Articles & News

November 20, 2008

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Nurse researcher Mary Byrne, CPNP, PhD, FAAN, says the incarcerated women and their babies she has studied behind bars at the Bedford and Taconic correctional facilities during the past eight years are imprinted in her mind.

"Many of the children are now 7 or 8 years old. I think about them often. They have affected me, as has the entire prison system," she says.

Byrne is the first researcher outside the New York correctional system to study incarcerated women and their babies living in a prison nursery. Her research began in 2000 at the Bedford Hills Correctional Facility and Taconic Correctional Facility, maximum- and medium-security women's prisons, respectively, about an hour's drive north of Manhattan. Prior to Byrne's research, no one had formally studied the impact of the prison nursery on an infant's development.

Byrne says so far her data shows that "the [co-habitation] of inmate mothers [and] their newborns can provide a positive environment that supports parenting and child development. However, the implications of our research show that mothers need supportive resources." These include treatment for depression, enhancement of self-esteem, and a sense of self as parent, as well as parenting guidance, she says.

Bedford Hills has the longest-running prison nursery in the country, since 1901. Women who are pregnant when they are incarcerated and have no serious disciplinary problems in prison may keep their babies with them for up to one year after birth, and sometimes longer, if parole is pending. The goal of the prison nursery is for mother and child to develop a secure attachment, which encourages healthy social, physical, and emotional development, Byrne says.

Becoming Parents

The typical day for a nursery mom at Bedford Correctional Facility is to wake up at 6 a.m., have breakfast, clean her room, and prepare baby for day care. By 9:30 a.m. mothers have dropped their babies off at infant day care — staffed by civilians and long-term inmates who have been trained as caregivers — and attend vocational, educational, and anti-crime-related programs. They join their babies at lunch and then return them to day care, as they attend an afternoon educational program. They pick their babies up at 4:30 p.m. and are responsible for their care for the rest of the evening. Recreation, college courses, and classes on domestic violence or 12-step meetings are offered, and the mothers often trade babysitting for attendance.

New York's Department of Correctional Services and those in other states are particularly interested in how the prison nursery affects the mother's recidivism.

"The Department of Correctional Services welcomed Dr. Byrne's research because we believe in the nursery program and felt reliable data from a recognized researcher would help document the program's effectiveness and success," said spokesman Erik Kriss.

"The mothers who participated in Dr. Byrne's study enjoyed their work with her and her research assistants and perceived the process as an intervention on their own behalf. They were more attentive to their children and their own parenting as a result."

Research Culture Clash

In spite of her prolific prisoner data collection, Byrne says conducting a prison research study is a culture clash between the punitive, restrictive environment of the corrections system and the open inquiry environment that is needed for health research, as noted in the July/August 2005 issue of the Journal of Professional Nursing.

In the 1970s, the U.S. government enacted strict guidelines to protect prisoners who had been coerced into and abused by health research. Byrne's strategies for overcoming obstacles to prison research by healthcare providers included gaining the participatory input of inmates, acquiring knowledge of criminal justice and specific prison systems, strict compliance with security regulations, and repeated dialogue with the administrators and employees who would be affected by the research taking place at the prison.

Now conducting an expanded study, funded by a $1.6 million National Institutes of Health grant, Byrne is assessing the developmental skills of the children who lived in Bedford's and Taconic's prison nurseries until they entered grade school, comparing the children's and mothers' status to norms of the general healthy population.

Byrne, who also holds a master's degree in public health, is the Stone Foundation and Elise D. Fish Professor in Clinical Health Care for the Underserved at Columbia University, NYC. As a pediatric NP, ethnographer, professor, and researcher, her career has focused on helping stressed childrearing families.

With funding from Columbia University, the New York State Department of Health, and later NIH, Byrne and her team of doctoral students, family nurse practitioners, and child development consultants assessed maternal-infant attachment, parent-child interaction, parenting competency, and child development in 97 women and 100 children, including two sets of twins. They followed the mothers and children during their stay in the prison nursery and one year after the children were introduced to civilian life. On average, children lived in the nursery 7.5 months and left with their mothers when paroled. Others were sent to live with family members or to foster homes while their mothers finished their sentences.

Byrne's team visited the prison moms and babies weekly, then conducted phone or mail follow-up through the first year of reentry. They provided mothers with ongoing support during reentry, answered questions, and provided anticipatory guidance about child care as problems arose.

"These services are much needed but rarely provided to families for successful reentry," Byrne says.

Byrne's research found —

• The mothers were at high risk for developing insecure infant attachment because of their backgrounds, including abuse and drug addiction. However, 71% of the infants who stayed with their mothers for 12 months demonstrated secure attachment.

• At all stages, the infants met developmental mental and motor milestones within prison.

• Social and emotional screening in toddlerhood showed high scores for potential problems but also high scores for competencies.

• When the mothers were released on parole, there were no new convictions, but a 10% short-term return to jail for parole violations.

According to Byrne, many of the mothers said of their prison nursery experience, "I've been a mother before, but this is the first time I've been a parent."

Leslie Flowers is a freelance writer. To comment, e-mail editorNY@nursingspectrum.com.