Incarcerated Pregnant Women Face Traumatic Birth-Situations

Illustrations by Abagail Summers

by Sophia Englehart and Eleanor Bishop

The stark gray walls and tall barbed wire fences of the Ohio Reformatory for Women, (ORW) are a contrast to the brightly colored nursery built within the walls of the prison, a new addition to the all- female correctional institution. The sight is rare in prison, where most children born in lockup are taken away almost immediately after birth, to be placed in foster care or with other family members while the mother serves out the rest of her sentence.

ORW, located in Marysville, Ohio, is home to one of only 11 prison-nursery programs in the U.S., and the only prison in Ohio to have a program such as this. ORW’s Achieving Baby Care Success program, also known as the ABC program, was established in 2001. The program takes a hands-on approach to teaching these young mothers how to raise their children and establish healthy parenting habits while they serve their sentence. Mothers are screened before being allowed to enter the program and must be serving a short sentence for a non- violent crime.

According to information stated about the program on ORW’s website, the bond between a mother and baby in the first couple months is critical to the intellectual development of the baby. Separation, especially right after birth, can lead to cerebral development issues and various complications in the “emotional and intellectual functioning” of the baby. ORW’s goal with the childcare program is to ensure that the mother and child leave the program together.

A study of 22 state prisons and all federal prisons conducted by John Hopkins University in 2016 and 2017 found that nearly 1,400 incarcerated women were pregnant when admitted into prisons during that period. Of the births from these pregnancies that occurred in prison, over 90% ended in live births with no maternal deaths. Eleven abortions, four stillbirths and three newborn deaths were also reported. This study is believed to be the first of its kind to take a systematic look at pregnancy in U.S. incarcerated populations, as federal agencies and state prison systems do not track birth statistics. Dr. Carolyn Sufrin, the lead author of the study and an assistant professor in gynecology and obstetrics at Johns Hopkins University stated that there are no mandatory standards for prenatal and pregnancy care for incarcerated women.

Kirstine Taylor, an assistant professor of Political Science and Law, Justice and Culture at Ohio University, explained that American prisons are ill-designed to support the health and wellness of incarcerated individuals.

“They are places of organized punishment,” she says. “Access to quality healthcare, especially for vulnerable populations such as pregnant women, is a serious problem.”

Prisons, while being funded by taxpayer dollars, are excluded from Medicaid funding. This means the federal government can't mandate a certain level of care for incarcerated individuals. “There's nothing that the government [can] provide as an incentive,” Sufrin says. “They can't say, ‘If you don't follow these standards, we'll take your Medicaid funding away,’ because there isn't Medicaid funding to be given.”

The Rebecca Project for Justice, a national organization dealing with the protection of women’s rights, documented in their 2010 project, “Mothers Behind Bars,” that prison healthcare was not designed to cover the medical needs of pregnant inmates. They released a comprehensive state-specific “report card” on the services provided by state prison systems, with the intent to educate and encourage state and federal prison systems to evaluate and update prisoner policies. States were evaluated on the quality of their prenatal care, shackling policies and family-based treatment as an alternative to incarceration. Only one state, Pennsylvania, received an -A, the highest composite score recorded. Ohio received a C overall.

While prisons like ORW are attempting to provide a healthy environment for new mothers and their children, there is still a long way to go. Only recently have many states passed anti-shackling laws banning the practice of forcing pregnant inmates to give birth in shackles.

Shackles, like any type of restrictive device, are designed to limit the capacity of motion of the person they are being used on. The act of shackling someone and forcing them to remain partially immobile while going through a process as painful and variable as childbirth can be extremely dangerous and traumatizing for the mother and baby. Sufrin explains that, in obstetrical situations like preeclampsia, breech births or caesarean sections, shackles prevent doctors from effectively working on their patient and ensuring a safe delivery for both the mother and child.

“If the baby's heart rate drops [during] fetal monitoring, one of the first things that we [would do is] change the position of the woman to try to increase blood flow to the uterus, but we can't change her position if she's shackled,” Sufrin says. “If we need to do an emergency C-section and transfer her to the operating room in an emergency, you can't do that if she's shackled.”

In 2018, the First Step Act was passed, a federal law that prohibits the shackling of pregnant incarcerated women. However, this law does not apply to women in state prisons and county jails, where a majority of incarcerated women in America are held. According to a 2020 Guardian article, 23 states still do not have laws against the shackling of incarcerated pregnant women.

In February 2019, Ohio Senators Nickie Antonio and Peggy Lehner introduced Senate Bill 18, which would prevent pregnant women from from being shackled while in their third trimester, in labor, or while recovering postpartum. The bill was passed in the Senate but has been stalled in the House Criminal Justice committee since May 2020.

Sufrin says that even if the practice was made illegal in all 50 states, additional accountability measures would be needed.

“The laws aren't enough,” she says. “There need to be implementation programs and trainings within hospitals and within the individual correctional institutions to make sure that people are following the law and they understand why.”

Even in situations where shackles are not employed, most incarcerated mothers still have to deal with the trauma of being separated from their newborns as soon as they’re discharged from the hospital and sent back to jail.

“[The Ohio] prison system has one of the few other care programs where the baby can get back to the prison with the moms,” Surfin says. “These programs are out there on the surface celebrated [as] fantastic models because moms [are with their] babies and they can learn parenting skills, but there are also a lot of complexities too.”

The strict criteria to qualify for programs like ABC means that many mothers cannot participate, and despite measures to improve conditions like ORW’s new nursery facility, the situation is far from ideal.

“The baby is still starting out their life in prison ... It's hard to start to imagine,” Sufrin says. “There's just a lot of variability [in] experiences.”

The iron bars of American prisons stand strong and cold, enclosing not only its inhabitants, but also the spread of equal healthcare and services that all incarcerated individuals deserve to access.