Originally published on December 10, 2019 10:10 am

There’s wide variability in state policies about what care to give to women who are pregnant and behind bars. That’s according to a new report from the Prison Policy Initiative, a research and advocacy organization focused on mass incarceration.

“Women's populations in prisons have been growing faster than men's for quite awhile now,” said Wanda Bertram, a spokesperson with the Prison Policy Initiative. “So it's a good time to start looking at how women's experiences differ from men's while they're inside.”

The state-by-state review found that all states in the Mountain West do have policies limiting the use of restraints on pregnant women. But, with the exception of Montana, the region lacks policies specifying nutrition requirements.

“That's a big deal because, as any woman who's been pregnant will tell you, what you need in terms of your diet and what you're putting in your body completely changes when you're pregnant, so states should be paying more attention to that,” she said.

The review also found that Utah and Nevada are among 22 states that don’t have guidelines on care for high-risk pregnancies. Utah is also one of 12 states without policies on the books requiring that pregnant women receive prenatal care from a medical professional.

“There is very little data that is collected about pregnant people who are in custody,” said Dr. Carolyn Sufrin, an obstetrician/gynecologist and a medical anthropologist at Johns Hopkins School of Medicine.

A 2004 survey by the federal Bureau of Justice Statistics found that about half of pregnant women in state prisons said they’d received prenatal care.

“But that was over 15 years ago,” said Sufrin, who published a study earlier this year in the American Journal of Public Health that she said is the first national report on pregnancy outcomes among women who are incarcerated.

Sufrin and her colleagues found that women who were behind bars in 2016 had a lower rate of preterm birth than expected.

“It was 6%, which is lower than the national preterm birth rate of 10%,” said Sufrin. “That's not to say that prisons are protective or prisons are good for someone's health, but it does suggest that in some cases people may have access to treatments including things like access to drug treatment that they may not have in the community.”

But, she said, it can also go the other way.

“When we broke it down by state, the rate was highly variable and there were some states with very low preterm birth rates and some with a rate as high as 16%,” said Sufrin. “What we can infer is that, with variable access to prenatal care, with variable quality, the outcomes are going to be variable. And we see this on an individual level through media accounts and through lawsuits.”

Surveillance footage from July 2018 shows a woman in a Denver jail give birth to her son in her cell. According to a lawsuit filed this past August, Diana Sanchez alerted staff “at least eight times” that she was in labor, she gave birth “on a cold, hard bench, feet away from a toilet … alone and with no medical supervision or treatment.”

The American College of Obstetricians and Gynecologists recommends that pregnant women who are incarcerated should receive dietary supplements, perinatal care, and, for those who are opioid-dependent, treatment with methadone or buprenorphine. The opinion also states that birth should occur in a licensed hospital and that “the use of restraints on pregnant incarcerated women and adolescents may not only compromise health care but is demeaning and rarely necessary.”

This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, KUER in Salt Lake City, KUNR in Nevada, the O’Connor Center for the Rocky Mountain West in Montana, and KRCC and KUNC in Colorado.

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