Birth Beyond Bars MCH Leadership Lab Student Project - PowerPoint Presentation

1. Birth Beyond BarsMCH Leadership Lab Student ProjectBethany Kotlar, MPH

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4. Birth Beyond Bars CohortCohort of children exposed to incarceration in prisons in utero, their caregivers, and their mothersFollow-up currently for 2 yearsPilot in Georgia, now expanding to other states Mixed methods designQuestionnaires assess: Caregiver demographics, mental health, social support, enrollment in social services, household needs, and relationship with the incarcerated motherChild health, attachment to primary caregiver, cognitive and social/emotional development, and contact with the incarcerated motherMother demographics, experiences during incarceration, re-entry needs and challenges, attachment to the target childFamily choices regarding who would be a caregiver to the target child, who would care for the child after his or her mother was released

5. Birth Beyond Bars FlowchartCaregiversIntake3 months6 months9 months12 months18 months24 monthsMother is releasedCaregiversIntake3 months6 months9 months12 months18 months24 monthsMothersIntake (at age of the child when mother is released)Continued follow-up surveys at 3-month intervals starting at next age interval following intakeMothersIntake (at age of the child when mother is released)Continued follow-up surveys at 3-month intervals starting at next age interval following intakeCaregiver is no longer involved (just mother)Both caregiver and mother are involvedThis is also the scenario used when mother is not releasedIn this scenario, the caregiver questionnaires are stoppedMother is not involved (just caregiver)Caregiver 1Caregiver 2Intake3 months6 months9 months12 months18 months24 monthsIntake (at time of entry)3 months6 months9 months12 months18 months24 monthsCaregiver 2Intake (at time of entry)3 months6 months9 months12 months18 months24 monthsA new caregiver and original caregiver share responsibilityNew caregiver takes over care

6. Temporary caregivers of children born to incarcerated mothers (n=42) 23% of infants in our cohort have had a change in temporary caregiver, 1 infant has had three caregivers32% indicated food insecurityOver 30% living under the federal poverty line17% met the cutoff for moderate to severe distress 2/3 were caring for other dependent children

7. Stress of accepting an unexpected child “Oh my God, can I handle this? I got another one. What am I going to do? And, and I, you know, stood here and said, ’here I'll take her.’” “I can’t keep raising babies, you know, at 50 years old”“I struggled yesterday because my granddaughter, she cried [for] one hour because she thought that the baby was getting more attention than she was. And at the same time she was crying and that made him upset and he was crying. So I had to deal with that [for] one hour and I said, Oh my goodness, I try to call my husband, ‘so when you're going to be home, we got to give me a break.’”When you're pregnant and you have a baby, your body tells you what to do and how to do it. And just your body goes through a process of getting ready. Right, to give birth. But then when you pick up the baby that somebody else has given birth to, you don't have that… It was like four days or three or four days of like, do I have everything? Do I have a bag to unpack your bag and then pack your bag in? And, you know, just it was a lot of stress until I got her home and then I felt kind of relief some. But then I was like, oh, gosh, look at my baby.”

8. Barriers to mother/infant contact “Yeah, because right now, she’s on that 40-day thing. I don’t want her to get that postpartum depression or whatever it is. You know, I try to be careful, you know, with what I say to her.”“I was holding him when she called and of course he’s making noises and sounds, and I could tell it upset her, but I don't know if she thinks maybe more out of sight out of mind, you know? Um, and she was like, all right, well, I love you. I'm gonna have to get off the phone now.”“I learned that when she was in, with her daughter, I’d tell her everything about her. Then I'll see how upset she gets, you know? And I said, well, you know, there's no sense to make her upset if I don't have to, you know?”

9. Student projectActivitiesQualitative analysis of mother and caregiver in-depth interviewsConducting mixed-methods interviews with caregivers and mothers Student qualificationsSome qualitative experience (practical or course) preferredInterest in or experience with working with marginalized populationsInterest in qualitative methodsLogisticsCommitment of at least 10 hours per week Ability to join weekly Zoom meetingsOther work on your own schedule

10. Join this amazing team! Amy Ard, MBBHenning, known entityIsa Berzansky, HSPHRaina Cohen, Harvard CollegeJulia Vitagliano, HSPHVanessa Garrett, MBBSarah Perry, MBBKate Dawson, Rollins