Today, more than 200,000 women live in correctional facilities nationwide.[1,2] Over the last 10 years, the female prison population has grown faster than the male prison population.[3,4] These women depend on the prison's health care services for all their needs, including pregnancy-related and reproductive health care.

As many as one in 10 incarcerated women in the United States are pregnant before incarceration or become pregnant in prison.[5] Massachusetts has the lowest rate of female imprisonment in the nation; however, the national average indicates that 400 or more women in the Commonwealth face this situation each year.[6] NARAL Pro-Choice Massachusetts believes that all women have the right to proper medical care- including the right to continue or terminate a pregnancy.

The prison health care system was originally established to serve a predominately male population and few modifications have been made to reflect the increase in incarcerated women.[7] In the Commonwealth, according to the Department of Correction's policy, female inmates should have access to a medical provider for gynecological and obstetrical medical care, including prenatal and postpartum care.[8] Upon determination of pregnancy, the health service administrator will arrange for the appropriate counseling services and develop a plan with the inmate.[9]

Unfortunately, there is no law in Massachusetts guaranteeing adequate prenatal and postpartum care. An incarcerated woman who chooses to continue her pregnancy is also often subject to gross mistreatment.[10] Federal prisons may restrain women's legs or wrists in shackles throughout the pregnancy and during labor.[11,12] The American College of Obstetricians and Gynecologist have stated that shackling during labor may cause serious complications for the mother and her baby, including hemorrhage or decreased fetal heart rate.[13] In Massachusetts, prisons, women can be shackled throughout their entire pregnancy, until they arrive at the delivery room or begin "active labor."[14]

Pregnant women are typically transferred to a nearby hospital for delivery. Afterwards, a woman may be granted the opportunity to live with her infant at a special facility.[15] However, doctor's visits are often infrequent, which can be detrimental to the health and well-being of a woman and her baby.[16] And the program for pregnant inmates at MCI-Framingham, called Catch the Hope, is currently under-funded, under-staffed, and unable to provide necessary medical care and support services to pregnant and postpartum women in prison.[17]

A woman's options are even more limited if she wishes to terminate her pregnancy while incarcerated. In 1976, the Hyde Amendment banned the use of federal funds for abortions, so federal prisons cannot provide abortion care.[18] Thirty-two states and the District of Columbia pay for abortions for their inmates only when the women's life is in danger or the pregnancy is a result of rape or incest[19]; seventeen other states, including Massachusetts, provide abortions in additional medically necessary situations.[20] South Dakota only provides abortions when the woman's life is threatened.[21]

In the Commonwealth, an inmate who desires to terminate her pregnancy is referred to counseling services.[22] However, neither the Department of Corrections nor the medical provider will provide funds for abortion services unless the pregnancy is deemed medically necessary by a physician.[23]

NARAL Pro-Choice Massachusetts supports legislation that would establish minimum standards for the treatment and medical care of female inmates to promote reproductive health and safe, healthy pregnancy outcomes; prohibit shackling during childbirth; and ensure that release planning includes child custody and basic family planning information and services. Children born to inmates deserve the opportunity for a healthy start to life, physically and emotionally, as well as a mother who is physically and psychologically well. In addition, we support legislation that requires prisoners in women's correctional institutions to be given access to written information on women's health, contraception, and sexually transmitted infections.

Learn more about An Act Relative to Safe Pregnancies and Related Health Care for Female Inmates (including our fact sheet) and An Act Relative to Providing Health Education in Women's Correctional Institutions.

[2] U.S. Department of Justice, Bureau of Justice Statistics, Bulletin: Prisoners in 2009 (2010), available at: http://bjs.ojp.usdoj.gov/content/pub/pdf/p09.pdf [accessed 22 June 2011]

[3] Id.

[4] Women's Prison Association, Institute on Women & Criminal Justice, Quick Facts: Women & Criminal Justice - 2009, available at: http://www.wpaonline.org/pdf/Quick%20Facts%20Women%20and%20CJ%202009.pdf [accessed 22 June 2011]

[5] J.G. Clarke, et. al., Reproductive Health Care and Family Planning Needs Among Incarcerated Women, 96 Am. J. Pub. Health 834, 834 (2006) available at: http://www.ajph.org/cgi/reprint/96/5/834.pdf [accessed 22 June 2011]

[6] Women's Prison Association, Institute on Women & Criminal Justice, Quick Facts: Women & Criminal Justice - 2009, available at: http://www.wpaonline.org/pdf/Quick%20Facts%20Women%20and%20CJ%202009.pdf [accessed 22 June 2011]

[7] National Women's Law Center, The Rebecca Project for Human Rights, Mothers Behind Bars (2010), available at: http://www.rebeccaproject.org/images/stories/files/mothersbehindbarsreport-2010.pdf [accessed 22 June 2010]

[8] Mass. Dep't of Corr., Health Services Division, Special Health Care Practices, 103 DOC 620.04. Available at: http://www.mass.gov/Eeops/docs/doc/policies/620.pdf [accessed 22 June 2011]

[9] Id. note 1

[10] J.G. Clarke, et. al., supra

[11] D.L. Sichel, Giving Birth in Shackles: A Constitutional and Human Rights Violation, 16(2) American University Journal of Gender, Social Policy & the Law 223, 255 (2008)

[12] Law Students for Reproductive Justice, Women in Prison (2008), available at: http://lsrj.org/documents/factsheets/08-09_Women_in_Prison.pdf [accessed 22 June 2011]

[13] Press Release, Cal. State Assembly, Governor Signs Bill To End Shackling of Women During Labor and Delivery (Oct. 7, 2005), available at http://democrats.assembly.ca.gov/members/a22/Press/p222005023.htm.

[14] Law Students for Reproductive Justice, supra

[15] Laura Crimaldi, For prison moms, a shot at redemption. Boston Herald, Boston Ma, Oct 29, 2006

[16] J.G. Clarke, et. al., supra

[19] Id.

[20] Id.

[21] Id.

[22] Mass. Dep't of Corr., Health Services Division, Special Health Care Practices, 103 DOC 620.04. Available at: http: http://www.mass.gov/Eeops/docs/doc/policies/620.pdf [accessed 22 June 2011]