America’s Biggest Secret : Pregnant in Prison

Shreya Sharma

America’s Biggest Secret  


There are few things as morally offensive as children being born behind bars: perhaps this is why the fact 2000 children born last year in prison is so shocking [1].

The News and other media platforms rarely mention the fact that the number of women imprisoned in the United States is increasing by approximately 1.6% a year and around 3-4% of these women are pregnant [2]. These women need to be given publicity as their suffering is almost unimaginable: you are chained, malnourished, you don't know when your due date is, but it doesn't matter because you know they'll take your baby from you days after birth.

Although the Pregnant Women in Custody Act (2018) and Estelle v Gamble (1976) protect pregnant inmates from harsh treatment in prisons, enforcement mechanisms are fragile and legislation is not always put into practice. Consequently, many expectant mothers still experience unnecessarily cruel treatment which can affect their child’s health. The state of American Prisons for pregnant women is unacceptable and looking the other way is no longer an option.

Physical treatment while pregnant

The Pregnant Women in Custody Act places strict limitations on the use of shackles and solitary confinement on pregnant inmates in federal prisons [3]. However, the protection that this act provides is inefficient given that the USA only has 109 Federal Prisons in comparison to 1,719 State Prisons [4]. Furthermore, there are still only 22/50 states in America that have passed laws against the shackling of pregnant prisoners which means many women still experience treatment which is so alienating [5]. Michelle Aldana gave birth to her first child chained to a hospital bed in Utah State Prison [6]. Aldana said that she “felt like a farm animal” showing that shackling is not just an issue concerning inhumane physical treatment, but it is a “fundamental issue of dignity [7].” It is a moral stain on the US to have 1 state that that allows shackling pregnant women in prison, let alone 28. When giving birth, a woman’s past shouldn’t matter, even if they have committed the most serious of crimes. Doctors and Prison officers, for those few hours of labor should just focus on making sure that the mother and her child are treated with respect to ensure a speedy recovery after a process as difficult as childbirth.

Inadequate Medical Care

The landmark Supreme Court Case Estelle v Gamble (1976) addressed the medical treatment of US prisoners. It affirmed their constitutionally protected right to sufficient health care under the 8th Amendment [8]. It is shocking that despite this act being in place for over 40 years, the medical attention that pregnant inmates receive today is still appalling. Most prison wards ignore concerns during pregnancy which can cause further complications at a later stage. Siwatu-Salama Ra, a 27-week pregnant inmate in Detroit had a common yeast infection which can normally be easily treated but she was given no medication. Her condition caused stress which exacerbated her blood pressure levels and induced early labor [9]. This is just one of the many instances in which pregnant inmates have been given inadequate medical care. It’s not that the government are failing to protect expectant inmates due to incompetence, it’s that the government have no incentive to actually enforce legislation protecting expectant inmates in a robust way. In order to push the government into enforcing legislation, it is highly recommended that incarcerated mothers who are victims of poor medical care should make a Human Rights Claim in order to push federal government into providing them with professional medical treatment. The Law is lying to American prisoners and all inmates have the constitutional right to complain about poor medical treatment and to voice their concerns to the courts under the First Amendment [10].


The state of modern prisons makes one wonder whether their managers are actually the biggest criminals of all. It is not hyperbole to suggest they are complete and utter liars. The Bureau of Prisons (BOP) said in a statement that they were “committed to ensuring the safety of all staff and inmates in our facilities through a controlled environment that is secure and humane” [11]. However, former prisoner Ms Bass said that the BOP have made empty promises. Bass said that she met a pregnant inmate who had asked for supplemental nutrition and was then given one extra peanut butter and jelly sandwich per day [12]. Another former pregnant prisoner said that much of the food she was served was heavily processed; she rarely had access to fresh fruits and vegetables and her medical notes confirm that she was “starving and dehydrated” [13]. A lack of nutrition can affect the physical development of a baby in the womb causing it to be born underweight or prematurely. Although it could be argued that the pregnant women ‘deserves hard treatment’ for her crime, not feeding a pregnant woman enough food violates the 8th Amendment as it is “cruel and unusual punishment.” Likewise, it would be absurd to argue that her baby should be punished as babies are born innocent. It is simply unacceptable to compromise a child’s health because of their mother’s position. Prison officers need to be made aware that expectant inmates should be given a standard amount of nutrition so that their children can have a healthy start to life.

Horrifying Treatment whilst giving birth

It brings many of us guilt to know that the process of giving birth for many pregnant inmates is far from the intimate and empowering experience that most pregnant women would dream of having. Instead, those who give birth in prison would describe their delivery experience as truamatising, degrading and insulting. Whilst most mothers mentally prepare themselves for their baby’s due date, pregnant inmates are not told when their babies are due. Hence in most cases, pregnant inmates who are scheduled for a C-section are told about their surgeries only on the day. They are handcuffed, put in a dark van, rolled to the nearest hospital in an uncomfortable wheelchair and then have no choice but to be induced [14]. There is a fine line between punishing a woman for the crimes that she has committed and being simply barbaric. This process dehumanises pregnant women and violates their constitutional human right to be able to govern their own bodily autonomy.

Additionally, after giving birth, many women wish to spend time with their baby. However, most prisons only allow mothers to spend 24 hours with their child before he/she is placed in protective custody or given to a trusted individual on the outside. Furthermore, sometimes women are taken back to prison without knowing that their child is safe. The uncertainty that the tragic divide between a mother and her child creates contributes to the 67.9% of incarcerated women reporting mental health problems such as post-natal depression (PND) [15]. It is simply inhumane to make a woman who has just given birth suffer in such a lonely environment. The BOP should make sure that if possible, mothers in prison are given regular updates about their children as it reduces their chances of developing mental health issues.

What’s worse is that, most mothers don’t get the chance to cuddle their babies as they are handcuffed during the pregnancy or straight after the birth of their baby. Mellissa Hall who was handcuffed whilst giving birth had to put a pillow between “his tiny body and the crook of her arm” so he wouldn’t get hit by her chains [16]. For a mother who has just given birth, cuddling her baby is one of the most rewarding and comforting feelings she will ever experience. However, more than 17% of US prisons require women to be handcuffed during and after delivery and 22 states either explicitly allow the use of leg irons or waist chains on pregnant inmates and this puts limitations a woman’s ability to hold her baby comfortably [17]. Ruining this beautiful moment between a mother and her child is one of the greatest injustices a prison can commit. In 2010 the United Nations adopted Bangkok Rule 24. This rule states that “instruments of restraint shall never be used on women during labor, during birth and immediately after birth” [18]. Although the United Nations Committee against torture have been attempting to pressure the USA to conform to international standards, they have not been very successful as of yet. It is necessary for the USA to adopt this rule as by not conforming to international standards, the USA will never live up to their image as country that upholds human rights.

Poor Post Birth Care

It may surprise you to know that in some of the USA’s highest security prisons, mothers are allowed to serve 18 months of their sentences in a nursery unit that includes a playroom and single mother and child bedrooms [19]. Although this can be a good way for a mother to bond with her child, children who are born (and live with) mothers who are in prison are more likely to be incarcerated themselves in the future [20]. This puts the law in a tricky position in terms of moral sympathy. Whilst building a relationship with their mother can support a child emotionally, being born in prison can have wider psychological impacts that can affect the child’s future. Article 3 of the UN Convention on the Rights of the Child [21] states that the best interests of the child should be the primary consideration in all actions concerning children. It is arguable that children should not be brought up in prison with their mothers as it is not a suitable environment. Instead a better solution would be that children should be allowed to visit their mothers in prison more frequently. This would allow a mother and child to build a relationship without the child living in prison.

Post-Natal Depression

PND is high amongst new mothers behind bars because not only do most prisoners not get to spend the time they need with loved ones but many of them feel guilty for getting themselves and their child in the stressful situation that they are in. Whilst most pregnant or new mothers in prison go to childbirth classes which can serve as a form of ‘group therapy’, this is not enough because pregnant prisoners often have post-natal needs (like speaking to a close friend or family member) that are not met by prison systems [22]. Consequently, many new mothers in prison resort to smoking to help them relieve stress. In correctional facilities, depression and anxiety was found amongst 80% of inmates, whilst tobacco use amongst post-natal inmates exceeded 50% [23]. In order to prevent the health of female inmates from deteriorating, it is necessary for the US government to introduce a more effective form of post-natal care.  


A body of evidence suggests that prison is not designed, nor is able, to support pregnant inmates during their pregnancy and child birth. It should not have taken this article to criticise the brutal way in which pregnant prisoners in the USA are treated. The Federal government should be doing something drastic to stop needless cruelty against pregnant inmates, but they aren’t. Journalists should be doing more to raise awareness about the hidden abuse pregnant women experience, but they aren’t. There needs to be clear regulations so that these existing laws can be enforced in all American prisons to stop this torture of pregnant inmates.


1] The Guardian, Pregnant and behind bars: How the US prison system abuses mothers-to-be, Victoria Law, 20th October 2015

[2] Babygaga,12 Truths about Pregnancy Behind Bars, Bethany Babchik, April 14th 2017  

[3] ACLU, New Bill Would Ensure No Women Is Forced to Give Birth in Chains, Amy Fetting, 19th September 2018

[4] Prison Policy Initiative, Mass Incarceration: The Whole Pie 2019, Wendy Sawyer and Peter Wagner, 19th March 2019

[5] CBS News, Shackling Pregnant inmates is still a practice in many states, 13th March 2019

[6] Ibid

[7] Ibid

[8] The Current State of Public and Private Prison Healthcare, Brian Bereke, 24th

February 2017

[9] Quartz, Should a pregnant person ever go to prison?, Zoe Schlanger, 6th April


[10] Jailhouse Lawyer’s Handbook, Your First Amendment Right to Freedom of Speech and Association

[11] Independent, Majority of women in the US House unite on bill protecting pregnant prisoners from ‘shameful conditions, Emily Shugerman, 13th September 2018

[12] Ibid

[13] Babygaga,15 Things that Happen when a baby is born in Prison, Alexandra

Sakellariou, 22nd November 2017

[14] Verso, An excerpt from Inside This Place, Not Of It, Nawal Kumari Arjini, 9th

August 2017

[15] The Marshall Project, Mental Health Crisis Facing Women in Prison, Manuel

Villa, 22nd June 2017

[16] Cosmopolitan, She Knew She’d Deliver Her Son While She Was In Jail. She

Didn’t Expect to Do It in Chains, Rebecca Nelson, 25th October 2017

[17] American Psychological Association, The Restraint of Pregnant Inmates, Tori

DeAngelis, June 2016

[18] National Resource Centre on Justice Involved Women, The Use of Restraints on

Pregnant Women in Jails and Prisons

[19] MailOnline, Raised behind bars: Inside America’s prisons where babies get to stay with their felon mothers while they serve their jail sentences, Darren Boyle, 25th May 2016

[20] ASPE, Effects of Parental Incarceration on Young Children, Ross D. Parke, 12th January 2001

[21] Article 3 UNCRC

[22] US National Library of Medicine, Perinatal Needs of Pregnant, Incarcerated

Women, Barbara A. Hotelling

[23] US National Library of Medicine, Mental Health Issues Among Pregnant Women in Correctional Facilities, Mukherjee S, Pierre-Victor D, Bahelah R, Madhivanan P

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