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Improving Reproductive Healthcare for Incarcerated Women

Megan Shanahan, Marley Kalata, Emily Sheridan, Lauren Harris, Taylor Walters

Improving healthcare for incarcerated women has important benefits for both inmates and society as a whole. Women that are incarcerated have less access to reproductive care including but not limited to prenatal care, menstrual supplies, contraceptives, postnatal care, and more (Liauw 2021). Women in prison are also at an increased risk for unintended pregnancy, making access to proper contraceptives particularly beneficial (Liauw, 2021). Incarcerated women are also less likely to receive support during birth or miscarriage (Liauw, 2021). We propose that incarcerated women should have greater and better quality access to reproductive and preventative care by increasing access to onsite physicians and resources. 

Incarcerated individuals cannot use their private health insurance or Medicaid/Medicare benefits (Medicaid and CHIP Payment and Access Commission, 2018). Health care services for incarcerated individuals is the responsibility of prison, jail, or institution, and its financing is dependent on local funds and legislation, which are often neglected. If an institution offers healthcare to incarcerated individuals, they often require a copay which poses a new barrier for individuals.

Incarcerated women often face challenges in obtaining the necessary menstrual hygiene products. Women and girls constitute the fastest-growing demographic within the incarcerated population, often receiving insufficient consideration.Kimberly Haven, who experienced incarceration, shared her resourcefulness in making her own makeshift tampons from less-than-adequate menstrual supplies (Haven, 2023). Access to pads and tampons is heavily restricted, leaving women with no option but to request additional supplies, which comes at a cost. In 38 out of 50 states, there is no legislation mandating the provision of menstrual products to incarcerated individuals (Haven, 2023). Pads and tampons are sometimes used as tools of control, withheld to compel certain behaviors. 

Prenatal care is essential for well-being of mothers and the development of their newborn. In the US, the infant and maternal mortality rate is alarmingly high at 5.4 deaths per 1000 live births (Petrullo,2023). Regular prenatal checkout are necessary to detect and address pregnancy related issues such as preeclampsia, blood clots, anemia, monitor fetal development, reduce preterm birth and low birth rate and provided intervention to address any birth abnormalities or growth issues (Liauw et al., 2021).

Currently, 14 states have no laws restricting the shackling of inmates during pregnancy, labor and delivery, transport, and postpartum care (Health care for incarcerated women, n.d). Shackling can interfere with the pregnancy and put the fetus at risk. Therefore, there is an increased need to have better policies that can protect incarcerated women.

Data has demonstrated the importance of mother-infant attachment for infant development and maternal well-being (Goshin, Byrne, & Henninger, 2013). However, mothers who give birth while serving time are separated from their infants almost immediately following birth, leading to higher rates of postpartum depression and emotional trauma. This separation takes an emotional toll on the wellbeing of many women who are incarcerated and has been found to increase rates of re-entry into the prison system (Goshin et al., 2013).

Increased access to contraceptives would allow for a decreased rate of unintended pregnancies in women, also decreasing the need for prenatal and postnatal care. Additionally, increased prenatal care can help reduce poor health outcomes for both mother and child including rates of pregnancy related complications, infant and maternal mortality.

If institutions were to have increased healthcare for incarcerated women, there would also be high costs associated. This may result in higher taxes for the public. We believe that there is no cost too great to prioritize the healthcare of individuals who are incarcerated. The potential crimes that these individuals may have committed do not negate the need to provide humane care for all individuals, regardless of pre-determinants of health. All in all, providing increased reproductive healthcare for incarcerated individuals would decrease long-term health complications associated with less access to care. 

 

REFERENCES

American College of Obstetricians and Gynecologists. (2011). Health care for pregnant and postpartum incarcerated women and adolescent females. Committee Opinion No. 511. Obstetrics and Gynecology, 118, 1198-1202.

Goshin, L. S., Byrne, M. W., & Henninger, A. M. (2013). Recidivism after release from a prison nursery program. Public Health Nursing, 31, 109-117.

Haven, Kimberly. “Why I’m Fighting for Menstrual Equity in Prison: ACLU.” American Civil Liberties Union, 18 July 2023, www.aclu.org/news/prisoners-rights/why-im-fighting-for-menstrual-equity-in-prison  

Health care for incarcerated women. (n.d.). ACOG. https://www.acog.org/advocacy/policy-priorities/health-care-for-incarcerated-women#:~:text=ACOG%20advocates%20for%3A,necessities%20such%20as%20menstrual%20products

Liauw J, Jurgutis J, Nouvet E, Dineley B, Kearney H, Reaka N, Fitzpatrick-Lewis D, Peirson L, Kouyoumdjian F. Reproductive healthcare in prison: A qualitative study of women’s experiences and perspectives in Ontario, Canada. PLoS One. 2021 May 18;16(5):e0251853. doi: 10.1371/journal.pone.0251853. PMID: 34003876; PMCID: PMC8130921.

Medicaid and CHIP Payment and Access Commission . Medicaid and the criminal justice system. Issue Brief . Washington, DC : MACPAC ; 2018 . Available at:https://www.macpac.gov/wp-content/uploads/2018/07/Medicaid-and-the-Criminal-Justice-System.pdf