Incarcerated pregnant women are back in the media again because of the National Women’s Law Center (NWLC) October 2010 Mothers Behind Bars Report. The report looked at how each state treated incarcerated pregnant women and then graded them according to certain standards.

According to the report, there are more women in the U.S. behind bars than at any other time of history, most of them non-violent first-offenders convicted of drug charges and an increasing number of them are pregnant. As an obstetrician, this is important because the quality of care or lack thereof will have a profound effect the health of their unborn babies. Sick babies place a significant burden on our healthcare system and the economy.

Shackling of pregnant inmates was discussed in a previous blog, and also addressed in the NWLC Report. Thirty-six states received failing grades of D or F for failing to limit the use of restraints on pregnant women during transportation, labor and delivery and post partum care.  Ten states adopted laws that address shacking procedures but 22 other states didn’t. A disappointing 38 states received failing grades for not implementing policies that would ensure prenatal care for pregnant women. Although these women are incarcerated for committing crimes, their unborn babies should not be punished through benign neglect. Women in prison have high-risk pregnancies and inadequate prenatal care only compounds the problem. What was even more disturbing was the absence of advance transportation plans or arrangements for deliveries from the prisons to hospitals by forty-four states.  An advanced delivery arrangement is always preferred in the event of unforeseen emergencies that require special equipment or staff. The last thing one wants is to transport a patient to a hospital in an emergency only to discover that there’s no one on duty that can perform a C. Section or administer anesthesia.  

Prison nurseries were not offered in 38 states to new mothers who are incarcerated. This which means there is no opportunity to for bonding or attachments between infants and mothers.

Pennsylvania was the lone state to receive an “A” grade for prenatal care, shackling and family-based treatment as an alternative to incarceration. Hopefully, the other 49 states will take notice.