Access to abortion in prisons after the end of Roe v Wade

JAne Roe, a 22-year-old inmate from Nebraska, wanted an abortion. Knowing the state had banned the procedure after 22 weeks, she quickly alerted prison officials so she wouldn’t miss her window.

Inexplicably, officials denied the request, even though it was a legally protected part of the medical care available to people inside the Nebraska Correction Center for Women. She made other requests, which were also denied. After one, officials said they couldn’t follow through because Jane had to pay for it herself and there was a 21-day freeze on money being paid to inmates. Soon, factoring in the state’s mandatory waiting period and counseling periods before an abortion, she was closing in on the legal deadline.

She decided to sue in prison in April, arguing that her 14th Amendment rights were being violated. The facility eventually relented and a corrections officer resigned in protest at the long wait Jane Roe faced.

This all happened in 2021, before the Supreme Court overturned the constitutional right to abortion in June. Nebraska joins the many states that are considering (or beginning) a complete ban on abortions.

According to doctors and lawyers, it is now almost impossible for pregnant women incarcerated in the 25 states where abortion is partially or totally prohibited to access the procedure, while those in states where it is legal still carry out a uphill battle for healing. And people in both scenarios are in the hands of a prison medical system that has always been shown to fail mothers.

Women are the fastest growing population in the US prison population, and many of the estimated 58,000 pregnant women who enter jails and prisons each year have suffered from sexual assault, trauma, poverty and domestic violence.

“These are all things that can lead to unwanted pregnancies. You have this population that needs abortion more than the average person, and they are less likely to be able to access it,” said Wanda Bertram of the Prison Policy Initiative (PPI). The Independent. “As soon as a state criminalizes abortion as a whole, it will effectively be impossible to provide abortion care behind bars.”

The 10 states with the highest female incarceration rates – Idaho, Oklahoma, South Dakota, Arizona, Wyoming, Kentucky, Montana, Arkansas, Mississippi and West Virginia – are also those set to apply more restrictions on abortion.

As a result, pregnant women in these states face a harrowing set of conditions.

A 2020 PPI report found that at least 20 states had inadequate prenatal care in their prison systems, and new mothers are often separated from children born behind bars within hours, forced to leave their children with family or send them to the host system.

In June, a federal court found that Arizona’s $280 million-a-year privatized prison health care system was so “appalling” and “grossly inadequate” that it constituted a denial of constitutional rights to those found on the inside.

Pregnant women only received an extra peanut butter sandwich and a carton of milk for prenatal nutrition. Inadequate supplies were offered to those suffering from postpartum bleeding, who received at most a thin panty liner. A patient, who prison authorities knew had a history of drug use, was not recommended for methadone therapies which could have prevented her from miscarrying.

“The medical care incarcerated people receive in ICE jails, jails or detention centers is often abysmal. And they have each shown historically that they are unable to meet the needs of pregnancy or postpartum,” according to Corene Kendrick, deputy director of the ACLU’s National Prisons Project.

The situation is not much better in states where abortion is still legal.

“Unfortunately, in practice, some prison and prison systems make it virtually impossible for incarcerated people to obtain an abortion,” Ms Kendrick added.

The Supreme Court has ruled that prisoners are entitled to adequate medical care, and state courts have interpreted this to cover abortion, but there is often a great gap between what the courts say is mandatory and what the prisons actually deliver in practice.

According to a landmark 2021 study of 22 state prison systems, all Federal Bureau of Prisons sites, and six county jails, only half allowed abortion in the first and second trimesters, and 14 percent completely prohibited abortion. abortion. Of the 19 states that allow abortion, two-thirds required inmates to pay for it themselves, a bill that often went beyond the procedure itself to cover overtime and staff transportation. Pregnant women are almost 20 times less likely to have an abortion in prison than in the outside world.

“You’re stuck between this rock and this difficult place, when you can’t really get good pregnancy care, but you also have a hard time getting access to abortion,” said Ms Bertram of PPI. “It’s kind of a Catch-22.”

After the Dobbs decision annulling deer, pregnant people outside of prison can at least travel to other states to access abortions, get treatment via mail-order drugs, or, sometimes at great personal risk, access clandestine treatment options. All of these options are difficult enough on their own, and none are available to incarcerated pregnant women, according to Dr. Carolyn Sufrin, professor of gynecology and obstetrics at Johns Hopkins and co-author of the 2021 survey of reproductive care in prisons.

“They can’t move. They can ride in a car. They can get on a bus. Someone who is incarcerated has no control over where they are. They have to stay there,” she said.

Federal prisons, which until June were at least nominally bound by Roe vs. Wadealso required inmates to pay more than $500 for an abortion under the so-called Hyde Amendment, which prohibits federal funds for abortion except for health emergencies and rape.

There are also hundreds of thousands of women on parole at any one time in the United States. According to the PPI, at least 200,000 parolees live in 13 states where “trigger laws” banning abortion are to be put in place, and it is unclear to unlikely that the terms of their parole will allow them to get through. state lines to get an abortion.

The BOP said it was still reviewing the abortion rights of its inmates in the post-deer world, and whether these extend to people housed in federal facilities in states where abortion is now illegal.

“The Bureau of Prisons is considering all potential policy options to protect the reproductive health of inmates in our care and custody,” said BOP’s Donald Murphy. The Independent.

Dr. Sufrin doubts the federal government will go the extra mile for these patients. The Biden administration has already pushed back against persistent calls to open abortion clinics on federal lands, arguing it would lead to “dangerous ramifications.”

“It’s hard for me to imagine that they would facilitate the transportation of someone in their custody to another state to obtain what is considered illegal care in their home state,” Dr. Sufrin said.

“For pregnant women in states where abortion is illegal, they are going to be forced to have an unwanted pregnancy, forced to give birth. And they will do so where their access to quality prenatal care is highly variable and sometimes non-existent.

“They might have to give birth in chains.”

Meanwhile, some facilities in states that allow abortion in name simply don’t have written procedures when an incarcerated person requests an abortion, or have processes that allow officials considerable personal discretion to deny requests. As they wish.

All in all, incarcerated people face the very real prospect of being forced to carry a pregnancy to term, in a system that exposes them to medical risk and then separates them from their children.

“What we can say is that it makes a bad situation even worse,” Dr Sufrin said. “Humans deserve health care. No matter what they’ve done, they deserve health care. If they are pregnant, they should have access to comprehensive pregnancy care, whether it is abortion care or comprehensive prenatal and postpartum care. The Supreme Court recognized it. »

The past few months have shown, however, that the Supreme Court can take away rights as quickly as it grants them, rights that often fail to make it through the prison door in the first place.

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