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Trigger warning: Story mentions infant death 

When Julie Bilotta was forced to give birth in her Ottawa-Carleton Detention Centre cell without support from prison guards or nurses in 2012, her child was bruised from the waist down, was put on a ventilator, and dealt with chronic breathing problems until his death one year later. This was one of the preventable tragedies that led to Wellness Within working with criminalized pregnant people.

“For us, the concept of the state having control over your body is something that became really foundational to use,” says Claire Rillie, the vice chair of Wellness Within.

Based in the unceded territory of the Mi’kmaq people, which is colonially known as Nova Scotia, Wellness Within is a volunteer-run non-profit organization that has been supporting incarcerated women, non-binary and trans people through pregnancy services since 2015. 

Wellness Within volunteers are doulas, nurses, midwives, physicians, social workers, lawyers, students, policymakers, researchers, writers, educators, and mentors who have experienced criminalization. They assist with abortions, childbirth, infant feeding, and newborn care. 

Rillie says Wellness Within’s goal is to provide incarcerated and criminalized women, non-binary and trans people with the same quality of healthcare people outside correctional facilities receive. 

From reproductive justice to economic support

When Wellness Within incorporated in 2017, they realized they needed to partner with crucial sister organizations to support the provision of wraparound services to clients. They began solidifying their mandate to support a more holistic vision for reproductive choice in addition to their health equity work and doula services. Experts on their team and within partner organizations such as the Elizabeth Fry Society (EFS) Cape Breton, Caitlan’s Place, and Women’s Legal Education & Action Fund (LEAF), were pushing to expand services for pregnant people to ensure they did not ignore other aspects of autonomy putting expecting pregnant people at risk.

Rillie says it is important for services to address barriers underrepresented groups face, especially those “tangentially linked [to the] root causes of poverty and criminalization as a result of being part of a marginalized group.”

Wellness Within now advocates for decarceration (reducing the number of state-imprisoned people), access to housing, income supports, and healthcare for women, trans and non-binary people who have experienced criminalization while pregnant or who are raising young children. 

Why? Because the experience of pregnancy doesn’t exist in a vacuum — and pregnant people living in poverty are deeply marginalized.

“You basically have no agency on your own to make any decisions if you don’t have an income and a house,” says Rillie. 

Rillie says this affects the ways someone can seek an abortion, have a healthy pregnancy, and manage their addictions. 

For one member of the team, the reason for expanding the organization’s mission is even more simple: “We advocate for housing and income equality and healthcare because that is what society needs,” says Martha Paynter, Wellness Within board chair and coordinator. “It doesn’t need prison systems. That’s the foundation of our philosophical belief.”

Reproductive justice + economic support = freedom of choice

Without access to reproductive choice, many criminalized women, non-binary and trans people are trapped in cycles of poverty and abuse — and more criminalization. 

For example, Rillie says many of the women Wellness Within works with are criminalized because of their affiliation with the men in their lives committing crimes. Research, too, by the United States’ Department of Corrections reveals that trends in criminalized women’s offenses link their criminal activity to people they have close relationships with, and are more likely than men to co-offend with romantic partners or family members. Rillie recalls the story of a pregnant woman who had her baby while in jail on remand, awaiting charges for being caught with the drugs her boyfriend had asked her to carry in the trunk of her car.

Criminalized women are also more likely to have histories of abuse or victimization, substance use, and mental health issues compared to criminalized men. “And because of the lack of choice, a lack of financial independence, extreme poverty, familial links, once you’re linked to someone with pregnancy, if you have no way to end that pregnancy, you’re also linked to that situation indefinitely, if you can’t access abortion,” says Rillie. “We have plenty of moms that we support who aren’t seeking abortion, but it’s a really, really crucial piece of our work.”

Rillie’s right, though — criminalized pregnant people’s struggles don’t end after prenatal services and childbirth. 

According to Public Safety Canada’s report on economic outcomes of federal offenders, only 19 percent of women find a job after incarceration, compared to 50 percent of men. 

Another report on maternal incarceration in a provincial prison prepared by academics from Dalhousie School of Nursing, IWK Health, Wellness Within, and Coverdale Courtwork Society, shares the barriers experienced by many participants –– mothers who are currently or previously incarcerated. 

Many of the participants struggle with housing and income on multiple levels: landlords do not want to rent to them because of criminal records, there’s a delay in applying for income assistance and receiving it to pay rent, they don’t have enough money to secure housing, and some shelters will not accept them if they are using substances. 

“If someone doesn’t have income, it means they don’t have the ability to make choices,” says Rillie. “Giving people a lack of resources means lack of choice, and so your life just becomes a lot more easily controlled.” 

Because of this, Wellness Within works with partners and non-profit organizations in housing, such as Caitlan’s Place and EFS. They both offer transitional housing and support formerly incarcerated women, non-binary and trans people. 

However, Rillie says housing is becoming a bigger issue for everyone –– “I find [this happens] whenever middle class people start to notice something as an issue” –– so Wellness Within tends to rely on their partners to speak for themselves, while they support their work and refer the criminalized pregnant people or new parents to their respective organizations. 

“It’s slightly out of our wheelhouse, but that’s not to say it won’t become more part of our work,” says Rillie. 

Ecosystems of support

Rillie says the relationship between Wellness Within and organizations like Caitlin’s Place and EFS is mostly informal, but there may be opportunities to formalize partnerships in Nova Scotia. 

Wellness Within’s research portfolio is expanding and they are relying on and contributing to more studies to document the experiences of criminalized women, non-binary and trans people to understand how to serve them best. 

One of their promising opportunities for formal partnerships is the IWK Health Centre, a pediatric hospital and trauma centre in Halifax. When an incarcerated pregnant person leaves the correctional facility to give birth, the Wellness Within doulas are welcomed into the birthing environment and can provide their services. 

Outside Wellness Within’s services, a doula typically costs anywhere from $600 to $1000 in Canada, which includes two prenatal visits, labour and delivery support, and a postpartum visit. 

Doulas are not covered by provincial health care plans. Midwifery is only covered publicly for citizens and permanent residents. Otherwise, midwives services vary, but start around $850 in Atlantic provinces. (Midwives are trained medical professionals, authorized to give pain medications, order an epidural, manage postpartum hemorrhages, and address other issues. Doulas are not medically trained, but are childbirth professionals who give emotional support, physical comfort, and information about pregnancy to their expecting clients. They also provide postpartum care and can act as a pregnant person’s advocate with medical staff.)

Via Wellness Within, incarcerated pregnant people can access this service for free. 

“The goal is for women to be able to leave, to get as much healthcare as folks get on the outside,” says Rillie. “The goal is equity here.”

An earlier version of this story mistakenly mentioned a Wellness Within client who gave birth while on remand, but it was the case of Julie Bilotta, who was not a Wellness Within client. The current story reflects this change. 

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