Legal Issues Regarding Medical Care for Pregnant Inmates

Date01 December 2010
DOI10.1177/0032885510382211
Published date01 December 2010
Subject MatterArticles
The Prison Journal
90(4) 417 –446
© 2010 SAGE Publications
Reprints and permission:
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DOI: 10.1177/0032885510382211
http://tpj.sagepub.com
1Lewis University, Romeoville, IL
2Sam Houston State University, Huntsville, TX
Corresponding Author:
Michael S. Vaughn, Institute for Legal Studies in Criminal Justice, College of Criminal Justice,
Sam Houston State University, PO Box 2296, Huntsville, TX 77341-2296
Email: mvaughn@shsu.edu
Legal Issues Regarding
Medical Care for
Pregnant Inmates
Natalia D. Tapia1 and Michael S. Vaughn2
Abstract
This article examines mothers in prison, highlighting the complexity and
detrimental consequences incarceration has for their families and children.
It documents the legal remedies available to pregnant prisoners, focusing on
their unique medical needs. After reviewing the U.S. Supreme Court’s stan-
dard for liability, the article explores lower court case law to establish the
legal parameters of pregnant prisoners’ health care needs. The article con-
cludes that although correctional health care systems have made strides in
bringing appropriate medical care to pregnant prisoners, more remains to be
done to raise the quality of care to those similarly situated in the free-world.
Keywords
pregnant female inmates, Supreme Court standard for liability, quality of care
Introduction
Incarcerated women are growing at a faster rate than men but still remain a
small percentage of the overall inmate population. In 1997, more women
were arrested, convicted, and sent to prison than ever before (n = 895,300).
That year, female offenders consisted of 6.4% of the state and federal prison
Article
418 The Prison Journal 90(4)
populations, an increase from 3.8% in 1975. Females account for only 22.2%
of the total state prison population, whereas men account for 77.8% of pris-
oners (National Criminal Justice Reference Service [NCJRS], 1998).
The nature of female crimes resulting in incarceration has changed from
larceny, forgery, embezzlement, and prostitution in the 1970s to drug-related
offenses in the 1990s and 2000s (Heidensohn, 1995; NCJRS, 1998). Although
the criminal activities of female offenders has changed, the gender-specific
needs of female offenders have not (Balis, 2007; Marcus-Mendoza, 2004). In
addition to drugs, many female offenders are incarcerated for “moral” and
sex offenses, or minor property crimes—offenses that are not as dangerous
as crimes committed by males (Gibson, 1976; Kurshan, 1997; Mann, 1984).
Female offenders have needs that differ from males, stemming in part
from female offenders’ disproportionate victimization from sexual or physi-
cal abuse, their responsibility for children, and their distinct medical needs
(Hannaher, 2007; Parkes & Pate, 2006; Rafter, 1998). The Law Enforcement
Assistance Administration (LEAA) in 1975 characterized women in prison
as “forgotten offenders”; correctional environments are better for women
today than in the 1970s, but some institutions remain inadequate (NCJRS,
1998). This neglect is primarily due to a lack of awareness of the special
needs of female offenders, and as a result, the priority is given to male-
specific programs (Marcus-Mendoza, 2004). As one author put it, the pro-
grams for women inmates are “shoe-horned into a system designed for men”
(Zoia, 2005, p. 118). Many state prisons and jails, particularly those with
small female offender populations, have few special provisions, either in
managing or programming, for meeting the needs of women. In short, more
needs to be done to ensure that women are treated fairly and that their unique
circumstances are addressed as they move through every phase of the criminal
justice system (Marcus-Mendoza, 2004); equal protection demands no less.
Female prisoners possess legal remedies if their health care needs are not
met. Since pregnant prisoners present unique challenges to correctional med-
ical systems, there exists litigation surrounding their correctional experience.
In fact, lawsuits pursuant to Title 42 U.S.C. Section 1983 are the primary way
pregnant prisoners seek to address their grievances. This article examines
mothers in prison, highlighting the complexity and detrimental consequences
incarceration has for their families and children. It highlights the legal rem-
edies available to pregnant prisoners, focusing on their unique medical needs.
After reviewing the U.S. Supreme Court’s standard for liability, the article
explores lower court case law to establish the legal parameters of pregnant
prisoners’ health care needs. The article concludes that more remains to be

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