Women imprisoned at California's Santa Rita Jail say they're being housed in filthy conditions, denied basic hygiene products, pressured to have abortions, subjected to incessant strip searches, and forced to endure many other manners of cruel and inhumane treatment from guards and staff at the Alameda County facility.

In a new federal lawsuit, they're asking a federal judge to intervene on behalf of them and future female prisoners, particularly those who are pregnant.

"It would be very difficult, if not impossible, to have a healthy pregnancy and a healthy baby while incarcerated at Santa Rita," plaintiff Christina Zepeda—who miscarried while in the county's custody last August—told the court. She is one of six named plaintiffs in the case.

The jailhouse horror stories they tell can be tough to read. But they provide an invaluable glimpse at the sorts of systemic degradation many such institutions foster, and give voice to an often voiceless and powerless population.

They also speak to a major and overlooked issue in the criminal justice system: how the treatment of pregnant prisoners punishes not just the women themselves but also inflicts harm on their unborn children.

The women's suit comes as attention is rising about the plight of incarcerated women. At jails and prisons around the country, female inmates face the standard abuses inflicted on male prisoners as well as those unique to their sex, from being forced to "free bleed" during their periods if they can't afford to buy tampons to facing higher levels of sexual assault and coercion from guards and staff.

The treatment of expectant mothers can be especially bad, with pregnant prisoners denied proper nutrition and prenatal care and, in some places, forced to give birth in shackles. At Santa Rita, they're subject to all sorts of conditions that could cause harm to a developing fetus and increase the risk of birth defects or miscarriage, according to the new lawsuit. One inmate was allegedly left alone in solitary confinement to give birth.

Santa Rita is the third largest jail in California and the fifth largest it the country. It houses most people, including all women, who are locked up in Alameda County, an area that neighbors San Francisco and includes the cities of Berkeley and Oakland.

Run by the Alameda County Sheriff's Office (ACS), this "mega-jail" features 18 self-contained housing units that can hold around 4,000 prisoners. Those passing through are primarily pre-trial detainees (people who haven't been convicted of any crime yet) and people serving time for minor offenses or probation violations.

As part of the new lawsuit, nine current and former inmates submitted statements detailing their experiences at Santa Rita. Here's what they had to say.

Careless Caging

The only care I receive that is different than what the rest of the women prisoners receive is that my vital signs are monitored three times [per] day, including every day at 2 a.m. This means they wake me up at 2 a.m. to take my blood pressure. Breakfast is at 3:30 or 4 a.m., and if I am unable to get up to go to breakfast, which is most days, then I must endure 18-19 hours of no food from dinner to lunch. —Jaclyn Mohrbacher, pregnant inmate at Santa Rita since mid-December 2017

Under California law, jails must provide an individualized plan of care for each pregnant inmate. The pregnant plaintiffs from Santa Rita say none of them were ever told about or saw such a plan.

A lawyer for Alameda County said he is not able to comment on the case.

Abortion Pressure

"Up until I was past four months pregnant, the medical staff kept handing me pamphlets to tell me that the 'option for abortion is available,'" said Erin Ellis, who has been imprisoned at Santa Rita since last October. Now around 30 weeks pregnant, Ellis has stopped getting these comments herself. But she has still seen staff pressure other pregnant prisoners, particularly Mohrbacher.

Mohrbacher told the court she doesn't trust the jailhouse doctor "because she is always promoting abortions" and scheduled Mohrbacher for one even though she wants to have her baby.

Although I refused to consent to an abortion, she scheduled me for an abortion. When I refused to go, she had two men come to my housing pod, trying to forcibly take me to have an abortion. When I again refused to agree to an abortion, the deputies yelled at me and told me I was on drugs. From then on, their treatment of me grew more abusive and worse. From that time on, if I requested medical care, or said I was not feeling well, the housing guards… would all tell me that my problem was that I was on drugs, and they would strip me, meaning they would subject me to the humiliating and degrading practice of doing strip search and body cavity search. To do these searches, they would take me and often another pregnant woman and put us in the isolation or solitary confinement cells. We would have to stay there for hours. Then they would often take us to another room, make us strip naked, squat, and show our vagina, our anal cavities, and our mouth.

Menstrual Pad Shortages

The guards, instead of finding out how many women are menstruating, will just hand out some small number of menstrual pads, like eight or ten, and no matter how many women are menstruating. And these pads are tiny and thin to begin with. That means that regularly and routinely, there are insufficient menstrual pads, and women end up bleeding through their clothes. Because laundry is only once a week, often women are forced to endure dirty bloody clothing for long periods of time. —Alexis Wah, 47, incarcerated at Santa Rita "on multiple occasions"

Starving for Two

I am not receiving sufficient food. I am regularly hungry. … My diet is completely deficient in fresh fruits and vegetables, and the amount is not enough to sustain a healthy pregnancy. — Dominique Jackson, pregnant with twins, imprisoned in Santa Rita since December 1, 2017

Jackson can't eat bologna due to a health issue—and pregnant women are advised to avoid cold cuts anyway—but said she is not offered a replacement option on days the cafeteria serves bologna sandwiches for lunch. The only special dietary consideration pregnant inmates are given is an extra eight ounces of milk per day.

Filthy Food

The kitchen at Santa Rita is filthy. There are birds that live in the kitchen and there are bird droppings all over. I have counted seven birds who appear to live in the kitchen. There are rats.…There is nothing that prevents the rats from climbing over the bread and chewing open packages…The sandwich meat, which is primarily bologna, often has white spots on them. I do now know what the white spots are, but that meat is still given to prisoners to eat.…There is no soap in the kitchen bathroom. —Jane Doe, inmate and cafeteria volunteer at Santa Rita Jail

Constant Searches

The guards have been very hostile, always claiming that there's drugs despite a large number of shakedowns and searches. In December, during one week, there were three shakedowns and no drugs were found. No drugs have ever been found. When no drugs are found, the guards then punish the entire [housing unit]. — Natalie Garrido, in custody in Santa Rita due to an alleged probation violation

During the month of December, the deputies claimed they were looking for drugs. I never saw drugs. I never saw the deputies find drugs. Yet searches were repeated, up to multiple times in one week. — Dawn Dedrick, imprisoned in Santa Rita since November 7, 2017

Dedrick said the guards "especially harassed Jaclyn Mohrbacher because they believed she provided leadership to the women and was helping women stand up for our rights."

Dirty Demands

During one strip search, Mohrbacher was "spotting"—light bleeding which could be a sign of miscarriage or other pregnancy complications. A sheriff's deputy allegedly told her to wipe off blood so she could do the search. "I asked her for some pads or a paper towel," Mohrbacher told the court in a statement, but the the deputy instead picked up a nearby trash can and told her to find something in there to use.

I had no choice, but under threats of reprisals and punishment, used a used menstrual pad to wipe myself so that defendant Divine could conduct the invasive, offensive and demeaning and sadistic strip search and body cavity search.

(After the lawsuit was filed, Mohrbacher was transferred to a federal detention facility.)

Dirty Underwear

It would behoove an institution with the responsibility for housing and caring for pregnant women to take immediate steps to reduce the incidences of bacterial vaginosis through the simple measure of insuring sanitized and well laundered underwear. There is no justification for a failure to to so. — Jenny Scafidi, midwife & nurse practitioner, in declaration to the court

Multiple inmates testified about poor laundering, mass bacterial infections, and overprescription of antibiotics at Santa Rita. Erin Ellis, who is currently pregnant and incarcerated at Santa Rita, said that underwear distributed to inmates "are not clean, are stained, and often have pubic hairs on them."

Ellis and multiple other women were diagnosed with the same vaginal bacterial infection, which could be spreading through the unclean underwear. To treat the infection, Ellis was prescribed an antibiotic by the jail's doctor. "I have heard that the antibiotics [the OB-GYN] is prescribing may cause birth defects so I am reluctant to take them," Ellis said.

"Depending on the trimester," the use of certain antibiotics "could result in significant birth defects," said Scafidi. She also pointed out that "bacteria on soiled underwear can lead to a UTI as well as bacterial vaginosis, which both can lead to significant maternal and fetal health conditions if left untreated."

Alameda County denied all responsbility for these issues, noting that a private contractor, California Forensic Medical Company, is in charge of inmate medical care.

Solitary Birth

When Candace, who looked very pregnant to men, complained of not feeling well, she was in so much pain that she could not walk and had to crawl on her hands and knees. The nurse came in and examined her in the cell. The nurse had said that Candace was not dilated, and that Candace was just eight months pregnant. All of us thought Candace was further along than eight months. The nurse proclaimed that Candace just had a stomachache. This is part of the pattern in Santa Rita to paint women prisoners as complainers and exaggerators. —Denise Rohrbacher, incarcerated at Santa Rita from April 2017 through January 20, 2018.

For about a week, Rohrbacher shared a housing unit with the woman known only as Candace. The woman's story was mentioned in statements by several Santa Rita inmates. When Candace continued to complain of being in pain, she was placed in an isolation cell.

In solitary confinement, Candace "began to scream, and yell," said Rohrbacher. "She was banging on her metal door." The guards allegedly just "closed the slider-window to her door, so she could not see out, and no one could see in," and the sound of the screams would be muffled.

This went on for over two hours, until the next guard shift came on that evening. It was agonizing and torture for us to hear her scream like that. Finally, we could hear the crying of a baby. Apparently, Candace had given birth, alone. Only after we could hear the crying of the baby did the deputies finally go over and open her door.

Living With Lice

All cleaning is done by prisoners. We are given very little in the way of supplies, and we are only allowed to have the supplies for a very short time. There is no hand soap anywhere, so we can only rinse our hands. While I was there, we had a very bad infestation of lice. One of the women who was in my pod, [P.K.], was pregnant, and she had such a bad case of lice they had to remove her from our housing unit. All of us had to be removed from our housing unit and we all lost all our our stuff, including the stuff that we had paid for. While I was in custody, I know that [P.K.] also lost her baby and had a miscarriage. I believe her miscarriage was shortly after the lice problem became terrible. —Christina Zepeda, former Santa Rita inmate who miscarried while in county custody

Zepeda was taken to a hospital during her miscarriage, which happened a few days after she was arrested on an alleged parole violation and taken to Santa Rita, and returned to the jail that same night.

A month later, in September 2017, Zepeda was released. In January, she joined the lawsuit against the Alameda County Sheriff's Office and spoke publicly at a press conference about it. Later that day, she was arrested by sheriff's deputies for an alleged parole violation.

In a statement to the court, the county's lawyer said that "by chance, Zepeda's arrest happened to occur about four hours after she apparently participated in a 'press conference' in Oakland regarding the subject matter of this civil lawsuit. It had absolutely nothing to do with this civil lawsuit or the press conference." Zepeda was held at Santa Rita for seven days before being released without charges.