partnership proposals from urban centers Committee has developed an operational place in other jurisdictions and countries and nearby Aboriginal communities) plan for the new facilities. Because the to effect change for the generally small were evaluated. The first-place submis- new approach to Federally sentenced numbers of women in prison worldwide. sion from Maple Creek/Nekaneet in women will, in some cases, mark a The unique aspects of the Canadian Saskatchewan was endorsed by the significant departure from existing policy experience, which appear to have worked Solicitor General and made public on and practice, it was deemed important to to positive advantage, relate to the May 22, 1992. This community was develop a plan that would provide a significant involvement and consultation selected because of its strong Aboriginal framework to ensure some commonality with women offenders, the partnership qualifications: sacred land, pure spring and consistency among the new women’s developed with private-sector groups, water, and the support of a traditional facilities. The operational plan was including Aboriginal peoples, and the Aboriginal community, including elders developed in consultation with private- commitment of the Correctional Service and medicine people. In addition, this sector partners and other CSC staff, of Canada and the Canadian Federal community was favored because of the and with input from women offenders Government to make needed changes for harmonious relationship that seemed to themselves. The plan reflects the women in prison. n exist between the native and non-native principles of the Task Force report, as citizens. well as the knowledge about women in prison gained through consultation and Jane Miller-Ashton is the National research. Similarly, the warden’s job Coordinator for the Federally Sentenced description for the new facilities has been Women’s Initiative, Correctional Service written to capture the unique aspects of of Canada. managing in this type of setting. Other aspects of the facility development will receive similar attention to ensure sensitivity to women’s issues.