Reproductive health in lockdown

By Michelle Chen Mar 12, 2009

For many women behind bars, barriers to reproductive health follow them from their communities to their prison cells. A study published in the current issue of Perspectives on Sexual and Reproductive Health found that an incarcerated woman’s ability to assert control over her reproductive health depends heavily on where she is held. (See also related commentary and analysis by the reproductive health think tank Guttmacher Institute.) Noting large variance in the availability of Medicaid-funded abortion services across states, researchers said state politics are a major factor in the availability of reproductive health services and information to women the state’s prison system:

…abortion appears to be more accessible to incarcerated women in states with predominantly Democratic or bipartisan legislatures than in states with Republican-controlled legislatures…. Correctional health providers from states with very restrictive Medicaid abortion coverage were significantly less likely than those from states with the least restrictive Medicaid programs to say that abortion was allowed (60% vs. 80%), that they helped women arrange an appointment for an abortion (41% vs. 62%) and that transportation was provided (81% vs. 86%).

Yet the researchers concluded that however inconsistent prison-based services are, the obstacles to equitable reproductive health care also permeate the communities these women come from:

At the end of 2005, more than 1.2 million were in custody—in jails or prisons, or on parole or probation. These women disproportionately represent marginalized sectors of our society; they are predominantly women of color, poor, unemployed and undereducated and thus may not have adequate access to health care in general, and reproductive health services in particular. Although many of them may spend only a short period of time in custody, their involvement with the correctional health system may represent one of their few opportunities to access medical care.

Prison should not be a woman’s first opportunity to obtain quality medical care, though neither should it replicate the systemic problems that limited her opportunities on the outside. President Obama recently started redirecting federal family planning resources toward comprehensive clinical services and away from abstinence-only sex education programs. It remains to be seen whether some of the country’s least free women will see brighter prospects for reproductive freedom under the new administration. Image: Lucinda Hernandez, almost eight months pregnant, is incarcerated at the California Institution for Women in Corona. San Francisco Chronicle / Mark Savage