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issues could disrupt the cycle of incarceration, or churning, through
the system which disproportionately affects women of color.
The growing number of children with an incarcerated parent
represents one of the most significant collateral consequences of
the record prison population in the U.S. (The Sentencing Project,
2009). Close to six million kids in America have experienced losing
a parent to prison or jail at some point in their lives. Nationwide,
this population increased by 636,000 children since 2011-2012
(Annie E Casey, 2016).
These figures are significant because parental incarceration increases
the risk of children living in poverty or experiencing household
instability (Phillips, 2006) and children with a history of maternal
incarceration are more likely to experience adverse outcomes including
attachment disorder, depression, behavioral disruption and poor
academic performance (Muftic, 2016).

participants to discuss barriers and successes in achieving health and
well-being while incarcerated while planning for a healthy lifestyle
once released. Like the parenting and prenatal classes, advocates
provide the most up-to-date information on health and well-being,
engage participants about actionable steps they can take and help
them identify the motivations behind their patterns.
Case Management: Advocates provide individualized case management services to mothers who are incarcerated and work with
them to address material needs, provide referrals to agencies in the
city, and serve as a liaison between an incarcerated mother and her
children. These services continue for one year after a mother returns
home, and advocates help parents navigate reentry and reunification
during this time. Advocates support the entire family by providing
a consistent, empathetic presence during a mom's incarceration and
transition back home.
MOMobile at Riverside is one of the few programs like it in
the country, but a crucial one due to the increase of women in the
criminal justice system. The growth rate for female imprisonment
has been more than 50 percent faster than that of men between 1980
and 2014 (Philadelphia Reentry Coalition, 2017). Of the 219,000
incarcerated women in the United States, nearly half (44 percent)
are held in local jails (Prison Policy Initiative: the Whole Pie). The
jail experience is unique and differs from state prison. County jails
have short stays of under 24 months (the average length of stay is
usually far less, often 30-90 days). Most women in jail are arrested
on misdemeanors such as drug possession and are pre-sentenced
without formal charges. Unable to afford bail, they may remain
behind bars until their trial.
Without community support, women often repeat the cycle of
incarceration, leading to continued disruption in parent-child bonding.
Treating their underlying trauma, mental health and substance use
32 Philadelphia Medicine : Summer 2018

Current research demonstrates essential brain development occurs
during pregnancy and through a child's first three years. The impact
of extreme poverty, maternal depression, trauma, repeated abuse, and
other forms of "toxic stress" that children of incarcerated mothers
face may lead to long-term consequences. Parent-child bonding is
critical to healthy brain development for young children and may
serve a protective function for mothers during the reentry period
given mothers' concerns about their children and desire to be a role
model for them. A two-generational approach is critical in addressing
the needs of this population.
While providing resources to women is critical during incarceration and reentry, there is a movement towards keeping pregnant
and parenting women out of the criminal justice system altogether
by providing community alternatives to incarceration. The City
of Philadelphia's Office of the District Attorney's Diversion Unit
operates over 15 diversion programs, including several targeted to
women dealing with domestic violence and prostitution.
Currently, there aren't any official diversion programs targeting
pregnant women or mothers with young children. Home visiting
programs, such as the various ones MCC offers, serve high-risk
women and children in their homes and are uniquely suited to
disrupt the cycle of churning through the criminal justice system.
Home visiting programs provide at-risk pregnant women and
families needed resources and skills to improve maternal and child
health, prevent child abuse and neglect and encourage positive
parenting. They also assist mothers to access preventive health
services, navigate the complex behavioral health systems and work
with mothers to set goals for the future, continue their education,
and find employment and child care solutions. Pennsylvania,
and Philadelphia in particular, are positioned to make important
progress towards criminal justice reform and are national leaders
for this cause. Some initiatives currently underway include:

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Table of Contents for the Digital Edition of Philadelphia Medicine Summer 2018