Saturday, February 27, 2021

MCN/USA TODAY NETWORK: The plight of pregnant women in prisons and jails

Matthew T. Mangino
February 26, 2021

Pregnancy can be challenging to a mother and fetus under the best of circumstances.  According to Johns Hopkins University, pregnant women are particularly vulnerable to life threatening complications if not closely monitored by a physician.

Without close medical observation, conditions like hyperemesis gravidarum, a severe form of morning sickness that can cause significant weight loss; gestational diabetes, which may cause the fetus to grow larger than normal causing problems during child birth; or preeclampsia which causes dangerously high blood pressure, can cause harm or death to a mother and child.

Now, imagine pregnancy in jail or prison. Incarcerated pregnant women are a vulnerable population with special needs. For example, national guidance provides that they should receive regular prenatal care, screening, and diagnostic tests. However, the U.S. Government Office of Accountability (GOA) found that while the U.S. Marshals Service and the Federal Bureau of Prisons (BOP) have policies on pregnancy-related care, they do not always align with the national guidance.

Outside of the prison walls the government and private businesses make a host of accommodations for pregnant and parenting women.  The Pregnancy Discrimination Act is a federal statute that protects pregnant workers and requires covered employers to make job-related modifications for pregnant employees. The Act forbids employment discrimination based on pregnancy, childbirth, or medical conditions related to pregnancy or childbirth.

When a family is expecting a new child, the Family Medical Leave Act (FMLA) provides equal leave for both the mother and father. Both, or either covered parent, may take 12 weeks leave for the birth of a newborn. If both parents work in positions covered by the FMLA, they will both be entitled to leave. FMLA also provides leave for pregnancy-related health reasons. 

In prison, the government is not so generous when it comes to pregnant women or women who have recently given birth.  According to the GOA report, while the Marshals Service and BOP both have policies in place for pregnant women, not all policies fully align with national guidance recommendations on 16 pregnancy-related care topics.

Women in the custody of the Marshals Service are typically those in pretrial detention.  Those inmates may be in federal facilities, but are more likely in state or local facilities where beds are leased by the federal government.  Those in the BOP have been sentenced to a term of imprisonment.

GAO analyses of available data show that from 2017 through 2019, there were at least 1,220 pregnant women in Marshals Service custody and 524 pregnant women in BOP custody.

According to The Crime Report, national guidelines created by the American College of Obstetricians and Gynecologists call for special nutrition for pregnant women and, if needed, mental health care, as well as other screenings and services.

According to the GOA the Marshals Service policies align with only on three of 16 care topics and BOP policies fully align with eight of 16 recommendations.

Prisons and jails are not equipped to properly care for pregnant women. For instance, pregnant women with mental health problems are advised to stop taking psychotropic drugs for bipolar, anxiety and depression. Obviously, confinement exacerbates their condition.  Intensive mental health therapy must stand in the void.

Special nutritional concerns like seafood, foods not fully cooked or fruit and vegetables not properly cleaned put women and their babies at risk. Proper intake testing and evaluation, prenatal care and postpartum care, especially mental health care after separation from a newborn child can go a long way toward protecting pregnant women and their newborn.

Pregnant women do not belong in prisons or jails, but until we get to the point where society can achieve an alternative—intensive evaluation, observation, care and treatment are essential.

(Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly & George P.C. His book The Executioner’s Toll, 2010 was released by McFarland Publishing. You can reach him at and follow him on Twitter @MatthewTMangino)

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