Today more than 200,000 women live in correctional facilities nationwide, and these numbers are continuing to grow at an alarming rate. In particular over the last ten years alone, the female prison population has grown faster than the male prison population. The conditions for prisoners are very difficult to withstand and many women in need of health care, instead suffer from poor health outcomes and lack of access to services. These negative outcomes include but are not limited to mental illness, physical and sexual abuse or trauma as well as harmful reproductive practices.
These conditions experienced within the system perpetuate the structural inequities experienced outside prison walls, including marginalization based on race, income and class. As a Global Health Corps fellow I have been able to learn more about this critical and cross-cutting issue. As a fellow it is also my personal belief and passion that health be seen and implemented as a universal right.
In the prison setting women are forced to depend on the system to provide for all their healthcare needs. Chief amongst these neglected health care needs, with the potential for serious consequences and trauma, is reproductive health. In these contexts women are faced with less than desirable circumstances in which their ability to fulfill their reproductive health and well-being is not only limited, it is in some cases all out restricted. Access to pregnancy related care as well as birth control options are difficult to attain, as one’s reproductive health is co-opted by the prison system. Unsurprisingly, this last piece regarding birth control, and more specifically, abortion, is once again fraught terrain behind bars.
Women, who request access to have an abortion while incarcerated, face extremely limited options. In fact in 1976, the Hyde Amendment prohibited the use of federal funds for abortions, meaning federal prisons cannot provide abortion care. Women in immigration detention centers also face similar challenges in obtaining abortions as the hill has struck down legislation which would allow for the provision of these services. This is problematic for many reasons but especially so as, “as many as one in 10 incarcerated women in the United States are pregnant before incarceration or become pregnant in prison.” Furthermore, the birth process can be a harrowing one, as prison conditions are less than appropriate for expectant mothers. In other words these women deserve access to comprehensive and dignified reproductive care, yet often times this is simply not the case. Instead, if they are able to access the treatment they need, these individuals are faced with distressing and “humiliating” circumstances.
Pregnant mothers and women are often shackled and bound during medical consultations and even during active childbirth itself—what’s more these women are not able to have family members present during their labor and delivery, further disadvantaging them. According to the Women In Prison Project, “46 states have no legislation that restricts the shackling of pregnant women in jails, and detention centers, leaving the practice to the discretion of individual facilities.” The American Civil Liberties Union (ACLU) also found that women who are detained in immigration detention centers face similar challenges, in that “18 states have enacted laws which prohibit the shackling of pregnant detainees, [while] the other 32 states have no such laws protecting women from these practices.” Though the Immigration and Customs Enforcement (ICE) agency policy seemingly restricts the use of such restraints on women, there are cases which have been reported in which this degrading treatment has persisted.
These bars represent various restrictions that women face to their sexual and reproductive health and well being while incarcerated
Essentially the prison setting and the associated shackling policies leave women and their newborns in vulnerable positions, with potential health related risks and harm to both mother and child. A further account from the Women In Prison Project reports that shackling, in particular, “heightens the risk of blood clots, limits the mobility needed for a safe pregnancy and delivery, and increases the risk of falling, which can cause serious injury and even death to the fetus.” This sort of treatment is unimaginable. As one former prisoner details, “Thirty minutes after giving birth, I was once again handcuffed and chained, and wheeled to another floor.” After enduring these conditions these mothers often only have twenty four hours with their new babies and in some circumstances, mothers do not have the chance to be reunited with their own children even after having served their sentence.
This is a clear and egregious case of human rights being neglected and violated. The time for prison reform is now–there must be a call for change in the current policies and the way in which they are enforced, as current measures fail to address these most basic health needs. Ultimately the prison system must be held accountable, as those who are incarcerated do not cease to deserve fair and just care and treatment. To stay engaged and active follow along with the work of Human Rights Watch and other such independent monitors.