Widespread abuse of pregnant inmates

Aug 1st, 2015 | By | Category: In The News, Women and Jails

At Texas Jail Project, we’ve always been disheartened by jail staff and officials who automatically assume that all complaints coming from a pregnant woman—or from any prisoner for that matter—are lies. As the authors of this interesting series state: “This notion—that prisoners, and especially women prisoners, are liars—permeates the dozens of cases we reviewed where prisoners suffered miscarriages, still-births, and even deaths.”
They take a clear-eyed look at this negative attitude that shapes so much of the treatment of women. The stories are moving, the research solid, and their reporting reveals previously unknown forms of abuse, such as the Chicago jail’s practice of forcing women who are close to term to have induced labor.
In the course of their five-month investigation, RH Reality Check authors spoke with TJP’s director several times, and we are pleased to see their references to Texas Jail Project’s efforts on behalf of Texas women.                          D. Claitor

 

Here are their articles:

Women, Incarcerated: Investigative Series Shows Systemic Abuses of Women in Prisons and Jails

by Sharona Coutts, VP, Investigations and Research, and Zoe Greenberg, Investigative Fellow, RH Reality Check 

Keeley Schenwar learned she was pregnant the same day she was arrested. That spring of 2013, she didn’t pee on a stick and study the results in the bathroom; there was no moment of elation. Instead, a nurse at the Cook County Jail in Chicago led Schenwar to a separate part of the facility, away from the other women. When Schenwar asked why, the nurse broke the news.

Schenwar, who was just 23 at the time, with warm brown eyes and glossy black hair, barely knew what to say. She had been struggling with a heroin addiction for more than five years. For the second time, she’d been caught stealing from a Walgreens—medicines, makeup, razors—anything she could sell to local corner stores to scramble together the $400 or $500 she needed to pay for her addiction.

She’d been in and out of county jails for years, but this time she was headed to state prison, and she was pregnant.

“I cried,” she told RH Reality Check. “I didn’t want to tell anyone I was in jail. I didn’t want to tell anyone I was pregnant.”

Over the course of her incarceration, Schenwar experienced two instances of human rights abuses linked to her pregnancy. She also joined the ranks of a growing group in the United States: women who are incarcerated.

While women make up a small share of all those detained in local, state, and federal prisons and jails, their numbers are growing. The number of women in state and federal prisons jumped by 646 percent between 1980 and 2012—from around 25,000 to more than 200,000—one-and-a-half times the speed at which the incarceration for men increased during the same period. In 2012, more than 200,000 women were held in prisons or jails, according to the Sentencing Project, a D.C.-based nonprofit group that has tracked these issues for more than 25 years.

The surge in incarceration disproportionately affects women of color, according to the Sentencing Project. In 2010, Black women were incarcerated at nearly three times the rate of white women (133 versus 47 per 100,000), while Hispanic women were incarcerated at 1.6 times the rate of white women.

Experts told RH Reality Check that, because corrections systems were created with men in mind, the facilities, practices, and policies remain ill-suited to the particular needs of women behind bars.

“There’s been a tremendous neglect of incarcerated women’s medical needs because, overall, they’re a small proportion of the incarcerated population: 9 percent of prisons, and 11 percent of jails,” said Dr. Carolyn Sufrin, assistant professor of gynecology and obstetrics at Johns Hopkins University.

In fact, federal, state, and local officials charged with overseeing corrections facilities collect virtually no consistent data about how women are treated in a system made for men, RH Reality Check found in a five-month investigation. This week, we will publish a collection of stories based on that reporting.

The federal Bureau of Justice Statistics, when asked for a national count of corrections facilities that house women, could only provide RH Reality Check with data that was a decade old. It showed that in 2005, there were a total of 1,821 state, federal, and privately run facilities, of which 187 facilities were authorized to hold only female inmates, and 276 were authorized to house both males and females.

The dearth of information points to the invisibility of, and lack of concern for, incarcerated women, experts told RH Reality Check, and makes it difficult to determine how often abuses occur.

In our Women, Incarcerated series, we have detailed some of the major themes that emerged from our review of hundreds of lawsuits, public records requests, and interviews with experts, public officials, and currently and formerly incarcerated women.

Our findings show the existence of deep, systemic problems in the way that the criminal justice system deals with women.

While some of the egregious abuses of incarcerated women are well known—shackling of pregnant women, and rampant sexual abuse in some facilities—RH Reality Check has identified a host of other problems that receive virtually no attention from mainstream media.

The problems include substandard conditions for pregnant prisoners; widespread failure to provide treatment or medical care for women with drug dependency, who comprise the overwhelming majority of women inmates; frequent denial of care for women experiencing miscarriage; forced induction of birth; and, ultimately, the termination of women’s parental rights because of rigid federal and state laws ostensibly intended to protect children. Articles later this week will delve deeper into these issues.

Like Schenwar, the majority of women behind bars are of reproductive age (the median age of incarcerated women in the United States is 34) and more than four-fifths suffer a serious substance abuse disorder, often related to prior trauma. The vast majority—84 percent—are behind bars for non-violent crimes, usually related to their drug dependency or social marginalization, according to a 2012 report for the Bureau of Justice Assistance that surveyed nearly 500 inmates in urban and rural jails in multiple states—one of the very few national studies of incarcerated women.

In other words, for women, incarceration frequently amounts to punishment for poverty, mental illness, addiction, and abuse, experts said.

“We’ve seen a skyrocket in the prison population overall, and women have increased faster than men,” Amy Fettig, senior staff counsel at the ACLU’s National Prison Project, told RH Reality Check. “That’s a direct result of the fact that so many low-level offenders end up in prison or jail where previously they may have been diverted into the community, or had access to mental health care.”

Schenwar’s story is representative of many women’s experience in incarceration. In this first part of our Women, Incarcerated series, we focus on Schenwar’s prison time—which involved a high-risk pregnancy, forced induced labor, and shackling—to illustrate the problems that thousands of women face behind bars.

Inadequate Food, Conditions for Pregnant Inmates

As with many women who are incarcerated, Schenwar’s crimes were related to her drug dependency.

Her criminal record shows arrests for thefts, trespassing, a DUI, and parole violations. Schenwar was living with her boyfriend at the time she was arrested, and he too was struggling with heroin.

Keeley Schenwar and her daughter.

After finding out that she was pregnant, Schenwar hoped to avoid going to prison. She reasoned that the judge would go light on her, due to her condition, and allow her to do community service. Instead, she was sentenced to a year at the Logan Correctional Center, a place where inmates wear blue and white, but pregnant prisoners wear pink. Apart from that, the facility makes few accommodations for pregnant prisoners.

Even something as basic as food posed problems. In her four months of pregnancy during incarceration, Schenwar recalls being hungry “all the time.”

“When you’re pregnant, you want to eat,” Schenwar told RH Reality Check. “It wasn’t like I expected my craving foods to be delivered to my cell,” she said, but she needed more than the extra apple or egg and carton of milk that were provided to pregnant inmates every day.

She also recalls that pregnant women, like all prisoners, had to walk through the open yard to access the mess hall, whether it was snowing or brutally hot.

The failure of corrections facilities to provide adequate food for pregnant prisoners emerged as a pattern across many states, our research found. Most recently, the Correctional Association of New York released a damning report, based on five years of interviews and legal research, revealing that New York’s state facilities were also failing to provide sufficient food and acceptable living conditions for pregnant inmates. And Diana Claitor, executive director of the Texas Jail Project, told us that the lack of plentiful, healthy food is a frequent problem for pregnant inmates in Texas as well.

Despite the inadequate food and conditions, Schenwar says she received good medical care while she was incarcerated. She recalls regular visits to an OB-GYN, and frequent ultrasounds. In fact, for many pregnant inmates, incarceration affords them the first opportunity to receive prenatal care. (For more on prenatal care for people in prisons and jails, read our Women, Incarcerated article on that issue.)

Schenwar is quick to explain that she wasn’t seeking sympathy. But she says that the guards reacted to her requests, and those of other pregnant prisoners, with demeaning comments.

“The officers judged us constantly,” she said. “If you would complain, they would say, ‘You put yourself here. You were doing drugs and pregnant. I don’t feel bad for you.’”

While at the prison, Schenwar maintained her use of methadone, as prescribed by her doctor. Abruptly ceasing opioid use is extremely dangerous during pregnancy, as it can lead to miscarriage. However, Schenwar’s methadone use created an unexpected complication: It disqualified her from transferring to the Decatur Facility, which has a nationally recognized prison nursery program that allows inmates to stay with their babies for the first year of their lives. So Schenwar knew that she would be separated from her daughter as soon as she gave birth.

“You’re Not Going to ‘Fall Out’ in My Yard”—Forced Induction of Labor in Illinois Prisons

What most upset Schenwar was the prison’s decision to induce her labor when she did not want to be induced—an act that constitutes a human rights violation, experts told RH Reality Check.

At 5 a.m. in early September, Schenwar was on her way to the mess hall with the other prisoners.

“Schenwar, fall back,” she recalls one of the guards saying, as she walked behind the other inmates heading to breakfast.

Two weeks earlier, the prison doctor had informed Schenwar that her delivery would be induced. Schenwar had tried to object, saying that her baby was not ready to be born, and that she wanted to wait until her labor started naturally. Inducing labor can be risky for mothers and their babies. Studies have shown induction to be associated with higher rates of cesarean sections, longer stays in the hospital, and greater blood loss for women giving birth.

But, Schenwar says, the doctor made it clear that she did not have a choice, and when she still objected, she says the doctor called prison guards.

“I had three, maybe four, guards surrounding me saying, ‘I don’t know where you think you are. This is our prison. … You’re not going to fall out in my yard or in the mess hall and cause some kind of chaos,’” she said. “I was scared and I was having a baby and I was in prison. I went back to my cell and I cried, because I knew I would be alone.”

So, when guards told Schenwar to fall back, she thought she was in trouble. But instead guards told her it was time to give birth.

“They explained that because I was being induced that day, which I did not know, they said I could not eat,” she recalled in an interview with RH Reality Check.

When RH Reality Check first sought comment from the Illinois Department of Corrections in relation to Schenwar’s allegation of forced induction, Tom Shaer, who was then the director of communications, did not reply to our specific questions, but wrote in an email, “Inmate anecdotes are often either wholly inaccurate or grossly exaggerated. Not always, but often.”

This notion—that prisoners, and especially women prisoners, are liars—permeates the dozens of cases we reviewed where prisoners suffered miscarriages, still-births, and even deaths. (These cases are detailed in future articles in the Women, Incarcerated series.) While there are undoubtedly instances of false allegations, time and again prisoner’s allegations have been borne out in litigation and federal investigations.

Shaer has since left the department, and his replacement, Nicole Wilson, told us in an email that induced births are an “option” for prisoners:

Pregnant inmates consult with their physician on nutrition and birthing options to make decisions that best meet each individuals’ needs.  Offenders whose pregnancies are deemed high risk are encouraged to elect induction so they can be transferred to Bloomington where the hospital can meet their specific needs for a safe delivery. [sic]

In a later email, Wilson changed her stance, saying instead that Schenwar’s methadone treatment meant she was deemed to be a high-risk patient, and that the “decision to induce would have been made by the OB/GYN and would have been made for the benefit of both mother and baby.”

Wilson said that Schenwar had not signed a “refusal of treatment,” which, Wilson said, was offered to prisoners who did not want their births induced.

However, RH Reality Check was able to speak with Kendra Smith, who was also pregnant while incarcerated at Logan. Smith recounted that guards also tried to force her to induce her delivery, but she resisted, involving the warden and the prison’s family services officer. Smith said she recalled similar pressure being put on a third pregnant prisoner incarcerated at Logan.

According to Gail Smith, founder of Chicago Legal Advocacy for Incarcerated Mothers (CLAIM), the Illinois Department of Corrections seems to have initiated a practice of requiring incarcerated women to have induced labor.

“Every woman that I have spoken with after release who has given birth inside in the past year has been induced,” Smith told RH Reality Check.

In a close examination of cases involving the shackling of incarcerated pregnant womenRH Reality Check found hints that induction may be a standard practice at corrections facilities in other states as well.

Farah Diaz-Tello, a staff attorney at National Advocates for Pregnant Women, told RH Reality Check that forced induced labor constitute clear human rights violations of pregnant prisoners.

“Any forced induced labor is a human rights violation, even if the pregnant person isn’t incarcerated, because people have a fundamental human right to bodily integrity and to refuse unwanted medical intervention,” she said.

Diaz-Tello said that the stories from Illinois are consistent with what her organization has been hearing from other states. For instance, she said that she had worked with a Texas woman who was forced to undergo a cesarean section while incarcerated, because the doctor was only scheduled to be at the facility for one day.

“The fact that it is happening in prison, where people are even more deprived of power than in a medical institution—that makes it even worse,” Diaz-Tello said.

“All Female Inmates Are an Escape Threat”

In addition to the forced induction, Schenwar described a lonely and traumatic labor, during which she was shackled to the hospital bed.

“There’s a guard on the couch reading magazines as your whole life is torn apart,” she said. “They don’t let any family come. After you have the baby, they shackle you to the bed at their discretion. You hold your baby and then they take her and you go back to prison.”

At the time, Illinois still had an official policy that allowed prisoners to be shackled as soon as they were “no longer pregnant,” said Wilson, the corrections department’s spokesperson. That policy was changed in November 2013 so that “inmates who’d recently delivered a child could also go unrestrained for a pre-determined period of time.”

Despite media attention to the issue, shackling of pregnant inmates remains common, with the majority of states still permitting the barbaric practice. Even in states where shackling is theoretically banned, local activists and incarcerated women say legal loopholes mean that many pregnant inmates still find themselves bound in metal chains during transportation to the hospital, and after birth.

For instance, the 2009 law that barred the use of restraints on pregnant inmates in Texas contains an exception for women deemed to be a flight risk, but doesn’t define what exactly that means.

At a 2012 meeting of the Texas Commission on Jail Standards, a commissioner “spoke publicly about his belief that all female inmates are an escape threat and that therefore the exception to the bar on use of restraints would always apply,” according to a letter drafted to the commission’s chairwoman by then-state Sen. Wendy Davis. (RH Reality Check obtained a draft of the email.)

In other words, even women in active labor and birth should be seen as escape threats.

Diana Claitor of the Texas Jails Project told RH Reality Check that better monitoring of each incident of shackling is required to ensure the law is being properly enforced.

The emotional impact of shackling, including post-partum depression, can be profound, Claitor said.

“You suddenly feel yourself in the position of being rolled around like a piece of garbage chained to a table, and the other women there [at the hospital] shrink away in horror that you’re some kind of crazed animal that has to be shackled.”

The experience of being pregnant in prison, forcibly induced, and ultimately shackled during delivery certainly left Schenwar with a sense of shame.

Her journal from October of that year—a month after her daughter was born—shows the young woman’s regret at the situation she was in.

“You held my hand just a few hours after I gave birth, wrapped your fingers tightly around my thumb and I knew as you focused your eyes on mine without turning away that I’d love you in every way, each day for the rest of eternity,” Schenwar wrote. “I tried not to sleep, knowing we only had a short time together. Shackles tied my ankles to the hospital bed. You’re the daughter of a prisoner, twice convicted felon, all result of a heroin conviction.”

“I’ll spend the rest of my life making this up to you,” she wrote.

Schenwar was released from prison in 2014, and is now sober. She is successfully caring for her daughter, as well as working with other mothers who have recently been released from prison or jail.

“Just because you’ve been to prison three or five times, doesn’t mean you have to go back,” she said. “People get past it, and they have careers and they have lives and they have families.”

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2nd article in the RH Reality Check series

Deprived of Care, Incarerated Women Suffer Miscarriages, Stillbirths, Ectopic Pregnancies

On the morning of September 11, 2011, Krystal Moore thought she was dying. Sharp pain stabbed at her stomach, so much so that she curled up into a fetal position on her bed. She didn’t know what was happening. Though she was pregnant, she was only six months along, not nearly ready to give birth.

She couldn’t simply call the family doctor. She was an inmate, serving time at the Jerome Combs Detention Center in Kankakee, Illinois, for smoking marijuana while on probation. But in the early hours of that Sunday morning, her pain was escalating quickly.

“I woke up hurting,” she told RH Reality Check. “I tried to get in the shower, and I couldn’t.”

She asked to go the hospital. She had spoken to some other inmates, and she began to think she was having contractions. The pressure on her stomach was getting worse.

Krystal Moore
Krystal Moore

A guard telephoned the jail nurse, Ivetta Charee Sangster, to tell her that Moore was having stomach pains. Sangster was on duty that Sunday, though she wasn’t actually at the detention center, which, like many jails, doesn’t have full-time medical staff available, despite housing a sick and vulnerable population. Even if Sangster had been there, she was only a licensed practical nurse, a role that generally involves providing only very basic medical care, like taking a patient’s blood pressure or changing a bandage. She would not have been able to give Moore the urgent care she required for what had become a serious infection of her womb.

Meredith Manning—Tennessee, 2004

Twenty-three-year-old Manning began to miscarry in a Corrections Corporation of America facility. She bled for two days before she was taken to the hospital, where she gave birth to a baby that died shortly after. This case settled for $250,000.

Sangster sounded irritated on the phone, according to the transcript of the call that later appeared in a lawsuit filed by Moore.

“Krystal Moore, she’s—in my opinion, a lot of times she’s full of shit,” Sangster told the guard. “You can go eyeball her and call me back if you want. She’s probably full of shit. But you can let her know that she can see the doctor tomorrow if she’d like.”

Our attempts to contact Sangster were unsuccessful.

By 2:30 that afternoon—at least eight hours since she first alerted guards to her pain—Moore began bleeding while sitting on a toilet. Screaming out of pain and fear, she was finally taken to a local hospital, but not before being forced to walk down the stairs from her cell to the ambulance, according to a court opinion from December 2013.

Moore was fully dilated by the time she arrived at the hospital, where she says she was shackled to the hospital bed. Then, around 5:20 p.m., she gave birth to twins. Had she been taken to hospital earlier, there was a possibility that the babies could have survived, according to an expert who provided evidence for the lawsuit. Instead, one baby lived for only a day; the other survived for 16 days.

“I remember it clear as yesterday. I think about my twins every day and every night. How would they be?” Moore said.

Shela Williams—Texas, 2014

Williams was 18 weeks pregnant when she entered a Texas jail. She had a high-risk pregnancy but did not receive adequate obstetric care while incarcerated. When a doctor finally did examine Williams, he told her that her child “wasn’t going to make it.” She went to a nearby hospital, where she delivered her stillborn; she was not allowed to attend his funeral.

Moore’s case settled last year for $620,000, according to her lawyer. But in a five-month investigation, RH Reality Check found that her story is not unique. After reviewing more than 200 legal cases, as well as the Human Rights Defense Center’s database of “Deaths in [Corrections Corporation of America] Custody,” RH Reality Check identified at least a dozen instances of women experiencing miscarriages, stillbirths, and ectopic pregnancies in jails and prisons across the country, in circumstances that show a shocking lack of medical care from the professionals charged with providing it.

This number is most likely a dramatic under-representation of the problem. In addition to the shame and grief that many women feel at the loss of a pregnancy, incarcerated women often fear complaining about their miscarriages behind bars because they do not want to compromise ongoing cases or face retribution from jail or prison staff, according to community activists and researchers who work closely with incarcerated women.

Bethany Cajúne—Montana, 2009

Although Cajúne was pregnant, and both her doctor and drug treatment counselor had prescribed her continued use of Suboxone (a medication that suppresses withdrawal symptoms) in jail, the doctors and nurses there would not give her the prescription. She went through immediate withdrawal, losing ten pounds in less than two weeks. She feared she would lose her baby. Finally, after nine days, a public defender intervened and she received the treatment. This case settled in 2011.

To be sure, low-quality prenatal care is a symptom of the larger problem of poor medical care in corrections facilities in the United States, as has been documented in California, Arizona, and Florida and through thousands of lawsuits against prisons and the private contractors that sometimes run them.

Prison health services were so bad in the 1960s and 1970s that in 1976 the U.S. Supreme Court ruled that failure to provide appropriate medical care to prisoners amounted to a violation of the U.S. Constitution’s prohibition on cruel and unusual punishment. As a result, incarcerated people are the only group in the United States with a constitutional right to medical care.

But with the swelling number of women behind bars, the failure to provide prenatal care is becoming a major concern.

The cases we examined were strikingly similar to Moore’s: pregnant women waiting weeks to see doctors, nurses instructing women to take antibiotics for labor pains, and inmates miscarrying in toilets or on cell floors. Sangster’s comments would have fit into any of the cases that we read. Again and again, we saw women inmates in need of prenatal care ignored, silenced, and disbelieved.

Gretchen Harbison—Indiana, 2010

Harbison could not feel her fetus move for three days. She was eventually transferred to a hospital, where she delivered a stillborn. Harbison alleges that the prison doctor failed to treat her pregnancy with any urgency, despite knowing that she had four complicated deliveries in her past.

“I feel like that jail done killed my kids,” said Moore. “I’ve been feeling that since the day I gave birth.”

Prenatal Care Is Crucial—and Missing—Behind Bars

At the end of 2012, there were more than 200,000 women in prisons and jails, comprising 9 percent of the nation’s incarcerated population. Based on current trends, the number of women behind bars is expected to grow.

The median age of women in state and federal prison is 34, and the majority of incarcerated women are of reproductive age, according to a study by the Bureau of Justice Statistics. Many women in prison have high-risk pregnancies, complicated by problems including poor nutrition, domestic violence, mental illness, and drug and alcohol abuse.

Poor prenatal care in corrections facilities is a grave concern, especially since those facilities have become one of the major providers of health care for marginalized communities, according to Brad Brockmann, executive director of the Center for Prisoner Health and Human Rights at the Miriam Hospital in Providence, Rhode Island, an affiliate of Brown University.

“For many of the individuals who come into the system, their first physical as adults is when they enter prison or jail, because prior to January 2014 Medicaid was not available to many, with only safety-net programs available in the community,” Brockmann said.

Tiffany Pollitt—Pennsylvania, 2010

An inmate hit Pollitt in the stomach; she repeatedly reported the incident, but no doctors or nurses took her seriously. She continued to say she was in serious pain. Corrections officers told Pollitt to “grow up,” asked her what she expected them to do, and told her “better luck with next shift.” Then Pollitt bled all over the floor of her cell. Finally, she was transferred to a nearby hospital, where she delivered a stillborn baby.

The quality of prenatal care provided by prisons or jails varies wildly between and within states, with most facilities providing very poor care, according to a 2010 review of state policies by the National Women’s Law Center and the Rebecca Project.

The survey graded all 50 states on their treatment of mothers behind bars. Thirty-eight states received a failing grade in the category of prenatal care. The researchers reported that 43 states do not require medical exams as part of prenatal care for women in confinement. Forty-eight states don’t offer pregnant women screening for HIV.

And this review only examined what states said their policies were; there were no on-site inspections. “Paper reviews are of limited value in a corrections context,” said Amy Fettig, senior staff counsel for the ACLU’s National Prison Project.

The reality is, no one is looking closely at what is happening in practice on a national scale when it comes to the care of incarcerated pregnant people, experts told RH Reality Check.

DeShawn Balka—Georgia, 2012

Balka was about 24 weeks pregnant when she entered the jail. She experienced nausea, cramping, bleeding, and vaginal discharge, which she reported to jail guards. No one examined her. Then she began experiencing extreme pain and cramping. She sat on the toilet in her cell and pressed the emergency call button; no one responded. Ultimately she gave birth into the toilet. Her baby was pronounced dead at the hospital a few hours later.

For instance, there are no clear answers to some fundamental questions, such as how many women are pregnant during incarceration each year in the United States. A 2011 report by the American Congress of Obstetricians and Gynecologists put the number at 6 to 10 percent of incarcerated women, while a 2008 study by the Bureau of Justice Statistics estimated that between 4 and 5 percent of women admitted to state and federal prisons that year were pregnant.

There are also no comprehensive data for the number of pregnant women in jails, which typically house people prior to conviction or sentencing, or sometimes for immigration matters or for shorter sentences.

And there is simply no national picture of pregnancy outcomes—miscarriages, abortions, stillbirths, and live births—for incarcerated women, experts told us. The most recent data we could find came from 1998, when the Government Accountability Office reported that there were about 1,400 births in prisons that year.

Only two states require collection of data on pregnancy outcomes for incarcerated women—Delaware and Oregon, according to the Rebecca Project report. Delaware did not respond to our request for records, but Oregon provided information recorded about the only state prison that houses women, Coffee Creek Correctional Facility, between July 2012 and November 2014.

Countess Clemons—Tennessee, 2011

Eighteen-year-old Clemons started miscarrying in a prison in Tennessee. After leaving her in a cell for almost three hours, guards took Clemons to a hospital, where she delivered a baby who died soon after he was born. This case settled for $690,000 in 2014. The Corrections Corporation of America was also issued a sanction for destroying video evidence of the delay in treatment.

That data say there were 51 pregnant prisoners during that time, but give little insight into the type of care provided to these women, apart from the indication that some women were assessed to see whether their pregnancies were high-risk. Of these pregnancies, 37 resulted in births while incarcerated. Eleven women had c-sections, and three women’s labor was induced. There was one miscarriage and one abortion, and an additional four women returned a negative pregnancy test after earlier indicating that they were pregnant. At the time the data were provided, seven of the pregnant prisoners remained incarcerated, while at least two had been released prior to giving birth.

The data do not cover jails, which are governed separately by each of Oregon’s 36 different counties, according to Wendy Smith, a spokesperson with the state’s Health Services Administration.

Another data set comes from Texas, which tracks how many pregnant inmates are booked into county jails—last month, there were 382. A draft bill would require Texas jails to collect data on prenatal care, as well as the use of solitary confinement or restraints on pregnant inmates.

It’s therefore reasonable to imagine that thousands of women around the country are experiencing a wide range of pregnancy outcomes while in jails and prisons, with no oversight mechanism to track the care they receive.

But most states do not collect data on incarcerated pregnant woman, and there is no national set of data about prenatal care or pregnancy outcomes for incarcerated people.

Experts say this lack of national and local data is no coincidence.

“It’s one of the many areas where the lack of data points to the invisibility of incarcerated people, and specifically incarcerated women,” Tamar Kraft-Stolar, director of the Correctional Association of New York’s Women in Prison Project told RH Reality Check.

Nicole Guerrero—Texas, 2012

Guerrero began to experience pain, bleeding, and cramping, and alerted medical staff. Guerrero was put in solitary confinement, where she went into labor by herself on the floor of her cell. The umbilical cord was wrapped around the baby’s neck, and the baby was later pronounced dead. Guerrero was made to stay in solitary confinement while the infant was taken away.

Despite the lack of comprehensive national data, our investigation found that, with few exceptions, prenatal care in prisons and jails across the country is shockingly inadequate.

In addition to insufficient food and inappropriate living conditions for pregnant people, our research underlines what health experts and women’s rights advocates have said for years: Prisons and jails are among the most dangerous places to be while pregnant.

“A Near-Death Sentence” for Writing Bad Checks

For Laila Batts, poor prenatal care behind bars came close to ending her life.

In early January 2007, Batts was detained for ten days at the Elmwood Complex Women’s Facility, in Santa Clara, California, after writing a bad check to pay some bills.

Batts was in her first trimester of pregnancy the day she entered jail, and that night she began to experience spotting and severe cramping. For the next ten days, Batts complained to nurses about her pain.

By Monday, January 8, Batts told jail staff that she wanted to go to the hospital, because her condition was getting worse. Her request went unfulfilled. On January 9, a nurse saw Batts bleeding on the floor of her cell and complaining that her symptoms were getting dramatically worse, but the nurse did not send for emergency help. When Batts finally saw a doctor the next day, January 10, the doctor noted that she was suffering from an abnormal pregnancy, was at risk of an ectopic pregnancy, and required care, according to records produced in the lawsuit. But instead of providing that care, the doctor sent Batts back to her cell. Batts thought she was suffering a painful miscarriage.

“What started out as a request for modified community service in light of her pregnancy turned into a near-death sentence, bringing Ms. Batts within hours—perhaps minutes—of losing her life,” court filings said.

The day after she was released from jail, Batts woke in excruciating pain and was rushed by ambulance to the emergency room, where, she told RH Reality Check, surgeons removed her ectopic pregnancy, as well as a fallopian tube. Ectopic pregnancies are extremely dangerous, and require immediate attention to avoid potential death of the pregnant person.

Latish Durden—Georgia, 2012

Durden had a high-risk pregnancy and had surgery on her cervix while at the jail. She required constant monitoring. She began experiencing cramping, bleeding, and discharge, but she was not treated. Eventually she was taken to the hospital, where she delivered a stillborn baby.

Batts settled her case, but declined to say how much she was awarded.

What is unusual in her lawsuit is that the complaint focused on the physical and mental pain that she endured. The vast majority of cases we examined focused on the loss of the fetus, not on the suffering of the pregnant woman, because the law tends to focus more on permanent losses—the death of a “viable” fetus—than on temporary pain experienced by the woman. For this reason, we found more cases involving stillbirths (a loss of pregnancy after 20 weeks’ gestation) than miscarriages, which occur prior to 20 weeks.

And because many miscarriages are difficult, if not impossible, to prevent, it is extremely difficult for women who have suffered them while incarcerated to prove any fault on the part of the authorities. This makes mistreatment of miscarriage tough to detect, with even grassroots community advocates struggling to identify where it has occurred.

Diana Claitor, executive director of the Texas Jail Project, says she usually doesn’t hear about a miscarriage from the woman who suffered it.

“Mostly we get a grandmother calling,” Claitor told RH Reality Check. “The first call I got was an elderly Hispanic woman asking, ‘Is there any way we can get the body of our dead grandchild and put it in the family plot?’”

“Sanctity of Life in Texas Looks Like This”

Many of the cases of miscarriage or stillbirth we found occurred in states that have recently introduced laws that claim to protect fetuses, even at the expense of the woman bearing them.

For example, miscarriage in Texas is treated differently if it does not happen behind bars.

Last year, Dallas police swarmed a high school after a fetus was found in a toilet. They launched an investigation, reviewing video footage and interviewing teachers to find the “suspect.”

But two years earlier, no such attention was given to the case of Autumn Miller, who in the summer of 2012 miscarried into a toilet while serving a one-year sentence at the Dawson State Jail, also in Dallas.

Miller, who in pictures has light brown hair and a warm smile full of straight, white teeth, was already the mother of three children. She had entered the jail in February, after violating probation on a drug possession charge, not realizing she was pregnant.

Throughout May and June, Miller complained of cramps and fatigue, and requested a pregnancy test and Pap smear. She never received either from the jail.

On the night of June 14, Miller began bleeding, and experiencing pain so severe that she couldn’t walk, according to a lawsuit filed against the Corrections Corporation of America. Miller told guards she felt like she was having a baby.

Guards brought her to a medical unit where a nurse waited on a telescreen (like the jail in Kankakee, there was no full-time medical staff on-site). But Miller could barely explain what was happening before a guard turned off the screen, handed her a menstrual pad, and locked her in a segregated cell.

Screaming, Miller gave birth into a toilet. She was then handcuffed, shackled, and transported to the hospital separately from her newborn. Miller named the infant Gracie Robinson; she barely weighed a pound. Gracie died four days later.

“They had her locked in a cell down in the medical area, all by herself, when she was laboring, unbeknownst to her,” Miller’s lawyer, Paula Sweeney, told RH Reality Check. “Then they couldn’t find the key to get the door open when it became apparent what was going on. Then, as she’s laying there on the cot, with blood everywhere, in terror and agony, the male guards start taking pictures with their cellphones.”

Miller’s case was settled in January 2014, and the facility that housed her has since been shut down because of budget cuts as well as increased scrutiny about what was going on behind the prison walls.

“Texas runs around bragging about the sanctity of human life, until you get a chance to see it in real life,” Miller’s lawyer told us. “Sanctity of life in Texas looks like this.”

No Role for Prosecutors in Prenatal Care

Experts have a wide range of recommendations to improve pregnancy care in prisons and jails, including laws that require tracking and reporting pregnancy outcomes, the elimination of solitary confinement for pregnant prisoners, and an increase in inmates’ access to OB-GYNs.

In Texas, a coalition of groups, including the Texas Jail Project and the ACLU of Texas, is pushing for a bill that would mandate tracking of prenatal care and treatment of pregnant prisoners in the state’s approximately 250 county jails.

The bill has caused unease among some women’s advocates, however, because of fears that gathering data on pregnant inmates could lead to more punitive action by the state.

“There is legitimate fear from legislators that are interested in doing this kind of tracking that those numbers will be used to punish pregnant women for drug use,” Mathew Simpson, policy strategist at the ACLU of Texas, told RH Reality Check. “When it comes down to it, if we don’t know the birth outcomes, we can’t make an assessment of where the gaps are.”

The broader picture, however, is that jails and prisons are generally the wrong place to house pregnant women, given that they frequently lack the appropriate staff or facilities, and are fundamentally geared toward punishment, not care.

“Judges and prosecutors think that it’s a good idea to empower jail guards—whose job is to punish criminals—to give prenatal care,” Lynn Paltrow, the executive director of National Advocates for Pregnant Women, told RH Reality Check. “There has to be a very clear consensus that there is no role for prosecutors to be involved in prenatal care.”

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To schedule an interview with Sharona Coutts and Zoe Greenberg contact director of communications Rachel Perrone at rachel@rhrealitycheck.org.

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One Comment to “Widespread abuse of pregnant inmates”

  1. Cathy Cervera says:

    Heaven is not blind to the evil the jails are committing and the jail employees will stand before God to answer for their evil crimes aswell!!!! Shame on lawmakers that are weak and careless to make positive changes

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