Pregnant women in prisons and jails should be guaranteed a minimum standard of care

It’s a scary time to be pregnant – especially if you’re incarcerated.

That’s because high-density prisons and jails are like Petri dishes for the COVID-19 pandemic.

While the CDC doesn’t identify pregnancy as a high-risk condition for COVID-19, it does urge “extra precautions.”

More than enough reason for the California state Senate not to jettison Assembly Bill 732, as it streamlines its bill load to address the pandemic.

AB 732, authored by Democratic Assemblyman Rob Bonta from Oakland, would establish uniform standards for pregnancy and reproductive health care for state prisons and county jails, codifying regulations mostly in place at state facilities, but not throughout the state’s 121 county jails.

Many of the regulations for reproductive care in California’s state prisons were adopted after successful lawsuits forced the California Department of Corrections and Rehabilitation to accept standards guaranteed under federal law.

The lesson? Provide and pay for reproductive care – or get sued and pay even more in legal fees.

“Most people have never thought about pregnancy behind bars,” said Minouche Kandel of the ACLU, an AB 732 sponsor.

But we should, as national research on prisons found “3.8% of newly admitted women and 0.6% of all women were pregnant” in 2016.

In California, more than 5,000 women are held in state prisons and about 9,000 in county jails.

Lorena Garcia Zermeño with California Latinas for Reproductive Justice, another AB 732 sponsor, acknowledges that “some county jails are trying to do a better job than others,” but the “quality of reproductive health care shouldn’t be tied to where a person is incarcerated.” 

That’s why more than 50 organizations signed on to support AB 732: to require a consistent standard of pregnancy and reproductive care for incarcerated people – in prisons and county jails.

So why is the California State Sheriffs’ Association opposing AB 732?  

They claim the bill would create a local mandate, requiring services without funding for “specific, inflexible and costly prenatal and postpartum care for pregnant county jail inmates.”

A tried and true, but in this case, irrelevant argument.

The U.S. Constitution and legal precedent already require that health care, including reproductive services, be provided in prisons and jails.

The real issue is power, not cost.

Too many sheriffs consider their counties like territories in the Wild West, where their word is law.

Some provide decent care, others don’t.

In 2016, the ACLU published “Reproductive Health Behind Bars in California.” It paints a disturbing picture of pregnant people in some county jails being shackled, or not provided timely prenatal care, vitamins and nutrition supplements.

In 2018, Candace Steel filed suit against the Alameda County Sheriff’s Office for placing her in isolation while pregnant and then ignoring her screams as she gave birth without medical assistance.

In moving the case forward, U.S. District Judge James Donato wrote that the sheriff’s treatment of Steel was “a textbook example of deliberate indifference.”

That’s legal shorthand “for conscious or reckless disregard of the consequences of one’s acts or omissions.”

Wouldn’t it be smarter – and kinder – for county sheriffs to ensure basic care for pregnant people – rather than write big checks to law firms?

Of course it would – and it’s time for the sheriffs’ association to end their opposition to AB 732.

It’s also time for the state to collect and make public standardized reports on health care quality in county jails – including reproductive care.

Without information, there can be no accountability.

As the ACLU learned while developing “Reproductive Health Behind Bars in California,” it currently takes time-consuming public records requests to assemble a statewide picture of the quality of health care in California’s local jails.

The COVID-19 crisis has laid bare the threadbare nature of our health care system. Despite a common threat and unifying fear, we remain divided into communities of health-care haves and have-nots.

The purpose of AB 732 is to safeguard the least among us, to guarantee incarcerated people a minimum standard of pregnancy and reproductive care.

I’d call that a moral mandate.

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Kate Karpilow is a writer who previously directed the California Center for Research on Women and Families at the Public Health Institute, Kate.Karpilow@comcast.net. Karpilow has also written about the need for a pay equity czar and a new class of superheroes in the battle against COVID-19. She wrote this commentary for CalMatters.