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CAPRON, Va. — At 3 a.m. on a frigid night in January 2017, Susan Van Son, a nurse at the Deerfield Correctional Center in southeastern Virginia, left the prison’s medical department and walked through a series of eight locked doors. At a security checkpoint, she made sure that the normal guards — the ones known for breezily waving employees through the metal detectors — were on duty. Then, risking her livelihood, she headed to the prison’s parking lot.

A breast pump sat on the passenger seat of her gray Honda Accord. Ms. Van Son unscrewed the pump’s handle and shoved it into her bra.

Retracing her steps, she strolled back into the prison, past an indifferent guard, and hid the contraband on a shelf in the pharmacy. Over the next two nights, she sneaked in every piece of the pump, save for one. Ms. Van Son’s breasts weren’t big enough to conceal the funnel, so she enlisted a better-endowed colleague to shuttle it in for her.

Other women who worked at the prison took part in similar smuggling schemes. It was necessary, they said, because Deerfield, a state prison in the town of Capron, didn’t allow them to bring breast pumps into their work space, inside the security perimeter.

That situation, where producing breast milk at work is unfeasible, is common among American employers — even though failing to provide hourly workers with break time and a private place to pump is often a violation of federal law. There are health consequences for potentially millions of families.

There is consensus among doctors that breast-feeding tends to make both mothers and their children healthier. Controlling for socioeconomic factors, studies find that babies who consume breast milk are at lower risk of sudden infant death syndrome, infections, allergies, asthma, childhood diabetes and two types of leukemia. Mothers who breast-feed or pump are at lower risk for breast and ovarian cancers, diabetes and hypertension.

Yet the United States has one of the lowest breast-feeding rates of any industrialized nation. One reason is that, unlike every other developed country, the government doesn’t guarantee paid maternity leave.

Once back at work, many women find that their employers make it virtually impossible to pump. A 2013 survey of 550 women nationwide conducted by researchers at the University of Minnesota School of Public Health found that 60 percent did not have the time or a place to express milk on the job.

The Affordable Care Act tried to solve the problem. It required employers to provide breaks and a private place other than a bathroom for almost all hourly workers to pump. But the law didn’t apply to most women who earn annual salaries. Twenty-one states and the District of Columbia have passed legislation extending the benefits to white-collar workers, but according to a report released Dec. 31 by the University of California-Hastings College of the Law, there are still five million women of childbearing age without the right to pump at work.

“Discrimination against nursing mothers is the next frontier in pregnancy discrimination,” said Joan Williams, a professor at the school and a co-author of the report. “It’s not just unfair to women, it’s unfair to children.”

But when women have sued their employers, federal judges in Iowa and Rhode Island have suggested there was no effective way of punishing the companies in court. The A.C.A., also known as Obamacare, does not allow workers to sue for punitive damages or compensation for emotional and physical harm after being denied space or time to pump.

The results can be humiliating and physically painful. Women who choose to breast-feed babies who are less than 6 months old have to express milk every few hours. If they don’t, their breasts can become swollen and infected, and their milk may dry up.

Women who work in historically male-dominated professions often face the greatest obstacles to pumping at work. Five female pilots, for example, have filed employment discrimination complaints against Frontier Airlines with the Equal Employment Opportunity Commission. One, Randi Freyer, developed mastitis, an infection, twice after the airline’s human resources department ignored her 10 emails and a dozen phone calls asking to modify her flight schedule so she had enough time to pump. Her breasts became inflamed and she had a 104-degree fever. “It’s worse than swine flu,” Ms. Freyer said in an interview.

A Frontier spokeswoman, Allison Redmon, said that the airline has “made good-faith efforts” to find rooms for employees to pump while traveling and has offered reduced schedules for pilots who are breast-feeding. “While some workplaces allow for nursing mothers to express breast milk during a break from work activities, the duties of commercial airline pilots and flight attendants present unique circumstances,” she said.

Simone Teagle, a police officer who has filed a claim against the New York Police Department over employment discrimination, said her superiors at the 113th Precinct in Jamaica, Queens, refused to provide her a private room to pump, forcing her to use a moldy, trash-filled women’s locker room, surrounded by co-workers. She said in an interview that a colleague once told her, “You look like you’re pumping a cow. It’s just like udders.”

A spokesman for the Police Department, Phillip Walzak, said that all new police precincts would include private rooms for pumping and that the department would designate private rooms for expressing milk in existing buildings.

Nikki McNaulty, who has accused the Bay Area bus operator AC Transit of employment discrimination in a lawsuit, said she had to pump in a conference room. After she complained, she said the company opened a lactation room in a dusty closet next to an area where employees took cigarette breaks. Her older colleagues told her she had two options, Ms. McNaulty said: “Drive engorged or dry out.” (Robert Lyles, an AC Transit spokesman, said the company could not comment on the allegations to protect its employees’ identities.)

At Deerfield Correctional Center, Ms. Van Son decided that if the law didn’t protect her, she didn’t have to respect it.

Deerfield — a flat complex with a turquoise roof, 70 miles south of Richmond — is the nursing home of the Virginia Department of Corrections. It houses hundreds of male offenders, many of them geriatric, who need constant medical care.

Ms. Van Son, 39, joined the prison staff as a nurse in 2011 after working at a hospital for seven years. A big part of her job was treating inmates injured in cane fights, wheelchair tippings and other medical emergencies. Ms. Van Son, who grew up in a town nearby, found the job fascinating.

In 2015, after years of fertility treatments and miscarriages, Ms. Van Son got pregnant. Natalie was born in March 2016. “She was the little one that could,” Ms. Van Son said.

Natalie had trouble latching, and a hospital lactation consultant told Ms. Van Son that “women with infertility problems sometimes just can’t breast-feed.” (Infertility is associated with breast-feeding troubles, research shows.) Ms. Van Son, who has “Carpe Diem” tattooed on her arm, was determined to prove the consultant wrong. She started pumping on maternity leave. “Even if nothing else with my body works,” she told herself, “this is going to work.”

A month before she returned to Deerfield, Ms. Van Son got a call from a fellow nurse, Tishanta Olds. She wanted to give her a warning.

Ms. Olds had recently given birth to a boy named Braylon. He was her fourth child, and she intended to feed him breast milk like all the others. That meant pumping at work. But security rules at Deerfield generally prohibit anything that isn’t transparent from entering the facility, Ms. Olds said. Electric breast pumps are opaque and have plenty of nooks in which drugs or weapons could be stashed.

When Ms. Olds asked for a clean place to pump at the prison, she said, the administrators at Armor Correctional, a private contractor that manages medical services at the facility, told her that she could use her electric pump in the men’s restroom, which was just outside the prison’s security checkpoint.

Ms. Olds tried expressing in the bathroom, but she said she could barely produce milk because of the stench and the prison guards constantly rapping at the door. Stress can limit milk production by inhibiting the release of oxytocin, a hormone that causes the muscles around the glands to contract, said Alison Stuebe, the medical director of lactation services at UNC Health Care. “If a mom is trying to pump at work and someone is banging on the door,” Dr. Stuebe said, “milk will not flow as easily.”

Ms. Olds asked it she could bring in her manual pump, which was made mostly of transparent plastic, and use it in one of the many private offices inside the secure facility. She said she was rebuffed by the assistant warden, JoAnn Halsey-Harris.

Gregory Carter, a spokesman for the Virginia Department of Corrections, said the agency was “working to determine what communication may have occurred between the referenced health services employees” and Deerfield staff. Armor Correctional did not respond to multiple requests for comment.

Determined to find a way to pump, Ms. Olds resorted to expressing in the back seat of her Volkswagen minivan. Her co-workers and a roving patrolman kept driving by. She began limiting the number of treks she made to the parking lot, and soon her milk supply dwindled. She stopped being able to satisfy her son’s hunger when he woke up crying in the middle of the night. “It made me feel inadequate,” Ms. Olds said.

‘She Had No Idea’

Before her shift began one evening in May 2016, Ms. Olds stuffed her manual breast pump into her purse. When she got to the prison’s metal detectors, she emptied her pockets, took her shoes off and set the pump on top of her bag. It looked like a spray bottle you might bring to the beach, with purple accents and a funnel for a spout.

Ms. Olds held her breath. If she got caught, she feared, she might lose her job.

The guard, a woman, picked up the plastic device and inspected it. She seemed to not know what she was looking at. She handed the pump back to Ms. Olds.

“She had no idea it was something I was told not to bring in,” Ms. Olds said. “I walked through the gate and was like, yes!” She began pumping in private offices, using pieces of cardboard to cover up windows facing the hallway. Her co-workers knew what she was doing, but no one told Armor Correctional’s management.

“It was a pumping conspiracy,” said Ms. Olds, who no longer works at the prison.

Her story unnerved Ms. Van Son, who had already sent four emails to her bosses at Armor and the Department of Corrections requesting a clean place to pump when she returned and asking whether she could bring a manual pump into the facility. No one had responded. Ms. Van Son knew Ms. Olds had found a way to pump in secret, but there was no guarantee that she could pull off the same gambit.

“My understanding is our current pumping room is a men’s bathroom, so I was hoping to avoid that if possible,” Ms. Van Son wrote to Ms. Halsey-Harris, the assistant warden, in an email. “If anyone could let me know if this request was even under consideration would be helpful.”

Ms. Halsey-Harris finally offered to let her pump in a cinder block vestibule known as the overflow shakedown room, a space where guards searched babies’ diapers for contraband. It was next to a busy area where visitors and staff entered the prison.

“There is no electrical outlet in the room,” Ms. Van Son replied to her boss that night. “Was there ever a decision on the manual pump?”

Major Samuel Ridley, who ran security at the prison, responded that if Ms. Van Son wanted to use a manual pump, she could use the women’s restroom, which is outside the security checkpoint.

For eight months after Ms. Van Son returned to work, she parked her car in a spot facing away from the prison and toward some woods. Twice a night — around 11 p.m. and 3 a.m. — she pumped with the machine plugged into the lighter charger.

‘Tonight’s the Night’

In July 2016, another Deerfield nurse, LaQuita Dundlow, 32, returned to work after giving birth to her second daughter. Like Ms. Olds, Ms. Dundlow said managers told her to pump in the men’s restroom. She couldn’t produce milk in the fetid space. “The smell, it messed with me,” she said.

So Ms. Dundlow hung baby blankets from the windows of her Ford Expedition. Three times a day, she came out to express. Occasionally, she said, she had to explain the situation to a security guard who tapped on her window, wanting to know what was going on inside.

Sometimes, she didn’t have time to take the quarter-mile walk from one end of the prison to her S.U.V. On those occasions, painfully engorged, she would take a sterile cup normally used to collect urine samples, go to the bathroom and express milk by squeezing her breasts. Then she would hand the cup to her husband, who was also employed at the prison, as a correctional officer. He would take it to a cooler in their car.

After both women spent months expressing in the parking lot, Ms. Van Son decided she had had enough. Bone-tired and out of patience, she decided to smuggle her pump past the security checkpoint.

“Tonight’s the night,” she told herself. She brought in the manual pump’s pastel-yellow handle first. Before dawn, she got her co-worker to bring in the bulky spout. The next night, Ms. Van Son hid a number of smaller parts in her bra, and the night after that she maneuvered an adapter that let her use plastic bags instead of bottles under her breasts and walked it past the guards.

Her mission accomplished, she pumped for months in the relatively blissful privacy of the prison’s pharmacy and stored the milk in the refrigerator there. She had no trouble carting her milk out of the prison in the brown paper bags that inmates’ medication came in.

Ms. Van Son stopped working at the prison a few months later. She was never caught.

“I tried to do it the right way and I was met with zero response,” she said. “I was going to do what I had to do to continue pumping. They weren’t going to stand in my way. Period.”

This article by Natalie Kitroeff originally appeared in the New York Times on December 31st, 2018.