Speaking Up About Postpartum Depression

Amie Newman

What new mothers don't know can hurt them. Postpartum depression can have a devastating effect but these women prove there can be a way out.

Tom Cruise's take?

"You can use vitamins to help a woman through those things."

Cruise told Brooke Shields, after the birth of her first child, that "she should have used vitamins" to get over her postpartum depression; adding that he was, in fact, "disappointed" that Shields chose to use the anti-depressant Paxil to alleviate some of the symptoms of her postpartum depression.

You can't really blame Tom Cruise for his perspective. You can get angry at his pompous statements. And, as a mother who experienced PPD and survived because of an extraordinary husband and the miracle of anti-depressant intervention, I did – as did Rosie O'Donnell and Brooke Shields herself. But the general public has tended to lump postpartum depression (PPD), until very recently, under the catch-all "new mother issues" to describe what many women experience after the birth of a baby. And there are still far too many women who are caught unaware, without preparation, support or understanding of what is happening to them.

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Sure, if you're lucky enough to have access and means to attend a childbirth education class prior to the birth of your baby you're likely to receive some information about the subtle differences between the cute-n-cuddly-termed "baby blues" and the more severe "postpartum depression."

But this is clearly not enough to help the millions of women and their families who have suffered through (and some who haven't made it through) a very real mood disorder.

Just ask Thomas Soukakos, owner of Vios, a café in Seattle, and the father of Alexander, now almost five years old. Soukakos' wife, Carol, committed suicide just months after Alexander's birth in 2002 while suffering from severe post partum depression.

Soon after her death, he was quoted in The Seattle Times as saying, "I've lost the love of my life, my soul mate and my friend and I look toward my son, Alexander, for inspiration now. I'm so grateful I have him."

Soukakos decided, however, not to let his wife's death go unnoticed. After receiving letters from around the country from other women and families who had been touched in some way by postpartum depression, he decided to embark upon a mission to help educate not only women about this condition – but everyone.

Christin Jamieson, communications director for the Washington state "Speak Up When You're Down" postpartum depression awareness campaign calls Thomas "the father of the campaign." In fact, in 2005 Soukakos provided the testimony to the Washington state legislature that secured the first round of funding to launch the campaign.

"Speak Up When You're Down" was developed with help from the New Jersey PPD campaign – the first in the nation. New Jersey's governor from 2004 to 2006, Richard J. Cody, helped secure over $2 million in funding for their PPD public awareness and education campaign with the help of his wife, Mary Jo Cody, who had suffered from the condition after the birth of their first child.

Jamieson says, "When we decided it was time for Washington state to launch a similar campaign we had only $25,000. We called the campaign folks in New Jersey and they gave us permission to use their tag line, their artwork, everything for free."

The "Speak Up When You're Down" campaign was rolled out in 2005 to shed light on an issue that desperately needed a spotlight.

Jamieson says, "While no one is sure what causes PPD…understanding that this has nothing to do with how good of a mother or person you are underscores the importance of speaking up to your partner or your doctor when you're not feeing like yourself…Having an understanding of the signs and symptoms of PPD can also help loved ones support the mother and encourage her to get the help she needs so she can start to feel like herself again."

And while "Speak Up When You're Down" was developed strictly as a public awareness campaign Jamieson notes that, "When you increase awareness without the resources to meet the needs, it's not as helpful. We need to train and educate health providers and increase knowledge as well. There is a delicate balance that needs to be reached."

A delicate balance that strikes many as crucial.

"It felt like the medical profession wasn't aware – that question wasn't asked: Does my family have a history of depression? My family does have a history of anxiety and depression…" Monica Lopez shares.

Monica is a Parent Educator for Parent Trust for Washington Children, the organizational leader of the "Speak Up When You're Down" campaign. But Lopez was once a new mother herself, angry and confused, suffering from PPD.

"As a first-time mom, I wanted to read it all. To know as much as I possibly could. It would be nice if there was more information out there from medical professionals so women can be as educated as much as possible."

As an example, she points to the book "What to Expect When You're Expecting" – a handbook for so many soon-to-be new mothers over the years. "The book is like an inch thick. I read it like a bible when I was pregnant. But there is not even a half of a paragraph in there about postpartum depression – it's a small, little blurb!"

Monica received relatively speedy relief from her PPD symptoms but the experience was traumatic.

"I first realized something was wrong when I brought my daughter home from the hospital and she needed to be nursed. I didn't even want to look at her. I back-pedaled when my husband walked towards me holding her in his arms."

"I said, ‘No – I don't want to. Keep her away from me.'" He knew something was not right and he immediately called 911. The paramedics had some sort of an idea of what I was experiencing so I got dressed and they took me to the hospital. There they told me it was common and with the right medication I'd get back on track."

Monica says she was lucky. "My husband was so patient and understanding and knew to call 911 when something wasn't right. But what about the women who don't have that support?"

And Monica notes, her mother was her rock. "In the Hispanic culture, mothers are right there after childbirth, like a right arm. They come in and make tea, encourage you to nap and help you self-soothe." But, she says, when a new mother is experiencing symptoms of PPD, "you need medical attention. You need to hear that you're not alone from a health professional."

Monica says that increasing public awareness and letting women know that they are not alone is crucial to helping women. "We need to educate our neighbors, educate each other." But, she stresses:

"Doctors need to make sure and tell women: this is normal. It occurs. It's more common than you think. If this should happen, this is what I'd recommend. If it comes from a doctor, you'll be more successful in treating the symptoms."

"When I saw a nurse, after I was diagnosed with PPD, she told me she had gone through the same thing. I said to the nurse, ‘How can I feel this way? My daughter is healthy, beautiful – and I want nothing to do with her.' It was so helpful to hear a nurse say that it was okay. What I was experiencing was normal."

And now, as a woman who has experienced PPD and come out the other side, Monica is committed to helping other women who experience the same thing.

"We need to get in the faces of OB's and pediatricians. We need to approach gynecologists with a card – like the breast-check self-examination shower card – but for new mothers: If you're feeling this, this and this you might be experiencing postpartum depression. If you're a first time mother, you may not know the difference between the baby blues and PPD," says Stefanie Pistole-Mangum, a first-time mother and volunteer for Postpartum Support International's (PSI) Washington chapter.

Pistole-Mangum gave birth last year to a beautiful baby girl. She says, "Today, I can't imagine my life any other way. It's absolute bliss. But a year ago, I didn't know how I would possibly imagine having a normal life ever again."

Stefanie is a phone volunteer for the Washington chapter of PSI's "Warm Line." Once every three weeks she is the assigned volunteer who checks messages and returns calls to new mothers, their family members or even providers who call the hotline needing help and resources from other mothers who have experienced PPD and recovered. The "Warm Line", according to Kathleen Pantoja, Volunteer Coordinator for PSI of Washington and herself recovered from PPD, is "an exceptional first step to initiating recovery" for a new mother who recognizes that something is wrong and needs help.

Stefanie has a questionnaire with a check-off list of symptoms: Are you experiencing loss of appetite? An inability to sleep? Severe or higher than normal levels of anxiety? What does your support system look like? After hearing answers to these and other questions, Stefanie can provide them with referrals to a doctor or a support group for postpartum depression, if there is one in their area.

But, Stefanie says, "If you've been through this, you know that just hearing someone say ‘I've been there too and I got through it and you can too' and then helping to eliminate the chasing around to find a doctor can help a woman immensely."

Stefanie prefaces her story of her experience with PPD by saying "Postpartum depression wasn't even on my radar screen before I became pregnant. I didn't know what PPD was. It's not something I even thought about. If I would have thought about it though, I probably would have said Tom Cruise is right – people shouldn't take drugs. I would have told a new mother who told me she was depressed to go get a pedicure or listen to some happy music."

Which makes some of what she relays about her depression that much more crushing.

"For me, it was gradual but once I hit the bottom I couldn't believe it. It was hell and it was grueling. I remember sitting in my car with my dad soon after I had my daughter thinking: ‘You know, we're on a freeway. If I just open the door and fall out, it would kill me. How would me being gone affect my daughter? Wouldn't it be better for her? I just don't want to be here.' It was just complete apathy for me. Now, I realize, hell isn't fire and brimstone. It's just an empty place filled with apathy."

But Stefanie is also quick to say that she too had a great deal of support from her family. She had everything in her favor: an understanding and "unbelievable" husband who was quick to act, good health benefits and access to quality medical care.

So, what about single mothers who may not have a partner or friend readily available to recognize symptoms and provide crucial support when it's needed? Or more marginalized populations of women who do not have access to care or resources because of income or language barriers?

Stefanie says, "For me a lot of it is about the state of health care. Who doesn't have the access, the benefits or the support? Because with no support or access to care, I wouldn't have made it through."

Christin Jamieson says that, "PPD…can affect a woman no matter her age, income, race or level of education. It's not enough to assume that it only happens to a small number of women – it doesn't."

Kathleen Pantoja says that social isolation and chronic stress are major risk factors for developing PPD and says that the "Speak Up When You're Down" campaign as well as PSI of Washington "feel strongly about reaching out to diverse populations at risk for PPD."

In addition to printing pamphlets in Spanish, there are Spanish-speaking "Warm Line" volunteers. Also, Kathleen notes, "We help bring awareness of PPD to low-income families by supplementing community service organizations with the latest PPD educational and informational materials."

And Jamieson is hopeful that a new web-based tool being developed for health care providers (including social workers and mental health providers) will help them "gain a better understanding of cultural impediments to relationship building with clients."

There is reason to be extraordinarily hopeful.

Almost all of the women I spoke with – Monica, Stefanie, Kathleen and Christin – have come through the tunnel of PPD and want nothing less than to see it conquered in their lifetimes. Kathleen is clear: "We save lives with the work that we do…and it gives me great joy!"

Monica finds comfort in the knowledge she can now pass down to her own daughter: "My daughter knows all about my experience with PPD because I want her to know that she's at risk and what she can do if she does suffer from PPD. She knows that mom had PPD and she got medical attention."

Stefanie offers it straight: "I crave this campaign works. I want to help others who are going through this. I want to tell them: you're not alone, you're not weird and you won't always feel this way."

She continues, "You know when you're on a plane and they tell you to put an oxygen mask on yourself before placing one over your child's mouth? That's what seeking help for PPD is about. My own oxygen mask needs to be on before I put my child's mask on."

For a woman who just one year ago had "active suicidal thoughts", the peace and clarity evident in Stefanie's voice is startling – and comforting.

If you, or someone you know is suffering from PPD or may be experiencing some of the symptoms, you can call PSI's toll-free line at 1-888-404-7763.

Culture & Conversation Media

Filmmaker Tracy Droz Tragos Centers Abortion Stories in New Documentary

Renee Bracey Sherman

The film arrives at a time when personal stories are center stage in the national conversation about abortion, including in the most recent Supreme Court decision, and rightly so. The people who actually have and provide abortions should be driving the narrative, not misinformation and political rhetoric.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

A new film by producer and director Tracy Droz Tragos, Abortion: Stories Women Tell, profiles several Missouri residents who are forced to drive across the Mississippi River into Illinois for abortion care.

The 93-minute film features interviews with over 20 women who have had or are having abortions, most of whom are Missouri residents traveling to the Hope Clinic in Granite City, Illinois, which is located about 15 minutes from downtown St. Louis.

Like Mississippi, North Dakota, South Dakota, and Wyoming, Missouri has only one abortion clinic in the entire state.

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The women share their experiences, painting a more nuanced picture that shows why one in three women of reproductive age often seek abortion care in the United States.

The film arrives at a time when personal stories are center stage in the national conversation about abortion, including in the most recent U.S. Supreme Court decision, and rightly so. The people who actually have and provide abortions should be driving the narrative, not misinformation and political rhetoric. But while I commend recent efforts by filmmakers like Droz Tragos and others to center abortion stories in their projects, these creators still have far to go when it comes to presenting a truly diverse cadre of storytellers if they really want to shift the conversation around abortion and break down reproductive stigma.

In the wake of Texas’ omnibus anti-abortion law, which was at the heart of the Whole Woman’s Health v. Hellerstedt Supreme Court case, Droz Tragos, a Missouri native, said in a press statement she felt compelled to document how her home state has been eroding access to reproductive health care. In total, Droz Tragos interviewed 81 people with a spectrum of experiences to show viewers a fuller picture of the barriersincluding legislation and stigmathat affect people seeking abortion care.

Similar to HBO documentaries about abortion that have come before it—including 12th & Delaware and Abortion: Desperate ChoicesAbortion: Stories Women Tell involves short interviews with women who are having and have had abortions, conversations with the staff of the Hope Clinic about why they do the work they do, interviews with local anti-choice organizers, and footage of anti-choice protesters shouting at patients, along with beautiful shots of the Midwest landscape and the Mississippi River as patients make road trips to appointments. There are scenes of clinic escorts holding their ground as anti-choice protesters yell Bible passages and obscenities at them. One older clinic escort carries a copy of Living in the Crosshairs as a protester follows her to her car, shouting. The escort later shares her abortion story.

One of the main storytellers, Amie, is a white 30-year-old divorced mother of two living in Boonville, Missouri. She travels over 100 miles each way to the Hope Clinic, and the film chronicles her experience in getting an abortion and follow-up care. Almost two-thirds of people seeking abortions, like Amie, are already a parent. Amie says that the economic challenges of raising her other children make continuing the pregnancy nearly impossible. She describes being physically unable to carry a baby and work her 70 to 90 hours a week. Like many of the storytellers in the film, Amie talks about the internalized stigma she’s feeling, the lack of support she has from loved ones, and the fear of family members finding out. She’s resilient and determined; a powerful voice.

The film also follows Kathy, an anti-choice activist from Bloomfield, Missouri, who says she was “almost aborted,” and that she found her calling in the anti-choice movement when she noticed “Anne” in the middle of the name “Planned Parenthood.” Anne is Kathy’s middle name.

“OK Lord, are you telling me that I need to get in the middle of this?” she recalls thinking.

The filmmakers interview the staff of the Hope Clinic, including Dr. Erin King, a pregnant abortion provider who moved from Chicago to Granite City to provide care and who deals with the all-too-common protesting of her home and workplace. They speak to Barb, a talkative nurse who had an abortion 40 years earlier because her nursing school wouldn’t have let her finish her degree while she was pregnant. And Chi Chi, a security guard at the Hope Clinic who is shown talking back to the protesters judging patients as they walk into the clinic, also shares her abortion story later in the film. These stories remind us that people who have abortions are on the frontlines of this work, fighting to defend access to care.

To address the full spectrum of pregnancy experiences, the film also features the stories of a few who, for various reasons, placed their children for adoption or continued to parent. While the filmmakers interview Alexis, a pregnant Black high school student whose mother died when she was 8 years old, classmates can be heard in the distance tormenting her, asking if she’s on the MTV reality show 16 and Pregnant. She’s visibly distraught and crying, illustrating the “damned if you do, damned if you don’t” conundrum women of color experiencing unintended pregnancy often face.

Te’Aundra, another young Black woman, shares her story of becoming pregnant just as she received a college basketball scholarship. She was forced to turn down the scholarship and sought an adoption, but the adoption agency refused to help her since the child’s father wouldn’t agree to it. She says she would have had an abortion if she could start over again.

While anti-choice rhetoric has conflated adoption as the automatic abortion alternative, research has shown that most seeking adoption are personally debating between adoption and parenting. This is illustrated in Janet’s story, a woman with a drug addiction who was raising one child with her partner, but wasn’t able to raise a second, so she sought an adoption. These stories are examples of the many societal systems failing those who choose adoption or students raising families, in addition to those fighting barriers to abortion access.

At times, the film feels repetitive and disjointed, but the stories are powerful. The range of experiences and reasons for having an abortion (or seeking adoption) bring to life the data points too often ignored by politicians and the media: everything from economic instability and fetal health, to domestic violence and desire to finish an education. The majority of abortion stories featured were shared by those who already had children. Their stories had a recurring theme of loneliness and lack of support from their loved ones and friends at a time when they needed it. Research has shown that 66 percent of people who have abortions tend to only tell 1.24 people about their experience, leaving them keeping a secret for fear of judgment and shame.

While many cite financial issues when paying for abortions or as the reason for not continuing the pregnancy, the film doesn’t go in depth about how the patients come to pay for their abortions—which is something my employer, the National Network for Abortion Funds (NNAF), directly addresses—or the systemic issues that created their financial situations.

However, it brings to light the hypocrisy of our nation, where the invisible hand of our society’s lack of respect for pregnant people and working parents can force people to make pregnancy decisions based on economic situations rather than a desire to be pregnant or parent.

“I’m not just doing this for me” is a common phrase when citing having an abortion for existing or future children.

Overall, the film is moving simply because abortion stories are moving, especially for audiences who don’t have the opportunity to have someone share their abortion story with them personally. I have been sharing my abortion story for five years and hearing someone share their story with me always feels like a gift. I heard parts of my own story in those shared; however, I felt underrepresented in this film that took place partly in my home state of Illinois. While people of color are present in the film in different capacities, a racial analysis around the issues covered in the film is non-existent.

Race is a huge factor when it comes to access to contraception and reproductive health care; over 60 percent of people who have abortions are people of color. Yet, it took 40 minutes for a person of color to share an abortion story. It seemed that five people of color’s abortion stories were shown out of the over 20 stories, but without actual demographic data, I cannot confirm how all the film’s storytellers identify racially. (HBO was not able to provide the demographic data of the storytellers featured in the film by press time.)

It’s true that racism mixed with sexism and abortion stigma make it more difficult for people of color to speak openly about their abortion stories, but continued lack of visual representation perpetuates that cycle. At a time when abortion storytellers themselves, like those of NNAF’s We Testify program, are trying to make more visible a multitude of identities based on race, sexuality, immigration status, ability, and economic status, it’s difficult to give a ringing endorsement of a film that minimizes our stories and relegates us to the second half of a film, or in the cases of some of these identities, nowhere at all. When will we become the central characters that reality and data show that we are?

In July, at the progressive conference Netroots Nation, the film was screened followed by an all-white panel discussion. I remember feeling frustrated at the time, both because of the lack of people of color on the panel and because I had planned on seeing the film before learning about a march led by activists from Hands Up United and the Organization for Black Struggle. There was a moment in which I felt like I had to choose between my Blackness and my abortion experience. I chose my Black womanhood and marched with local activists, who under the Black Lives Matter banner have centered intersectionality. My hope is that soon I won’t have to make these decisions in the fight for abortion rights; a fight where people of color are the backbone whether we’re featured prominently in films or not.

The film highlights the violent rhetoric anti-choice protesters use to demean those seeking abortions, but doesn’t dissect the deeply racist and abhorrent comments, often hurled at patients of color by older white protesters. These racist and sexist comments are what fuel much of the stigma that allows discriminatory laws, such as those banning so-called race- and sex-selective abortions, to flourish.

As I finished the documentary, I remembered a quote Chelsea, a white Christian woman who chose an abortion when her baby’s skull stopped developing above the eyes, said: “Knowing you’re not alone is the most important thing.”

In her case, her pastor supported her and her husband’s decision and prayed over them at the church. She seemed at peace with her decision to seek abortion because she had the support system she desired. Perhaps upon seeing the film, some will realize that all pregnancy decisions can be quite isolating and lonely, and we should show each other a bit more compassion when making them.

My hope is that the film reaches others who’ve had abortions and reminds them that they aren’t alone, whether they see themselves truly represented or not. That we who choose abortion are normal, loved, and supported. And that’s the main point of the film, isn’t it?

Abortion: Stories Women Tell is available in theaters in select cities and will be available on HBO in 2017.

News Human Rights

Mothers in Family Detention Launch Hunger Strike: ‘We Will Get Out Alive or Dead’

Tina Vasquez

The hunger strikers at the Berks County Residential Center in Pennsylvania are responding to recent comments made by Department of Homeland Security Secretary Jeh Johnson in which he said the average length of stay in family detention is 20 days. The women say they've been in detention with their children between 270 and 365 days.

On Monday, 22 mothers detained inside Pennsylvania’s Berks County Residential Center, one of the two remaining family detention centers in the country, launched a hunger strike in response to recent comments made by Department of Homeland Security (DHS) secretary Jeh Johnson in which he said the average length of stay in family detention is 20 days.

The average length of stay for the 22 hunger strikers has been between 270 and 365 days, they say.

Erika Almiron, director of the immigrant rights organization Juntos and a core member of the Shut Down Berks Coalition, informed the women detained inside Berks of Johnson’s recent comment via email, hoping they would want to release a statement that her organization could help amplify. Instead, the women decided to launch a hunger strike, with recent reports indicating the number of participants has risen to 26.

“When Johnson said [ICE] only detain[s] people for 20 days, he said that thinking that no one would care,” Almiron told Rewire. “Our goal has always been to make people aware of the inhumane nature of detention in general, but also that children are being locked up and moms are being held indefinitely.”

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By definition, “family detention” means the women in Berks are detained alongside their children, who range in age from 2 to 16 years old. In an open letter addressed to Johnson, the women share that their children have routinely expressed suicidal thoughts as a direct result of being imprisoned. The women allege that they are being threatened by psychologists and doctors in the detention center for making this information public, but are choosing to move forward with the hunger strike.

In part, the letter reads:

The teenagers say being here, life makes no sense, that they would like to break the window to jump out and end this nightmare, and on many occasions they ask us if we have the courage to escape. Other kids grab their IDs and tighten them around their necks and say that they are going to kill themselves if they don’t get out of here. The youngest kids (2 years old) cry at night for not being able to express what they feel … We are desperate and we have decided that: we will get out alive or dead. If it is necessary to sacrifice our lives so that our children can have freedom: We will do it!

An August 2015 report about the Berks center by Human Rights First, a human rights advocacy organization, seemed to confirm what women and children detained inside of the facility have been saying since the detention center’s inception in 2001: Detention is no place for families and being imprisoned is detrimental to the health and well-being of children.

According to the Human Rights First report, detained parents in Berks experience depression, which only exacerbates the trauma they experienced in their countries of origin, and their children exhibit symptoms of depression, anxiety, and increased aggression. Frequent room checks that take place at 15-minute intervals each night also result in children experiencing insomnia, fear, and anxiety, the report says.

Families detained inside of Berks have no real means to alleviate these symptoms because the facility does not provide adequate mental health care, according to the report. Human Rights First notes that Berks does not have Spanish-speaking mental health providers, “though the majority of families sent to family detention in the United States are Spanish-speaking and many have suffered high rates of trauma, physical and sexual violence, and exploitation.”

The organization also explains that only 23 of the total staff at Berks (or less than 40 percent) reportedly speak some conversational Spanish, “making it difficult for many staff members to effectively communicate with children and their parents.”

Berks has a history of human rights abuses. A 41-year-old former counselor at Berks was recently sentenced to between six and 23 months of jail time for the repeated sexual assault of a 19-year-old asylum-seeking mother. The young woman, along with her 3-year-old son, fled sexual domestic violence in her native Honduras. The assaults on the young mother at the detention center were witnessed by at least one of the children detained with her.

There have also been health-care issues at Berks, including the failure by the detention center to provide adequate services, according to Human Rights First.

The organization was able to collect some of the letters women detained at Berks wrote to Immigration and Customs Enforcement (ICE), along with ICE’s response to their concerns. One woman, detained at Berks for four months, told ICE that her 5-year-old daughter had diarrhea for three weeks and that the detention center’s doctor failed to provide her child with any medication or other care. The woman asked for “adequate medication” for her daughter and for the opportunity to have her asylum case handled outside of detention. ICE’s response: “Thank you! You may disolve [sic] your case at any time and return to your country. Please use the medical department [at Berks] in reference to health related issues.”

Using family detention as a way to handle migrants, especially those fleeing violence in Central America, has been called inhumane by many, including activists, advocates, mental health specialists, and religious leaders. But the prolonged detainment of women and children at Berks is in violation of ICE’s own standards.

In June of 2015, Johnson announced a series of reforms, including measures aimed at reducing the length of family detention stays for families who had passed a protection screening. But then earlier this month, Johnson defended family detention, saying, “The department has added flexibility consistent with the terms of the [Flores] settlement agreement in times of influx. And we’ve been, by the standard of 1997, at an influx for some time now. And so what we’ve been doing is ensuring the average length of stay at these facilities is 20 days or less. And we’re meeting that standard.”

But all of the 22 mothers on hunger strike at Berks have been in detention for months, according to the letter they sent Johnson.

There’s also the issue that in July, a federal appeals court ordered DHS to end family detention because it violates Flores v. Johnson, which determined that children arriving to the United States with their mothers should not be held in unlicensed detention centers. Soon after, family detention centers scrambled to get licensed as child-care facilities (a battle they’re losing in Texas), but the Pennsylvania Department of Human Services (PA DHS) licensed Berks to operate as a children’s delinquency center. In October 2015, PA DHS decided not to renew the license, which would have expired February 21, 2016, because the facility holds asylum-seeking families as opposed to only children, as the license permitted. Berks appealed the decision to not renew its license, and continues to operate until it receives a ruling on that appeal.

“Our argument from the start has been that we don’t think any of this is legal,” Almiron told Rewire in a phone interview Friday afternoon. “What is happening inside of Berks is illegal. I have no idea how they continue to operate. Right now, Berks does not have a license. It was revoked because the license they did have didn’t fit what they were doing. They also have prolonged detention. Women who are hunger striking have been there 360-something days, but then Jeh Johnson says it’s only 20 days. There is no accountability with DHS or ICE. There are numerous ways [DHS and ICE are] not accountable, but Berks is a prime example. There is no transparency and they can to change the law whenever they like.”

Neither DHS nor Berks responded to requests for comment from Rewire.

Advocates have expressed concerns that the women in Berks will be retaliated against by ICE and detention center employees because of their participation in the hunger strike. As Rewire reported, when women at Texas’ T. Don Hutto Residential Center, a former family detention center, launched a hunger strike in November 2015, participants alleged that ICE used solitary confinement and transferred hunger strikers to different facilities, moving them further from their family in the area and their legal counsel. ICE denied a hunger strike was even taking place.

In December 2015, men detained at the Etowah County Detention Center in Gadsden, Alabama, ended a 14-day hunger strike after a local judge authorized officials to force-feed one of the hunger strikers because of his “deteriorating health” due to dehydration. Advocates told Rewire force-feeding was being used as a form of retaliation.

Almiron said the hunger strikers at Berks have already been threatened by guards, who told the women that if they continue to hunger strike and they get too weak, their children will be taken away from them. The organizer said the letter the women wrote to Johnson shows their bravery, and their understanding that they are willing to take whatever risk necessary to help their children.

“Honestly, I think they’ve been retaliated against the moment they came to this country. The fact that they’re in detention is retaliation against their human survival,” Almiron said. “Retaliation happens in detention centers all the time, women are threatened with deportation for asking for medical care for their children. These women are incredibly strong. In my eyes, they’re heroes and they’re committed to this fight to end family detention, and so are we.”

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