Inadequate medical treatment for female inmates

By Rahsaan Thomas

Medical treatment is inadequate for incarcerated women in California jails, the American Civil Liberties Union of California reports. Jails also fail to provide adequate protection against rape, especially for transgender people, the report added.

Among the problems the January 2016 report lists are:

Women forced to submit to guard-administered pregnancy tests.

Abortions denied until the second trimester — making the procedure more difficult, painful and expensive.

Women illegally shackled during labor and delivery of their babies.

Coercive sterilization.

Ignored menstruation-related hygiene needs.

Inadequate prenatal care.

Insufficient dietary and physical accommodations.

The claims are detailed in a 32-page report titled “Reproductive Health Behind Bars in California”.

For example, in 2010, the police arrested 69-year-old Jane Harman during a political protest. While at the county jail, they required her to take a pregnancy test. While the guards administered the test themselves, no one saw to her diabetic medical needs, according to the report.

“Being forced to submit to a pregnancy test against my will was not about my health,” said Nancy Mancias, who was also forced to take a guard-administered test over her objections while serving less than a day for a political demonstration arrest. “It was invasive, offensive and humiliating.”

The ACLU won a lawsuit to prevent forced pregnancy tests in Alameda County Jail in 2015, making the test optional and administered by medical staff only.

“After the ACLU case against Alameda was publicized, we received a complaint from another Bay Area woman who stated that she too was subjected to mandatory pregnancy testing in a different county,” the ACLU report said.

In another instance, guards repeatedly shackled a 19-year-old pregnant woman on trips to court.

“I can handcuff you in the back if I want to — being pregnant is not an excuse,” the woman said the guard told her.

The ACLU reports that restraining pregnant people improperly poses medical risks like greater stress, complications, falls and even miscarriages.

A California law passed in 2012 now bars shackling of pregnant women “with leg irons, waist chains or handcuffs behind the body during any point in pregnancy,” said the report. However, a 2014 report indicated that only 21 of California’s 55 counties were in full compliance with the law. Two counties did not comply at all.

The problems increased with the rise in the county jail female populations after Proposition 47 passed, reducing many low-level crimes from felonies to misdemeanors. Crimes that would have sent the person to prison are now served out in county jails.

However, the California Code of Regulations offers women housed in state prisons more medical protections and housing accommodations than offered in county jails. Since women are more likely to be arrested for low-level crimes, they now primarily serve their time in county jails where there are fewer protections, the report said.

California has continued its history of forced sterilization of incarcerated people, the report states. From 1909-1964, 20,000 people were sterilized under compulsory laws, the ACLU said.

A 2013 report shows 150 women in California were sterilized without the required approvals and/or consent between 2006-2010.

In 2014, forced sterilization was prohibited unless necessary for an emergency medical procedure.

The ACLU report also outlines insufficient protection from rapes:

Transgender women, who are often housed in male facilities, face high rates of sexual assault and harassment. A 2015 estimate said 34 percent of transgender people housed in county jails were sexually victimized. Staff committed 23 percent of the incidents, according to the report.

To combat sexual assaults, in 2012 the Department of Justice issued mandatory standards for jails to protect women, including transgender women. However, the ACLU questions whether the county jails are implementing the Prevention of Rape Elimination Act (PREA) because not all counties have policies in place that meet PREA standards.

The ACLU made these recommendations to improve the health and safety of women incarcerated in county jails, including transgender women:

Radically expand alternatives to imprisonment programs.

Adopt reproductive health and sexual assault policies outlined in ACLU’s “Reproductive Health Care in California Jails: A Tool to Assess and Reform Policies and Practices.”

Include transgender people in applying new policies.

Ensure implementation of policies with training, monitoring and accountability.

Extend state prison regulations protecting incarcerated pregnant women to county jails.

Improve protection of incarcerated people’s access to lactation accommodations.

Improve data-keeping.

Ensure incarcerated people are informed of their health-care rights.


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