Being pregnant and giving birth are amongst the most memorable experiences in a woman’s life. The postpartum experience should be one of bonding between a mother and her child. However, this experience is much different for women who are in prison. Shackled until the moment they give birth—with only law enforcement and a doctor present, with no family or support person present—giving birth while incarcerated is one of the most inhumane experiences a woman can go through. The postpartum experience for incarcerated women is not one of mother to child bonding; the women are only given 24 to 48 hours with their newborn until their baby is taken away. And, they must also endure a period of lactating with no baby to breastfeed and heavy bleeding without access to proper menstrual products. Institutions don't always give mothers who are in the postpartum phase unrestricted access to hygiene products commonly used by mothers after they give birth—underwear, large sanitary napkins, and other items. Some institutions also don’t have appropriate waste disposal receptacles for said items.

The Prison Policy Initiative predicted that 55,000 women in the United States will be arrested while pregnant this year. In a single year, women in prison had 753 live births, 46 miscarriages, four stillbirths and 11 abortions. Of the 753 live births, there were three newborn deaths and no maternal deaths, and nearly a third of the live births were delivered via Cesarean sections. As laws are being passed to ban abortions and place those who have experienced miscarriages or stillbirths under suspicion for criminal acts, incarcerated women are dying and losing their babies inside of prison walls. The question at hand is: are the health rights of women being violated while pregnant in prison? 

“Many women give birth in prisons and jails every year, but many more give birth in hospitals because most prison medical units aren't equipped to handle deliveries,” said Wanda Bertram, Communications Strategist of the Prison Policy Initiative.

Though incarcerated women may give birth inside of hospital walls, these women are often shackled. Restraining a woman by the ankles, wrists, or waist during pregnancy and delivery is medically hazardous, emotionally traumatizing and unnecessary. According to the AMA Journal of Ethics, pregnant women who are shackled are at an increased risk of falling and sustaining injury to themselves and their fetuses. Most correctional facilities do not have on-site obstetric care. Because of this, pregnant women are typically transported to community-based providers for prenatal care and women in labor are transferred to medical facilities for delivery.

“Unfortunately, all too often, prisons do not provide proper pre- and post-natal care to pregnant women, and many prison systems don't even have written policies about how incarcerated pregnant women should be treated,” shares Bertram. “This neglect of pregnant women is likely often illegal, because people in prison have a constitutional right to be afforded proper medical care. That's what the Supreme Court decided in a 1976 case called Estelle v Gamble.”

Studies have shown that Black women are at a higher risk of pre-term birth because of economic and social impacts stemming from mass incarceration as well as population health and health inequities—including the persistence of racial disparities in pre-term birth and low birth weight for all Black babies—whether their mother is incarcerated or not. 

Across the country, Black women who are incarcerated and pregnant have had complications. A large percentage of Caucasian medical personnel believe that Black women have thicker skin or less sensitive nerve endings than their white counterparts; they are often perceived to have a high tolerance level. One can bear witness to same perception as when viewing the interaction of correctional officers and doctors with incarcerated Black women.

Recently in Florida, a Black woman named Erica Thompson who was seven months pregnant was arrested for violating her probation for a traffic citation. According to Thompson, she told jail staff that she was experiencing contractions, but was not given the proper attention or care. The baby, named Ava, later died after Thompson prematurely gave birth inside the Alachua County jail. Attorney Benjamin Crump is currently representing her as she sues the jail for “wrongful death” of her newborn child.

“Currently, we know that individuals in the care, custody, and control of the state do not know what to expect during their pregnancies, nor do they know their rights to care. Clear policies are needed to inform standards of care for pregnant people,” says Kimberly Haven, a formerly incarcerated individual and Executive Director of Reproductive Justice Inside (RJI). “With the medical and legal expertise of members of our coalition, and informed by the voices of the directly impacted, [our organization] has developed the first comprehensive Model Pregnancy Policy manual that covers specific subjects such as pregnancy testing, prenatal care, high risk pregnancy care, miscarriage management, abortion care access, labor and delivery, postpartum care, counseling and social services.”

Some facilities create systems so women can pump and store breast milk that can later be delivered to the infant, but most don’t allow this. RJI has launched a new initiative that will make it easy for institutions and an individual to pump, providing dedicated refrigerators to institutions.“Given everything we know about how important breast milk is for infants, the fact that this is not practice is for me unacceptable,” said Haven. “Individuals should be given the opportunity, supplies, and education to pump their breast milk according to their bodies schedule and to make it available to the caregiver of their infant.”

Through litigation and advocacy, Reproductive Justice Inside works to secure prenatal and postpartum healthcare rights in prisons and jails throughout the country, attempting to end the barbaric practice of women giving birth while shackled and protect the health of incarcerated women and their babies.

“Let’s make maternal health and healthy birth outcomes the priority," adds Haven.