Imprisoned and Pregnant

by Marianella Herrera

Image: UC Press


What You Can Do

  1. Get involved with the Minnesota Doula Project. You can find donation means and learn more about their mission here: https://www.mnprisondoulaproject.org/.
  2. Support Motherhood Beyond Bars by reading the stories of incarcerated parents or donating here: https://www.motherhoodbeyond.org/.

It is no secret that the growing incarceration rate in the United States paints a staggeringly bleak picture for the future of criminal justice reform. With one out of every five incarcerated individuals serving their sentences in the United States, one cannot help but balk at the sheer immensity of the American carceral state. [1] The profoundness of such a figure becomes even more radical when one considers how incarceration rates are drastically rising for specific segments of the population, namely women. Though imprisonment numbers are generally trending upward, the female incarcerated population has witnessed an increase of more than 700% between the years of 1980 and 2019. [2] Additionally, “more than 60% of women in state prisons have a child under the age of eighteen,” according to the Sentencing Project. [2] This cross-cutting issue, incarcerated motherhood, is characterized by some of the most demeaning and humiliating processes within the criminal justice system, especially for individuals who endure their pregnancy behind bars.

Statistics on incarcerated pregnant individuals are surprisingly far and few between, much to the dismay of prison and public health officials. The most recent systematic inquiry into the subject was conducted in 2004 by the Bureau of Justice Statistics; the report estimated that around “4% of state and 3% of federal inmates… were pregnant at the time of admission.” [3] However, because female incarceration rates have risen since then, it is reasonable to assume that such findings underestimate the pregnancy rate within the justice system. The American Journal of Public Health attempted to remedy this situation using data from 2016 and 2017. Their report sampled twenty-two state prisons and found that “up to 80% of incarcerated women reported that they had been sexually active with men in the three months before their incarceration, and only 21% to 28% were using a reliable method of contraception.” [4] Such scant findings allow one to deduce that pregnancies within prisons is intensifying in prevalence, yet it is glaringly obvious that existing research on the matter is woefully incomplete to address the issue. 

The lack of national data is compounded by ambiguities surrounding the resources available to pregnant incarcerated individuals. “Despite a constitutional mandate that prisons and all institutions of incarceration provide health care to people inside, there is no mandatory oversight that these institutions must follow,” says Dr. Carolyn Sufrin, an OB-GYN at Johns Hopkins School of Medicine, in an interview conducted by NPR. [5] Those who find themselves pregnant behind bars scarcely have the full depth of information regarding their options on the matter. “A survey of jail medical facilities found that, upon confirmation of pregnancy, fewer than a third informed women of options such as adoption or termination.” [6] Transportation to abortion services or facilitating the necessary steps in order to receive the desired medical treatment was likewise scarce and underemployed. 

Many women experience adverse health consequences as a result of labor, with the United States having one of the worst maternal mortality rates among other similarly-situated countries. The situation thus becomes even more dire when one considers the environment pregnant individuals are subjected to while incarcerated. The impact of prison conditions on perinatal welfare is incredibly severe; “labor and delivery may be additionally anxiety-provoking, because of lack of control over birthing experience, limited health education, absence of support from family or friends, separation following delivery, and concern about infant placement.” [6] Such circumstances directly translate into maternal and fetal complications, including preterm delivery, maternal depression, and low birth weights. [6] Moreover, the lackluster meals provided in prison systems deprive individuals of the necessary nutrients and supplements necessary to sustain a healthy pregnancy, leaving the child susceptible to birth defects.

These practices alone are enough to produce detrimental effects on incarcerated pregnant individuals, yet the use of shackles and restraints on those in labor provide substantial insight on just how difficult and degrading the experience is. Institutions justify the use of restraints by arguing that they prevent the individual in question from fleeing, yet “most incarcerated women are not violent offenders… and there are no known escape attempts among inmates who were not restrained during childbirth.” [6] A 2019 survey found that despite these facts, about 83% of perinatal nurses reported their patients being shackled sometimes to all of the time. [7] In a system where dehumanization is the norm, it is a distressing reality that adherence to such humiliation tactics is simply cited as protocol. Not only is shackling unnecessary, but it can also aggravate the circumstances of the pregnancy. According to the College of Obstetricians and Gynecologists, “shackling increases the risk of falls and decreases the individual’s ability to protect oneself and the fetus if a fall occurs” and “a number of tests and examinations to evaluate for serious conditions will be impaired while an individual is shackled.” [8] Though the use of restraints has been heavily criticized, twelve states continue to stay silent on its prohibition. [9]

Politically, it has become moderately unpopular to advocate for an easing of restrictions on incarcerated individuals. Yet, Minnesota recently passed the Healthy Start Act, allowing “mothers to be with or in contact with their newborns for up to a year” and offering the possibility of conditional release. [10] The piece of legislation seeks to uphold the integrity of parent-child bonds, for when disturbed, studies have shown that “these children often develop severe problems related to disorganized attachment patterns and other deviant behaviors.” [11] Minnesota is likewise unique in that its corrections department partners with the Minnesota Prison Doula Project, which supplies incarcerated parents with pregnancy and parenting support, as well as skilled doulas during labor and other educational resources. Yet, in states that lack such progressive policy, newborn children are often placed into foster care, a controversial move given the fierce scrutiny the system has come under, or into prison nurseries that are underfunded and unequipped to meaningfully care for newborn children. 

Minnesota, therefore, seems to be at the forefront of a long journey into advocating for the rights of incarcerated parents. While organizations like the Minnesota Doula Project are making great strides in shedding light on the issue, widespread change must be implemented in order to restore the humanity that should be rightfully afforded to pregnant incarcerated individuals. The distasteful practices upheld in prison environments directly translate to adverse health effects on pregnant individuals and their children, making the matter not only relevant to criminal justice, but also to public health and the safety of families. The adoption of federal policies to rectify such treatment, as well as the continued support for advocacy groups, is therefore vital to ensuring pregnant incarcerated individuals enjoy the same liberty in parenthood as those outside of the prison system.


References

[1] https://www.prisonpolicy.org/blog/2020/01/16/percent-incarcerated/

[2] https://www.sentencingproject.org/publications/incarcerated-women-and-girls/

[3] https://bjs.ojp.gov/content/pub/pdf/mpp.pdf

[4] https://ajph.aphapublications.org/doi/10.2105/AJPH.2019.305006

[5] https://www.npr.org/sections/health-shots/2019/03/21/705587775/pregnant-behind-bars-what-we-do-and-dont-know-about-pregnancy-and-incarceration

[6] http://jaapl.org/content/early/2020/05/13/JAAPL.003924-20#ref-14

[7] https://www.jognn.org/article/S0884-2175(18)30366-6/fulltext 

[8] https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/07/reproductive-health-care-for-incarcerated-pregnant-postpartum-and-nonpregnant-individuals#:~:text=Shackling%20increases%20the%20risk%20of,while%20an%20individual%20is%20shackled.

[9] https://www.prisonpolicy.org/blog/2019/12/05/pregnancy/

[10] https://www.nbcnews.com/news/nbcblk/one-state-trying-make-pregnancy-prison-slightly-bearable-rcna1578

[11] https://www.cwla.org/babies-behind-bars/