Ending Birth Behind Bars: Minnesota’s Healthy Start Act and Where We Go From Here

Minnesota’s Healthy Start Act gives incarcerated people who are pregnant or who give birth during their sentences the option to receive pre- and post-natal care in community-based prison alternatives. Pictured: A still from the film Tutwiler, which tells the story of pregnant women incarcerated at the Julia Tutwiler Prison for Women in Wetumpka, Ala. (Elaine McMillion Sheldon / PBS)

In July, Minnesota will make history as the first state in the U.S. to implement legislation that ends the practice of separating incarcerated parents from their newborns. Signed into law in May, the Healthy Start Act provides the option for incarcerated people who are pregnant or who give birth during their sentences to receive pre- and post-natal care in community-based prison alternatives. 

Currently, incarcerated people in Minnesota—like many other states in the U.S.—return to prison only two to three days after giving birth. Pregnancy itself brings an onslaught of harm and potential human rights violations for incarcerated people: shackling during childbirth; coerced cesarean sections and non-consensual sterilization; the unwanted presence of prison guards in an intimate space. The trauma of childbirth is then exacerbated by the near-immediate separation of the incarcerated mother and their newborn.

“I kept thinking, the whole time I was in prison, is my baby going to know who I am. Is my baby going to remember me?” said Jennifer Brown, a Minnesotan woman who was four months pregnant when she was incarcerated for a first-time probation violation. In March of 2020, she gave birth to her son Elijah while in prison. “Forty-eight hours after giving birth to him, I had to pass him over to people I didn’t even know.” 

Impact of the Healthy Start Act

“Normally, with an incarcerated client, that postpartum visit is emotional,” Raelene Baker, program director of the Minnesota Prison Doula Project, told Ms. “You go into the prison and they’re lactating for the baby that they don’t have with them.” 

The experience Baker explains was the reality for 278 pregnant people in Minnesota who were sentenced to serve time in prison between 2013 and 2020. “This bill is an incredible opportunity to disrupt cycles of trauma,” said state Representative Jamie Becker-Finn, who played a leading role in the passage of the legislation. 

The Healthy Start Act is a monumental first step in securing birth justice for incarcerated parents. For Baker—who has been working as a doula in the Minneapolis area since 2004—the law will significantly impact the operation of her organization, the Minnesota Prison Doula Project. The doulas at the organization provide emotional, physical and informational support to pregnant and postpartum incarcerated parents.

“Instead of going to a birth with two corrections officers and a looming separation, we will be able to help them welcome their baby with a partner with them if they choose, or other family members, because they will … be able to welcome their baby with more choice. That will look a lot different,” Baker told Ms

The Devil Is in the Details

While there has been much deserved celebration over the Healthy Start Act, doulas and organizers advise close watch of the bill’s implementation. “The idea of it sounds really good. I’m curious to see how the execution will happen, because it’s allowing the commissioner to make each individual determination,” said Baker. “So it could look different for every person—they could be going to treatment, they could be going home, they could be on confinement.”

Similar organizations to the Minnesota Prison Doula Project exist across the United States working to secure legal and human rights for incarcerated pregnant people. Marianne Bullock, the founder of the Prison Birth Project in Western Massachusetts—in existence from 2008 to 2018—shared a similar sentiment to Baker: “This is a start. For sure, this is a great start. The implementation of this is what actually matters.” 

For those who want to see similar legislation to the Healthy Start Act in their states, the most important piece of advice: Center those directly affected. 

“Listen to incarcerated people and what they need, because what they need might not be what you’re necessarily thinking about,” said Baker.

Bullock emphasized a similar note: “If you don’t have people directly affected doing this work, sharing their stories on their own terms, you know, it’s going to take you a lot longer—and it’s going to be a lot less impactful.”

A Future of Abolition and Birth Justice

Looking towards a future without birth behind bars, abolition emerges as a long-term goal among those with direct experience working with incarcerated parents.

“I wish our work towards changing policies were more in-line with dismantling criminal systems and shrinking carceral systems,” Bullock said. “I think the policies we need now are ones that no longer rely on caging, surveilling and controlling people to solve problems.

“Reforming prisons most often results in more prisons and more control, so I am hesitant to say this legislation is a step in the right direction. And, I never want to say my value of abolition is more important than a mother being with her baby, today.” 

Bullock encourages readers to hold two things at once: celebrating the Healthy Start Act for how it will materially improve the lives of incarcerated pregnant people, while acknowledging it is our job to always look towards how we can further create the conditions for true justice.

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Lily Sendroff is an editorial fellow at Ms. and a rising senior at Smith College in Northampton, Massachusetts. She majors in the study of women and gender and government, with a concentrative subfield in comparative politics. Her work typically focuses on feminist economics, transnational feminism, and policy analysis.