House Bill 1651, which Gov. Greg Abbott signed last month, won't make headlines, but it will have a large impact on the health of more than 4,000 pregnant women incarcerated in Texas county jails each year — not to mention the health of their unborn offspring.

Texas Jail Project, an Austin nonprofit that works to improve conditions in Texas’ 241 county jails, presented information to legislators about the need for mental health care for veterans, jailer training and personal recognizance bonds, as well as demographic data on inmates. However, much of our work focused on the unique vulnerability of pregnant inmates.

Consider Leah, a 24-year-old African American arrested on a minor charge. When she was jailed in rural Central Texas, Leah was five months into a high-risk pregnancy. Her family couldn’t afford to pay her cash bail, and her court-appointed attorney was never available. Her mother emailed Texas Jail Project after Leah had been incarcerated for six weeks.

“In the jail, they don’t listen to her,” wrote her mother, “and now she’s hurting and losing weight. She’s asked to see a doctor three times, but they don’t have one at this jail.”

That’s why we need HB 1651. It requires each jail’s medical plan to include care by an obstetrician/gynecologist for pregnant prisoners. Pregnant women are often held awaiting trial for weeks and months, on mostly small, nonviolent charges because they can't afford cash bail — another facet of our unjust justice system. Lack of action on the part of the court-appointed attorney or a mental health provider can also prolong their cases. More than 70% of the people in Texas jails are awaiting trial or haven't been convicted.

HB 1651 also requires that county jail staffers be able to identify when a pregnant prisoner is in labor and provide appropriate care, including prompt transport to a hospital. Why do we need a law stating the obvious? Consider the context.

The work of a jailer is hard, frustrating and sometimes dangerous. Pay is low and turnover rate is high. Thus, the jailer guarding a pregnant inmate may be a young beginner with no knowledge of pregnancy, and at the same time, distrustful of everything she says. Jailers sometimes order women to quit yelling and crying — and sure, some do yell for no reason — but the default reaction for a woman at term should be a medical assessment and transport.

Our staff has listened to grandmothers and mothers describe the trauma of bearing children on cell floors or inside ambulances — terrible experiences, and dangerous for the newborn. A law requiring recognition of labor and prompt transport to a hospital will help prevent those experiences and the tragic deaths like those that have occurred in jails in Ellis, Victoria, Wichita and other counties.

The third piece of the bill is the most complicated. Earlier legislation that banned restraint of women in labor, delivery and postpartum didn’t go far enough. The new law continues the prohibition along with exceptions allowed in rare cases, but it also requires jailers to follow directions of a health care professional regarding any restraints, and then requires each jail to issue a detailed report about any shackling of a pregnant woman to the Texas Commission on Jail Standards.

I’m glad to see campaigns shed light on the big problems in our criminal justice system in Texas. Yes, cash bail discriminates against low-income people and must be eliminated. Yes, we must reverse the criminalization of mental illness and homelessness. Yes, we must work to remove barriers for those in re-entry, so that formerly incarcerated persons can find work, places to live and support after release.

But as long as more than 1 million men and women are booked into Texas county jails each year, we have to push for proper medical care for them. If it takes one small bill at a time, then that’s what we have to do.

Claitor is executive director of the Texas Jail Project.