The Arizona Department of Corrections is inducing pregnant inmates to work against their will, according to three women currently incarcerated at Perryville Prison in Buckeye, Arizona.
Women said they were forced to induce labor even though they wanted to give birth naturally.
Medical records reviewed by the Republic of Arizona show that all three women were induced before their due date. The women agreed to release their medical information. Stephanie Pearson and Desiree Romero underwent induced labor in 2022 at 39 weeks pregnant. Jocelyn Heffner was induced at 37 weeks pregnant during separate incarceration in 2020 and she in 2022.
Studies show that elective procedures can safely induce labor at 39 weeks, and medical experts say it is safe to induce labor before 39 weeks for medical reasons. increase.
However, all three women were told by prison health care providers that they were induced because of the Arizona Department of Corrections policy for all pregnant incarcerated women and not because of their individual condition. The women say they received no explanation for the policy, but believe it is being implemented to reduce the prison system’s liability.
The Arizona Department of Corrections did not respond to multiple requests for comment. NaphCare, the state’s current prison medical contractor, denied it had a policy of mandatory introduction. NaphCare’s contract commenced on October 1, 2022.
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Centurion, a former prison medical contractor, did not respond to questions about women who claimed their labors were induced against their will during the company’s tenure in Arizona.
Since taking over the contract in October, a NaphCare spokesperson said one inpatient was induced “as per the orders of the hospital’s experts as a maternal and fetal safety measure due to a pre-existing condition.” There are currently six pregnant patients in Arizona prisons, according to
A NaphCare spokesperson said the “decision to induce or not to induce is solely the choice of the patient,” but all three women claimed they had no choice. They said.
Stephanie Pearson said of the explanation she received from the prison obstetrician, “They said they would induce everyone because they didn’t want anyone going into labor here.” , someone told me they went into labor in a cell and had a baby in a cell, so now I’m inducing everyone.”
In 2019, prison law firms and ACLU attorneys documented a case in which a severely psychotic woman gave birth alone in the bathroom of a Perryville cell. Lawyers found the woman was sent to the hospital after her waters broke and returned to prison for unknown reasons before she gave birth.
Desiree Romero said she was repeatedly told by health care providers at the Department of Corrections that it was the established policy to intern all pregnant prisoners a week before their due date.
“They are now inviting us not to go into labor in prison,” she said.
Romero said he had no choice in the matter. If so, Romero would have waited to have the baby naturally, he says.
“I’m pretty used to prisons making all these decisions for us because we’re still national property,” she said.
Joslyn Hefner said, “I felt like I was being seen as a burden. Nine months pregnant and walking around the prison yards did not reassure the institutions of this country.” Hefner said he challenged the decision to induce labor during two separate pregnancies while at Perryville, only to be denied each time.
“Most women get triggered here. I caught up with it,” she said.
more:A pregnant inmate went into labor and then the baby died. Is Starbucks bad?
loss of autonomy
All medical procedures in the United States, including labor induction, should be performed only with full patient consent, said Dr. Laura Mercer, associate professor of obstetrics and gynecology at the University of Arizona School of Medicine in Phoenix. says.
Mercer said he was concerned to learn that there are incarcerated patients who say they don’t know why they were forced to do so.
“Informed consent is an ethical requirement,” Mercer said. “From a medical point of view, patients have a duty to be fully informed about what we recommend, why we recommend it, and what the alternatives are.”
Mercer said there are valid medical reasons for providers to suggest adoption, such as high blood pressure, but patients refuse treatment, even if the decision puts them at risk to their health or the health of their unborn baby. must have the autonomy to
Kierra Otis is a full-spectrum Doula and co-founder of the Rooted Doula Collective in Arizona. She said that if the women’s allegations are true, the policy of forced introduction “absolutely violates human rights.”
Ortiz said those rights articulated by the Reproductive Justice movement included “the right to abstinence, abortion, and the right not to have children by contraception.” The right to have children under the terms we choose. The right to raise children in a safe and sustainable environment. ”
Otis said the loss of autonomy during pregnancy can add to the difficulty, physiologically and hormonally, of what she called a very delicate period in a person’s life.
“People can be really vulnerable when they’re going through a situation like this,” Otis said. .”
Ms. Pearson said she didn’t like the decisions made for her.
“Just because I made bad choices in life, they shouldn’t be allowed to make bad health choices for me and my baby.
physical and mental trauma
Ortiz said the loss of autonomy can affect more than pregnancy.
“As a doula, I’ve found that when people feel they have a choice about this issue, it’s a lot less traumatic,” she said. We know that if the person giving birth has this trauma, it will affect their ability to become parents, and it will affect their children.”
The women who spoke to Republic believe their children are healthy, but the loss of autonomy in the decision-making process adds to an already stressful and painful medical procedure, leading to symptoms of postpartum depression. said to have led to an increase in
All women reported experiencing prolonged labor after being induced.
“It makes your body not ready and the baby is not ready,” Pearson said. “It stresses the baby and the mother.”
Pearson said her previous experience of natural childbirth lasted only a few hours, while prison-induced labor lasted nearly three days.
“It’s more vigorous labor, which means more contractions and harder contractions,” she said. It took a long time to heal.”
Desiree Romero said her forced introduction lasted two days.
more:Homicide is the leading cause of death during pregnancy. These women are more likely to be killed.
Arizona does not follow state laws or best practices
Arizona passed a version of the Inmate Dignity Act in 2021 to provide several safeguards for pregnant people in state prisons. In addition to providing women with free access to adequate amounts of feminine hygiene products, the law prohibits the bondage of pregnant prisoners during labor, requires proper antenatal care, and ensures that mothers We require you to spend 72 hours with your baby after birth. .
Women interviewed by the Republic said they were not shackled and given allotted time with their children, but claimed the ministry did not provide them with proper treatment during and after pregnancy. The Dignity Act does not cover certain aspects of incarcerated women’s work. Two of the women interviewed said they had never heard of or been briefed about the law.
Pearson said she was denied breast pads after giving birth. .
In addition to their injuries, two of the women said they received medical bills for services provided during labor, even though the Department of Corrections and its contractors are financially responsible.
A spokesperson for the Federal Prison Service said that the BOP does not have a policy on induction of labor for pregnant women, but that “if there is a medical need for induction of labor, care will be coordinated with local hospitals and their respective specialists.” I will.”
The California Department of Corrections and Rehabilitation does not answer specific questions about labor induction, but the department’s procedures have an entire section on “Caring for Patients During Pregnancy and Childbirth” to help women in labour. Procedures for transportation to hospital are outlined.
A Texas Department of Criminal Justice spokesperson said there is no policy on inducing labor for pregnant inmates “because it is not done in the TDCJ unit.”
“Induction of labor is clinically determined by the hospital obstetrician,” the spokesperson said.
The Arizona Department of Corrections did not respond to questions about the treatment of pregnant inmates. not.
Dr. Carolyn Sufrin is an obstetrician-gynecologist and researcher at the Johns Hopkins School of Medicine, studying incarcerated women and reproductive health. She said best practices for prisons housing pregnant women include close communication between guards and medical staff.
“Custodial staff should always alert medical staff, and medical staff should be properly triaged and trained to know that labor is unpredictable,” she said.
Sufrin said signs of preterm labor are so subtle that they require evaluation by a qualified provider, so a lower threshold should be set for medical staff to take patients offsite. says.
Corene Kendrick, attorney for the ACLU State Prison Project, said: Security guards and medical personnel have reported for years that prison staff numbers in Arizona are dangerously low. “If you have enough nurses and protective personnel on site 24/7, you can implement best practices.”
“I think another response would be to improve training and culture,” Sufrin said, adding, “Distrust women’s reports of labor, bleeding and other birth symptoms.” rice field.
“Because they’re incarcerated, so much of their autonomy has been taken away from them, and I think it’s really important to have a say in their birth conditions,” Sufrin said. , it is part of shared decision-making and a principle adopted in obstetrics: anything that they can reasonably have agency and control medically can improve their well-being. I can do it.”
Got news tips about prisons in Arizona? Contact reporters at jjenkins@arizonarepublic.com or 812-243-5582. follow him on twitter @Jimmy Jenkins.
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