The Barriers to Reproductive Healthcare in California Prisons and Jails

Last week, reproductive justice advocates celebrated a significant win when the Supreme Court temporarily blocked a Louisiana abortion law and allowed four abortion clinics to re-open. The court is now deciding whether to uphold a Texas law that also places major restrictions on facilities providing abortion care, a law that has already caused about half of the abortion clinics in Texas to close.

While we await the Supreme Court's decision, it's important to remember that structural barriers to reproductive health access and a pattern and practice of denying care to low-income women of color in particular is a widespread problem that extends to prisons and jails as well. 

Incarcerated people in California have the right to reproductive health care while behind bars, however very often their lived experience in the system reflects barriers and abuses to these rights.  In January, the ACLU of California released an ambitious report, Reproductive Health Behind Bars in California, that details the problems people incarcerated in California jails and prisons experience.

The report analyzed policies and data, laid out interviews with incarcerated and formerly incarcerated people, and conducted research with allied organizations in order to expose these injustices and lay out recommendations for the future.  Some of the most striking problems addressed by the report were as follows:

1.     Barriers to Abortion Access: Jails cannot deny or interfere with a person’s choice to an abortion. Yet some jails have policies and practices that both interfere with a person’s integrity and present access issues. Demonstrating a lack of respect of humanity, jails “often apply special armbands… to people as soon as they are identified as pregnant” regardless of if the individual is considering continuing the pregnancy or not, and may not want the staff or community to know. Some jails also present excessive barriers that limit who can access abortion care such as requiring proof of pay, mental health clearance, or making women fill out detailed forms discussing why they want an abortion.

2.     Denial or Lack of Prenatal Care: Should a woman want to continue her pregnancy, there are many reasons why being in jail  while pregnant is inhumane, stressful, and even dangerous to the health of the mother and the child. Restraining women improperly (including aggressive shackling), tasering pregnant women, and inconsistent obedience with medical best practices for timely prenatal care are a few of the many ways jails mistreat pregnant women.

3.     Unmet Needs After Giving Birth: The physical and mental strains after giving birth are enormous for women outside the prison system, but within the system the experience is even more taxing. Separation from the baby can be traumatic for both the mother and child, and unfortunately there are very few programs that allow for this. In a long term sense, visitation and maintaining custody is a challenge for women in prison, and jails do little to help connect women to social services that assure the protection of their children. 

4.     Coerced Sterilization: California has a dark history with eugenics, and specifically the forced sterilization of incarcerated people. This history is not a distant past - between 2006 and 2010 nearly 150 women in California state prisons had been sterilized without the required approvals, and some reported without consent.  

5.     Insufficient Protection from Sexual Assault: Many people continue to experience sexual assault behind bars, and jails do little to protect incarcerated individuals from these threats. Under PREA (Prison Rape Elimination Act of 2003) standards jails must report and intervene when they learn of people being targeted/victimized, provide people with proper mental health services, maintain their confidentiality, and investigate assaults in due time. Because LGBTI people have a heightened vulnerability to sexual victimization, there are standards that protect these individuals specifically. Many county policies the ACLU investigated were not compliant with PREA, and insufficiently addressed the care victims have the right to receive.

Last September, the Ella Baker Center, Forward Together, Research Action Design, and 20 other organizations across the country released Who Pays? The True Cost of Incarceration On Families, which revealed the overwhelming debt, health challenges, and forced separation that families face when their loved ones are locked up. We learned that women of color in particular bear the brunt of these burdens. 

This report from the ACLU of California further demonstrates the harmful and dehumanizing impacts of incarceration on women and transgender men. There is much more that the report highlights, including the unique barriers to access that transgender men face, barriers to contraception, and recommendations for the future.

What is clear, however, is that the state of reproductive health care for folks behind bars is nowhere near what it should be. We need to embrace a reproductive justice framework and fight to ensure people in prison have their reproductive health rights met.