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As a prison doula, a birth attendant for incarcerated women, the author of this chapter has learned that incarcerated women love their children as much as any other mother. One of the recurring themes in the stories she has heard from incarcerated mothers is the damaging effects prison has on mothers and their children once they get caught in the criminal justice system or child protective services. The author has had the opportunity to support many women through their experiences of pregnancy, birth, and parenting while incarcerated and feels deeply connected to their struggles and triumphs. Two incarcerated women in Washington State Correction Center for Women, Delessia and Tabitha, worked very hard against daunting odds to keep their families together. Their experiences demonstrate clearly the inhumane and damaging effect of incarceration and suggest a need for alternatives that better meet the needs of people who are struggling with poverty and addiction.

Although there are many aspects of childbirth in the environment of evolutionary adaptedness (EEA) that would not be beneficial or desirable today (e.g., complications that result in high maternal and infant mortality and morbidity), there are a number of practices that, if adopted for contemporary low-risk births, may improve not only maternal and neonatal health but also parental satisfaction with the experience. This chapter discusses five practices that were likely used in the EEA and that may improve health of mothers and infants. The potentially beneficial practices include emotional support from a doula, delivery in the upright position, delayed clamping of the umbilical cord, little or no separation of mother and infant during the first postnatal hour, and initiation of breastfeeding soon after birth. Additionally, potential negative consequences of elected cesarean section are addressed.

Vigil is a rite observed usually on the third day. It is called a wake in the Roman Catholic tradition. Family and close friends gather around the deceased for a viewing to say their prayers and goodbyes on the eve of the funeral and burial. Sitting vigil with the dying person is an act of support for the dying partner and for the caregiver. To sit vigil requires the recognition and acceptance of death. It is an act of honoring the final stage of life and helps to create a quiet and peaceful environment for death. During this state of acceptance there are no attempts to resuscitate. Often circles of friends, family, and hospice workers rotate the sittings so as not to overwhelm one individual caregiver. To describe the complexities of the rite vigil, this chapter looks at the life experience of Megory Anderson, a death doula or a spiritual escort to death's door.

The Children’s Aid Society (CAS) early childhood initiative is located in two of our New York City community schools, Primary School (PS) 5 and PS 8, in the Washington Heights section of northern Manhattan. This initiative was conceived as a partnership between the New York City Board of Education and CAS. The collaboration brought newborns and their families into the schools in which the children would complete fifth grade. The initiative began in 1994 and has been in full operation since 1996. Since then, the need for such a project has been confirmed and experience has provided insights into how a program for pregnant women and children through age five (often called a Zero to Five Program) can be effectively implemented within a public school. The CAS Zero to Five model connects two federally funded programs—Early Head Start (birth to age three) and Head Start (ages three to five)—to provide comprehensive educational and social services to low-income families and their children. The population attending the Zero to Five Program confronts the obstacles facing all new immigrant families living in poverty in an urban setting. In both schools more than 75% of the families are from the Dominican Republic; another 20% come from other Central and South American countries. The parents’ language is Spanish, and language barriers and acculturation issues result in social isolation. In addition, because many residents lack legal documentation, they are reluctant to access health and social services. The few early childhood programs in the neighborhood all have long waiting lists. A majority of the families share overcrowded apartments with other families or extended family; whole families often live in one bedroom where books and age-appropriate toys are scarce and there may be little child-centered language interaction. However, in spite of the difficulties, these parents have a drive to succeed and they understand the importance of education. By combining and linking Early Head Start and Head Start programs and integrating them into a community school, the CAS Zero to Five Program provides children and families with quality educational, health, and social services, after which the children transition into public school classes within the same building.

Having examined the history of prematurity, Black women’s experiences of pregnancy, labor, and birthing, and their assessments of medical racism, this chapter gestures toward some approaches to address Black women’s high rates of prematurity. These approaches may also be applied to rates of infant and maternal mortality, as well as to addressing the adverse birth outcomes of other groups. Presently, much emphasis is placed on stereotyping the characteristics believed to cause prematurity. The general approach is to intervene in the problem. This chapter suggests that preventive approaches to birth outcomes must be deployed with the same commitment as is done with interventions. Transforming the model of care requires viewing pregnancy as an event, not a risk. And, unless risk is well established, pregnancy care need not be medicalized. In the event that medical interventions are necessary, a team-based model of care is preferable. Medical providers should be sharing the care with the family, a midwife, and a doula. Most important, medical professionals must acknowledge the ways that they uphold racism in their practice of medicine.

This chapter describes the development of the fetus in the ninth month of pregnancy. As the author gets close to delivering, she discusses the stages of labor and the task of creating a birth plan. Specifically, she discusses the benefits of choosing a natural birth versus a planned C-section, and the option of using pain-reducing interventions (e.g., epidural) and their potential effects on labor and delivery on the fetus. She also includes a brief discussion of the role that doulas and midwives can play in births in the United States.