Pregnant Incarcerated Women Can’t Get Abortion, Basic Care Even in Blue States

In Wills County, Illinois, in 2020, Aliyah was only four weeks pregnant when she began her sentence at the county jail; over the course of her pregnancy, she lost 67 pounds, recounts being put on the wrong medications against her will, and was repeatedly denied medical appointments and recommended blood work. At one point, she was attacked by guards and almost thrown to the floor because she accidentally took a shower during a lockdown. Aliyah was repeatedly handcuffed and shackled during her pregnancy, and when she told guards she was pregnant, she says they “called me a liar and said I was just fat,” per her account in a new report from the ACLU of Illinois released this week. 

In addition to the ACLU of Illinois, research and reporting this week from the Marshal Project and Gothamist also presented a harrowing glimpse of what pregnant women face behind bars—and the total lack of protections and safety standards governing them.

In a different county jail in Illinois in 2021, an incarcerated woman named Paige suffered from a high-risk pregnancy and had even been shot shortly before starting her sentence. Once behind bars, she tried to get an abortion out of concern for her safety. She was already a mother to four kids and had had three previous C-sections which made her pregnancy more dangerous. “When I found out that I was pregnant, I asked the jail about getting an abortion through the electronic messaging system. Their only reply to my request for an abortion was to send me back a message with a frowny face like this ‘ 🙁 ,’” Paige says in the report. “They never gave me any information or allowed me to seek an abortion.” Eventually, when her contractions began, she was taken to the hospital in shackles; there, she learned she wasn’t dilated enough, so she was taken back to the jail where she had contractions for two days before eventually being returned to the hospital. “I had a C-section, but I was almost forced to have a very dangerous vaginal birth because I was brought in so late,” she said.

According to the ACLU of Illinois, despite how abortion is legal in the ostensibly blue state, which has one of the most vocally pro-choice governors in the nation, there are no consistent policies around abortion access in Illinois jails county-by-county. Nor could the ACLU of Illinois find clear policies on health care and resources for pregnant and menstruating incarcerated people in general—other than policies requiring people to pay for their own abortions despite having no income.

Vague policies, a lack of policies, and requirements for incarcerated women to pay for their own abortions—and sometimes pay for transportation and the time of the officer taking them to get the abortion—are a universal problem with jails and prisons across the country. Approximately 3% of women in jail in the United States were pregnant in 2017, according to researchers at Johns Hopkins School of Medicine. The Marshall Project reviewed pregnancy policies in 27 jails in 12 different states and similarly found no consistent or clear policies—or sometimes any policies at all—around pregnancy or abortion access. According to data from 2009, just 68% of incarcerated women were aware they had a right to abortion while behind bars—that was before Roe fell, and most incarcerated women who did try to seek abortion care were unable to afford to pay for it.

In addition to a lack of established, basic rights to health care, incarcerated pregnant women also report suffering from distinctly cruel, dangerous mistreatment: In the same ACLU of Illinois report out this week, one incarcerated woman, Shawna, recalled being forced to wear handcuffs through an ultrasound and other basic health services for her pregnancy while jailed in LaSalle County and Rock County, Illinois in 2019; when she learned her pregnancy was high-risk because her placenta was dangerously close to her cervix, doctors recommended that she see a specialist. But she says, “The jail told me that they didn’t have to send me to a specialist, because I was only entitled to the minimum level of care, and they could send me wherever they wanted, whether I was pregnant or not.” 

And on Wednesday, Gothamist published a report reviewing 719 civil lawsuits between 1976 and as recent as last year alleging sexual violence on Rikers Island in New York. Per the outlet, pregnant women seemed particularly vulnerable to violence: At least nine women alleged that they were sexually assaulted or raped while pregnant; one woman reported that her doctor groped her breasts and gave her a gynecological exam that was so violent her cervix ruptured.

Across the country, abortion bans have changed the landscape of health care for pregnant women since the fall of Roe. But for years now, incarcerated pregnant women have endured unthinkable mistreatment with nonexistent rights—and that’s continuing even in states that ostensibly support reproductive rights.