EASTHAMPTON, Mass. – On Tuesday, the Prison Policy Initiative revealed that despite the 1.5 million women cycling through jail each year, there is no data collected for pregnant or postpartum people in jail.
A team of student researchers is drawing attention to this data blind spot through the Birth in Jails Media (BJM) Project. This project draws exclusively on news coverage of jail births, which provides more in-depth information about the conditions of the jail, labor, childbirth, and the experiences of pregnant incarcerated people, the Prison Policy Initiative reported.
The BJM Project is aided by efforts from the Advocacy and Research on Reproductive Wellness of Incarcerated People, or AARRWIP, which focuses on reproductive justice for incarcerated people. It is led by researcher and obstetrician-gynecologist Dr. Carolyn Sufrin, the initiative reported.
The BJM Project focuses on the cases of 35 mothers and newborns from 2013 to 2023. Their stories serve as powerful calls to action for improved care for incarcerated pregnant people, according to the Prison Policy Initiative.
Many stories go unnoticed and unresolved, as numerous incidents go unreported, the initiative stated.
The BJM Project revealed that labor behind bars causes significant distress and maltreatment. Pregnant people often face no choice but to give birth without support, safety protocols or medical assistance, the initiative said.
The Prison Policy Initiative noted that its data, which relies on news reporting, may reflect bias because cases involving negligence or abuse are more likely to make headlines. However, the group asserted the stories still accurately reflect what has happened behind bars and what will likely continue to happen.
Despite jails operating independently, the stories reveal patterns of systemic ignorance, lack of policies, and abuse. These patterns expose widespread misconceptions about how and why pregnant people become or remain incarcerated, according to the initiative.
The group quoted a lawsuit filed in Virginia after a 2021 jail birth that ended in a neonatal death: Jail staff and medical contractors “engaged in a cycle of punishing and isolating Ms. (unnamed here), while allowing her mental and physical health, and that of her unborn baby, to dangerously deteriorate.”
Among the cases reviewed, two-thirds—25 of them—took place inside a jail cell, the initiative reported. These cells often contained only a mattress, a toilet, or the floor as options for delivering a baby. Only about 22% of jails nationwide reported having medical treatment or hospital functions as of 2019, when data was last collected.
In at least three cases, births happened in solitary confinement. One woman was placed in isolation “to muffle her screams” during painful labor, the initiative said.
In at least 24 cases, jail staff ignored calls for help or medical assistance. In several cases, pregnant people used emergency call buttons or cried out but received no response.
In the most extreme cases, lawsuits and media reports claimed staff stood and watched, laughed, or belittled women in labor. In some instances, they assumed the women were experiencing withdrawal symptoms and offered no help, the initiative reported.
The BJM Project also found that one-fourth of the babies—nine out of 35—were stillborn or died within two weeks of being born. Causes included poor delivery conditions and infections, the initiative stated.
In at least one-third of the cases, the baby was born preterm—before 37 weeks. Preterm birth is a leading cause of infant mortality and can negatively affect individuals throughout their lives. Jails should provide healthcare that addresses risk factors for the most vulnerable people, the initiative urged.
More than half of the jail births—19 of the 35—resulted in lawsuits. Some targeted private healthcare companies contracted to the jails. While many suits remain unresolved, one was dismissed and eight settled, with payouts ranging from $16,000 to $1.5 million.
“That pain [of labor] was indescribable. What hurt me more, though, was the fact that nobody cared,” said a mother who gave birth unassisted in a Colorado jail in 2018, as quoted by the Prison Policy Initiative.
The research team found that when jail administrations responded to lawsuits or complaints, they generally denied wrongdoing and claimed staff followed protocol. Some admitted they had no training on pregnancy or childbirth.
Few cases resulted in legal reforms. When they did, the changes were often described as common sense. In Colorado, after the 2018 jail birth, the facility mandated staff training and changed policies to require immediate hospital transport for people in any stage of labor.
Years later, Colorado lawmakers passed HB23-1187, which allows courts to offer bond or alternative sentencing to pregnant defendants, the initiative reported.
A 2020 case in Florida involved the Tammy Jackson Act, which aimed to protect pregnant people in custody. However, the initiative reported that at least two jail births, including one resulting in a newborn’s death, occurred after the law was enacted.
Florida advocates are now backing Ava’s Law, which would allow judges to delay incarceration by up to 12 weeks to allow for birth or bonding with a child. It would also mandate pregnancy tests for women jailed longer than 72 hours and require better data collection.
“I basically held my baby all night, until she died, until she turned blue,” said a mother who gave birth three months early in a Florida jail. Her baby died just hours later, the initiative reported.
While there is national-level data from state and federal prisons, the initiative said it’s time for jails to produce similar statistics. Women’s incarceration has risen disproportionately in local jails in recent decades.
Data should go beyond simply counting how many pregnant people enter jail. It should include live birth outcomes such as birth location, term status, low birth weight, and neonatal death. It should also document cesarean deliveries, miscarriages, abortions, stillbirths, ectopic pregnancies, and maternal deaths.
Statistics should also cover what maternal healthcare services were provided, including pregnancy testing, prenatal vitamins, special diets, routine and high-risk care, and postpartum depression screening. Finally, the data should be linked to demographic, health and sentencing information, the initiative said.
Alongside data collection, basic education on maternal health could help improve outcomes. Jail staff must also believe, document and respond to reports of labor and pregnancy complications, according to the initiative.
Improved reproductive healthcare access, better data, and staff training may prevent traumatic jail births. AARRWIP argues that incarcerating pregnant people endangers maternal and infant health.
The Prison Policy Initiative concludes that sentencing reforms, including caregiver mitigation and diversion laws, combined with mandatory care standards and oversight, would be more effective at moving pregnant people out of jails and into community-based support and care.
