An Analysis of Court Decisions, Statutes, and Administrative Regulations Related to Pregnant Inmates
| DOI | 10.1177/0032885516635088 |
| Author | Leah McCoy Grubb,Rolando V. del Carmen |
| Date | 01 June 2016 |
| Published date | 01 June 2016 |
| Subject Matter | Articles |
research-article2016
Article
The Prison Journal
2016, Vol. 96(3) 355 –391
An Analysis of Court
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DOI: 10.1177/0032885516635088
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and Administrative
Regulations Related to
Pregnant Inmates
Leah McCoy Grubb1 and Rolando V. del Carmen1
Abstract
Pregnant inmates represent about 5% of females within the correctional
population. Although this is a small portion of the entire inmate population,
it is important to adequately address their needs to protect the health of the
mother and the fetus. Many states have failed to properly address this issue.
However, the states that appear to be the most comprehensive in terms of
their treatment of pregnant inmates are California and Pennsylvania. Other
states should model their statutes and administrative regulations after these
states to effectively address the needs of pregnant inmates.
Keywords
Pregnant inmate, women, prison, jail
Introduction
In the United States, there has been a significant increase in the number of
women who are incarcerated in prisons and jails. A proportion of those who
have entered prison and jail do so while pregnant. Estimates are that about
1Sam Houston State University, Huntsville, TX, USA
Corresponding Author:
Leah McCoy Grubb, College of Criminal Justice, Sam Houston State University, P.O. Box
2296, Huntsville, TX 77341, USA.
Email: lmccoy@shsu.edu
356
The Prison Journal 96(3)
5% of women who are incarcerated in prisons nationwide enter prisons
while they are pregnant (Levi, Kunakemakorn, Zohrabi, Afanasieff, &
Edwards-Masuda, 2010). Because of the limited resources devoted to incar-
cerated pregnant women in prisons and jails, programs and resources tai-
lored to this special population have been found to be inadequate in meeting
their needs. Some examples of these inadequacies include the absence of
special diets, lighter workloads, and medical resources for miscarriages, pre-
mature births, and deliveries (Wooldredge & Masters, 1993). Although the
treatment of pregnant women outside of the criminal justice system has sig-
nificantly advanced, this has not been the case with incarcerated pregnant
women.
In addition to these inadequacies, many pregnant inmates are classified as
high risk because of drug addiction, sexually transmitted diseases, or pelvic
inflammatory disease (Parker, 2006). Although drug use during pregnancy is
frequently cited by researchers as a critical problem, this has generally been
overlooked, even though there has been a trend toward incarcerating preg-
nant, substance-abusing women to protect the health of the mother and the
fetus. Given this trend, health officials in jails must be able to provide appro-
priate detoxification to pregnant drug addicts because the fetus may experi-
ence withdrawal symptoms (Parker, 2006). Many jails, however, have failed
to provide appropriate care for pregnant inmates and their unborn children.
Research indicates that drugs in prisons are readily available. This means that
pregnant inmates are likely to continue using drugs for the duration of their
pregnancy (Egley, Miller, Granados, & Ingram-Fogel, 1992). As a result of
inadequate care, numerous negative outcomes include increased levels of
fetal and neonatal death, intrauterine growth retardation, premature labor and
delivery, and other conditions that necessitate admission to neonatal intensive
care units (Siefert & Pimlott, 2001). Furthermore, such inmates may experi-
ence psychological distress as a result of the separation from their newborn
child, which is also related to long-term problems experienced by the child
(Wooldredge & Masters, 1993).
As of September 2013, 41 states and the District of Columbia have enacted
pregnancy-specific statutes and/or administrative regulations (American
Civil Liberties Union [ACLU], 2013). Some states have enacted statutes,
while others have passed administrative regulations, and others have done
both. This article seeks to analyze court cases as well as statutes and
administrative regulations related to pregnant inmates to determine
whether their specific needs are adequately addressed, as suggested by
Tapia and Vaughn (2010). A model statute is then provided to guide policy
makers when considering statutes and regulations that best meet the needs
of pregnant inmates.
Grubb and Carmen
357
Pregnant Inmates in Prison
As the number of women in prisons has increased, so too has the number of
women who are pregnant when entering prison. By 1998, about 5% of women
who entered state prisons and 6% of women who entered jails nationwide
were pregnant upon admission (Bureau of Justice Statistics, 1999). This
increase has resulted in the need to address the issue of the medical issues of
women in prison, particularly with regard to pregnancy and childbirth. This
section will address some of the issues related to the health needs of pregnant
inmates.
Problems faced by pregnant inmates. Various agencies have presented policy
recommendations to reduce the likelihood of pregnant inmates experiencing
physical and psychological problems. Such recommendations have included
providing prenatal care in prisons, providing full-time nurses and midwives,
allowing nursing infants to remain with mothers during their period of incar-
ceration, and extending visiting hours for mothers with their children
(Wooldredge & Masters, 1993). A study by Wooldredge and Masters (1993)
analyzed the presence of various types of services for pregnant inmates in
state prisons. Some of these services included prenatal care, networking with
community agencies providing prenatal care, Lamaze classes, and special
diets. None of the facilities reported having programs that allowed infants to
remain with the mother. Eight wardens noted no problems. Some problems
noted by wardens included inadequate resources for pregnancy complica-
tions, no maternity clothes, the use of belly chains during transport, and no
separate visiting areas for mothers and children. This study was conducted 20
years ago but is the only study that has been conducted with this group of
inmates.
Health care and prenatal needs of pregnant inmates. Women who enter cor-
rectional facilities are generally in poor health as a result of poverty, sub-
stance abuse, and the presence of physical and sexual abuse (Hotelling, 2008;
Parker, 2006). As a result, many women who enter prison while pregnant are
considered to have high-risk pregnancies. Having histories of drug addiction
and sexually transmitted diseases are examples of criteria that are used to
consider a pregnancy as high risk. These problems are exacerbated by the
lack of gynecological examinations upon admission, the failure to ask appro-
priate screening conditions, and the lack of on-site physicians who specialize
in obstetrics and gynecology (Arnold, 2004).
This is particularly problematic for drug-abusing pregnant women. The
failure to provide an appropriate form of detoxification may harm both the
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The Prison Journal 96(3)
mother and the fetus. Pregnant, drug-addicted inmates are forced to undergo
withdrawal without consideration for the health of the fetus, even though the
fetus can also experience withdrawal symptoms (Parker, 2006). Despite its
seriousness, this problem has remained overlooked even though there has
been a trend toward incarcerating substance-abusing pregnant women to pro-
tect the health of the fetus (Barry, Ginchild, & Lee, 1995). Continued drug
use during pregnancy can have a number of adverse effects for the baby,
including intrauterine growth retardation, reduced gestation, low birth weight,
decreased head circumference, and premature delivery (Siefert & Pimlott,
2001).
Drug-abusing pregnant inmates present a number of psychologically
based needs. The link between past and present instances of physical and
sexual abuse and current substance use has been well documented in the
research literature (i.e., Clark & Foy, 2000; Kaukinen & Demaris, 2005).
Women who have been physically and sexually abused at some point are
more likely to engage in substance use and abuse. Unless these issues are
recognized and dealt with, it is unlikely that such women will be successful
in achieving and continuing abstinence from substance use, especially if the
abusive partner is the father of the baby (Siefert & Pimlott, 2001).
Although some argue that incarceration is harmful to women and their
unborn child because of the level of stress, others maintain that incarceration
may improve the health of pregnant inmates because they are receiving an
adequate level of food and have limited access to drugs (Parker, 2006). One
study indicated that pregnant inmates who experienced short-term incarcera-
tion were more likely to experience poor prenatal care, histories of drug
abuse, and poor nutrition compared with the long-term incarceration group
(Cordero, Hines, Shibley, & Landon, 1991). Another study comparing a
group of incarcerated pregnant inmates with a control group indicated that a
greater percentage of those who were incarcerated acknowledged the use of
illicit drugs and tobacco, yet positive outcomes were still found among those
who were incarcerated, despite increased drug use (Egley et al., 1992).
Effect on mothers and children. Incarceration is found to be harmful to the
well-being of both mother and child...
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