Research Paper on Pregnant Women in Prison

Introduction

More people are incarcerated in the United States than in any other country in the world. Out of every 100,000 residents, 698 people are behind bars in federal and state prisons or jails while many others are on parole or probation (Kajstura, 2018). The statistics for women incarceration is 133 out of every 100,000 people, which makes it the highest rate in the world (Kajstura, 2018). The US only contains 4% of the world's female population, but it accounts for roughly 30% of those in incarceration (Kajstura, 2018). Correctional institutions are historically male-focused, and hence they often fail to address various needs of incarcerated women. Many women, already marginalized and vulnerable in many ways, are pregnant during their period of incarceration. It is estimated that 3%-4% of women are pregnant by the time they arrive in the prisons (Shlafer & Davis, 2016). Most of the women in jail are young, and hence they are in their child-bearing years. Such mothers face significant challenges since pregnant women require many services that may not always be readily available, or sufficient, while incarcerated. The prison system is not designed for the delicate and special needs of pregnant women, and hence they face many challenges.

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Prenatal Care

The Supreme Court ruled, under the Eighth Amendment of the US Constitution, that all incarcerated people are entitled to quality healthcare (Mothers Behind Bars, 2010). It is vital for expectant women to receive as much care as possible during the pregnancy to ensure a proper and healthy birth of the child. The imprisoned women are among the most vulnerable, and their pregnancies are often unplanned and high risk comprising of poor nutrition, domestic violence, lack of prenatal care, drug abuse, and mental illness ("Health care," 2011). When women enter jail or prison, they should be assessed for the risk of pregnancy by enquiring about their heterosexual activity, contraceptives use, and menstrual history. They should then be tested for pregnancy to determine whether they should be enrolled for perinatal care ("Health care," 2011). Women who do not wish to continue with their pregnancies ought to have abortion services, and the rest should receive regularly scheduled and readily available obstetric care until the postpartum period.

The inadequate healthcare in the US prison system is well documented even though it is protected in the constitution. The prison healthcare system, as with many other features, was initially set up to serve a predominantly male population. The healthcare provided is barely adequate for the men, and hence it falls far from meeting the needs of pregnant women. Most of the women who end up in prison are vulnerable, and they have faced substantial health risks, such as poverty, homelessness, sexual and physical violence, substance abuse, limited healthcare facilities, and poor mental health (Shlafer & Davis, 2016). Incarceration might benefit some women due to the availability of shelter, prenatal care, regular, meals, and protection from abusive partners. There are no set standards for necessary prenatal procedures such as resting time, the number of hospital visits required or the type of professional- midwife, obstetrician, or non-obstetric provider- that provides the care (Cardaci, 2013).

However, the health disparities of incarcerated women may worsen under the US prison system. Jails and prisons should offer prenatal care, but there are no established federal standards for providing this care. When care is available, the timing and quality are often inadequate. Statistics from the Bureau of Justice show that only 54% of the pregnant women in prison received some form of pregnancy-related care (Shlafer & Davis, 2016). Prisons often fail to modify the workloads of pregnant women to ensure maximum safety, and they also do not offer an opportunity for exercising to accommodate the pregnancy (Shlafer & Davis, 2016). The parents also fail to receive vital services such as counseling, childbirth education, and breastfeeding support (Cardaci, 2013).

The majority of imprisoned women in America were arrested for things like drug crimes and abuse. Most of them are single parents or primary caregivers who experienced mental health issues and high rates of drug abuse before they were incarcerated (Covington, n.d.). These individuals have unmet healthcare needs, and they still fail to receive sex-specific healthcare after incarceration (Cardaci, 2013). They are often malnourished, victims of domestic violence, have a drug addiction, or they have an underlying sexually transmitted infection. The specialized treatment that such women need is not readily available in the correctional facilities. Incarcerated pregnant women are also likely to have an undiagnosed chronic condition such as diabetes, hypertension, or depression, and all these underlying problems pose a significant challenge once a woman is incarcerated (Cardaci, 2013).

Diet

Prisons cannot adequately facilitate healthy and safe pregnancies, and one of the reasons is the diet offered. The recommended diet for pregnant women consists of three or more servings of vegetables, fresh fruit, protein, and dairy each day. The women should also eat complex carbohydrates, such as several servings of whole grain bread to ensure they receive the best nutrition (Law, 2018). These foods are often missing from the diet of prison facilities, and this lack of proper nutrition poses a serious challenge to the health of the mother and child.

A study done in Oklahoma, the state with the highest rate of women incarceration, indicated that prisons are not doing enough to offer proper nutrition to pregnant inmates. The women do not receive a special diet on a routine basis as required. Instead, they eat the same meals as other inmates, alongside an additional snack, unless there are explicit orders of a special diet from a doctor, which is a rare occurrence (Law, 2018). Prison breakfast primarily consists of hot cereal, coffee cake, fruit drinks, and coffee. Lunch consists of one cup of beans, half a cup of boiled rice, a little piece of cornbread, and a half cup of boiled vegetables. Dinners are equally starchy as they serve pasta or spaghetti with boiled vegetable, a slice of bread, and Jell-O (Law, 2018). What makes a bad situation worse is that, despite the poor diet, some pregnant women may not even get these servings since overcrowding leads to food shortages.

The high concentration of fat and starch in the prison diet increases the likelihood of gestational and maternal diabetes. Additionally, diets that are high in salts and fats increase the chances of high blood pressure, and this means that pregnant women are exposed to preeclampsia, which could lead to preterm labor, low birth weight, cardiovascular diseases, and organ damage (Law, 2018). There is no nutritional expert to guide the pregnant women on the appropriate diet, and this means that the women miss out on this critical prenatal guidance.

The poor nutrition is worsened by the small portions that leave the pregnant inmates feeling hungry (Law, 2018). The servings are meant for one person, but the condition of pregnant women means that their consumption is likely to increase. However, prisons still maintain the same portions, which are inadequate. Most women receive one snack, instead of two, per day, and there are no extra fluids.

Treatment of Women in Prison

One of the principal issues in the incarceration of pregnant women is the treatment they receive in prison. They are offenders and have been put in these correctional institutions as a form of punishment, and hence prison life is markedly different from life outside. The rules and regulations, which are maintained for all inmates, make life especially challenging for pregnant women.

Shackling

The elevated sense of security in jails can have a negative effect on pregnancies. When inmates are transported out of the correctional facilities, they are usually shackled with chains to prevent escape. The restraints use leg irons, a waist chain, and handcuffs that are drawn close to the belly (Law, 2018). According to Amnesty International, pregnant women- or those who have just given birth- should not be shackled or handcuffed if they are guarded by a corrections officer (Cardaci, 2013). The restraints should only be used when the prisoners pose a threat of self-inflicted injuries, damage of property, or escape. Organizations such as the American Congress of Obstetricians and Gynecologists, the American Correctional Association and the National Commission on Correctional Health Care have vocally opposed the shackling of pregnant women during active labor and child delivery ("Health care," 2011). The practice of restraining pregnant inmates is outlawed in twenty-two states (Law, 2018). It shows that the states and organizations realize that shackling the prisoners is detrimental to their well-being, and the pregnancy.

Nevertheless, many states in America continue to allow the physical restraining of pregnant prisoners. When these women are transferred to a hospital to deliver, they are often restraints on the wrists and ankles, and sometimes across the abdomen. The practice of shackling pregnant women places them under undue risks, and it has grave mental and physical effects on infants and mothers (Shlafer & Davis, 2016). The physical restraints increase the chances of falling and reduces the woman's ability to break the fall to cushion herself and the baby. Shackling also interferes with the process of assessment and diagnosis. It also impedes mobility, which exacerbates the risk of thromboembolic events during the pregnancy. The lack of mobility also interferes with the natural process of labor, which lowers the likelihood of normal delivery (Cardaci, 2013). Many other problems come with shackling pregnant women, but the practice is still rampant in many states.

Tough Prison Life

Pregnant women also have to endure the tough conditions in jail life. There is hardly any preferential treatment given to pregnant women, and this means they have to manage like everybody else. When one is pregnant, simple things like walking long distances and doing minor chores can be quite challenging. For example, pregnant women have to walk long distances to the medical area or cafeteria. When the pregnancy is advanced, these distances can cause discomfort and pain to the women, but they still have to walk (Law, 2018). The conditions mean that women will be under significant physical and mental stress to get through each day. Doctors often decline requests from inmates to receive meals in their housing units until they are at least 36 weeks pregnant (Law, 2018). Conditions like rain, ice, and snow exacerbate the situation since the pregnant women could easily slip and fall as they walk.

Birth

The process of giving birth poses some challenges to women who are behind bars. They have to cope with the shackling throughout during the trip to the hospital and back to the prison. Women also do not have the privacy and support required during the process of birth. Amnesty International recommends that, where possible, female prisoners ought to be guarded by correctional officers of the same gender. There are no clear guidelines that protect the privacy and dignity of women during the delivery period, even in states that are against shackling (Cardaci, 2013). The male officers, who often guard female prisoners, still maintain constant surveillance even during childbirth. The women giving birth are not allowed the supportive presence of a family member, partner, or friend. The women remain in the company of correctional officers and other unfamiliar faces during this critical period.

Time with Child

It is vital for mothers to spend time...