CHILD-REARING BY IMPRISONED WOMEN: SADNESS, ANXIETY, AND FEELINGS OF GUILT

The number of imprisoned women continues to increase. Imprisonment of women affects them as perpetrators of crime and those who have relationships with and ties to them, such as children. This phenomenological study aims to explore the experience of imprisoned women in Jakarta in playing the role of mother. In-depth interviews were conducted to explore the experiences of seven imprisoned women. Through a thematic content analysis, we identified specific keywords, the results revealing the sadness, anxiety, and feelings of guilt experienced by imprisoned mothers in relation to their child-rearing. Imprisoned mothers also experience difficulties in meeting their children's needs, together with inadequate child-rearing facilities. The situation experienced by imprisoned women influences their family relationships, which can lead to family crises. The results of this study are expected to serve as a reference for professional collaboration between judicial institutions, community nurses, academics, and related parties, increasing the attention paid to imprisoned mothers and children affected by maternal incarceration.


Introduction
The Sentencing Project conducted in the United States indicates that the number of imprisoned women increased by 646% from 1980-2010 in Washington, while between 2000 and 2011, there was an increase of 31%. In Indonesia, the num-ber of female prisoners has also tended to increase since 2000. In 2016 there were 9,844 imprisoned women, or 5.5% of the total number of prisoners in Indonesia (World Prison Brief, 2016).
The top three provinces that have the highest number of imprisoned women in Indonesia are North Sumatera (1,352 imprisoned women), East Java (1,211 imprisoned women), and DKI Jakarta (1,107 imprisoned women). Data on the number of imprisoned women in DKI Jakarta as of June 2017 shows overcapacity, with 564 detainees placed in the East Jakarta Class IIA Detention Center and 543 prisoners in the Jakarta Class IIA Women's Prison. This total number of detainees and prisoners exceeds the capacity of detention centers and prisons, with 827 imprisoned women (Correctional Data Base System, 2017). A detainee is someone awaiting adjudication, while a prisoner has been convicted based on a court decision and is serving a criminal sentence.
An increasing number of imprisoned women need attention due to their unique health needs and affected family members, including children, which also involves their role in childrearing (Shlafer et al., 2019). Sixty-two percent of imprisoned women in the United States have young children. In Indonesia, there is no national data that states the number of female prisoners who have children. However, in 2009, more than 70% of women imprisoned in Semarang and Malang Women's Prisons have children (Mustofa et al., 2019).
When parents are serving time in prison, children face various problems relating to care. Statistics from the United States Department of Justice show that almost 5% of children in the USA are affected by their mother's imprisonment and experience trauma while separated from her (Dallaire et al., 2015;Mcgee et al., 2015). Lack of parental support leaves the child in a vulnerable situation in relation to growth and development, while imprisonment of parents harms their emotional, social, physical, behavioral, psychological, and cognitive development (Ormeno et al., 2016).
Emotional and behavioral problems experienced by children result in them being involved in criminal acts such as drugs abuse (Goshin et al., 2014;Wildeman & Turney, 2014). Children of imprisoned parents are also at increased risk for school problems. This school problem affected children's cognitive development and experienced academic failure (Dallaire et al., 2015).
Problems experienced by children are inseparable from the stigma they receive as a result of having imprisoned mothers. These conditions result in vulnerability to symptoms of anxiety, trauma, and depression, which are more acute amongst children with imprisoned mothers compared to fathers (Goshin et al., 2014). This situation puts children in a difficult position, not only regarding socialization but also in seeking health services.
The negative impacts on the children of imprisoned mothers show that imprisonment causes harm to women in general and their role as mothers. This study explores the experience of imprisoned women in performing their role as mothers in childcare (Chui, 2016).

Methods
The study used a qualitative design with a phenomenological approach. Data collection was conducted through in-depth interviews with a voice recorder and field notes. The participants were selected based on the research objectives, with the principle of appropriateness and adequacy. The criteria for participants to be involved in the research were female prisoners in Jakarta who had children aged 0-19 years, either separated or living together in prison, and could communicate well. Participants also needed to have been in prison for at least one month so they would have sufficient experience of prison life and had participated in prison coaching programs, including ones on skills, women's health education, and correct breastfeeding.
The participants were vulnerable people as they were subject to judiciary monitoring. Therefore, the recruitment of prospective participants was conducted by involving the person in charge of the Maternal and Child Health Division of the prison based on the inclusion criteria. They were selected based on their willingness and re-adiness to be involved in the research. Qualitative research of a vulnerable population risks might be causing psychological distress during the interviews. Therefore, the researchers needed to have high sensitivity during in-depth interviews to refrain from asking questions about participants' experiences that were personal and caused fear so that participants did not feel exploited. When the personal questions that the researcher wants to ask in the interview were considered essential to answer the phenomenon under study, the researcher provided an opportunity for participants to express their inconvenience if it is felt. They should also be allowed to take counseling after the interview if needed, particularly related to parenting skills.
The data saturation was achieved in the seventh participant, and therefore the data collection was ended. In addition, the availability of time and resources was also taken into consideration in ending the data collection. Thematic content analysis was conducted based on the Colaizzi approach. The keywords found in the interview transcripts were organized into categories, subthemes, and themes. All the study was conducted in Bahasa, with the data then translated into English. The study was declared to have passed the ethical review by the Research Ethics Committee, Faculty of Nursing, Universitas Indonesia.

Results
The participants were women who had been imprisoned for two to seven years. Most were involved in drug abuse (five out of the seven). They were 29-35 years old and married, two participants of whom had been divorced and remarried. All the participants lived in the Jakarta area before their incarceration.
Almost all of the participants were elementary and high school educated, although one was educated to undergraduate level. Before imprisonment, they worked as laborers, private employees, and homemakers.
The participants had at least one child and up to six. Four of the seven lived in prison with their less than two-year-old children and did not give exclusive breastfeeding in the first six months of the child's life. One participant was also pregnant with her fourth child.

Anxiety and Feelings of Guilt Experienced by Imprisoned Mothers during Child-rearing.
All the participants expressed their sadness and anxiety in dealing with their situation. The feelings of sadness experienced by them were inseparable from their poor self-image. The statement below is an example of the thoughts of the participants.

"Then what should I do when I feel saturated; it's too late, angry, sad that it can't be said in words." (P3)
They were also affected by the loss of time with their children. The inconvenience of the imprisonment situation also caused the psychological pressure of the participants:

Imprisoned Mothers' Experience of Difficulties in Meeting their Childrens' Needs.
Childrearing in a prison situation was not easy for the participants living with their children in prison. Six out of the seven participants expressed the difficulty of caring for their child's health. They faced problems when a child was sick because they could not seek healthcare easily. The readiness of health workers in prisons is also limited by working hours.
"…the difficult is… when they were sick… they were sick in an off day, when there were no doctors." (P1) "It is difficult when my child feels inconvenient and keeps crying. What a fuss!" (P7) Three out of the seven participants explained the obstacles to meeting their children's needs due to limited money and baby equipment and food unavailability in prison. The statement below is an example of eight similar ones: The participants also had difficulties in obtaining good food. The statement below is an example of two such explanations: "It is hard to have something delicious to eat... the price is probably twice that of food out there." (P1) Three participants also talked about difficulties in meeting social needs. Those separated from their children had problems maintaining effective interactions due to the limited scheduled visits from the children and limited communication media. Besides the limitations of time and place, the participants also experienced a lack of adequate communication facilities. The statement below is an example of six similar ones: "I met them during the scheduled visits... I used a public telephone, but it was not a good connection ... I have to contact them, because they cannot contact me first." (P3) In prison, the participants stayed in cells grouped by blocks. Those who had babies were gathered in a particular cell that was slightly different from the others.

Imprisoned Women's Experience of Inadequate Child Rearing
"It was good enough, but when a new baby arrived, I was still in the same cell and it was beginning to fill... hehe" (P1) The prison also provided telephone kiosks to allow the prisoners' communication with their families. However, not all the participants used this facility because of the poor quality or the substantial costs involved.
"I need money for calling my family and it's not cheap, it's expensive, right." (P3) "There is a telephone kiosk ... but the sound is a poor quality." (P4) The prison provided a family visit program for imprisoned women, a more effortless procedure for children-this program aimed to maintain communication with families.
"For visiting, the child only needs to bring a family card and deed. Unfortunately, sometimes we cannot found the time to meet each other." (P3) "The children do not need to prepare any permission from the prosecutor to visit their mother." (P4) "Yeah... yeah. It was really helpful; moreover, the child visiting time was not too full." (P4) However, two participants still complained about the complexity of the family visit procedure.

Imprisoned Mothers' Parenting Constraints.
Imprisonment is a traumatic experience, especially for incarcerated women, who suffer a social impact, and in certain conditions, must be separated from their children and families (Chui, 2016;Martinez et al., 2015). Although following the Indonesian Government Regulation on the Requirements and Procedures for Correctional Guidance, incarcerated women may raise their children in prison until they are two years old, in practice, they face various obstacles in undertaking such care. Imprisonment as a traumatic experience expressed by participants 2 and 3 is expected to be the first and the last experience. Imprisonment makes it challenging to carry out the role of motherhood. Prisoners who are separated from their children cannot perform their role as mothers. This function affects the children's growth and development, as parents' role in a child's life is very important, especially in the early years of development, physically, so-cially, and emotionally (Baldwin, 2018;Kjellstrand & Eddy, 2011).
The situation of incarceration has an impact on the interaction between mother and child. Most incarcerated mothers suffer contact breakdowns and lose communication with relatives, including their husbands, which causes anxiety about the condition of the children left behind (Mustofa et al., 2019). The limitations of interaction and communication between imprisoned parents and their children, and the obstacles to visits during imprisonment, resulting in the separation of children's lives from their parents (Brown, 2016). This limitation affects how the prisoner lives in the correctional setting and how they prepare themselves to return to their role in the family. The limitation of interaction between mother and child is experienced by incarcerated women who cannot communicate with their children freely. Although imprisoned mothers can live with children aged 0-2 years, they may also have other children outside the prison who need their attention. This situation results in a disruption to the mother's parenting abilities (Chui, 2016).
Imprisoned women express concern that their incarceration has an impact on their abandoned children. Childcare must be passed on shortly after the mother's imprisonment, both to family and neighbors or friends. Interaction between mother and child is hampered by the difficulties in visiting, with distance being the main problem. Mothers depend on the willingness of the child's caregivers to arrange the transportation for visits. In addition, strict visit schedules are also a limitation; for example, visiting hours may coincide with children's school hours or babysitters' working hours (Cramer et al., 2017;Rees et al., 2020).
Detention centers or prisons do provide telephone facilities for incarcerated women to communicate with their families. However, the relatively expensive costs are an obstacle for the target people to take advantage of these. Life in prison or a correctional setting is seen as one filled with rules to guide prisoners. Both prison and correctional centers will control every activity or program that the inmates follow. This was stated by participant 1, who felt uncomfortable because of the limited freedom; this pressure can also lead to mental disorders in the inmates (Puspasari et al., 2020).
The situation of imprisonment is seen as a coercive environment, which is one of the vulnerability factors of incarcerated women. Even though in Indonesia the implementation of punishment and guidance for offenders is carried out using the philosophy of correcting the prison inmates, imprisoned women who care for children in correctional centers or prisons still face various difficulties, such as meeting their own needs and those of their children.

Mother's Distress in Child-Rearing During
Incarceration. Mothers' imprisonment results in low self-esteem in parenting. Imprisoned mothers feel that they are not good enough to be role models, particularly because of involving their children in such situations. The immediate impact is that babies are either reared in a correctional setting or separated from their mother (Cardaci, 2014;Shlafer et al., 2019).
The pressure experienced by imprisoned women begins with various negative impacts experienced by most of them. The mother's powerlessness during imprisonment results in psychological stress, poor relations with her family, and demanding situations (Maryatun et al., 2014;Travis et al., 2014). Imprisoned women express their sadness of being separated from their children and emphasize that sometimes criminal acts may have been committed because of maternal efforts to meet the needs of their children (Baldwin, 2018;Kjellstrand & Eddy, 2011).
The mother's distress has implications for the lack of an empathetic parenting style and may create the risk of violence to children. In situations of imprisonment, psychological stress results in mothers being unable to provide proper care for their children during imprisonment, and means they are at risk of not being able to perform the mother's role properly after being released from prison (Magee, 2016;Respler-Herman et al., 2012). This was expressed by participants 1, 5, and 6, who felt anger, both because of their difficulties and the fatigue they experienced. This condition has a direct impact on the appearance of physical and psychological problems in children.

Dysfunctional Family Process.
A good relationship between family and prisoners plays a role in the successful return of prisoners to society after release. The family process is the most significant factor for incarcerated women to return to everyday life in the community. Therefore, scientists and social practitioners recommend involving families in prison programs of imprisoned women to have a positive impact on prisoners, families, institutions, and society (Chui, 2016).
In the context of incarceration, the situation experienced by mothers creates psychological pressure and influences their family relationships. Concerning vulnerability, this condition is a factor causing the immediate impact of imprisonment on family life (Arditti & Savla, 2015). The results of this study indicate that incarceration results in imprisoned women facing family crises. Participant 3 and her family had a dispute with her husband because he was considered as the cause of her imprisonment. In addition, participants 1, 5, 6, and 7 did not communicate at all with their families, whereas participant 2 had conflicts with her husband and his family (Maryatun et al., 2014).
In general, incarcerated women come from less harmonious families or single parents, with other family members perhaps also experiencing imprisonment. Such women also support the family economy; in this study, participants 5 and 6 worked alone in meeting the needs of the children because their husbands had also been imprisoned. This is also in line with the results of other studies, that incarcerated women are often single women, divorced or separated from their husbands, and become the backbone of their children. In addition, they have generally had victims of physical and sexual violence before the crime they committed (Mcgee et al., 2015;Mignon, 2016).
Children who live with their mothers in prison are also in a dilemma. Incarceration is an inadequate environment for children's growth and development. Researchers have examined vulnerability in children, including their residential and social environment, the availability of health services, and the condition of the imprisoned mothers. Children are living with their mothers in prison lack affection and attention from their fathers and other family members. In addition, children's play needs are also not met because the facilities at the detention centers are inadequate. In addition, children are also exposed to other criminals, who risk influencing the children's behavior (Cardaci, 2014;Shlafer et al., 2019).
Incarcerated mothers' role function impairment is related to incarceration, which places people in a vulnerable condition, resulting from various factors caused by a lack of resources (Arditti, 2015). These factors include limitations in physical, environmental, human, and biopsychosocial resources, which incarcerated women experience. Motherhood can be facilitated or hampered by situations such as living conditions, economic status, preparation, knowledge, and social and community support. Cardaci's (2014) study also considered variables that influence maternal roles, including age, social pressure, social support, role strain, and health status. Most incarcerated women are in the productive age range and experience role strain due to imprisonment (Cardaci, 2014;Chui, 2016).
Social Interaction Learning Theory forms the basis of the relationship between parental imprisonment, family functions, parenting strategies, and children's social behavior. According to the theory, children and families are in conti-nuous interaction and influence one another. These interactions impact children's behavior, either prosocial and caring for the community, or antisocial and indifferent to the community. In the early stages of child development, risk factors in the family will influence the child's behavior, which impacts family functioning and parenting practices. This relates to the impact caused by the imprisonment situation, both for parents in prison and for their children (García et al., 2015;Kjellstrand & Eddy, 2011).

Conclusion
Imprisoned mothers face various difficulties playing their roles, both those who live with their children and those separated from them. Mothers who care for children in detention centers have problems meeting childcare needs, accessing information about care, and having limited health services. Mothers who are separated from their children face difficulties in maintaining interaction with them. They cannot perform their functions as mothers, which influences children's growth and development. This condition is one of the sources of stressors for incarcerated mothers and causes psychological pressure on their maternal role. The distress is also related to dysfunctional family processes due to imprisonment. The results of this study are expected to be a reference for professional collaboration between justice institutions, community nurses, academics, and related parties, increasing the attention paid to imprisoned mothers and the children affected by maternal imprisonment.