User:Nicolekoonce/sandbox

Below are my plans for the article Incarceration of women in the United States:


 * Adding a section on menstruation and the availability of sanitary products, as the cost and availability of feminine hygiene products is a huge barrier to sanitation and reproductive health for female prisoners.
 * Adding a section on birth in prisons, as there is currently only information available about pregnancy, but not about labor and delivery in prison.
 * Adding a section on the care of older women in prisons, as they often have special needs and health considerations that often go unmet.
 * Adding a section on the relevant law and policy on women's healthcare in prison, especially including various state regulations and the differences between private and publicly operated prisons.
 * Updating the section on mental health to include the effects of maximum-security prisons and pregnancy-related mental health issues in prison, and adding more sources to the psychological trauma sub-section.
 * Updating the section on pregnancy and pre-natal care to include more recent information.
 * Cutting down the history section at the beginning so the rest of the article is more accessible.
 * Improving linkages to and from the article so it is more visible.

Please let me know if you have any criticisms or suggestions of these plans!

Below are the drafts of new sections for the article:

Menstruation in US prisons:

Menstruation, menstrual symptoms, and their accompanying health care and sanitation demands are unique to female populations, and often go overlooked in prison healthcare systems (smith). Menstrual hygiene in US prisons is marked by irregular availability, poor quality, and minimal protection, and poses serious health risks to inmates who must improvise menstrual hygiene supplies or overuse the ones available to them, like bacterial infections, toxic shock syndrome, and sepsis (polka). As of 2018, only four states and the City of New York have passed legislation to provide free menstrual products in prisons (polka), and in other cases when women have to purchase sanitary products through prison commissaries it is often at rates they cannot afford on the minimal income they make for a day’s work, usually under $1 (Ronan). One study on facilities in Texas found that 54% of women don’t have access to menstrual supplies when they need them. (TCJC) Not having access to adequate supplies ultimately causes unnecessary shame and humiliation for female inmates when they are forced to consult male correctional officers for issues like bleeding through their uniforms (Ronan).

Incarcerated women also have high rates of menstrual irregularity and menstrual disorders that often go untreated in prisons. Issues such as pre-menstrual tension and cramping, excessive or painful menstruation, and menstrual cessation account for a large proportion of health complaints in women’s prisons (Smith). Menstrual irregularity is linked to certain stresses experienced both inside and outside of the prison setting itself, like violence, trauma, or poverty, and also from stress and anxiety disorders, which incarcerated women experience at significantly higher rates than the general population (Allsworth). One study published in Women’s Health Issues found that incarcerated women experience some form of menstrual dysfunction at three time the rate of the general population, and at twice the rate of women of low socioeconomic status outside of prison (Allsworth).

Labor and delivery in US prisons:

Incarcerated women face many challenges when they have to give birth in correctional facilities. The issue of shackling pregnant women and women in labor has recently come into the public spotlight, yet there are many other issues that receive far less attention. A woman in labor may struggle to convince correctional officers that she is even in labor. One 2015 study found “an astounding number of reported incidents in which correctional officials refused to accept that a pregnant woman was in labor” (Ahrens). And since a woman can only be transported to a hospital for delivery if a correctional official orders the transport, this issue in failing to establish labor can cause significant delays in transport, which subsequently delays the woman's pain management, or in the worse cases, can cause delivery to occur in a prison cell without adequate medical care, hygiene, and pain medication for the laboring woman (Ahrens).

Giving birth in prison also presents issues relating to bodily autonomy and control. While women outside of the prison context makes dozens of decisions about their pregnancies and deliveries, such as what type and how much pain relief medication to take, the method and timing of delivery, and who is present in the delivery room, an incarcerated woman is not able to make many of those decisions (Ahrens). Incarcerated women are not given adequate information to make informed decisions about their deliveries and treatment (Levi). Instead, correctional personnel and medical staff make decisions regarding a laboring inmate’s ability to access pain medication, and correctional facilities routinely schedule deliveries via cesarean section for women who have not requested them and do not require them due to medical complications. (Ahrens) Incarcerated women also have very little or no say about who is present in the delivery room (Ahrens), and policies about whether or not they have access to a birthing attendant are arbitrary and inconsistent (Levi).

Pregnancy and prenatal care in US prisons[edit]
It is not surprising that many women who enter correctional facilities in the United States are pregnant or become pregnant during their incarceration periods. Demographically, the majority of incarcerated women are of reproductive age (74.7%), and 80% of incarcerated women report having been sexually active in the three months prior to their incarcerations with the majority not using any "reliable form" of contraception. Though it is difficult to obtain data on the rates of pregnancy in correctional facilities due to a lack of reporting standards, it is estimated that about 2000 women give birth while incarcerated in the United States every year (Ahrens). Estimates of the percentage of women who are pregnant at the time of their incarceration range from 4% to 10%, which, given the total number of women incarcerated and its growing rate, is quite significant.

Current Treatment of Pregnant Inmates
Many current practices in US correctional facilities conflict with standards of obstetric care as outlined by the American College of Obstetricians and Gynecologists, and are often considered unethical or inhumane by human rights and health organizations such as Amnesty International, the American Civil Liberties Union, and the World Health Organization. Fewer than half of US prisons have official policies about medical care for pregnant inmates. and according to the Bureau of Justice Statistics, only 54% of pregnant incarcerated women received some type of pregnancy care.

Pregnancy among inmates is a challenge. In the United States, the prison system was designed to accommodate male inmates, and continue to be structured in such a way that neglects the specific needs of female inmates, particularly those who have specific pregnancy-related needs. The rising rate of female incarceration poses challenges on a variety of levels, including health care. It is estimated that 9% of women in prisons give birth while completing their sentence. In spite of a Supreme Court ruling Estelle v. Gamble, 1976, which declared entitlement to basic health care for all people who are incarcerated, provision of adequate prenatal care in US prisons has been inconsistent at best.

In addition, prisons have the power to hold incarcerated women and limit their contact with the outside world, which can result in women not being able to exercise their reproductive rights, such as getting an abortion. Incarcerated women’s struggle does not end after their incarceration, given that the 1997 Adoption and Safe Families Act (ASFA), expedites the process of terminating a parent’s rights if her children are in foster care, resulting in many incarcerated women losing the parental rights to their children.[1]

Prenatal care[edit]
Women who are in jail or prison often have very high-risk pregnancies due to a higher prevalence of risk factors, which can negatively influence both pregnancy and delivery. Among these are the mother's own medical history and exposure to sexually transmitted infections, her level of education, mental health, substance use/abuse patterns, poor nutrition, inadequate prenatal care, socio-economic status, and environmental factors, such as violence and toxins.

Prenatal care in prisons is erratic. The Federal Bureau of Prisons, the National Commission on Correctional Health Care, the American Public Health Association, the American Congress of Obstetricians and Gynecologists, and the American Bar Association have all outlined minimal standards for pregnancy-related health care in correctional settings, and 34 states have established policies for provision of adequate prenatal care. However, the services can vary widely, and there is not a reliable reporting measure to ensure services are delivered.

Prenatal care for incarcerated women is a shared responsibility between medical staff in the prison and community providers, but specific delineation of care is determined locally, depending on available resources and expertise. Women must often be transported for prenatal care and delivery, which can cause stress for the mother. In addition, some states continue to use shackles for security during transportation, labor, delivery, and postpartum care.[citation needed] The use of shackles is highly controversial, reported as both dangerous and inhumane.[citation needed]

Shackles[edit]
Main article: Use of restraints on pregnant women

Shackles are typically used for inmates, who demonstrate risk of elopement, harm to self, or harm to others. Historically, they have also been used with women attending prenatal care appointments, as well as during labor and delivery. When used during transit, the use of shackles on the ankles and wrists puts a mother at risk of falling, in which case she would be unable to reach out to soften the fall. In turn, this could put both the mother and the fetus at risk of injury. Shackles can also interfere with labor and delivery, prohibiting positions and range of motion for the mother, doctors, and nurses. Following delivery, shackles interfere with a mother's ability to hold and nurse her infant child. In addition, women feel ashamed and discriminated against when they are shackled in a community hospital. Eighteen states in the US currently have laws either prohibiting or restricting shackling pregnant prisoners, and ten states prohibit use of shackles by law.[clarification needed] As a result, it is still common practice in some places.[citation needed]