H. Issues of Importance to Women in Prison
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H. Issues of Importance to Women in Prison
As you learned in Section C, women in prison have the same rights under the U.S. Constitution as everyone else. But even though the number of women in prison continues to grow, most cases involving prisoners have been about male prisoners and their needs.
This section discusses some issues of special concern to women in prison, including gynecological care, prenatal care (medical care during pregnancy), abortion, and privacy from observation and searches. For discussion on the needs of transgender women, see Section I.
1. Medical Care
As you learned in Section F, Part 4 of this chapter, your right to medical care is guaranteed by the Eighth Amendment, which prohibits cruel and unusual punishment. To make a claim for an Eighth Amendment medical-care violation, you must show a "serious medical need" and a prison official must have shown "deliberate indifference" to that need.
Despite these rights, women in prison often do not get the medical care they need. In Todaro v. Ward, 565 F.2d 48 (2d Cir. 1977), for example, a class of women in prison argued that their prison's medical system violated constitutional standards. The court applied the "deliberate indifference" test and determined that by not properly screening women's health problems and poorly administering prison health services, the prison had denied or unreasonably delayed prisoners' access to proper medical care in violation of the Eighth Amendment. The court ordered the prison to take specific steps to improve its medical services.
a. Proper Care for Women in Prison
Most courts have not yet considered how to judge the level of medical care women in prison need, including pregnant women. However, state and local regulations sometimes require certain medical services, such as a physical exam, for every new prisoner. Under federal law, all federal prisoners are entitled to a medical screening, with appropriate record keeping, that meets guidelines issued by the Bureau of Prisons. 28 CFR §§ 522.20 - 522.21.
If you are unsure about your own medical needs or want to challenge the medical care you have received, you may want to take a look at some guidelines for women's health published by national medical associations. The Jailhouse Lawyer's Manual from Columbia University provides a good summary of the medical services and tests that national guidelines recommend for women. Information on how to order the Columbia Jailhouse Lawyer's Manual is available in Appendix K.
While a court cannot enforce these guidelines, a judge may be willing to take them into account, especially since there is not that much case law in this area.
b. Medical Needs of Pregnant Women
Women who are pregnant require special medical care, called "prenatal care," to ensure that they deliver healthy babies. Many pregnant women experience complications during their pregnancy. With immediate and appropriate medical care, these complications can be resolved, and women can go on to have healthy pregnancies and babies. When these complications are ignored, however, they can lead to miscarriages, premature or risky labor, and future reproductive health problems for the pregnant woman involved.
Challenging inadequate prenatal care in court
The two-part test for inadequate medical care under the Eighth Amendment raises some special questions in the area of prenatal care:
> Is pregnancy a serious medical need? Complications during pregnancy, like pain or vaginal bleeding, are serious medical needs. Coopers v. Rogers, 968 F. Supp. 2d 1121 (M.D.Ala 2013). But courts disagree whether a healthy pregnancy is a "serious medical need." One court said that pregnancy is not a serious medical need if a doctor has not identified any special need for care and when it would not be obvious to an average person that there is a problem. Coleman v. Rahija, 114 F.3d 778 (8th Cir. 1997). In a case about a prisoner's right to an abortion, however, another court stated that pregnancy is different from other medical issues and is a "serious medical need," even when there are no complications or abnormalities. Monmouth County Correctional Institution Inmates v. Lanzaro, 834 F.2d 326 (3d Cir. 1987).
> What counts as deliberate indifference? If you experienced major complications during your pregnancy, a court is likely to find that you had a serious medical need, but the court must still decide whether a prison official who denied you appropriate care showed deliberate indifference to your needs. In Coleman v. Rahija, 114 F.3d 778 (8th Cir. 1997), the court found that a prison nurse showed deliberate indifference when she ignored requests to transfer a pregnant prisoner in early labor to a hospital, leaving the prisoner to give birth in severe pain on the floor of her prison cell. The court held that the nurse must have known of the prisoner's serious medical need because the signs of her preterm labor were obvious and because the nurse had access to the prisoner's medical records, which documented a history of multiple pregnancies, all with serious complications. In Goebert v. Lee County, 510 F.3d 1312 (11th Cir. 2007), the court found that a pregnant pretrial detainee's rights were violated when she did not get medical care for 11 days while leaking amniotic fluid and ultimately had a stillbirth.
In some cases, a prison official's supervisor can be found guilty of deliberate indifference when the official violates a prisoner's rights, even if the supervisor was not aware of the particular incident in question. In Boswell v. Sherburne County, 849 F.2d 1117 (8th Cir. 1988), the court found a possibility of deliberate indifference among both the jailers who repeatedly ignored a pregnant pretrial detainee's complaints of severe vaginal bleeding and their...
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