Ep 61 Laura Abbott on Pregnancy in prisons, social reform, and changing the world

Ep 61 (ibit.ly/Re5V) Laura Abbott on Pregnancy in prisons, social reform, and changing the world

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paper link- t.ly/I41Rj

Ever wondered about the untold experiences of pregnant women behind bars and the amazing professionals dedicated to improving their lives? Well, sit tight as we unravel a fascinating conversation with Laura Abbott, a seasoned Associate Professor in Research and Senior Lecturer in Midwifery at the University of Hertfordshire. We delve into her personal growth, her steadfast commitment to shaping future midwives, and her candid take on successes and failures. 

We shift gears and explore Laura’s unique research on women's experiences in prison, a passion ignited by her stint as an independent midwife. Laura's invaluable work with marginalized groups and her fierce advocacy illuminates a typically ignored segment of society. Her doctorate work is a powerful testament to research's ability to influence policy. Laura's enlightening discourse on her research, the hurdles she encountered, and the subsequent policy alterations that her work brought about are truly compelling. 

Rounding off, we tackle Laura's involvement with PIPPI - Pregnancy in Prison Partnership International, an organisation committed to elevating the lives of pregnant women in prison. The highs and lows of operating within a global network are highlighted as Laura recounts the organization's endeavours in modifying policies and creating a global voice for incarcerated pregnant women. We conclude with a conversation on mother-baby units, the imminent coroner's report on a devastating incident in a UK prison, and the pressing need for cultural awareness and empathy in mother and baby care. 

Transcript

Liz: 0:15

And welcome to Through the Pinard, your conversational podcast talking to midwives around the world about the research they are doing to improve midwifery practice. This research can range from small quality improvement programs and projects to those starting partway through or just finishing their postgraduate studies, and to those that have been there, done that and got the t-shirt. So settle back and enjoy the conversation and remember you can continue the conversation on Twitter after you finish listening. Thank you very much for joining me, as per usual. Can you introduce yourself, please?

Laura: 0:53

Yes, I'm Laura Abbott. I'm a associate professor in research, senior lecturer in midwifery at the University of Hertfordshire in the United Kingdom.

Liz: 1:04

And so let's start at the very beginning. How did you get into midwifery?

Laura: 1:08

Well, I trained. Originally I trained as a nurse. So I qualified a long time ago, in 93. It makes me feel really old. And I worked in ITU for a while. I worked in urology and then I worked in ITU and then I had my first son when I was quite young, about 24. I was 24, not about 24. Yes, I was 24. And my experience of birthing and having him and being pregnant you know, both positive and not so positive really made me think I want to do midwifery. It always been in my head. I remember when I did my nurse training we used to do quite long placement in maternity. I absolutely loved it and it was a little seed that was planted then. But it wasn't until I had my own son that I thought right, this is what I really want to do. So that's how I came into it. So I qualified in 2000. So I did the 18 month training. Then it was as a young mum and, yeah, the rest is history.

Liz: 2:16

So how did you balance that training with being a young mum?

Laura: 2:21

It was a challenge, I think. I think it's a challenge that we recognise in a lot of our student midwives at the moment who have similar stories actually. So you know, it's often that spark of having, you know, a wonderful midwife or maybe not such a brilliant experience. Actually, this is something I want to do. I want to do this because I think I can really make a difference and I think that's what a lot of our students come into it for in the first place. And I think the balance it was hard, it was a challenge. It was a real challenge. Studying, actually no studying, juggling, working, being on placement, nights, days, essays. So I think I had with my little boy at the time I'm just trying to think how old he was, I mean, he's quite, he's grown up now so he at the time he was just, I think he was just starting school, so he was at school.

Laura: 3:23

So I sort of juggled around there and I had good childcare in place and I had recently met my now husband and he was brilliant with my son and with me and helping the juggles, so it was really quite good to be able to have him around to help. But yeah, it's just, I think it is. It's just that juggle, it's that, day by day, week by week, managing is a child got one to be able to manage to do an extra hour here and there. So, yeah, it was some, it was, it was interesting, you know, and I got on to have two more children. So the juggles, yeah, been real.

Liz: 4:02

But that support network is critical, isn't it? To have support with you for whatever it is, and I think later on we'll probably come back to it when you're doing a PhD as well. So what areas did you work in after you graduated as a midwife?

Laura: 4:16

Well, I went into, I worked in a birth centre. I worked at Watford General Hospital when I qualified and we worked in the birth centre which was just setting up and what was lovely about that? I worked with a lovely group of midwives and we had it was the ABC birth centre that's still there at Watford but we were sort of there right from the beginning setting up, choosing what colour tunics we were going to wear. It was really nice. But yeah, the priorities, yeah.

Laura: 4:48

In fire, yeah absolutely is a priority, absolutely. And you know I remember working on the birth centre at Waterbursts were not that common then. Actually they were. They were becoming more common and we had I remember one of the supervisors of midwives when we had supervision then two of them actually, nora and Bertie, who Bertie's at the RCM and Nora they both became very senior but I remember when they were on call when a woman came in wanting a water birth, just for the support and it was just amazing and it was just a lovely, lovely environment, work and the midwives there were all still in touch as well.

Laura: 5:29

I stayed there for a few years and then I decided I wanted to become independent. I'd always wanted to be an independent midwife. So quite early on in my career I went independent and had. I worked with my lovely friend Jane Dutton, who doesn't work in midwifery anymore, but we're still in touch quite a lot and we had we worked in partnership and it was just a really lovely way to work. So we had we built up quite a big case load quite quickly. So we covered quite a few areas and just mainly having home births with women that were choosing to have home births. So it was just. I just think it was just a brilliant way to work, to be able to give continuity of care. That was what something that I always loved with supporting the women to look out and all the way through the pregnancy, the birth and postnatally for quite a few weeks postnatally which doesn't happen now, because it's really cut down quite a lot.

Laura: 6:33

No, and I think I think that's a real shame, because I always remember as, as independent midwives, jane and I would always schedule if a woman had a partner. We'd always schedule a visit the week the partner went back to work, because we knew that that was a time where the woman might be feeling particularly vulnerable.

Laura: 6:53

And it was something that you couldn't necessarily do now, because it's like often 14 days, sort of 21 days maybe, after the birth, and that was something I think was it was just in our practice, the way that we practiced as midwives, but it was just so valuable and I sometimes wonder, you know, with our, with our rates, with perinatal mental health and and you know things, that the isolation that women tell us that they feel sometimes, especially with a new baby, I think having that, knowing that your midwife is coming that week, women would tell us that really made a difference and it it was they were often absolutely fine, but there was often a lot of sort of emotional support.

Laura: 7:41

It was emotional support that week, you know. It's when things start to settle into sort of the reality of this is it, this is it now, this is my life now, and then feeling quite lonely. So, yeah that I don't know why I've gone down that track, but it just made me think of our practice and how. You know, things like that we don't tend to do anymore, which I think so they're being released from hospital a lot earlier as well.

Liz: 8:09

So when you even look at a normal vaginal birth, they're they're pushing to kind of get out within that four to six hours for even a C-section. That's kind of like you're being pushed out after two days in the public sector. In the private sector you can kind of stay a little bit later, but it is that it used to be. You could stay for that at least the three days, four days. So you had that milk coming in, you had the baby blues dump, you had all of that kind of in and a controlled environment where you had people who could actually help you and then you could be established with breastfeeding, you could establish with okay, this is what it's going before you went home. But that's not happening anymore. It's very much that even though a C-section is a major abdominal surgery, it's like no, you'll be fine going home after two days. It's that kind of once again devaluing of women's health. That and the consequences of what we're doing. But yeah, postnatal is quite often I keep hearing is referred to the poorer cousin.

Laura: 9:07

Yeah, the poorer cousin or Cinderella service or yeah, yeah, and it's such a shame. It's what we hear from women, and especially with I'm not surprisingly the complaints for postnatal care as well. For women it's, I mean, having a new baby and not having support. I can't imagine how it would feel to be in that much pain post surgery and having to look after a new baby, and I think it's a time where we really need to nurture our new mothers really and it sort of empower women. And just as we're talking, I'm thinking of some of the women that I've cared for as an independent midwife.

Laura: 9:53

And I remember one woman very clearly, just as we're talking about that. She was from Thailand and she had every day for the first, I think, for the first 28 days, had someone coming in and bringing a meal every day it was just automatic and massages every day. So she had somebody. She was really, really nurtured into that motherhood. And I remember Jane and I thinking, wow, this is how it should be for all women, because she was literally not. She didn't have to do a thing, she didn't have to lift a finger, she had little ones, other children as well. She didn't have to do anything and it was just, it was just cultural. That that is what happened, and I think that's we don't do enough for our new mothers, I think as a society.

Liz: 10:46

So yeah, and I'm sure we're going to come back to this as we talk later on about your special area. But the importance of the bonding and attachment in those first instance, of having that supported and the opportunity to actually have that bonding and attachment, even if the baby is then separated later on, we know has intergenerational consequences about that baby's ability to bond and to form relationships and, as well as their childhood, adverse childhood experiences. So we know that there's so much that rides on that bonding and attachment in those very first kind of like few months.

Laura: 11:25

Yeah, absolutely, it's totally it, and it can have a major impact for the whole of the woman's life and also her baby. So, yeah, it's huge.

Liz: 11:39

So how long did you stay as an impenetra? So that's looking at the end of the 2000s.

Laura: 11:46

Yeah, so I stayed independent for about I'm just trying to think for about eight years, maybe a bit longer, because I then got pregnant, I had my middle child, so I'm trying to work out I can do it by birthday. So he was born in 2004. So, yeah, so I became a mum again twice over when I was working independently and by the time I had three children. It was just the juggler was a little bit too much, I think it was. It was more of the being on the on calls and I remember when I was breastfeeding and I went out on call for one of one of the women that I was supporting and she was, she was birthing shoes, she was birthing shoes. I just remember the baby was crowning and my milk was just like. You know, I think it was silver oxytocin and everything in the room, but I was just like I could, just just like my milk was just running away and, yeah, I was able to focus off as you, on her, but it was just. I just made me think, oh, maybe that's a sign. Yeah, yeah, because it was quite, it was. It was like three, four in the morning, so, and so, yeah, it was. That was the time when I thought, oh, maybe, maybe my babies are calling me. So, yeah, change.

Laura: 13:15

So what did you do after that? Well, I went. I stopped when I'd already started in some visiting lecturing at the University of Hertfordshire. I actually did my training at Hertfordshire, so they have never been able to get rid of me yet. So I started to do some visiting lecturing, which was great. So I'd also trained as a supervisor of midwives. I was one of the first independent midwives that was a supervisor of midwives, which was a really good model actually, I felt, because it meant that I was working within a trip, within maternity hospitals, maternity units, but as an outsider, so I was able to be quite unbiased when it came to investigations etc, etc and also supporting midwives. So yeah, where I'm going, I'm going to, I always do this visit, yeah.

Laura: 14:06

So I was doing some visiting lecturing, talking mainly about independent midwifery actually to groups of students and talking about supervision. And then I started to do some more work on on training midwives in supervision. We did action learning with our students supervisors. So yeah, and then I just really like I mean I always liked teaching but I really loved it. So I think that the first job I applied for I didn't do very well in my interview. I didn't get the first job, so I think it's you know while we're talking. So it's good to talk about the fact that you know you may look successful, but actually it doesn't come that easy. So I did a really, really rubbish interview and I didn't get the job first time round, which was was mortifying. But I didn't give up and I applied again when the next round of jobs came up and I got second time lucky, with a job as a lecturer at Hof Chair and, as I say, they've never, they've never been able to get rid of me since.

Liz: 15:08

And that brings up a really important point. I think that's something that quite often but we don't get in contact again and go. Can I have some feedback please? Can you give me some feedback and we should with everything that we kind of go through if we're not successful, it should be can we have some feedback on what areas I need to improve on for for next time? So I can actually have? And that's that we do it naturally within midwifery. We do that reflection naturally, but when we're looking at career wise or business wise, we don't necessarily follow through with that. Some people find it really difficult to get. Oh, I didn't get it, I'm not going to, I'm not going to worry. But I think that's something we need to kind of encourage people to do. So you have the opportunity to reflect and grow.

Laura: 15:51

Absolutely, absolutely right. And also I talk about this a lot with people, about sharing our failures as well as our successes. You know, I think that a lot with writing papers, the amount of rejections, people only see the papers that get published. They don't see the amount of times, they don't see the revisions that have been done. They don't see all of that. So it's really important to be honest and say you know, it's like when we're working with student midwives who may not be successful with, say, you know, an essay they've written or something in practice, but it can feel really personal and I think it's really important to understand that actually, one, it's not personal and two, we all do it. There's not many of us that get there without some, you know, not being successful at all or some failure. So, yeah, I'm always happy to share my failures with everybody because I think it's important.

Liz: 16:48

It is, I think, and there's a great meme that I have had posted outside my office stores in previous kind of like locations, and it's about right. We're about to sit an exam, and it's an elephant, it's a bird, it's a monkey, it's a duck, and they're all asked to climb a tree and that's the exam. So of course, you're sitting there going well, the monkey is going to be successful, because an elephant can't climb a tree, and so the way that we test, the way that we assess one assessment does not fit everyone. So if somebody can't write, then if they fail that, and that's when the authentic assessment comes in and moderation is OK. So let's have an RLV, let's talk about it, and then you tell me about what you know. Is there another way that we can assess it? Because some people are great with the writing, some people are great with the practice, some people are great with the talking, some people are great with the showing, but it depends on how we assess them, to what is being shown at that time.

Laura: 17:42

Yeah, absolutely, absolutely right, and I think I love that. I know the meme that you mean. Yeah, so I think it applies to children as well. In schools and you know all sorts, we all tend to put everybody in the same category, you know, with exams and some, and there's just no good exams, some are no good at coursework, it's just, yeah, I think we need to be adaptable, don't we?

Liz: 18:09

Adaptability takes innovation and time, something that we're not given a lot of in the system, because the system is much more and any system really is much more of a sausage factory Push them in, push them out, get them done. Higher numbers, higher quality, higher money, Whereas if we can slow down and go what's individualized learning for you, then we have a better quality at the end, not necessarily a greater quantity at the end.

Laura: 18:34

Yeah, absolutely, absolutely right.

Liz: 18:37

That's my dream, kind of like. Education was Okay, so how did you get going from independence to teaching? How did you get into your interest in research? How was that kind of fanned?

Laura: 18:52

Well, I think, when I did my supervision, then I did my masters and you know, I just think it just lived quite organically when I started lecturing and teaching and I just became more intrigued and there's an opportunity. I think there's. You know, when you go into education, there's an opportunity there to do a doctorate, and it was something that I had. Again, it was with that seed that planted in me as I sort of started my lecturing career and I just thought, yeah, like a challenge, I'd quite like to do this. So you know, I think it was, I think the idea of doing the doctorate came before the idea of what I was going to do the doctorate in, which is fair enough.

Liz: 19:37

In academic, what did you do your masters on?

Laura: 19:39

first, my masters was in advancing practice and I did my main bit of it. I could pick modules. I did modules in family violence and I can't even remember now, so it was like it was. It was to do. It was quite a lot of sociology actually.

Laura: 19:59

So I had some you know, brilliant, brilliant module leads on that, on that masters, and mainly from social work actually, and I think it was from there that I started to really think about you know the broader sort of society, what's going on in our world, and but yeah, I did my masters and I focused on policy analysis for my dissertation. So I think it's sort of, you know, I started thinking about you know what policies and why they work and why they don't work and who are the who pulls the strings there really. So that that was what I, what my main focus was on in my masters family, child, health and social, really. But it was called a masters in advancing practice, yep, so, yeah, so that's that's what I did from my masters, and also relating back to maternity and midwifery, of course, and yes, so that's that's.

Laura: 21:06

That's sparked in me sort of an interest in research, really, always qualitative. I'm. You know, there's numbers I can't do, you know I would be very foolish if I did anything, anything statistical I had to do In my doctorate program. I had to do some statistics and some constant stuff and you know my colleagues in my who were doing a doctorate with me it was. It was quite funny because I get so excited if I did anything that actually worked.

Liz: 21:45

I can understand that when I did statistics and I love numbers. But some of it is understandable, some of it is simply going. I just don't get this.

Laura: 21:52

Yeah, yeah, exactly. So, yes, I was always, well, I've always intrigued in what people think and what people see and what their experiences are, and I think that came from being an independent midwife, when, you know, our evaluations were really quite different from sort of hospital evaluations often, and also our, you know, assessment with the women it was. It was very much holistic, looking at emotional well being as well and it's maybe past experiences that may have impacted the woman's life. So that was really important. So it was always really important to me women's voices and hearing what women had to say about experiences. But that's when I started to think about, you know, who do I really want to know about here? And I don't know how it. You know, people often ask why prison, why pregnancy in prison, and it kind of I'm not quite sure.

Laura: 22:50

I think it's because as a group it's very marginalized in a real minority and I just was intrigued and interested and I just thought we don't know anything about this group at all. But if we don't know, we need to know. And then I started reading more and more around the experiences and I found there wasn't anything about experiences. So all the experiences of women in prison was based on the opinion and experiences of, maybe, staff so you know, when we are staff about how do you think the women that you're caring for are feeling? What do you think their experiences? Not many, I think. We're honest.

Laura: 23:38

Not many of us are going to say, well, actually I think they're having a really rubbish time and I'm quite biased view. Yeah, yeah, you might say, well, actually they, you know they're doing okay, they seem to be fine, because, especially in a prison environment, you're not necessarily going to be that open about how you're experiencing your life. Maybe people, that's going out, yeah. So that's how I think you know. When I reflect and think about how I came to it, it's talking about, you know, really minoritized groups.

Liz: 24:11

And that's, you know, also within the kind of the fraction. So how did you go about finding supervisors to fit such a bespoke area?

Laura: 24:21

Yeah, well, I think when I first started doing my doctorate I was assigned supervisors and I found my supervisor, who I had two of my supervisors, so one by supervisors. She'd actually done her research. She did her doctorate, her PhD at Cambridge, and she was a criminologist and she had looked at the experiences of in America transitioning to becoming Christian or religious sort of often life is life imprisonment. You know how these groups found religion and she, I mean she's amazing, her research is amazing and you know, working with somebody outside of midwifery as criminologists was just absolutely fascinating.

Liz: 25:17

You might sit in the way you answer questions and the way that you look at the situation as well.

Laura: 25:22

Yeah, and my other supervisor was an emergency nurse by background, so yeah, so quite different, quite, you know, not midwifery, but just, and in a way that was quite helpful because it I could focus on the midwifery, but it was very much their challenges before questions that I might not think about. Yeah, I think the thing is with having supervision is to challenge. I think that's the thing you need supervisors that are really going to challenge you. And also I had others along the way who were really, you know, really good as well at feeding into that challenging way. I mean, we do a half year, we do a it's a doctorate in health research. So we were like a cohort of, we were quite large cohort of nine of us, so it's like a thought doctorate and it was just a brilliant way to work because we could all feed off each other and you know they're all really firm friends now as well and you do your friendship group. It's it's absolutely lovely and we're all so different. So it meant that you'd have that sort of challenges as well from your cohort. You'd do presentations and people would have questions that be like, you know, and it'd be really things that you haven't thought about. So, yeah, it was a very supportive environment.

Laura: 26:50

But my supervisors were absolutely amazing and, you know, often I remember one of my supervisors. She put a post-it note on one of my notepads saying you can't do it all because at the time I was, I was. You know what it is when you start on a doctor, you just think you can do everything. You think, right, that's it, I'm going to, I'm going to change the world and I'm going to change everything. I'm not just going to do prisons, I'm going to detention centres and I'm going to spend a year of my life and inside, you know, and it was just not, you know, not practical. So when you start, you really think and I'm going to interview maybe a couple of hundred people.

Liz: 27:36

I think that's a universal I think that's a universal issue problem. Can under every PhD and in fact every honours student, master's student, phd, they want to do kind of like the world and you've got it as supervisors. It's like no no, no let's bring you back to something that's smart. This is the slice that you're doing in this timeframe.

Laura: 27:59

This is what you're looking at, yeah.

Liz: 28:01

Yeah, so how did you work out what slice of that pie that you were going to concentrate on?

Laura: 28:07

I think, I took quite a lot of convincing. If you were to speak to my supervisor, they say we are. Yeah, she was quite pain. We had to convince her. I think it was. It was having the vision of knowing that even just a small, small chunk, a small piece, would, would, would make a difference. And I think what I did is I really looked into the fact that there hadn't been very much done and looked into my methodology and looked into my methods and I realized that no one in the world had done an ethnography. Wow, and even though I was, I was told that you're never, ever going to, you're not going to be able to do that.

Liz: 28:47

Well, it's just in ethics and yeah, and I was told that.

Laura: 28:51

I was said, no, you know, once again someone puts a barrier there and you think, no, I'm going to climb that barrier. But yeah, I was told that ethnography, I mean, it's brilliant in theory, but in reality, how in earth are you going to do that? How on earth are you going to get in one? You've never worked in a prison and you you're a midwife and a lecturer, and how are you going to get in and how are you going to? How are you going to conduct this research when you've never been inside a prison before? So yeah, it was. I think I honed it down, but it was still quite big, it was ambitious.

Liz: 29:30

So how did you, how did you overcome those barriers?

Laura: 29:35

I'm quite persistent. I think so. I. I think if someone tells me I can't do something, I kind of think yeah. So I started off, and I think I've spoken before, maybe, about the work that I've been doing with birth companions. So we have an amazing charity here in the UK called Birth Companions, and Birth Companions were set up in 96, and they set themselves up after there was a piece on the news about a woman being shackled in labour in in prison Women being shackled in labour and they started as a very small group of NTT teachers going into one of the prisons that's now closed, which is Holloway Prison.

Liz: 30:22

They just defined for non UK people what's NCT? Yeah.

Laura: 30:26

National Childbirth Trust, so it's a charity that that does parent parent education. So this group of women started going into prisons and they set up birth companions and they were going in supporting women with anti-natal groups, supporting them post birth, attending births with women. So they were there in a kind of birth support or do do a capacity to support women. And they're still going and I what I did is I got in touch with them and I basically again it was an interview process I had to go through the processes. I trained as a volunteer. So I started going into prison as a birth companion. I still, I still am a birth companion volunteer. I haven't, yeah, I haven't been going in recently, but yeah, I have.

Laura: 31:22

I went in for many, many years actually and all the way through doing my doctorate as well, I continued because, it again, I just love birth companions and all they stand for and the kind of work, the compassionate work that they do, is just out this world actually. But what was lovely is I did training with them. So I did a nine month training program with them. So it was sort of every Saturday or every other Saturday and it was just brilliant. It was like a refresher, midwifery refresher and and it was just you know it was being with groups of women and and just going through sort of mechanisms of birth and labor and supporting women and trauma, especially with a thread that runs through all the work they do is being trauma informed. So it's just a great grounding for me and I think doing that volunteering gave me more credibility with the prison service, that actually I had some understanding of how prison works.

Laura: 32:22

I had some understanding of security. Obviously I had to be trained in security and I wasn't a liability in a big risk for the prison to manage. So that in turn helped me get my ethical approval. So I think you know I would say to anyone that they're thinking about doing some research. That is quite, you know, is a difficult area. So you look at what third sectors are working in that area and read out to them, because you know it's and also it's the start of a lovely relationship and friendship that continues, which is really great. So, yeah, that's how I overcame that barrier there. I think I think I think you know that that was really helpful for getting my ethics. It's always tricky, but it was networking as well, talking to lots and lots of different people prison researchers, my research supervisor, who was a criminologist. She had lots of contacts so she was really helpful and she was in touch with people. So those types of things with network, I'd say networking from really early is very important as well, so that was helpful.

Liz: 33:39

And so you were looking at the experiences of pregnant women in prison. Yeah, and you focused on one prison.

Laura: 33:50

I focused on three. Right, sorry, yeah. So I focused on three prisons and I was able to spend 10 months in those prisons in overall, not consecutively. I was allowed out at the end of the day. I spent quite a lot and lots of hours inside prisons so I could really try.

Laura: 34:15

I don't think anyone I didn't get to all of the prisons, not some vaults of the prisons, but I think it gave me a really good grounding of what the culture and environment and systems and so much of it was about, because I think you can't separate the experience of prison from the pregnancy. So to understand that and to really get under the skin of what was going on was really helpful, but really, really challenging. The environment is very challenging. I decided not to be key trained. So when you when, like prison officers that have the key belts that they can get themselves in and have the doors, I could have had that opportunity and in fact I went through the training. But I decided not to carry keys because I wanted to be able to Able to feel a little bit of what the women felt by having to you know, always somebody else having to let you in and out.

Laura: 35:15

Yeah, yeah, that that feeling of being controlled and it was. It was really hard and challenging. All the way through doing my research, I had supervision with a forensic psychotherapist to make sure that you know, because it can send you a bit crazy, I think and she just kept me, kept my feet on the ground, really. So that was that was really helpful. That's something that I would recommend if you're going into these places that are quite challenging.

Liz: 35:48

I can understand that.

Liz: 35:49

I've had the fortune of teachings of first aid courses in child remand centres, and so we had very much similar thing the whole control of security and what you could take in and and then being escorted and allowed in and out and absolutely under the watch, but then being surrounded by these group of and I'm like I'm five foot kind of one and a bit on a good day, five foot two when I wake up in the morning and then I shrink and a lot of these teen and tween romance, so that anywhere from 10 to 16 and you're in a group and most of them were towering over me and it was, yeah, interesting that feeling.

Liz: 36:32

So I'm, I can understand the need, if you're going to do that long term, absolutely to have someone to check in on your safety and your psychological safety, because also not just the physicalness of the environment, but the stories that you're going to hear from the women. And how do you deal with that? Because they're not all of the women are there because they've done something. Well, they've done something that's going against the law, but they haven't necessarily done something that's immoral or unethical. Some of them have defended family because of domestic abuse. They've they've stood up for themselves and yet they've ended up in this system, so those stories can be quite horrific as well.

Laura: 37:14

Yeah, absolutely, and it was the stories, mainly that, that I needed to sort of have somebody to offload with and I think you know it's really what you say it's really resonates, it's it's that environment, it's being in an environment that it can feel quite tense and brutal and hostile and quite frightening sometimes and you feel quite isolated because you're an outsider coming in and I think that can be quite tricky. But also, I think the stories that women would say and you're right, the majority of the women that I spoke to were in for pretty much short sentences, often crimes, not saying that you know it's right to do it, but often crimes like maybe shoplifting, drug offence, crimes that you know often stemmed from other things like poverty and trauma and especially trauma. And that is you know, and, pete, you come out and I can. I wrote my field, I wrote so much reflection, I wrote so many field note, but and I can just only describe it as sometimes I'd feel really haunted and it would, you know, I'd come out and I couldn't. I would dream about the environment and I would dream about what women had told me and I feel almost like guilty of being able to come out and leave and you know it was. It was tough, it was really really tough and I think, in a way, doing that hard research is it because it stayed with me is what keeps driving me, even now, actually. So it's particularly.

Laura: 39:11

You know, the women would often, when I was privileged enough to interview quite a few women in in the prisons and women would often come and sit in a room with me and you could see, often they would just relax because they knew, even though this was research, they knew that I wasn't part of the prison, I wasn't wearing belt, I wasn't jangling keys, so it was quite different and I think it would. You know, so I could. I can describe every single participant, even in my head, you know. I've still got them in my head. I can really think about all their, all their stories. But yeah, I think that that's. That is also the beauty of you know, when you pick something hard, it's it's actually quite beneficial in the long run, I think, because you've done all the hard graft.

Liz: 40:06

And it really shows the the intersectionality that we live in, that it is not just when you look at the lives and the reasonings and their background. It's the social determinants of health, it's all of those broader issues that come into play. It's not just one thing that has happened. There's usually been a cascade of events that have been caused by a trigger of something happening that we haven't been able to protect, or they've only seen one pathway because of whatever, they haven't had the social support network. So, within looking at all of that, you've got the forensic psychologist to help you. How are you maintaining your relationships at home while going through all this heavy stuff?

Laura: 40:49

I think you know it's tricky because, especially being a mum and having having children, having three, you know, got three sons and a husband and it was it was really hard. It was hard juggling, and you know my husband is really supportive and the, you know, by that time the boys were at school, so you know, but they, but again it's like, oh, mum's in prison again. You know it was always like that, you know, yeah, you know they just I think they just accepted it, like kids do so, but it was, it was really hard and, of course, working. So I was working full time as well, so juggling this, you know, my students, my personal students, my modules to run teaching, to do children, yeah, you know it's it's funny, but it's not funny. It's my, my son, my middle son, who's now 18, he had prom coming up and he, he was like mum, I cannot understand it. It's so embarrassing.

Laura: 41:58

We are the only family that don't have an iron. Why don't we have an iron in the house? I'm like because you know we don't need an iron. And so he was saying about me not having an iron and I think things like that is that that sort of I didn't and I never had, if that makes sense. So things like mouse work and, and you know, I've never I find yeah, yeah, prioritised, prioritising. So yeah, I never thought that that would be a problem.

Liz: 42:30

I think your old boy would be complaining about an iron. But let's face it, kind of wash clothes, you hang them up on a coat hanger and hang them up straight away. You generally don't need to iron, it drops out. I think it's a con. I think it's a big con. I just had to buy an iron to iron some kilter material because it wasn't kind of folded properly. I've sat around the house and kind of went I don't have an iron, I had to go buy a spotlight, to go buy one. So out of like the stories that you told about, you were told about all the experience of these women who would have, some would have gone into prison already pregnant. Some would have gone into prison and found out that they were pregnant while they were in prison. What's the what's the thing that kind of stands out the most to you, that still resonates the most to you now about those conversations or stories or experiences.

Laura: 43:24

I think the thing that really stands out. I mean, there's so many things but how women have to completely mask their feelings. So if you can imagine you, you know you're pregnant and you're wanting a place on a mother and baby unit and you know that you are being watched and your behavior is being monitored, but deep down you are feeling dreadful and emotional and stressed and worried and all the normal emotions that you'd have when you're pregnant. But you're in prison as well and you're isolated. I think women would say to me a lot that they you know I can't kick off in here. If I do, then I'm not going to be able to keep my baby, and I think it's alien. That's one of the things that's quite alien to us. I think that one of the things. Another thing is the shame that women would feel really, and we've talked about the fact that often women are in for non-violent you know crimes, that that may be, you know, through poverty and trauma. And yet when women would go into hospital they'd often have handcuffs on when they go for their anti-nacle appointments and they're with prison officers and they would feel such shame and such intense humiliation at being seen by everybody in the anti-nacle department and being looked at and stared at, and I think that was something that was universal with women, that they would talk about, and that was, you know, really quite stressful and I can just, you know it's. It's the things that we would all take for granted, like being able to go and go to the, go to the chemist and buy some over-the-counter, you know, anti-acids for for heartburn, things like that you just can't do in prison. You're you, you know things. Just just the food, the water coming out of your prostitutes, naps that's kind of lukewarm and discoloured, and women getting dehydrated because they weren't drinking enough, because they felt that they didn't want to drink the water in prison. There's so many things. I think there's kind of not one thing that really stood out. I think that the, the.

Laura: 45:41

The one thing that was recorded on in the UK and that stood out in a way for me was the woman who gave birth in herself, and that was that was when Alain Bell's really rang for me, that I couldn't sit back and not do anything about this, and it was a woman. She would. She came found me in one of the prisons. Actually, she knew I was doing some research and she told me about her experience of she was a, you know having her second baby. She was a multi-tip, she, she knew her body, she absolutely knew her body. She knew it was the same signs and symptoms were happening as her first labour, as her second labour and she asked for help, called for help. No one believed her. She was 36 weeks, so people assumed that she wasn't going to have her baby yet because she was 36 weeks, because it wasn't a midwife on duty in the prison to say well, actually, sometimes people have babies at those six weeks. She was the baby, was the baby was breached at 12.

Liz: 46:45

Which at that time is not unusual.

Laura: 46:48

Yeah, absolutely so, all the red flags for us as midwives. But no one believed her and she ended up giving birth in her cell and she hadn't really debriefed or been able to and it was very, as you can imagine, it was very traumatic. She had nothing for the baby. She didn't know whether she had a place in the mother and baby unit, you know. She didn't know whether her baby was going to be okay. There were no midwives there, so she just birthed a baby by the breach in a prison cell in the cold, and it was just awful.

Laura: 47:22

So to me was the sort of turning point for me that I thought well, actually, you know, and I spoke to staff about the births in cells and they, many of them, had experienced either hearing of births in cells or have been there when a really different birth and it was just it was some. I think you know it was something that was. It was just a massive red flag because we know of all the things that could potentially go wrong if you haven't got a qualified midwife there that is able to recognise you know all the things that midwives do and be able to recognise when someone needs. You know you and I would recognise 36 week her not the best place to be.

Liz: 48:11

You know we need to get her in and that itself is not an easy thing because when you're looking at transferring from a hospital, it's not an easy thing of let's just call an ambulance, let's go. It's looking and you need security. You need to then backfill the security. You need to make sure that if you can't backfill the security, that the other prisoners are actually locked away so they're controlled. And then you've got to have that security within the transport to kind of go to the ambulance. It can actually take an extra couple of hours to organise that transport to actually go to the level of care. When you don't have that time.

Laura: 48:46

Yeah, absolutely, you know. That's it in a nutshell, isn't it? So it's not straight, it's not straightforward. But then if you know that you have quite fast labours as well and no one's leaving you and you're locked in and there's no one to help you, it is incredibly stressful. I mean, the woman was so traumatised, understandably, about what had happened and you know that's why, over here, and we knew with birth companions this was happening anyway and it was a catalyst for us to work together. So I worked together with birth companions too, with some major outlets, and we did.

Laura: 49:30

You know, we went around the right channels. At first, we did talk to the prison service and we talked to the Care Quality Commission, and I'd learnt this from doing my policy analysis is the one way that you get things changed is through the media, and it really does work, because when things are reported in the media, it often captures the attention of politicians, and that's what happened in this case. So my research was talked about in our parliament and questions were raised and started to get that ball rolling of change actually. So having that media is really scary. As somebody that's not wanting to be in the public eye, it's really really scary. You know doing radio interviews and things like that, but it was really important to make sure it got out there.

Liz: 50:33

Absolutely so. Do we have the statistics for how many babies survived birth within the cells and outside of even just a health care unit within the hospital?

Laura: 50:46

We don't have exact statistics but what we do know is from the Nuffield Trust have done some really good work here and it's between we know the risk is between five and seven times for babies in prison and out of prison to die by being still born or to die near an ankle death.

Laura: 51:11

But I mean that's work done by Nuffield Trust, so it's not that's all statistics that I haven't been involved in, but that's the work that they've done and Moran Davis at Nuffield Trust has done a lot of work in that area, so she's brilliant at all the stats and bringing that all together. But I think we don't have exact numbers and what I found really quite worrying when I started talking to politicians is that they didn't keep the numbers at all of the pregnant women in prison. There was no, and I was given the reason that you know we couldn't keep numbers because numbers are small and it's confidentiality, and I thought, no, this is, you know we keep numbers of everything, don't we? I mean, you know it's, we're not just. I mean I've done my research but there's no identifiable factors in my research. There's no names. So you can do things confidentially, but, yeah, numbers we don't tend to have. Actually.

Liz: 52:11

But we're also looking at a population that is predominantly non-white, black, asian minorities anyway, which we know have a natural higher kind of like mortality rate. We know we have a greater discrimination and racism rate. So when we're looking at the kind of like where the power play in the interest is going to be in those minority groups and you're in prison, it's like double whammy. You're kind of we don't care about you, you're in the too hard basket. You're kind of behind closed doors, we don't have to see you. You're not going to vote for us, so we're not going to be worried about you.

Laura: 52:48

Yeah, and also, and you know, and and we're, you're not a vote winner, yeah, Society, no, that's. You know something else, so that so even less there's even less caring away, because not being a vote winner is that. That's part of you know often why politics, oh yeah.

Liz: 53:10

Okay, so let's talk about something happy. How did you celebrate when you finally finished having gone through this very kind of like emotional journey?

Laura: 53:19

It's really strange because you know, obviously my family, my, my husband and my boys, and you know it was just lovely, it was just. I remember my Viva was on the 31st of May. I can't think of 2017.

Liz: 53:33

I can't remember now, it's really weird. That's all right, it's okay.

Laura: 53:36

Yeah, was it 2017 or 2018? But I remember it was 31st of May and it I just couldn't. I almost expected to come out and not and then to say actually no, this is not very good and you haven't got your data, or you know, I just, you just have to. You know, you just have to. You know, you just have. I mean, I've gone with in with my thesis and I've gone through it and I'd stressed about every line, I'd critiqued my whole thesis so much and I had all these post-it notes in there and I never opened it. I thought, am I going to remember? Am I going to remember what I did? And I think the best advice is like, well, you're the expert, you know you're working inside out, but I I mean celebration, I think it just continues. Actually, even you know, obviously we celebrated and had champagne and cake and everything, but I think the celebration continues with it, just it, having achieved something so amazing and my Viva was.

Laura: 54:39

I loved my Viva and I know people are really I was really nervous about it really scared. I loved it because it gave me I. You know yourself, when you're doing a PhD, you're literally you live and breathe it. So it's a big opportunity to just talk about it for like hours. It's fantastic. I remember when the Viva finished after two and a half hours and they said well, you know, I think we can wrap up now and I'm like I actually went. Oh really, I was actually really really disappointed that I wanted to carry on talking, but it's loads more I can say.

Laura: 55:15

But yeah, I think, you know, and also my all my, you know, my lovely colleagues, and it was just great to be able to share that news because I feel that with with my doctor especially, there were so many other people that were involved along the way it didn't feel I didn't feel like just mine, if that makes sense. So, yeah, it was fantastic, but I've also there is a bit of a I can't say this is a bit of an anti-climax after, and often people talk about this. So you've been working, working for years. I mean, I did mine part-time, I did it in five years, which is quite a bit for a part-time one. And then it's like, okay, where's the why? Why the sky not lighting up with fireworks? Why? Why am I walking down the street and no one just jumping for joy? You know, it is a little bit of a okay bit of an anti-climax.

Liz: 56:12

It's so much he's wrapped up in it for so long.

Laura: 56:15

Yeah. So the cool thing is is when you go and you change your name and your bank details to doctor. That was. I really liked that Absolutely. That is. That was so cool. And I remember. I still remember the woman in the bank saying to me she goes. You know, I've never seen anyone so excited. She said I get married couples coming in changing their names all the time, but I've never seen anyone as excited as you.

Laura: 56:38

It was just like so I was absolutely buzzing so to do that. It was really really good. So and that never, never, ever broke out. No, actually.

Liz: 56:46

No, no, no, that's the kind of the hard work that goes through it. Yeah, do you know of any practice changes or policy changes that have happened as a direct result of your PhD before? You've now gone into the other stuff which we'll talk about, but did anything change within the jail system from what you had found out?

Laura: 57:10

Yes, but I don't think it's all me, so I don't take all credit for it. So the policy one of the questions that was asked by politicians when my research first came out was about what having mandatory standards for pregnant women in prison and that was a big question that was asked and we do now have mandatory standards for pregnant women and women we also there was not really a mention of any, the word midwife anywhere. It was like we were invisible too. There was no. And even pregnant women.

Laura: 57:44

There was an assumption from the prison service and I remember because I went up and visited the prison service, that you know the civil servants etc. And there was an assumption that all pregnant women would go on to a mother and baby unit when they went into prison and that was not the case at all. So things like that, I think, changing perceptions and knowledge right at the top from my research. But the biggest change is the new policy that I've been supporting the prison service with, amongst many, many others. That's been a big policy change that's now statutory, so that's in law. So yeah, there's been quite a lot of changes. I think also because there hadn't been any research done before, it's really sparked a lot of interest around the world Because it's quite, you know, it's really interesting. I think people find it really fascinating when you hear about people that we don't normally hear about and we hear voices from women that we don't really know.

Liz: 58:51

Which brings us nicely into Pippi. So what is?

Laura: 58:54

Pippi Pippi is a pregnancy international part. Pregnancy in prison international. We thought of the name I can't remember. So yeah, pregnancy in prison partnership international.

Liz: 59:08

Yeah, that's our Pippi Pippi pregnancy in prison partnership international Pippi.

Laura: 59:15

Yeah, pipi. So Pippi is born out of wanting to make changes. You know, to do what I was told I was never able to do is to basically change the world. So, yeah, so we just decided because in over in Australia we have Tani Kappa and Adele Baldwin who were involved with the birth chart a birth companion's birth chart which I helped to write, and they adapted that for Australian prisons. So we were in touch over that and just sided let's form a partnership and just do something, bringing everyone around the world to see if we can improve things for pregnant women, not just in the UK, not just in Australia, but globally and having a global voice. So that's what we decided to come together.

Laura: 1:00:08

So we meet now every month online and we have our rota of inconvenience. So we have, we try, we try at the moment to change the times that we meet. It's quite difficult because we've also got Rebecca Schaffler from the USA, who is a big name in imprisonment. She's done amazing things in America. She's in Minnesota, so we have, we have Rebecca, and we have Akimi, who is in Japan. So we have Claire, who's in New Zealand. So we have, we've got a bit of time zone is a nightmare.

Laura: 1:00:46

Time zone is an absolute nightmare. So at the moment we've been doing a late at night. So for me it's been like 10 o'clock at night and for, but then for in Australia I didn't realize you have like time zones within time.

Liz: 1:01:00

Oh yeah, we have time zones within time zones. Yeah, so America's the same the bigger, the wider the land, the more time zones you've got to go across.

Laura: 1:01:10

Exactly. So. You know we've got some getting up at five, some at six, some at seven. The UK 10, 11. So, yeah, it's, it's, but it's great. We've got a great network. We've already all did be presented, as you so expertly chaired for us. Thank you. The Midwife, with Tanya Kappa, and I presented on behalf of Pippi, which was a really lovely opportunity. We've written, we're writing papers together, so we've got one under review at the moment. Presentations together with. We talked about writing a tutorials together. You know, again, it's that power in the written word and what we're saying and I think you know, just to, just to get research out there, best practices out there, you know, so students can hear about what we're doing as well. So there's so much that's going on with Pippi and we're quite a formal group.

Laura: 1:02:10

We're not formal as in you know you're kind of great, yeah, but we're kind of um, yeah, we're very committed, we have, you know, we check, we have our meetings chaired and minuted and you know we like proper.

Liz: 1:02:26

It's important to show the structure and for those that want to have a bit of a sneak peek into the presentation you're just talking about with Tanya, you can go to vidmorg and look through all the recordings or actually look at virtual midwives on YouTube channel, because all the recordings are actually there and you can actually sit and listen to it.

Liz: 1:02:45

And it's part of that understanding because we look at the midwifery textbooks and we're seeing a change in the midwifery textbooks and looking at vulnerable women and who's actually included within vulnerable women. We're looking at the change we know for mortality, maternal mortality rates. We're seeing that change and that focus on what is vulnerable groups of women within the birthing communities that we need to think about. So it's not just refugees, it's not just the homeless, it is also women who are incarcerated or women who've been recently released. And looking at those that have not got secure accommodations, and so we know there are a high percentage of women in that vulnerable group who are couch surfing or who are kind of like not that secure foundation and yet they don't have the support services to go to.

Laura: 1:03:40

Absolutely. Yeah, it's so important, isn't it so, to have a look and all the complex, different, complex needs and how we know from all the studies and the reports that are out there, but the risks that are involved there for these groups of women and the vulnerabilities there. So, yeah, so it's so important, it's in our curriculum and how we make sure that we are inclusive for all women, like you say, and I think that's where we come with the women in prison and with who are caught up in criminal justice settings as well.

Liz: 1:04:20

We talked about earlier on the bonding and attachment and the postnatal. So within the UK system and the mother and the baby's unit, how long can the babies actually stay with the mothers in those units? Because I know that in South Australia I think we've got the only prison system where if you give birth the baby cannot come back to the hospital with you and you're separated straight away. So they're trying desperately to change. But what is the time period postnatal time period the baby can be with a child in the UK.

Laura: 1:04:51

It's usually between 18 and 20 months. So it's you know, we have about 64 places in the UK so and they're often underutilized actually. But it's around that sort of time frame 18 to 24 months, 18 to 20 months really when the babies become like they're needing more social outlet than being in the mother and baby units, just although they do get to go outside of the prison and get to be taken outside. But I think I think that's the big issue here at the moment, where and it's the research that I'm focusing on at the moment where we're looking at separations, like you say, the trauma of separations and sometimes quite necessary, but the ones that you know looking at decision making from different health professionals, different social professionals, seeing what's going on and why, why these, you know decisions being made and also the experiences of the women who have been separated.

Laura: 1:06:00

When I did my research, I spoke to quite a few women that have been separated from their babies, and that's what sparked my interest in this piece of research just really wanting to hone down and look at separations in general, because it is it's really harsh for the women and how even if it's a necessary separation how we care for her. What guidance is in place specifically for her and specifically looking at trauma-informed practices and how we best care. Care, because these are women that may have even more complex needs. So, yeah, that's something that we're looking at at the moment.

Liz: 1:06:43

Which is good, because that kind of answers my next question what is next? We have an issue here within Australia, especially with indigenous women whose children are not moved forcibly, and there is an increasing focus on reuniting, on how do you go about reuniting? How do you go about teaching them the skills to be safe when they're reunited, when they haven't had the practice, and so it's kind of like finding these little gaps in the bonding and attachment, in the mothercraft skills. How do we feel, though, so when they do get reunited or they get pregnant again, they're starting from a strength-based position as opposed to a deficit situation?

Laura: 1:07:25

Yeah, absolutely. You know, and I think it's just so, it's. There's no sort of raw book really is there, because everyone's so individual and it goes back to what we were talking about in the beginning. Now we need to be really culturally aware of what what's best for for that woman and her baby and her family? And it's the same. It's like when women are.

Laura: 1:07:48

When I used to come out of prison, I'd feel quite sort of shell shot, sometimes haunted, all the words, and I feel like I take a big gasp of fresh air coming out of the the environment. So for women being released with a new baby, so if they're having their first baby and they've been in prison that whole time and being released for the first time with a new baby navigating their way home and having to stop off on probation, probation on the way home, how does it feel for her? So it's those yeah, it's, it's complicated and it's things that we don't often think about. No, I think it's it's. I think it's the things that we don't often think about, the ones that we need to do more.

Liz: 1:08:30

Absolutely, which is why we're glad that we've got organizations and groups of passionate people like you within PP. Now there is a coroner's report coming out soon. Yes, in the UK. Yes, that's related to birth in well, to a death in prison.

Laura: 1:08:48

Yeah, in the last year I think it was in 2019, 2020, there were two tragedies where babies were born and babies died in our prisons, and there's been a big inquest into the case of Isha Cleary, who's a who's a baby who was born we believe born still born in one of our prisons. The mother was an 18 year old. She was her first baby. She was held on remand. She was told that she was non engaging with health care. She was told that she wasn't going to be allowed to keep her baby, but when she went into labor, she called for help a couple of times. She's on her call belt. Nobody came, nobody went to her and she ended up birthing in her cell on her own 18 year old first child. And they found her in the morning wrapped up with her baby who died. And it's just. You know, it's really. I mean, my heart absolutely breaks for the young, very young mother who lost her baby in that way, and so the inquest we know is the inquest is concluded, but the court is coming out, I believe, fairly soon.

Laura: 1:10:16

There will, I would imagine, be quite a lot of reporting on it and there will be lots and lots of lessons to be learned. We've already had the prison and probation ombudsman report, which was quite damning, and lots of the lessons to be learned have been put in place, actually. So I know the prison service has been working hard to try and put things in place to you know, to try and prevent this ever happening again. But I think this is going to be particularly shocking and I do hope it gets publicity because I think we need to know about it. It's horrible to hear about, but we need to know about this and for justice for Isha Cleary as well, for her mom, we need to know more about what's happened there and what went wrong and make sure it doesn't happen again.

Laura: 1:11:11

I think we've been campaigning over here to end pregnancy in prison altogether, because when you've got cases like this happening, you know we need to look at the sentencing and what's happening with our sentencing to see, you know, to try and stop sending, if we can. I mean again, I don't I never really focus so much on the crimes and the sentencing, but it's clear in this case that this was a young, a very young woman who was held on remand. So you know there was knowledge that she was pregnant. Was there a better alternative for her than being held in a prison and locked in a cell.

Liz: 1:11:55

And we know that stress increases the chance of premature birth. There's so many things that there has to be a better way of dealing with this, that there is a more humane way of dealing with this and midwives play a major role within being kind of like part of the solution, as long as we recognize for our scope of practice.

Laura: 1:12:17

Absolutely, and I'm also working. You know we've talked as well as Pippi in the UK I founded pregnancy, a prison midwives action group, so we get together with the prison midwives on a regular basis and we talk often talk about because you can understand that the people in prison, the women in prison, might be more challenging characters to work with. So we often hear this phrase of non-engagement and I think we have to work hard at turning that around because I think if people aren't wanting to engage with us, we need to look at us rather than them and not blame the woman because, you know, maybe we're not, we're not engaging in a way that is a supportive way.

Liz: 1:13:06

Not meeting their needs. It's not meeting their needs.

Laura: 1:13:11

So we're the ones that need to change really on that. And I know and it's not easy, and I know it's not easy, but I think and I know the midwives that I work with are with who work in prisons are amazing and they are very creative at finding ways of being really supportive to women and those women that might be appearing as more difficult to the outside world, and I think we need to learn from those midwives how best to support women that we are perceiving as non engaging and and change the language around that as well. And that's something you know when, when I hear about this particular case and the fact that this is a young woman that wasn't engaging and almost as an excuse to blame her for what happened to her. It's not right and I think we need to find ways. If somebody doesn't want to work with us, we need to look at us rather than them. I mean, that's just my opinion, but I think we need to do quite a lot of work on that.

Laura: 1:14:12

And it's the same, for women who've been separated from their babies will often disappear, become invisible, you know, go back into the prison system and we lose them, and I think, again, that's that's why I want to try and find out more about how we can best support those women that have, with the Los Mothers Project, that I'm doing so with those women as well. So, yeah, there's so much work, there's so much out there. I mean, there's there's a lot more PhDs to be done in this area.

Liz: 1:14:42

There certainly is, and I think it's an issue that the you've now started it by being one of the leaders in the area, by starting this kind of collection of really critical data that is now expanding across the world. That is now spying a shop like a spotlight spotlight, and so the area. But I think that that it does show that the more that you look into something, the more you see that needs changing, and especially for spending the dark for so long and purposely because of the structures of the prison. It's meant to be controlling, it's meant to be locked away. They want limited access. So it can be very awkward for everyone involved when it's like wait a minute, this is the way you've always done it, but this is actually isn't good. And so to make that more women centered, because regardless of where women are and what they've done, they still deserve the right to have quality care for pregnancy and for birth and postnatal.

Laura: 1:15:41

Absolutely, yeah, absolutely right, you know, and I think that's you know, we're there to care for everybody. We're not there to, you know, pick and choose, and that that's that's the essence of being a midwife. Really, we don't, we don't pick and choose. We, we don't pick and support women. Yeah, yeah, absolutely. And I think the women in prison in particular, really they really need, they need midwives, they need us.

Laura: 1:16:13

And I just think, with the deaths that have occurred, I mean I felt, I remember feeling absolutely dreadful when I found out, because I've been doing a lot of work in this area trying to prevent something like that happening, which you know. Talking earlier about the birth that have, the breach birth that happened in the cell, that was the red flag to me. I was thinking you know all the things that we're taught, you know entrapment and you know the the hemorrhage is more likely and etc. Etc. And I just felt that we needed to change. That's why I took that stand. And then for things not to change and those babies to die felt quite personal actually, and that's another reason why it just has to. We just have to keep going to try and prevent this from happening again.

Laura: 1:17:05

And then the level up campaign. That's another campaign that we've got here. That to try and stop pregnant women going to prison in the first place is another campaign that we were doing over here. So we I think we'll be hearing more about that in the coming weeks when this in question, when the findings are out there, and I hope it does get the coverage that it deserves really.

Liz: 1:17:30

I will do our best for it, and I know that a lot of other midwives would do their best for it as well, because, as you said, there's no votes in that kind of population, so it's up to us to bring in the the kind of the other part of the population to care as equally for everyone else. Thank you so much for your time. Thank you for having me.

Laura: 1:17:53

It's been great. Yeah, we can carry on.

Liz: 1:17:54

We can. Very much so. Thank you for joining us today. You'll find all the links on Twitter, instagram and on the podcast website. If you are a midwife and you would like to share your research, your postgraduate studies or even the quality improvement projects you are doing now, then email me at throughthepinardcom, send me a tweet or send me a DM.