The Prison Doctor: Women Inside

‘He’s gorgeous, Megan. I’m really happy for you.’ I smiled at her. ‘Congratulations.’

‘I never thought I could love something as much as I love him,’ she continued, looking tenderly at him. ‘Dylan has made me want to be a better person, to do better, y’know?’

I nodded.

As a mother, of course I knew. There is something about having children that makes most people determined to be the best versions of themselves they can possibly be.

My regular GP clinic at Bronzefield does not discriminate. In addition to dealing with lots of drug and alcohol issues, patients arrive with a whole selection of medical complaints, some more serious than others. From time to time, this includes new mothers, who enter my clinic with their little charges in tow. They are just like any other mothers of newborns outside prison: usually exhausted and often with grey shadows under their eyes, sometimes pale and feeling sore after the birth, but more often than not, completely in love with their babies.

She brushed her hand through her cropped, dyed red hair and gazed lovingly at her son.

‘I do feel guilty he’s been born while I’m in here,’ she added. ‘I don’t want him to hate me for it when he’s older. But I’m going to make it up to him. Do better. I know I’m being punished but I don’t want him to be punished too. I’m trying to make the best of it.

‘My room on the MBU is great, I love it there. I’ve made it really cosy and Dylan has his little corner with all his stuff. I never knew babies could get through so many nappies and clothes!’

Alongside the house blocks at Bronzefield is an established twelve-room Mother and Baby Unit (MBU). As well as rooms for single babies, there is one room specifically designed for mothers of twins, taking the child capacity to thirteen. This allows women who give birth while they are in prison to stay with their children until they are 18 months old.

Megan had moved to the unit as soon as she returned from hospital just after she had given birth.

‘I was like a whale before Dylan was born, my bump got to a room five minutes before I did,’ she laughed. ‘I was enormous!’

‘How was the birth?’ I asked.

‘I went by ambulance to the local hospital. It was a bit weird, having the officers there with me, but at least I didn’t have to be cuffed to them. The rules have changed, apparently,’ she said.

‘They were outside the room and I was screaming and shouting so much I had a sore throat afterwards! They were nice though, and joked that their ears were ringing when it was all finally over.’ She then smiled sadly. ‘I could choose a birthing partner to be with me, and I’d have loved my mum to be with me, y’know, or my sister, but they live too far away.

‘I can’t wait for them to meet him at next month’s Stay and Play Day at the MBU. Mum is absolutely desperate to meet him.

‘The birth went on for hours. It was so painful, I thought I was gonna die,’ she said, rhythmically pushing her buggy backwards and forwards in the tiny room. ‘Honestly, it’s a bit of a blur now. But he’s okay, and that’s all that matters, really, isn’t it?’

‘Of course it is, you’ve done really well… I hope you’re managing to get as much rest as you can. It’s so important,’ I told her. ‘So, how can I help you today, Megan?’

‘It’s my tits. They’ve both been a bit sore, but now the left one’s red and feels rock hard and like it’s on fire. It’s really painful too!’

‘Okay, let’s have a look and see what’s going on. Can you lie down on the couch and let me examine you?’

Megan lay down and then pulled up her Nike jumper and released her breasts from the greying nursing bra.

‘The bra ain’t very sexy – one of the other mums on the MBU gave it to me, but at least there’s no one else to see it, thank goodness,’ she laughed.

‘Don’t I count?’ I smiled.

Her left breast was engorged, red, and felt hot to touch. Her nipple was also cracked and tender.

‘It’s agony when I feed him,’ she explained. I popped the thermometer in her ear and took her temperature, which was slightly raised. It was clear that she had mastitis, an infection that occurs in the tissue of the breast, most commonly during breast-feeding.

‘Are you still managing to breast-feed him?’ I asked her.

‘Yeah, all he wants to do all the time is feed, feed, feed. He’s a right greedy guts!’ she said. ‘It took a while to get the hang of it, and my god, my tits were a mess at the start – but we got there in the end.’

‘You look like you’ve been doing a brilliant job,’ I told her. ‘He is a really good size.’

She beamed at me with a wide smile, proud as punch. ‘Yeah, he’s put on 200 grams this week… I feel close to him when I feed him. Loads of the other girls don’t wanna do it, say it messes up your body and going on formula is easier. But I’m gonna try to stick with it, at least while I can.’

‘Good for you,’ I said. Breast-feeding is an excellent way for new mums to bond with their babies and feel close to them, which is perhaps even more important when in prison than at home, where they would most likely be surrounded by friends and family.

Another of nature’s powerful tools.

‘Keep feeding him as much as you can,’ I told her. ‘It might help to ease the pain a bit. Just make sure he is properly attached.’

‘He’s going to the nursery in two weeks though,’ Megan added. ‘They’ve told me I need to go back to work. I’m doing a course in catering, which I love, and I’m really hoping I can open my own little business selling sandwiches in offices when I get out of here.’

‘I hear wonderful things about the nursery,’ I told her. Within the MBU, which is set apart from the main accommodation units, is an OFSTED-registered nursery, Little Stars, which allows the mums to do their prison jobs and education with the rest of the residents, whilst their babies are looked after by nursery nurses, from around the time the babies are six to eight weeks old. ‘It’s a lovely place,’ I told her. ‘Bright and airy with a wonderful range of colourful toys and games. There are cots for the babies to nap in and the doors open to a courtyard area, with lots of outdoor toys, like ride-ons and a little toddler climbing frame.’

‘I know, the other girls rave about it. And I already feel like I know the staff there really well. They’re always helping us out. I dunno what I’m gonna do about feeding him then,’ she added. ‘Guess he’ll have to go on the bottle. I’m feeling so exhausted though. I don’t know how I’m ever gonna get back to work.’

‘You’ll be fine,’ I told her. ‘I’m sure you will manage. You strike me as being very strong and determined.’

I thought back to when I first met Megan when she first arrived at Bronzefield. I was working in Reception that evening. She had been in a very controlling relationship for about three years. She had never been in prison before and was so scared and shocked, as she said that she had not expected to be given a custodial sentence. She didn’t even know she was pregnant when she came in, but as part of the new Reception screening process, most of the new residents have a pregnancy test when they arrive, as well as having their urine screened for drugs and alcohol.

I remember how surprised and initially distraught she was when she found out that she was expecting.

She had been charged with conspiracy to supply class A drugs, along with her older and dominant ex-boyfriend. She said that she was aware that he had been involved with dealing drugs in the past, but he had told her he was no longer doing it. She said she was totally unaware that he had drugs hidden in the flat that they shared, until the police raided their property.

‘I later found out there were drugs hidden in his sock drawer, and in all his designer trainers in our bedroom – he had loads, rows of ’em,’ she told me. ‘The first I knew about it was when I was woken up at about six in the morning, with a team of police leaning over me, telling me I was under arrest. I nearly shit myself I was that scared.’

The judge said that it was impossible that she hadn’t known that the drugs were there. Megan had sobbed throughout the Reception process, and she was still crying when my Reception shift was over.

I continued to see her from time to time over the next few months, and as her pregnancy advanced, her excitement and hope grew at the rate of her expanding belly, which was wonderful to see. She had been in touch with Birth Companions, a community-based organisation that holds weekly meetings with perinatal women within the prison, who had helped her prepare for motherhood. She was intent on being there for her baby, and being a good mum.

‘I feel like one of the lucky ones, being able to have Dylan with me,’ Megan said. ‘I made an application, and different groups of people decided it was the right decision for me and for him.’

‘He knows we’re talking about him,’ I joked, as Dylan made gentle gurgling and snuffling noises.

We both peered back into the buggy, as he stretched his arms out from where they had been tucked closely into his chest.

‘I want to start afresh. I mean, I’m only 22, and my family have stuck by me and will help me – help both of us – when we get out of here.’

‘That’s great that your family are so supportive,’ I said.

She looked thoughtful.

‘It must be so hard for the girls who don’t get to look after their babies. There was one girl on the block where I lived, whose baby girl was fostered out because her family wouldn’t take her. Her sentence was really long – a few years, I think. She was worried that her daughter might end up being adopted, and she would lose her forever. She was so desperate. It must be heartbreaking.’

When the women are in prison for a long time and there is no family available to help out, babies might go into foster care temporarily until the mother is released, or be adopted with the mother’s consent, a process called voluntary adoption.

In some cases, when the sentence is long, the baby will initially be looked after by the mother in the MBU, and then will start to spend increasing amounts of time away from the unit with family members or a foster family, to cause minimal trauma to mother and child. Babies are also taken out of the prison environment regularly, to the local parks and a nearby toddler group, so they can get used to the unfamiliar sights, sounds and smells, and to acclimatise them to life on the outside.

In cases where the baby is taken away from the mother and adopted without their permission – involuntary adoption – the sorrow can understandably be deep and profound and can make it even harder for the women to tackle their addictions and other issues. A powerful stigma exists for women who have been deemed by the courts to be unfit to look after their child or children. It is very hard for everyone involved, but ultimately, the decision always has to be made in the child’s best interests. There are many, many people involved in the care of both the mother and the baby. Mothering simply adds a whole new layer of complexity to the female prison experience and there is rarely a perfect solution.

‘I see many women in the MBU that have the chance to start afresh,’ I told Megan. ‘You are doing a great job.’

‘I hope so,’ she said, smiling and softly stroking Dylan’s little hands. ‘I just want to move on from my old life. The MBU feels really safe and I’m learning loads. The health visitors are teaching me and the others different things – how to cook, sterilise bottles, and how to get the best out of my playtime with him as he gets older.

‘It’s great being with the other girls. We’re all going through similar stuff, so we understand each other. You should see lunchtimes when we all sit together with the babies. The bigger ones make such as mess – it’s absolute carnage!’

I laughed. ‘Yes, babies don’t often follow the rulebook.’

Megan smiled.

Megan had been given a three-year sentence, but would most likely serve eighteen months in custody and the rest on licence – meaning she would spend the remainder of her sentence on the outside, but would need to stick to certain conditions, including keeping in touch with supervising officers, not committing any offences, and residing permanently at one address. This meant that unlike some mothers, hopefully, she wouldn’t be split up from her baby. If women come into prison with babies under 18 months old, they can apply for a place on the MBU, and if they get a place, they have all the normal responsibilities of parenting, from changing nappies, to bath-time, playtime and everything in between. Apart from when their babies are in the nursery, the mums are encouraged to be fully responsible for the welfare of their children.

‘It never ends,’ she told me. ‘No telly time for me.’

The mothers are also given the opportunity to shop for their babies’ things using a combination of their own funds and child support money. This helps them with issues like budgeting, so that when they return home, buying nappies, formula and other items for their babies would not feel unfamiliar. When Dylan was old enough, Megan would be able to wean him herself, using food she had bought and cooked for him.

‘Some of the other mums shop from Asda for their babies. Those Organix toddler biscuits taste so good! They’re better than the food they serve us,’ Megan chuckled.

The unit also offered a therapeutic environment and sessions around parenting, as well as practical help. The very regime of prison – the rules, the regularity of food being provided, no drugs, no domestic violence – promotes bonding with children and is ideal for young women like Megan, who need the support.

‘The team are so helpful and always have time for us,’ she told me. ‘I know some of the other residents think we have it easy on the MBU, but we don’t. It’s a tough graft!’

‘It is,’ I smiled. ‘Being a mum is very hard work!’

I prescribed a course of antibiotics and painkillers on the computer for Megan, so that she could start them straight away, and told her to come back and see me if her symptoms persisted.

‘I will,’ she said. ‘Thank you for seeing me.’

‘You’re welcome. It was really good to see you again,’ I said, and with that she wheeled her buggy and baby out of my little room and off down the corridor.

As I watched her go, a memory flashed into my head of the day I had to go back to work when my first son, Rob, was three months old. Apart from all the usual hormonal and emotional fluctuations of the postnatal rollercoaster ride, I was also struggling to imagine a future for my beloved little boy.

When I was thirty-four weeks pregnant, I was referred for a scan to check the placental flow as my bump was measuring smaller than it should’ve done at that stage of the pregnancy. I wasn’t nervous going to the scan, and I thought it was routine, so I drove there myself. I had seen enough pregnant women to know that the size of the bump often did not reflect the size of the baby. I didn’t for a moment imagine there would be anything wrong.

The consultant I was referred to in Oxford was very quiet and seemed to spend an eternity scanning me until he finally announced: ‘I can’t find his right leg.’

As he said that, my head started spinning and even though I was lying down, I felt as if I was going to pass out.

‘What do you mean?’ I asked in disbelief, wanting him to say he had made a mistake, that it wasn’t true.

He continued in an unemotional way to give me a medical list of other possible problems that Rob may have; complicated syndromes that I had never heard of, that could be associated with a limb not developing.

‘But we won’t know what else may be wrong with him until he is born,’ the consultant said.

As he carried on talking, I became more and more terrified until I convinced myself that my poor little baby was going to face a life of unimaginable difficulties.

I felt as if I couldn’t breathe. I don’t know how I made it home.

Over the next ten days, my fears spiralled out of control as I imagined all sorts of dreadful scenarios. I couldn’t imagine the future and felt like I was living in a nightmare I couldn’t wake up from.

I struggled to eat and sleep and even just to think straight in the end.

I lost a stone in weight in that time, and when I felt that I just couldn’t cope any longer the decision was made for me to have a caesarean section when I was thirty-six weeks, as there was a growing concern for both my sanity and Rob’s welfare.

I hoped and prayed with all my heart that it would only be his leg that was missing, and that all the fears and dark imaginings that had formed and grown in my mind would not prove to be a reality.

Holding him in my arms and looking into his tiny face for the first time, my love for him was immediately overwhelming, overpowering and beautiful. My fears of multiple problems were unfounded, to my massive relief. But despite my incredible love for him, I thought I could never truly be happy again. He was born with a very short bent right tibia, no fibula, and he only had three little toes on his right foot. It was obvious that he would have to undergo major surgery to enable him to walk, and would forever be dependent on a prosthetic leg.

It is impossible to know, when our children are babies, what the future will hold for them. I shed so many tears in those first few weeks, that I began to wonder if I would ever get through a day without crying. Little did I know then that he would turn out to be one of the happiest and most positive people I have ever met. He loves life with a passion, and after leaving school travelled all over the world with a spare leg in his rucksack. While on his travels he skydived and did the biggest bungee jump in the world with his one leg strapped for safety.

I still remember the dreadful thought of leaving him, and of how nervous I felt about going back to work. I had convinced myself that I had forgotten all the medicine I ever knew, and felt I had lost every tiny grain of confidence I ever possessed, especially as I’d never had much to start with. I felt the same dread of separation and loss of confidence just before going back to work when my beloved second son Charlie was three months old. It was no easier second time around. Even though it was over thirty years ago, the memory was still so clear and vivid.

By definition, the fact Bronzefield is a prison for women means it is full of mothers and the human female chains that form our society. Around two-thirds of women in prison have dependent children under the age of 18 at home. There are mothers whose kids have been taken away from them; mothers whose kids are temporarily being looked after by others; new mothers looking after their babies on the MBU; and, sometimes, mothers who have harmed their children.

In many cells are photos of kids – baby photos, school photos, holiday pics – little gummy faces staring down from the confined walls. Alongside these are scrappy bits of paper with drawings of rainbows, cars, princesses, footballs and everything in between; a complete range of children’s wonderful creations and imaginings to cheer up their rooms and make them feel a bit more homely.

Around 18,000 children per year are separated from their mothers due to imprisonment, yet only nine per cent of them are cared for by their fathers in their mothers’ absence, and only five per cent remain in their own home. One fifth of the mothers in prison were lone parents before imprisonment. The impact must be far-reaching. There is an army of women out there who take on these mothering roles. It may begin with a sudden phone call from the police station or social services. Sometimes it is only when a mother gets to Reception that she will tell an officer that she has left her child or children with a friend or neighbour who will be expecting her to pick them up. What a terrifying thought for a mother to know that she will not be able to see her children, and for her to think of the fear and shock that they may be feeling.

Many women must struggle with their identity as mothers when their children are not with them. How can you be a mother in the truest definition of the word when you are not there to care for them? The separation of mothers and their children is definitely one of the most painful aspects of being in prison for a lot of the women I meet, and the trauma of this severance must cut both ways. There are people whose job it is to aim to improve the ties between mothers and their children, but once mothers are in prison, it must be really difficult.

I was driving into prison to work a Saturday afternoon shift, and I could see a wide variety of people of all ages and ethnicities arriving to visit friends and loved ones. Some people were being pushed in wheelchairs, some had walking aids and appeared to struggle to walk, but they were all there to support the person they cared about.

As I drove up to the prison, I reflected that many of these people may have travelled a long way, and by that time the children and elderly guests might be exhausted and running on pure nerves. I could see babies being pushed in buggies along the pavements and young children skipping and laughing with excitement at the thought of seeing the person they loved. It was a strangely heart-warming sight, but at the same time it was also quite sad and thought-provoking. It was hard to imagine the huge range of emotions everyone might feel in that single day: from excitement, heightened anticipation and apprehension before the visit, to joy and happiness at being reunited, through to profound sadness and grief at being parted again. I imagined there would be many tears shed later in the day when it came to saying goodbye.

As I was pulling into a parking space, I noticed an elderly lady who appeared to be struggling a bit to get out of her car a few spaces along from me. I could see that she was on her own and so I offered her a helping hand, which she graciously accepted.

She asked if I could pass her walking stick and handbag out of the car.

‘It’s my arthritis,’ she said. ‘I can walk, I just find long distances hard and it can be quite a trek across this car park.’

‘Yes, I know it can, and it’s worse on a miserable old rainy day like this,’ I said. ‘Are you here for a visit?’

‘Yes, to see my daughter, Denise. She’s been here for four years. Are you here for a visit too?’

‘No, I work here. I’m due to start at two,’ I explained.

The lady told me that she had spent the last four years as the sole carer for her twin nine-year-old grandsons, after her daughter and her daughter’s partner were both imprisoned. She didn’t tell me what their crime was, and I didn’t like to ask.

‘We’d been led to believe that they wouldn’t be given a custodial sentence, so it came as a massive shock,’ she explained. ‘It just doesn’t seem right to take a mum from her kids, but I s’pose that’s what happens if you get on the wrong side of the law.’

Sometimes women arrive in prison while their children are still at school, not for a minute even thinking they would be given a custodial sentence when they set off for court that day. They would more likely be thinking about what they would be serving their kids for tea. Similarly, there would be children up and down the country at school expecting to go home as normal, without any idea that it would be someone different picking them up. There are no tearful goodbyes, just separation, cutting through their lives as sharp as a knife.

‘I never thought I’d end up looking after young kids at my age though,’ the woman continued. ‘It’s so exhausting but I love ’em to bits. Every day of her trial, I sat listening and waiting, hoping with all my heart for a good outcome. It wasn’t to be.

‘On the day she was sentenced and led away, the only two thoughts I had were, “How am I going to tell the children?” and “How on earth am I going to cope?” I was devastated.