The ACLU of California today released a report that finds county jails are putting people’s health at risk by denying, delaying, and ignoring crucial reproductive health care.
The report Reproductive Health Behind Bars in California shines a light on the lack of adequate care and provides a blueprint for change. It's informed by a review of written policies from a geographically diverse sample of jails throughout California, and by ACLU interviews with people in jails who have been denied care. The release of the report is also accompanied by the release of a tool to help jail administrators assess their reproductive health policies, and a Know Your Rights guide for people in California jails.
"Across California, we're seeing that accessing reproductive health care becomes a frightening and traumatic experience for people incarcerated in county jails," said Melissa Goodman, director of the LGBTQ, Gender & Reproductive Justice Project at the ACLU of Southern California. "Jails need to make concrete changes to make sure that they are meeting the reproductive health needs of the people in their care."
The report identifies a wide array of problems with policies and practices in jails, including:
- Delayed and denied abortion access: Some jails deny timely access to abortions, or have unlawful policies on the books that give jail staff the authority to deny abortions. One woman interviewed by the ACLU had to wait two months for an abortion, despite repeated requests. The jail told her she had to prove she could pay for the procedure before she could get it, which is illegal.
- Dangerous prenatal conditions: The ACLU has compiled reports from people who weren’t given the food they needed to have a healthy pregnancy, were forced to sleep on dangerous top bunks, were shackled while pregnant, and were denied prenatal and emergency visits with medical staff. In one especially disturbing instance, a woman reported that after she went to the jail clinic with intense abdominal pain, the nurses failed to find a fetal heartbeat but still sent her back to her cell because an OB/GYN wasn't on shift.
- Denial of menstrual supplies: In many jails, people don't have sufficient access to menstrual pads. A formerly incarcerated woman told the ACLU that in her county jail, people in solitary confinement weren't given any sanitary products and were forced to bleed on the dirty floor.
- Denial of lactation accommodations: Jails should be providing lactation pumps to people who need them. The ACLU interviewed a mother whose child developed bronchitis because the jail wouldn't let her pump milk to be picked up for her infant. The sudden cessation of breastfeeding also put the mother at risk for medical complications.
The new report and assessment tool provide California jails an opportunity to look at the law, look at medical best practices, and make concrete changes to their policies. In addition to changing written policies and training staff to implement them, the report recommends that jails collect robust data on reproductive health needs and outcomes. Currently, this crucial data is widely untracked and unavailable.
The ACLU of California also recommends that jails update their policies to protect the reproductive health of transgender and gender nonconforming people. For instance, menstruation pads should be provided to everyone who needs them, regardless of gender identity or whether they are housed in a men or women's jail. And practices to prevent sexual violence should address the fact that transgender women are at a heightened risk for sexual assault while incarcerated. Currently, many jails have reproductive health policies that imply that cisgender women — women whose gender identity matches their sex assigned at birth — are the only people in need of reproductive health care.
The report notes that at a time when mass incarceration is a national crisis, with an especially harmful effect on poor communities and communities of color, counties should also be supporting alternatives to incarceration. Families and communities benefit from pre-trial diversion, home sentencing and treatment programs for addiction.
The report also notes that reform is important, legally necessary and feasible. For instance, two years ago the ACLU of Southern California uncovered a range of problems pregnant people experienced — from abortion delays to illegal shackling — at Los Angeles County’s women's jail, the largest women's facility in the country. The ACLU worked collaboratively with the Los Angeles Sherriff's department on positive reforms that improved access to medical care and other necessary accommodations for pregnant people, including housing. The collaboration also initiated the launch of a pilot program allowing family members to pick up pumped breastmilk for delivery to children at home. The ACLU is continuing to monitor the county to ensure that change in policy translates into real change in practice.
The government has an obligation to provide medical care to the people it incarcerates. Sadly, that definition too often fails to include reproductive health.
The ACLU of California is a collaboration of the ACLU of Northern California, the ACLU of Southern California and the ACLU of San Diego & Imperial Counties.