Introduction
Last year, more than 200,000 women are imprisoned in the U.S. This figure has multiplied by over 800% in the last thirty years. (Columbia Human Rights Law Review, 2011) More and more women are being incarcerated due to drug-related cases. These female prisoners are also very prone to have histories of sexual or physical abuse prior their imprisonment. (Ibid.) According to researches, female prisoners or women inmates have varied health problems than their male counterparts. Many of them suffer from complex and chronic health conditions as outcomes of their complicated life situations including drug use, poverty, family violence, sexual assault, teen pregnancy, poor nutrition, and poor healthcare. (Ibid.) They also suffer from psychological illness, with higher incidence rates than male inmates.
It is very deplorable to note that the prison system does not often take into full consideration the specific health needs of women. Some of the serious issues include providing women inmates with accessible hygiene products during their periods, proper nutrition for pregnant women inmates or specialized care for women infected with HIV/AIDS. (“Correcting Gender Inequities in Prison Health,” 2008)
Furthermore, the rate of increase of women inmates is higher than the males but the prison system does not take this into account in their general management of the prison facilities. The women inmates are often isolated from their families and friends due to the locations of the prisons. They are also provided with inadequate “educational, vocational, and other enriching programs.” (Ibid.) More importantly, the more serious female offenders are not separated from the less serious women inmates.
All these are just parts and parcel of the overall plight of women inmates in various prison systems in all parts of the world. This paper will try to explore one of the most rampant problem of women inmates that is related to their sexuality and gender - that of their pregnancies inside the prison environments. It aims to explore this very important issue to bring to light critical reforms which must be instituted in the female correctional institutions worldwide.
Women Inmates Who are Pregnant
The American Congress of Obstetricians and Gynecologists (2011) reported that the number of women inmates who are pregnant has dramatically increased over the last ten years. However, they said that most states “have failed to institute proper policies to support their health care needs.” (Ibid.) Women inmates’ conditions are very important during pregnancy. Many prisons have risk assessment procedures for pregnant prisoners, specifically their nutrition and diet, prenatal care and tasks inside the prisons. (Columbia Human Rights Law Review, 2011)
While in advanced states there are ample measures such as the provision of prenatal care and the necessary medical services, this is not often the case inmost prison facilities. According to Tapia & Vaughn (2010), about 5-10% of women inmates are pregnant while others get pregnant while inside the prison. Many of these pregnant inmates suffer from the following: anemia, bleeding during early pregnancy, high stress, improper nutrition, and multiple hospital entries. (Ibid.) Hence, they become high-risk pregnancies which need more attention than the ordinary women inmates.
However, aside from not being properlay taken care of, these pregnant inmates also suffer from maltreatment inside the prison. They suffer from abuse. One of the most common abuse known to pregnant inmates is the use of shackles or leg irons on them as they are being brought to the hospital or during their labor. (Liptak, 2006) This practice is legally recognized as a violation of the Eighth Amendment in the U.S. (Columbia Human Rights Law Review, 2011) State laws such as those in implemented in Connecticut, California, Illinois, the District of Columbia, and New York explicitly penalize shackling. However, in other regions, it is still widely used. Pregnant inmates are still shackled while they are on their way to the hospital or during their labor. It is hard to assess the prevalence of this practice since there are no recorded data on the actual figures of pregnant inmates who deliver in restraints.
International laws detest shackling and consider it as a denial of the basic rights of women. They also consider it very cruel and degrading form of inmate and human treatment. (Nelson, 2006) The United Nations has issued a standard called Rule 33, Standard Minimum Rules for the Treatment of Prisoners. Amnesty International USA interprets this rule as prohibiting the use of shackles for pregnant inmates unless they are a danger to themselves, others or property or they have an absconding history. (Ibid.) The use of such device on pregnant inmates during labor is in violation of both the United Nations Convention against Torture and the International Covenant on Civil and Political Rights. (Ibid.)
Pregnant inmates are also treated harshly. Some prison staff are abusive toward pregnant inmates because they feel that they are unworthy to have children. (Ibid.) Some pregnant inmates are also denied of their rights to commit abortion even when they can afford to. (Deason, 2009) They are left with no choice but to go on with their pregnancies and deliver their babies even when they have already decided not to.
According to law, a pregnant inmate does not lose her legal right to decide whether or not to continue her pregnancy or commit an abortion. (Columbia Human Rights Law Review, 2011) There are some states, however, which restrict or limit this right because of “undue burden.” This is why some prisons make regulations that prevent an abortion. (Ibid.)
Because of the harsh conditions, the pregnant inmates are very prone to high risk pregnancies, which include various medical conditions, premature childbirth and miscarriages. Medical problems that put pregnancies at risk include cardiac related diseases, diabetes, HIV, epilepsy, hypertension, and renal diseases. (Whitehead, 2012) As these women have received poor medical attention prior and during their incarceration, they have a higher tendency to smoke, drink heavily and use illicit drugs. (Ibid.) These, in turn, put their pregnancies to higher medical attention or prenatal care, which ironically, they do not receive. Similarly, they also do not receive adequate counseling, education and drug abuse treatment programs during their pre and post pregnancy.
Other serious medical conditions which pregnant inmates may face include the following:
1. Pre clampsia – this is because incarcerated pregnant women have higher tendency to suffer from hypertension. Hence, it requires monitoring on the part of the pregnant inmates which is often lacking in a prison facility. (Ibid.)
2. Placental Abruption - this happens when the placenta disunites from the uterus because of internal bleeding. This occurs mostly between the twentieth week and during the birth of the baby. A hematoma further disunites the placenta from the wall of the uterus thus causing compression and reducing the blood supply for the baby. This is a rare case but it also occurs to those pregnant inmates with hypertension or diabetic, heavy smoker and/or drinker. The history of drug use is also a risk factor in this case. (Ibid.)
3. Preterm Labor, Short Cervical Length, Incompetent Cervix (IC), and Infection – these are the other complex medical conditions which can happen to pregnant inmates showing the risk factors discussed above. These are either directly or indirectly linked with one another. (Ibid.)
Another serious problem for pregnant inmates is the uncaring and even brutal treatment they receive when they have delivered their babies. Sadly, the women who become pregnant inside the prison are victimized more because prison officers or staff rape or sexually abuse them. (Tapia & Vaughn, 2010) While it is a crime for prison staff to have any sex with an inmate, some get away with it. Furthermore, many women inmates who become pregnant in prison are often blamed for “luring” the prison staff. Some officials even accuse them of “being hyper sexual.” (Ibid.) Women inmates are stereotyped as being bad girls and they are believed to have dressed seductively in order to lure the prison staff. The staff use their prison status and criminal records to counter the complaints of the women inmates for sexual abuse. Hence, they are discredited and their complainst are delegitimized.
Carried over to the pregnancy is the problem of mother-child bonding. This is because a pregnant inmate’s newborn baby is often taken to her relatives or to a foster home directly after birth. This is also a problem for women inmates who have just given birth when they enter prison. These two types of separations lead to the infant’s developmental problems. It also causes psychological issues for the mothers.
Conclusions and Recommendations
While the prison institutes have made several reforms in the health care systems inside the prison facilities, the issue of delivering quality and proper medical and health care to pregnant inmates is still prevalent. More changes have to be done in order to raise the quality of care to these prisoners. As female prisoners, they have a right to proper gynecological care and general physical examinations. (Columbia Human Rights Law Review, 2011) Many of them have unplanned and high-risk pregnancies. They also need HIV testing, psychological health screening and alcohol and drug abuse treatment. They must receive good nutrition and prenatal supplements. They must be assigned to less heavier tasks and be made to sleep in bottom bunks during pregnancy so as to protect their conditions. Lastly, they must have access to quality health care, specifically an obstetric care.
Prenatal care is highly important for all women and these women inmates are no exceptions. Everyone has a right to a healthy pregnancy and this must be followed by the prison institutes anywhere in the world. There should also be prison nurseries that enable the women inmates to bond with their new born babies and to have them breastfed. This also facilitates the prevention of foster care placement and helps reduce the rate of recidivism among the female inmates.
Every entering female inmate must be tested for pregnancy the instant they enter prison. This is to help the prison officers identify the inmates who need pre natal care.
An ultrasound must be performed on all pregnant inmates to identify pregnancy.
Theymust ensure that all pregnant inmates must take pre natal vitamins fortified with folic acid as soon as they are identified as pregnant.
Prison facilities must educate female inmates on the benefits of nutrients and supplements to their baby's development. Explaining to pregnant inmates that their babies could be endangered as a result of non compliance may help them to better comprehend the needs of their nurturing their babies and thus improve their motivation to cooperate.
Prison facilities must provide adequate medical care and they must also institute programs to educate the female inmates on proper nutrition, quitting to smoke and other drug and/or alcohol treatment.
They must also take a complete and detailed medical history all their pregnant wards. This must be taken by a trained obstetrician who will orient the pregnant inmates about the risks factors invovled in their pregnancies.
Female inmates must also be screened and treated for sexually transmitted diseases and HIV.
Reference:
Columbia Human Rights Law Review. (2011). A Jailhouse Lawyer’s Manual, 9th ed.: Chapter 41, Special Issues of Women Prisoners. Web. Retrieved on April 18, 2012 from, https://docs.google.com/viewer?a=v&q=cache:POCEeDShthUJ:www3.law.columbia.edu/hrlr/jlm/chapter-41.pdf+issues+about+female+inmates&hl=tl&gl=ph&pid=bl&srcid=ADGEESgP5oVhzNhvMjuk0l3hoBpfIChxXu5xvHKoBt22p5EvQnpHyxu2pTxwVCcFEVcsJOUiPtdoZMdbMGEJD0cq5lKRy8DUoiOqqSRddDo3r-wzrv-uiptjfxUPn6BCmmDECHdakboJ&sig=AHIEtbSWx-IA1RVWcmHN_TuslIz5xbTjFw.
“Correcting Gender Inequities in Prison Health.” (November 15, 2008). Consultative Document for Discussion at the WHO International Conference on Prison Health. World Health Organization Europe, World Health Organization Conference on Women’s Health in Prison. Retrieved on April 18, 2012 from, http://www.euro.who.int/Document/HIPP/prison_gender_inequities.pdf.
Deason, C. (2009). Unexpected consequences: The constitutional implications of federal prison policy for offenders considering abortion. Minnesota Law Review, 93, pp. 1377-1409.
Liptak, A. (March 2, 2006). Prisons often shackle pregnant inmates in labor. New York Times. Retrieved on April 18, 2012 from, http://www.nytimes.com/2006/03/02/national/02shackles.html?
Nelson, R. (October, 2006). Laboring in Chains: Shackling pregnant inmates, even during childbirth, still happens. American Journal of Nursing, 106(10), pp. 25-26.
Tapia, N. & Vaughn, M. (2010). Legal Issues Regarding Medical Care for Pregnant Inmates. The Prison Journal, 90(4), pp. 417-446. DOI: 10.1177/0032885510382211.
The American Congress of Obstetricians and Gynecologists. (October 27, 2011). Pregnant Prisoners need Prenatal Care, too. ACOG Website. Retrieved on April 18, 2012 from, http://acogpresident.org/2011/10/27/pregnant-prisoners-need-prenatal-care-too/.
Whitehead, K. (2012). Pregnant in Prison - A Recipe for High-Risk Pregnancy. Web. Retrieved on Paril 18, 2012 from, http://ezinearticles.com/?Pregnant-in-Prison---A-Recipe-for-High-Risk-Pregnancy&id=6898801.
