Policies governing abortion and reproductive health care services in U.S. prisons and jails were restrictive and often hostile even before the Supreme Court overturned them. Roe v. WadeConstitutional Protection for Abortion. After the June ruling, many fertility services have been banned entirely, putting the health of pregnant women at risk.
This threat is especially urgent in states where lawmakers have made clear their intent to roll back abortion rights.
“There used to be at least some legal recourse for an incarcerated person, but that no longer exists for people who live in states where abortion would be severely restricted or illegal,” said Dr. Carolyn Sufrin, an OB-GYN, professor, and Director of Advocacy and Research on Reproductive Wellness at Johns Hopkins University.
The Northern Rockies and upper Midwest regions are home to some of the states with the highest rates of incarcerated women in the country. According to 2020 data from the Sentencing Project, Idaho has the highest incarceration rate — 110 women per 100,000 adult female residents — of any state, followed by South Dakota, Wyoming and Montana, which have rates more than double the national average.
Nationally, women make up an increasingly large portion of the jail and prison population. From 1980 to 2020, the number of women incarcerated increased nearly fivefold.
State and federal prisons do not reliably track or report the number of pregnant inmates. The Prison Policy Project, a nonprofit research organization, estimates that about 58,000 people a year become pregnant when they enter prison or jail, or about 4% of the total number of women in state and federal prisons and 3% in local jails.
The quality of pregnancy care available to the incarcerated population varies greatly not only by state, but also between facilities. Alexa Colby-Molinas, deputy director of the ACLU Reproductive Freedom Project, says this is due to a lack of universal standards and different approaches by the authorities that run jails and prisons, as well as different healthcare providers. “Too little room for accountability, and too much room for prudence.”
Sufrin co-authored a study published in August 2021 that surveyed pregnancy outcomes in 22 state prison systems, all federal Bureau of Prisons sites and six county jails. It concluded that only half of the state prisons surveyed allow abortion in the first and second trimesters, and 14% prohibit it entirely.
Other facilities, including some within the Federal Bureau of Prisons, nominally require abortion and access to appropriate prenatal and postnatal care during pregnancy—often making abortion and maternal health care services virtually inaccessible.
Those with written policies had barriers including distance from abortion care providers, delays in treatment until abortion was no longer legal, and the cost of abortion for the pregnant person and, sometimes, the need for transportation to and from the clinic. Educationist and lawyer. Other facilities did not have a formal written policy and instead left a person’s care to the discretion of the jail or prison.
Julia Arroyo of the Young Women’s Freedom Center, a criminal justice reform advocacy organization, was pregnant while in prison. “Accessing reproductive health is very difficult on the inside,” she says, adding that women are often thought of as disruptive or difficult simply for seeking treatment.
“When I was pregnant and in jail, I was never once asked what I wanted to do with my pregnancy,” she said.
Sufrin’s research found that state prison facilities that have been identified as “hostile” to abortion make abortions possible but impossible to access. Several states — including South Dakota, Wyoming and Idaho — have already banned most abortions or are in the process of imposing stricter restrictions on abortions.
South Dakota’s trigger law to ban most abortions went into effect shortly after the Supreme Court’s June 24 decision.
An abortion ban that was set to take effect July 27 in Wyoming but was temporarily blocked by a judge makes the procedure illegal except in cases of torture or rape or to save the mother’s life.
Idaho’s trigger ban, which is set to take effect Aug. 25 but is being challenged in court, would ban abortions after six weeks of pregnancy. It criminalizes any person who provides such treatment.
Wyoming’s Department of Corrections declined to comment, and Idaho officials did not respond to questions about how their state’s new abortion ban — which is being challenged in court — would affect incarcerated people. However, experts suspect that statewide bans will likely worsen access to prisons and county jails.
In Montana, abortion is protected by a 1999 state Supreme Court ruling that the Montana Constitution’s right-to-privacy provision extends to an individual’s medical decisions. Republican Attorney General Austin Knudsen is asking the state’s high court to overturn that ruling, and Republican Gov. Greg Gianforte has said he would consider calling a special session to consider anti-abortion legislation if lawmakers have a plan that passes court review. . The next regular session is in January, and Republican lawmakers have said they want to explore new ways to restore those protections.
Montana Department of Corrections spokeswoman Alexandria Klapmeyer said in an email that all facilities “meet the standards of care for inmates required by law, including prenatal care, which is at or above the level of care they would receive if they were not incarcerated.”
However, Klapmeyer declined to comment further on how the Supreme Court’s decision would be Dobbs v. Jackson Women’s Health Organization Will influence the agency’s abortion policies or make specific recommendations on treatments and protocols. As recently as 2019, the ACLU Montana released a report that found the state failed to ensure that incarcerated pregnant people had access to routine prenatal care.
Federal Bureau of Prisons facilities must provide abortions, as well as other reproductive health care services. However, they don’t have to pay for the procedure or travel to the clinic, which means many women don’t have the cost of the treatment.
According to the Prison Policy Initiative, the federal prison system and most states require some form of payment for medical services by inmates, although California and Illinois have reversed their policies. Even states without co-payment policies may require inmates to pay for medical expenses. Montana, for example, states that an inmate is liable for expenses related to a pre-existing condition and for self-inflicted or certain other injuries.
There are no federal prisons in Montana, Wyoming or Idaho. Among the closest in the region are six in Colorado, two in Oregon and one in Washington, all states with laws protecting abortion access. The Bureau of Prisons declined to comment on how Dobbs Policy will affect.
Sufrin says he fears a “chilling effect.” Dobbs Essential Pregnancy Care Decisions for Prisoners. This includes the treatment of abortion, which many experts believe is often a reflection of the abortion protocol. Physicians and other health care providers have raised concerns that without this treatment, women’s lives could be at risk because medical professionals are nervous about how their actions could violate state abortion bans.
According to multiple experts, forcing someone to conceive while incarcerated can cause major trauma for the mother, as well as compromise the care of the child. Forcing a pregnancy to full term can make it harder for a person to escape poverty and derail life plans, and forced pregnancies behind bars have greater punitive consequences, Colby-Molinas said.
Although federal law prohibits the use of shackles for pregnant women giving birth in federal prisons, some states — including Montana, Wyoming and Idaho — do not have laws that make the practice illegal, and prison officials have been accused of using the restraints on women in the delivery room in the past.
Imprisoned women are often forced to give birth unaccompanied, and once a baby is born, the child is usually taken immediately and placed with a family member or, when none is available, placed in the foster care system.
“It violates all principles of reproductive justice,” Sufrin said. “They don’t have the right to choose to have children and they don’t have the right to parent.”
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