Chained In Labor: Incarcerated Women & Reproductive Healthcare
By Talyiah Dickens, Wisteria Magazine
The landscape of childbirth varies from one mind to the next. Home births in kiddie pools and bathtubs. Hospitals with masked faces and cotton-candied colored gowns. The back seat of a taxi cab in a scene from a drama series. Each image feels relevant, viable, and above all imaginable, yet the unimaginable truth bears its fangs in a colder scenario of armed guards and sealed doors. Childbirth for thousands of Incarcerated women is one where their hands and feet remain in shackles.
This image permeates the growing rate of incarcerated women in the United States. Despite the passage of the First Step Act in December 2018, a federal law that prohibits certain punitive measures against incarcerated persons. However, regulations in private, state, and county jails remain unchanged regarding application and enforcement. United States Marshals Services and the Federal Bureau of Prisons both have policies that address the treatment and care of pregnant women. Still, not all policies fully align with national guidance recommendations on 16 pregnancy-related care topics.1 These topics range from mental health care services to nutrition and dietary needs. As a direct result, thousands of pregnant women are subjected to involuntarily dangerous conditions which invite physical and psychological trauma. Before, during, and following childbirth, an incarcerated pregnant woman is continuously denied the freedom of choice. This denial is symbolic of the landscape of a woman's body and bodily functions. State to state, the subjective definition of "shackling" or "restraint" and degree of timeframe varies. These inconsistencies only further worsen the outcome for mother and child during pregnancy, active delivery, and postpartum.
Discussing the treatment of incarcerated women requires understanding its history. Embedded in the fabric of this nation is the foundation of our present-day criminal justice system and the social structures which allow it to not only survive but thrive and evolve. The nature of this evolution is synonymous with the legacy of slavery and racism. This socio-historical context directly contributes to the disproportionate incarceration rates of Black and Hispanic people, and women have become the fastest-growing group within that population. A 2019 report from The Sentencing Project states that, in 2017, Black women were almost twice as likely to be incarcerated as white women. Where there is Black and Brown suffering, there is a system ripe for profit.
Furthermore, the accumulation of profits does not lead to improving the conditions of incarcerated populations. In conjunction with the high risk of infectious diseases and mental health disorders, individuals in need of reproductive health care meet inconsistencies and, often, neglect. Reproductive injustices obstruct standard procedures and services cognizant of a women's health through imprisonment. Cases of bodily harm pile up year-round due to life-endangering restraints that exist to punish instead of protect.
Institutions of Obstetricians and Gynecologists have long withheld the notion that such restraints are not only life-endangering but bear little to no evidence as a requirement. In the eyes of health care practitioners, an incarcerated pregnant woman in labor becoming a flight risk is irrational due to the physical limitations of labor itself. Given the particular severity of an incarcerated patient's medical needs, guards and practitioners may be more likely to fail due to grey areas in existing prison regulations. As opposed to acting in the patient's best interest, the presumed threat of an incarcerated individual is assessed in lieu of bias, sexism, and racial discrimination. In the case of a nonviolent offender, 29-year old, and six-month pregnant, the shackling caused mental and physical injuries and the disregard of her ongoing pain due to them. This woman contended that the shackling during her labor resulted in extreme mental anguish and pain, as well as a "permanent hip injury, torn stomach muscles, and an umbilical hernia requiring surgical repair." 2 Her orthopedist stated that the shackling injured and deformed her hips, preventing them from going "back into the place where they need to be." 2
To describe such helplessness is difficult, but to fix it is a feat of its own. Women who are often navigating the violence of gendered policies, poverty, abuse, and racial oppression, once incarcerated, succumb to an existence built around invisibility. The symptoms of menstrual cycles or trimesters go neglected and ignored throughout their time in isolation. The scope of this problem is incoherent due to an overall lack of oversight in data collection. As the road narrows, intersections of We discover for incarcerated mothers, women, and persons alike, the price of your freedom comes with the ownership of your body. The thought of a kiddie pool is a pipe dream.
As a society, our treatment and views of the most vulnerable members define us. Across the nation, local laws function as a limiter on the freedoms and ownership of the reproductive cycle of the female anatomy. Envision how the criminal punishment system has stifled our imagination and how it shapes our relationships with one another. Criminalized human beings should afford the implementation and enforcement of Anti-shackling laws, comprehensive care and education for prison employees and incarcerated populations, and access to sustainable resources from trained health care providers to criminalized human beings. Bettering birth outcomes both to the free and incarcerated begins with the repudiation of punitive and local laws that cause needless birth complications, trauma, and death. During labor, incarcerated women do not have the choice between home births or hospital beds. The setting of child delivery, even in the back of a taxi cab, should not intentionally inflict risk and suffering to either life.
Sources: 1. Nelson v. Corr. Med. Servs., 583 F.3d 522 (8th Cir. 2009). 2. Pregnant Women in DOJ Custody: U.S. Marshals Service and Bureau of Prisons Should Better Align Policies with National Guidelines (GAO-21-147). (2021, January).
