http://inthesetimes.com/article/18410/u.s.

-prisons-are-threatening-the-lives-of-pregnant-mothers-andnewborns

U.S. Prisons and Jails Are Threatening the Lives of Pregnant Women and Babies

Our 6-month investigation reveals the horrific and shameful conditions facing
pregnant prisonersand the inhumane treatment they receive.
BY VI CTORIA LAW

Though the United States accounts for only 5 percent of the worlds
women, it has 33 percent of the worlds women prisoners.
At 5 a.m. on June 12, 2012, lying on a mat in a locked jail cell, without a doctor,
Nicole Guerrero gave birth.
Guerrero was eight-and-a half months pregnant when she arrived 10 days earlier
at Texas Wichita County Jail. The medical malpractice lawsuit Guerrero has
filedagainst the county, the jails healthcare contractor, Correctional Healthcare
Management, and one of the jails nurses, LaDonna Andersonclaims she
began experiencing lower back pain, cramps, heavy vaginal discharge and
bleeding on June 11. The nurse on duty told her there was no cause for concern
until she had bled through two sanitary napkins. Several painful hours later,
Guerrero pushed the medical emergency button in her cell.
At 3:30 a.m., more than four hours later, Guerrero was finally taken to the nurses
station. Guerrero says she showed Anderson her used sanitary pads filled with
blood and fluids, but was not examined. Instead, she was taken to a one-person
holding cell with no toilet, sink or emergency call button, known as the cage. At
5 a.m., her water broke. She called out to Anderson, but, Guerrero says,
Anderson refused to check on her. Shortly after, Guerrero felt her daughters
head breach. A passing guard stopped to assist her, and Guerrero, unable to
keep from pushing, gave birth on a blood and pus-covered mattress.
The baby was dark purple and unresponsive, with the umbilical cord wrapped
around her neck. When Anderson arrived minutes later, she did not attempt to
revive the baby, Guerrero says. The EMTs got there after 20 minutes and rushed
the baby to the hospital. Guerrero remained in the cage, where she delivered the
placenta. At 6:30 a.m., the baby was pronounced dead.
No data, no problem

The number of women who cycle through U.S. jails is increasing by

approximately 1.6 percent each year, to 109,100 in 2014, while the number of
women in prisons has risen nearly tenfold in the past 40 years, to 111,300 in
2013. Though the United States accounts for only 5 percent of the worlds
women, it has 33 percent of the worlds women prisoners.
There is no current data on how many of those women are pregnant. In 2004, a
Bureau of Justice Statistics survey found that 3 percent of women in federal
prisons and 4 percent of those in state prisons were pregnant upon arrival. The
statistics on pregnancy in local jails is oldera 2002 survey found that 5 percent
of women entered local jails pregnant. At those rates, approximately 9,430
pregnant women are incarcerated annually.
There is even less data on what kind of care pregnant prisoners receive: their
nutrition, prenatal check-ups and medical attention, which can be a matter of
infant life or death in cases like Guerreros. Nor do we hear much about the
trauma of pregnancy and childbirth under prison conditions, or the heartbreak of
having an infant taken away hours after birth.
In a six-month investigation, In These Times reached out to dozens of
incarcerated women, activists and advocates, seeking to reach women who had
been pregnant behind bars. Twelve came forward to share their stories.
In These Times then requested information about pregnancy care and policies
from the prisons and jails where the women were incarcerated. Only four of eight
complied. Correct Care Solutions, a contractor that provides healthcare at
Nashvilles Davidson County Jail, refused, declaring that private companies do
not need to open their records to public scrutiny. Those that did provide records
typically took months to do so, and the data was often poor. Phoenixs Maricopa
County Jail records live births, miscarriages and abortions, but not stillbirths.
Washingtons Clark County Jail keeps track of the number of medical visits by
pregnant women (42 in 2014), but not the number of pregnant women
incarcerated.
However, from the 12 individual womens accounts, a picture began to emerge.
Many received no medical care or experienced long waits. Most were constantly
hungry. Others were restrained during labor, delivery or postpartum recovery,
even in states that ban the practice. The majority of those who gave birth in
custody had their infants taken away within 48 hours.

Care and loathing

Medical neglect can endanger the lives of pregnant women as well as fetuses.
Diana Claitor, executive director of the Jail Project of Texas, says she
interviewed a young woman whose complaints of extreme pain were dismissed
by a jail doctor as morning sickness. But it was because her fetus had been
dead for some time, says Claitor, who also examined the womans medical
records. She was very ill and could have died. The woman was finally taken to
the emergency room, where she delivered the dead fetus.
Bridgette Gibbs says that, despite telling staff of her history of miscarriages, she
received no medical attention in two months of pregnancy at the Westchester
County, N.Y., jail. She still hadnt been examined when, early in her second
trimester, she went into labor. Before being taken to the hospital, she was stripsearched and shackled at the hands, waist and ankles. She gave birth to twins
handcuffed to the bed, and was still handcuffed there hours later when she
learned that her premature newborns had died. The hospital told her that the
early labor was the result of a treatable infection. (The Westchester County
Department of Correction could not confirm or deny her story, saying that it no
longer has Gibbs records.)
In Arizona, complaints about prison medical care prompted the ACLU and the
Prison Law Office to file a class-action suit in 2012. An accompanying
investigation uncovered two incidents in the summer of 2013 when officials at the
state prison in Perryville dismissed womens claims that they were going into
labor. One woman said that it took two hours to convince the guards to transport
her to the hospital. She gave birth 20 minutes after arrival. The other said nurses
refused to believe her water had broken even after it tested positive for amniotic
fluid. Officers sent her to the hospital only when she began screaming.
It hurts to be hungry like that
Pregnant women especially need nutrient-rich food. Its typically recommended
that they eat three or more servings of fresh fruits, vegetables, dairy and protein
each day, as well as several servings of whole grain breads or other complex
carbohydrates. Nutritional deficits can, for example, increase the risk of
gestational diabetes, which can cause a fetuss trunk and shoulders to become
too big for vaginal birth.

Withholding healthy food from a pregnant woman is withholding medical care,

says Tess Timoney, a certified nurse-midwife and director of womens HIV
services at New Yorks Bronx-Lebanon Hospital.
In jails and prisons, meal times, foods and portions are limited. More than half of
the dozen women interviewed by In These Times recalled an overwhelming,
unrelenting hunger.
Some jails and prisons specify a special pregnancy diet and an additional snack.
But women report that these foods are often inadequate.
Twenty-three-year-old Minna Long was pregnant with twins when she entered
the Clark County jail in Washington state in 2010. She received an extra 8-ounce
carton of milk with all three meals, but, she recalls, There were countless times
the milk was expired and sour and I couldnt drink it. Her pregnancy also caused
her to feel revulsion toward many of the foods served. During her four months in
jail, she subsisted on milk, fruit and cold cereal, as well as commissary
purchases of donuts, candy, trail mix, meat and cheese sticks, and flavored
popcorn.
Kandyce (who is still incarcerated, and asked that her last name not be used and
her prison not be specified, for fear of retaliation) says that when she was
pregnant in prison in 2014, between breakfast and dinner was a 12-hour wait. It
hurts to be hungry like that, she says.
I dont ever want to be pregnant again
Even when medical care is adequate, the restrictions and confinement inherent
in prisons can make pregnancy and birthing traumatic. It is standard policy in
U.S. prisons and jails to strip search prisoners upon entering and exiting,
including a squat and cough, with no exceptions for pregnant or postpartum
women.
A five-year study by the nonprofit Correctional Association of New York found
that while there were delays in pregnancy care upon arrival, most women in state
prisons then received prenatal care at roughly the frequency recommended by
the U.S. Department of Health. Waiting for those visits, however, was often
painful. Women were seated for up to five hours on a narrow wooden bench with
no food or water. Though pregnant women are supposed to move around
frequently to ease muscle tension and prevent fluid build-up, the women were not

allowed to stand, and were often threatened with disciplinary tickets if they
leaned back.
Kandyce saw a doctor regularly during her pregnancy, but the nurses, she says,
strictly enforced the prisons policies and often refused her doctors requests. For
instance, her doctor asked for a wedge pillow and an extra mattress to
supplement the thin prison mattress. As you get bigger, they get thinner,
Kandyce recalls. Im already heavyset and being pregnant was even worseI
couldnt really breathe if I wasnt propped up. The nurses denied her the pillow
but allowed extra blankets. Those were confiscated by officers in the monthly
room search, however, and each time, Kandyce had to go to the sergeant to get
them back. By the time I was eight months pregnant, I was really frustrated, she
said.
Medical staff told Kandyce that she needed a caesarean section. The night
before, she was placed in the prisons Inpatient Unit. Youre in a room by
yourselfno TV, no book, no nothing, she recalls. All you do is sit in this room
by yourself. You know that youre about to have your baby [and] that youre going
to have to give your daughter up. All you have time to do is think about it. By 11
a.m., when officers arrived to transport her to the hospital, she no longer wanted
to go through with it. I just wanted to keep my baby with me.
Normally, caesarean sections require only regional anesthesia, but when
Kandyce arrived at the hospital, she was so stressed and anxious that the
doctora man she had never metdecided to put her to sleep. My daughter
was going to be here and everything was wrong, she recalls thinking. Her
daughter was born healthy, but the entire experience was so devastating that
Kandyce says, I dont ever want to be pregnant again.
Each time Minna Long went to court, jail staff placed her in handcuffs, ankle cuffs
and a waist chain, a practice known as shackling. Then, they stopped.
Washington had become the seventh state to pass legislation restricting the
shackling of pregnant women. That was in 2010; fourteen states have followed
suit.
But advocacy groups in California, Massachusetts, New York, Pennsylvania and
Texas have found that the practice persists despite bans. Sierra Watts, 37,
incarcerated in Washington state just after the law went into effect, learned this
firsthand. While she was allowed to give birth without restraints, she was then

cuffed to the bed. Her son was placed in a cradle next to her. I just had to lean
over to get him out, but its harder when you cant move that far, she says.
The Washington State Department of Corrections says that a post-incident
review determined she was not supposed to be cuffed.
Sierras choice
For Sierra Watts, the worst part wasnt the shackling, but what followed. Although
she had granted her mother temporary guardianship, child welfare workers told
her that they would not send her son to live with his grandmother. After spending
24 hours with her newborn, Watts was taken back to prison without knowing her
sons fate. Because he was born on a Friday, he was to remain in the hospital
until child welfare offices opened on Monday.
As Watts tells this story, her eyes fill with tears.He was going to stay in the
hospital with nobody holding him, nobody knows where hes going, nobodys
even going to tell me where hes going, she says. Nobody said [to me], Its
going to be okay. Were going to watch him. We wont let anything happen to
him. She did not learn where he was placed until the following Tuesday. The
nextand lasttime she saw him in person was during a prison visit one year
later, shortly before he was adopted.
Under the 1997 Adoption and Safe Families Act, if a child is in foster care for 15
of 22 months, the state must begin proceedings to terminate parental rights.
Watts says that she initially fought to maintain custody, but finally signed away
her rights. They told me that if I was to take it to trial and lose, then I wouldnt be
able to get photos or hear how hes doing or send him cards or anything, she
says. She receives photos of her son, age 3, several times a year, but never
sees or speaks to him.
Thats relatively common for incarcerated women who give birth; two other
women interviewed by In These Times arranged for their babies to be adopted.
By contrast, when Michelle Barton, 37, gave birth in an Oklahoma prison in 2013,
she knew that her baby would be safe with her sister-in-law, who was already
taking care of Bartons 3-year-old son until her release from prison. But she still
cried when it was time to leave the hospital. Upon her return to prison, she was
reminded how little motherhood means there. A nurse had given her a piece of
paper with her daughters footprint. The officer who strip-searched her upon

arrival threw it away. Getting strip searched is nothing, Barton says, but
watching her daughters footprint tossed into the garbage just tore my heart out.
Another way
Michelle Bartons daughter was 18 months old when Barton was released from
prison in August. She boarded a bus to Oklahoma City with only the clothes on
her back. Although she has a job lined up at Churchs Chicken, she is homeless
and cannot reclaim her two young children from her sister-in-law until she finds
affordable housing.
The Mabel Bassett Correctional Center spends $14,800 per year to incarcerate
each woman. Barton was there for nearly two years. What if that $29,600 had
been spent directly on resources for her and her family?
Oklahomas incarceration cost is dramatically low. At the Washington Corrections
Center for Women, incarcerating each woman costs $44,400 per year. Sierra
Watts was sentenced to 40 months. What if the $148,000 spent to imprison her
had instead been spent to help her stay out of the prison system?
The UN Rules for the Treatment of Women Prisoners and Non-custodial
Measures for Women Offenders, known as the Bangkok Rules, recommend that
for a pregnant woman or a childs primary caregiver, non-custodial measures
should be preferred where possible and appropriate. But pregnancy and
parenting are rarely taken into consideration in the U.S. legal system. Across the
nation, more than 120,000 mothers and 1.1 million fathers of children under 18
are behind bars. Approximately 10 million children have had a parent
incarcerated at some point in their lives.
Recognizing that maternal incarceration can devastate children, some states are
exploring alternatives. In November 2014, the Delaware Department of
Correction created New Expectations, a group home for pregnant women with
drug addictions who would otherwise be imprisoned. The home provides meals,
prenatal vitamins, clothing, toys, intensive substance abuse counseling, and
classes on infant care, parenting, breastfeeding, nutrition and budgeting. But the
facility is run by the Department of Corrections and its healthcare provider,
Connections Community Support Programs, and the doors are locked and
alarmed.

By contrast, New York Citys Drew House and JusticeHome operate

independently of the prison system. To be eligible, mothers must plead guilty to
felony chargesbut the charges are dismissed once they complete the program.
In the meantime, they avoid prison, and their children avoid foster care.
Olgita Blackwoods youngest child was barely a week old when she was
arrested. I was so worried about my kids, she told the Associated Press. They
depend on me. They asked for me every day. The 24-year-old was sent to Drew
House instead of prison, enabling her to stay with her three children. Nearly two
years later, as she prepared to take her GED, she said that the program made
her independent. I can make decisions on my own, raise my kids. I cant imagine
it any other way now.
What if such alternatives to incarceration were available everywhere?
The Bangkok Rules recognize that womens needs are unmet in a prison model
designed for men and that womens incarceration is often a result of layers of
gender discrimination. In addition to recommending non-custodial measures for
pregnant women, the UN urges countries to establish alternatives to
imprisonment for all women.
If the United States took these ideas seriouslyor at least took seriously its basic
healthcare responsibilities in its prisons and jailstoday, Nicole Guerrero might
be watching her 3-year-old daughter, Myrah Arianna, scamper around the
playground.
This investigation was supported by the Fund for Investigative Journalism and
the Leonard C. Goodman Institute for Investigative Reporting.

VICTORIA LAW

Victoria Law is a freelance writer, analog photographer and parent. She is the author of Resistance Behind Bars:
The Struggles of Incarcerated Women and co-editor of Don't Leave Your Friends Behind: Concrete Ways to Support
Families in Social Justice Movements & Communities.