By, Kate McQueen

Legislation can improve medical care for pregnant inmates and their infants
ONE PREGNANT WOMAN assists another as she gives birth in a county jail, after receiving slow response to their urgent requests for medical care.
If this strikes you as extraordinary, the stuff of TV dramas, then con- sider this: Dozens of incarcerated women give birth in Oklahoma every year. Most of these occur at the overcrowded Mabel Bassett Correctional Center (MBCC), where Laci Berg was sent after the arrival of little Patience Rose.
Rewire News, a nonprofit online daily that covers reproductive and sexual health, reported the number of births that take place at MBCC at 30 in 2015 and 40 in 2016.
The chances of becoming a mother while incarcerated are rising, and not just in Oklahoma, where women are imprisoned at double the national average (149 out of every 100,000 women, according to the Bureau of Justice Statistics). A 2011 Journal of the American Medical Association article estimates that 5 to 10 percent of women in the US enter prison or jail pregnant, and that nationwide every year around 2,000 children are born within the prison system.
Laci’s story highlights a few of the many dangers facing pregnant women behind bars. Like Cheree, mothers-to-be may face risky delivery in their cells, without medical assistance. Those who are transferred to hospitals may do so under restraint and face giving birth shackled to a bed. Access to necessary nutrition, adequate substance abuse treatment, proper prenatal screenings and educational programming during pregnancy also vary greatly. Postnatal care is equally uncertain. Few correctional centers in the US give women easy access breast pumps, for example, or to counseling services to deal with the pain of separation from their newborns.
This is a national problem. The “Mothers Behind Bars” report, compiled in 2010 by the Rebecca Project for Human Rights and the National Women’s Law Center, gave 21 states failing grades across three categories: prenatal care, shackling, and family-based treatment as an alternative to incarceration. Only Pennsylvania scored above a “B” on this report card.
What is being done to improve the situation? Lawmakers at the state and federal level have slowly started to address the issue. In May 2018, Oklahoma passed a bill that banned the use of shackles on women in labor, joining a handful of states that already for-bid the practice, including California, Illinois, New Mexico, New York, Texas, and Vermont.
Similar legislation was introduced at the federal level. The House of Representative’s “The Pregnant Women in Custody Act” seeks to “address the health needs of incarcerated women related to pregnancy and childbirth” by “prohibiting the use of restraints on prisoners during … pregnancy, labor and postpartum recovery” and by requiring the Bureau of Justice Statistics to collect data on incarcerated pregnant women and the results of their pregnancies. Both requirements were also part of the Senate’s “First Step Act,” which passed both houses in December 2018.
Thanks to the determination of advocacy groups like the Minnesota Prison Doula Project and the Alabama Prison Birth Project, incarcerated women in some states now have access to birth coaches. And a few state prisons—in California, Illinois, Indiana, Ohio, Nebraska, New York, South Dakota, Washington, and West Virginia— have opened prison nursery programs, which allow mothers to stay with their infants from 30 days to 30 months. Much more needs to be done. The Rebecca Project recommends that states clearly delineate standards of care and introduce policies that encourage compliance across correctional facilities. The bottom line is that the penal system is simply not built to accommodate the health needs of expecting and new mothers. States would best serve mothers sentenced on nonviolent and drug- related offenses by prioritizing family-based treatment programs over prison time.