Recommendations for the care of pregnant women in all County Jails
from Mama Sana/Vibrant Woman
To Texas Commission on Jail Standards
Presented to Commission meeting on Nov 6, 2014
We appreciate your willingness to receive recommendations regarding the standards for pregnant women in Texas County Jails.
Our overall recommendation:
That the current standards of care be implemented, that written policies and procedures be established, and that all pregnancies and pregnancy outcomes be documented in jails across Texas.
1. Implement the current standard requiring jails to have a good medical plan that ensures timely and appropriate prenatal care, specialized obstetrical services when indicated, and postpartum care.
2. When a pregnant woman says that she is experiencing labor symptoms, the jail shall provide an immediate evaluation by an obstetric specialist. If there is no obstetric specialist on site, an ambulance shall be called immediately and the woman shall be transferred to an appropriate medical care facility. In the event that a woman gives birth in the correctional facility, the jail shall immediately call an ambulance to transfer both the mother and baby to a hospital.
3. Prohibit the placement of pregnant women in any form of solitary confinement, including a medical segregation cell.
4. All women should receive immediate medical attention and pregnancy testing at their request or at any sign or symptom of potential pregnancy.
5. Due to the stressful nature of incarceration and the research-based information regarding the impact of stress on pregnancy, all pregnant inmates should receive some aspects of high-risk care, including prenatal visits at twice the regular rate (so, twice a month instead of once a month, etc.), complete blood work at every trimester, regular blood pressure assessment, and close attention to fetal growth to identify IUGR (Intra Uterine Growth Restriction) early on.
6. Pregnant women should have access to a specialized maternal care provider – OB/GYN, Nurse Practitioner, CNM (Certified Nurse Midwife), or CPM (Certified Professional Midwife).
7. All pregnant incarcerated women should have the right to choose a birth companion to accompany them during their birth. Women should not be forced to birth in isolation. Birthing Companions can include a family member, friend, or a certified Doula or Labor Assistant.
8. All correctional departments should develop clear written policies and procedures on custody of pregnant inmates that are sensitive to the inmates’ unique health issues.
9. If the above mentioned recommendations are not implemented within the next 180 days, we recommend that an independent oversight mechanism be established to ensure proper and impartial response to custodial negligence or misconduct.
Mama Sana/Vibrant Woman and Mamas of Color Rising welcome the opportunity to further discuss these recommendations with the commission.