Senate Probe of Births in Prisons Exposes ‘Pervasive Abuse and Mistreatment’

An investigation into jail and prison conditions for pregnant and postpartum women revealed dangerous, unsanitary, and inhumane conditions, according to the Senate Judiciary Subcommittee on Human Rights and the Law.

As part of the subcommittee’s probe, investigators interviewed more than 100 past and currently incarcerated women, attorneys, healthcare workers, academics, among others, beginning in February, said Subcommittee Chair Sen. Jon Ossoff (D-Ga.).

“We’ve heard from mothers forced to give birth in prison showers, hallways, or on dirty cell floors. Mothers who gave birth into toilets after being told they were not in labor and that they should ‘lie down and go back to their cell,'” he said.

Combined with a review of federal lawsuits and other public reports from the past 6 years, these interviews uncovered “significant and pervasive abuse and mistreatment” and more than 200 human rights abuses nationally, he noted.

Some women were forced to wear shackles around their ankles, wrists, and stomachs during their pregnancies, which reportedly led to injuries and miscarriages, Ossoff explained. Forty-one states prohibit or restrict shackling, but the investigation found violations in at least 16 of those states, he added.

Karine Laboy said her daughter has been incarcerated at York Correctional Institution in Niantic, Connecticut since 2017. She was 6 weeks pregnant when she entered the facility. On Feb. 9, 2018, her daughter began experiencing labor pains, but correctional officers dismissed her concerns, giving her a heating pad and telling her to lie down, Laboy said.

Just a few days later, on February 13, her daughter began bleeding while using the toilet. She screamed for help but no one came, Laboy said.

“My granddaughter was born into the toilet bowl,” she continued. The baby was unresponsive and not breathing. Her daughter’s cellmate told her through the wall to pat the baby on its back to clear the water from her lungs. Had she not done that, her granddaughter might not have survived.

When prison staff arrived, they joked that the baby had gone for her “first swim,” Laboy recounted.

Laboy said her granddaughter was born premature and underweight, and her daughter was deprived of proper medical care. Four days after delivery, her daughter was shackled to her hospital bed. Laboy heard nothing from her daughter for 2 weeks. She only learned the depth of her daughter’s struggles a year later when her daughter sued the facility.

“No human being should endure such cruelty and neglect,” Laboy said.

Another witness, Carolyn Sufrin, MD, PhD, of Johns Hopkins University School of Medicine in Baltimore, explained that the signs of preterm labor can be “very subtle … and they require urgent attention from a qualified provider and not a heating pad.”

But many jails, particularly small, rural jails, do not have medical staff on site 24/7. Correctional officers then become the de facto “gatekeepers to medical care,” she said.

“They’re tasked with acting in the role of a nurse when they don’t have any medical training to know when someone’s having a pregnancy emergency, or when they’re in labor, and what that looks like,” Sufrin noted, adding that lack of knowledge, or in some cases, intentional neglect, is what leads to mothers delivering in their cells.

From 2016 to 2017, Sufrin conducted the Pregnancy in Prison Statistics (PIPS) study across 22 state prison systems, the Federal Bureau of Prisons, six jails, and three juvenile justice systems. She estimated that there were 58,000 admissions of pregnant women in jails and prisons annually.

However, that was a one-time study and did not involve all 50 states or all of the roughly 3,000 prisons. Today, there is still no tracking of pregnancies and births in prisons and jails, she pointed out.

“So, if we don’t know how many pregnant women are behind bars, then people think they don’t exist,” Sufrin said.

In addition, a 2019 report from the Prison Policy Initiative found that across 50 state departments of corrections, 24 had no pre-existing protocols for where to transfer a pregnant woman in labor.

To that end, Sufrin called for implementing a system to track the data linking maternal health outcomes to incarceration. Without that data, we cannot understand the scope of the problem or identify solutions, she added.

Furthermore, to protect the physical and mental well-being of incarcerated pregnant women, Sufrin said there needs to be a pathway to mandate medical standards of care in prisons and jails.

There is precedent for requiring prisons and jails to require access to needed medical care, she noted. The Supreme Court decision in Estelle v. Gamble stated that not providing such care violates the Eighth Amendment, which prohibits “cruel and unusual punishment.”

Recommended standards do exist, but they’re optional, Sufrin said. One possible pathway to requiring standards and oversight is to consider changes to Medicaid’s Inmate Exclusion Policy. Modifications to that exclusion could open up funding for healthcare for incarcerated individuals and could improve medical standards of care.

Sen. Cory Booker (D-N.J.), who chairs the Subcommittee on Criminal Justice and Counterterrorism, urged passage of the Justice for Incarcerated Moms Act, which he argued can end the practice of shackling women “once and for all.” Previous legislation attempted this, but this bill has teeth — tying restrictions on shackling to grant funding. The bill also includes funding for programs to improve maternal health, incorporating doulas, mental health counseling, nutrition education, healthy food options, and opportunities for maternal-infant bonding.

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