A loss for Winn

At six months pregnant, Pamela Winn found out she would be serving time in federal prison for a white-collar crime. While incarcerated, she received no prenatal care. She says the drinking fountain in her cell spewed brown water. 

During transportation to and from court, shackles bound her feet and held her wrists together at her stomach. One day, while stepping into a van, she tripped and fell.

Shortly after, Winn noticed blood spotting and reported it to staff. However, she was unable to receive medical attention due to the lack of OB-GYN resources at the prison. Waiting weeks for approvals prevented her from being able to see an outside physician. One night, after experiencing severe cramps, she returned to her cell early. She woke up in extreme pain and called for help. She went unanswered for several hours until a guard finally came and noticed blood pooled beneath her. At the hospital, the doctor told her she had miscarried before arriving at the ER. Winn discovered the officers had thrown out her unborn child with her soiled sheets.

She says, “Just to hear that my baby was thrown in the trash and that their [the officers’] tone was just so nonchalant, was really devastating for me. Whenever I think of the worst things that have happened in my life, that definitely is right there.”

Restored hope

“When I came home, I was determined to do something about what had happened to me,” Winn states. “Everybody kept telling me that there was nothing I could do – that it was a bad thing but unfortunately nothing could be done. And I just refused to accept no for an answer.”

Pamela Winn is now an activist. She founded RestoreHER US.America, an organization based in Georgia that empowers incarcerated and formerly incarcerated women through education, leadership, and policy change. In 2019, RestoreHER helped pass GA HB345, which details prohibited practices regarding pregnant incarcerated people.

How many incarcerated people are pregnant?

It is hard to determine how many incarcerated people are pregnant because national data on this demographic is sparse and outdated. According to 2004 data from the US Bureau of Justice Statistics (BJS), 4% of women in state prisons and 3% of women in federal prisons are pregnant at the time of admission. 

Advocacy and Research on Reproductive Wellness of Incarcerated People (ARRWIP) investigates reproductive wellbeing within the criminal justice system. Through their Pregnancy In Prison Statistics (PIPS) project, ARRWIP tracked data on pregnancy outcomes of people in US prisons and jails for twelve months (2016-2017). Of the prisons they studied that year, roughly 1400 pregnant people entered. Of the jails they studied, roughly 1600 pregnant people entered. Using national numbers of total incarcerated females, ARRWIP estimates that about 3,000 pregnant people enter US prisons and 55,000 pregnant people enter US jails annually.

What are the problems?

As Pamela Winn’s story demonstrates, pregnant people in jails and prisons often receive insufficient care. The BJS found that only slightly over half (54%) of pregnant women receive prenatal services in prison. Even fewer (35%) received prenatal services in jail. Furthermore, the Prison Policy Initiative found that 31 states lack a nutrition policy for pregnant people in prisons. They claim even those that do have policies often omit specific guidelines, making it difficult to hold anyone accountable. 

Prenatal care is especially essential for incarcerated pregnant people since they are more likely to have experienced domestic violence and drug abuse.

In their study, PIPS found that 26% of incarcerated pregnant people received an opioid use disorder diagnosis. Of those people, one-third were put through withdrawal, which can induce premature labor or harm the fetus.

Giving life, chained

The First Step Act became law in 2018, making the use of restraints on pregnant people illegal. Yet, this law does not apply to state prisons or county jails, where 85% of incarcerated women are located in the US, as cited in The Guardian. Thus, prisons and jails continue to shackle incarcerated pregnant individuals during transportation to and from courts, hospitals, and even during delivery.

It was while shackled that Pamela Winn fell, leading to her miscarriage. When she arrived at the ER after she was found bleeding, she says she was chained to a hospital bed – two male officers between her legs the entire time. She says, “It was very humiliating and dehumanizing.”

Shackling during labor poses life-threatening health risks, including delayed delivery and obstruction of medical assistance. Furthermore, it is damaging to the dignity of the person bringing new life into the world.

Pregnant with progress

Pamela Winn is currently working on the Georgia Women’s Care (Child Care Alternatives, Resources, and Education) Act. If passed, this bill would allow a convicted pregnant woman to defer her detainment up to 12 weeks after she delivers her baby. Through RestoreHER and the wellness and leadership program she designed as a 2019 Soros Justice Fellow, Winn has also recently helped women reintegrate to life after prison amidst the COVID-19 pandemic. Furthermore, she is collaborating with Spelman College in Atlanta to provide tuition-free college courses to incarcerated and formerly incarcerated women. 

“I’m just hopeful about everything,” Winn says.

Mass incarceration – the root of the problem

People like Pamela Winn have made undeniable strides, but the fight is not over. The problem runs deeper than inhumane treatment of incarcerated pregnant individuals, lack of procedural standards, or inadequate data collection. The root of the problem is mass incarceration. The US holds more incarcerated individuals per capita than any other country, a disproportionate number of whom are people of color and from impoverished backgrounds. Creating solutions to the plight of pregnant people in prisons and jails will require not only collaboration between various stakeholders but also reforming the criminal justice system as a whole.

Read also:
The Broken US Criminal Justice System That Puts Women At a Disadvantage
Prison: A System Designed For Men, Used By Women
On The Anniversary Of My ER Visit: The Need For More Rural OB-GYNs