A photo of Merle Hoffman, founder and CEO of the Choices Women’s Medical Center. Photo credit: Vanessa Valenti

When the Rose M. Singer Center opened on New York City’s Rikers Island in 1988, it was touted as a “state of the art” facility where women prisoners would get training in the culinary arts, horticulture and sewing. According to the Center’s official history, the new center was expected to provide the correction facility’s staff with a chance to implement innovative programs—with an emphasis on vocational skill-building—that would lead to jobs when the women were released. In addition, the Center boasted of creating the nation’s first jail-based nursery, where new mothers and their babies could spend time together.

Fast-forward three decades. While the nursery remains open, few other innovations remain. In fact, many of the 800-plus women housed in the medium security prison have multiple gripes—from the food, to the boredom they experience, to the lack of access to medical and mental-health care.

Merle Hoffman, founder and CEO of the Choices Women’s Medical Center, heard these complaints and, with several clinic staff, recently went into the prison and met with some of the women who are incarcerated there.

She spoke with Eleanor J. Bader about what they found, and what they hope to do to ameliorate these difficulties.

Eleanor J. Bader: Choices Women’s Medical Center has pretty much always offered more than just abortion care. How and why did the clinic decide to offer a wider range of reproductive healthcare services?

Merle Hoffman: Choices opened to provide abortions in 1971, two years before Roe v. Wade was decided, right after New York state legalized the procedure, and we expanded our offerings as the need arose. It was an organic response to the needs women presented. When a woman is facing a crisis pregnancy, issues including sex, mothering, death, gender and relationships get raised. We saw that sometimes a woman would come in for an abortion, but then change her mind, and we would then need to refer her to an obstetrician. This inspired us to offer prenatal care and general gynecological services. The conflicts around pregnancy that women shared with us then led us to offer mental-health services.

Reaching out to women in prison is similar, and comes out of my desire, my attraction, to going where the need is greatest. That was the catalyst for opening Choices in Jamaica [the New York City borough of Queens], where poverty rates are high and there are very few high-quality health care providers.

 EJB: Had you ever worked in a prison before?

MH: Yes. In the early 1980s Choices paired with the Creedmoor Mental Health Players from the Creedmoor Psychiatric Center in Queens Village, NY. We went into Riker’s Island every four to five weeks and worked with both men and women there. The program was organized around themed workshops, skits that involved role-playing. One that sticks in my mind involved the prisoners acting out how they thought their family members felt about them being in jail during the holidays. I remember that it was pretty easy to get the prisoners to verbalize their feelings—in this scenario, guilt, sadness and shame—and then discuss their reaction. It was illuminating and rewarding but the program eventually ended—it involved an enormous effort—and we basically felt that it had run its course and come to a natural end.

I remained interested in prison issues, though, and after reading about Susan Rosenberg—a young leftist who was sentenced to 58 years in jail in 1984 after being convicted on weapons and explosives charges—I interviewed her for On The Issues Magazine, a quarterly print publication that was published by Choices.  When I heard her story something in me clicked. I felt I could have made the choices Susan had made, but somehow didn’t. There but for fortune… I’d like to think that the article played a role in getting Rosenberg’s sentence commuted by Bill Clinton in 2001.

EJB: How did you arrange your current effort at the Singer Center?

MH: I contacted people in the administration at Rikers and asked if we could come in. They knew about my work and said that they wanted us to speak to the women and offer services. Setting this up is still in process, but I’ve gone there once already with three staff members and have to say, it’s always arresting—please forgive that word choice—to enter a prison.

We were allowed to go into three different areas: The nursery, the lunch room, and an area where a group of eight women in different gestational stages of pregnancy were sitting.

 The nursery is a very large room and had an impressive amount of donated toys. I met with one woman there. She was with her little one and told me that she spends the whole day with her baby. Her cell is directly across the hall from the nursery so if the baby cries at night the guards can easily and quickly get her. After she told me she’d be leaving the prison fairly soon, I asked her if she wanted information about birth control and was stunned when she told me that she is afraid of birth control and believes that it causes cancer. It’s amazing that myths about contraception persist, even in 2017. This woman had three other children—I’m not sure if they were at home with a family member or were in foster care—and she made it clear that she wanted to give her kids as much as she possibly could give them. What also seemed clear, at least to me, was that she needed good, factual information.

The pregnant women we met with wanted to know about their bodies, about anatomy. Most said they wanted to put their time inside to productive use but didn’t know what to do. They also asked us to help them formulate strategies for dealing with conflict. How do you deal with an enemy? How do you engage someone without getting physical? What do you do to get a bothersome person off your ass? These women were all young, in their 20s and 30s, and were articulate and present. They wanted real strategies and tactics.

The other issue that came up over and over was the food. One woman said that she’d gained 20 pounds because everything was fried or a starch. Others said that they were afraid of getting diabetes or heart disease while inside. That complaint felt terrible to us because there was nothing we could do to help other than repeat their complaints to prison administrators.

 EJB: Despite this, it sounds like this visit went relatively smoothly. Were there any frustrations?

MH: Absolutely.  It took us two hours to see the women after we arrived. The staff had to call a bunch of different people and we had to wait and wait for the right authorization.

Once we got in, however, it was fine, and the women said they wanted us to return. We want that too, but have to wait for the administrators to give us a return date. Prison is an incredibly structured, bureaucratic environment. Alarms go off constantly and they did roll call repeatedly when we were there. There are also unsettling elements: At one point we saw a prisoner being walked down the hall in chains. Nonetheless, I’m hoping we’ll be able to return every four to six weeks.

EJB: Was there anything in particular that you and the other Choices staff took with you from the visit?

MH:   The need to stay positive. Of course, you can feel hopeless and despairing, but we can’t allow ourselves to wallow in these feelings for long. I think it was Holly Near who, at the memorial for Kate Millett in early November, reminded us that we are part of a chain of struggle and if we allow ourselves to feel desperation, it negates and minimizes the work that has gone on before us. We’re letting our foreparents down if we despair. Sure, I sometimes feel like a drop in an ocean, but who knows where the waves go? Every action we take has an effect and if you want to do something, you do it, even when there are barriers, obstacles, and bureaucratic frustrations.

The views and opinions expressed in this article are the author’s own and do not necessarily reflect those of Lilith Magazine.