Forgotten Behind Bars — Centering Equity in Women’s Health in Prisons and Jails

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When we talk about mass incarceration in the United States, the conversation often centers around numbers—how many people are locked up, how long they’ve been there, and what it costs. But behind those numbers are real people, and among them are women whose specific health needs are often ignored, neglected, or misunderstood.

This post kicks off a six-part series examining equity in women’s health care within prisons and jails, inspired by the powerful work of researchers and advocates like Dr. Carolyn Sufrin and her co-authors. Their 2021 article, “Women’s Health Care in the Criminal Justice System,” exposes the critical gaps in how incarcerated women are treated—or not treated—when it comes to their health.

Here’s the truth: Our criminal justice system was never designed with women in mind. From its very foundation, the architecture of incarceration has centered the experiences, needs, and bodies of men—particularly cisgender men—leaving incarcerated women to navigate a system that doesn’t see them, understand them, or serve them.

Yet today, women are the fastest-growing incarcerated population in the U.S., with the overwhelming majority being Black, brown, low-income, LGBTQ+, or survivors of violence. And while their numbers have surged, the policies, practices, and healthcare systems inside prisons and jails have failed to keep pace. Instead, women are still being forced to receive care within a system designed for someone else entirely.

What does this look like in practice? It means reproductive health care is inadequate or altogether unavailable—from the denial of abortion access and contraception, to a lack of menstrual products and gynecological screenings. It means pregnant women often receive substandard or even dangerous care, shackled during labor or left without access to prenatal vitamins, mental health support, or appropriate nutrition.

It also means that chronic illnesses like diabetes or asthma go untreated or poorly managed, and mental health services are scarce, punitive, or absent, despite the fact that the vast majority of incarcerated women have a history of trauma, abuse, or sexual violence. Too often, trauma responses—like substance use, self-harm, or hypervigilance—are criminalized rather than understood or treated.

Even worse, this system refuses to reckon with the lived realities that funnel women into jails and prisons in the first place. For many, incarceration is a direct outcome of structural violence: poverty, racism, gender-based violence, housing instability, and survival economies like sex work or drug sales. These are not moral failings—they are consequences of being locked out of opportunity and care.

And yet, when women arrive at the doorsteps of the criminal legal system, they are met with indifference or punishment instead of support. Their survival is pathologized. Their trauma is ignored. Their healing is delayed.

To build a more just and humane future, we must begin by asking: What if the system was built with women in mind? What would care look like if it prioritized dignity, agency, and healing?

Because women behind bars are not invisible—and they are not disposable. Their health, their stories, and their lives matter.

Despite the urgent need, the article highlights deep gaps in healthcare for incarcerated women—gaps driven by systemic neglect, chronic underfunding, and a lack of enforceable policies. Access to even basic services varies widely across facilities. In many places, menstrual hygiene products are inconsistently distributed, and pregnant women often face dangerous birthing conditions, inadequate prenatal care, or are denied essential medications. There is also no universal standard or oversight body to ensure that incarcerated women receive even the minimum constitutionally mandated healthcare.

Reproductive autonomy is routinely compromised. Some women are denied access to contraception or abortion services, while others are subjected to coercive practices or provided limited information to give proper consent about their reproductive choices. Mental health care is equally bleak. Many women enter custody with serious trauma histories, yet therapeutic services are limited, punitive in nature, or entirely unavailable. Medications are frequently delayed, mismanaged, or withheld, leaving women without support for conditions like PTSD, depression, or anxiety.

The challenges don’t end at release. There is little to no continuity of care once a woman exits the system. Prescriptions are not refilled, care plans are not communicated to community providers, and follow-up for chronic illnesses or mental health conditions is rarely arranged. These shortcomings disproportionately impact marginalized populations. Black, Indigenous, and women of color face heightened barriers and worse care, and they are overrepresented in the prison population. Transgender women, in particular, experience additional layers of medical neglect and violence, often without access to gender-affirming healthcare. The result is a system that not only fails to heal but actively perpetuates harm.

Over the next five posts, we’ll explore:

1. Reproductive Injustice: How jails and prisons violate the reproductive rights of incarcerated women.

2. Pregnancy and Prenatal Care: What happens when a woman is pregnant behind bars?

3. Mental Health and Trauma: The cycle of incarceration and untreated trauma.

4. Barriers to Reentry: How inadequate healthcare behind bars sets women up to fail once they’re released.

5. Models for Change: Community-led and policy-driven solutions that center healing and equity.

This series is an invitation—to policymakers, healthcare professionals, advocates, and community members—to face the uncomfortable truths about how our systems fail incarcerated women, and to do better. Women behind bars deserve more than piecemeal care and overlooked suffering; they deserve comprehensive, equitable, and trauma-informed health services that honor their humanity. As we move through the next five posts, we’ll dig deeper into these injustices—exploring the reproductive, mental, and physical health challenges that incarcerated women face, and lifting up the bold solutions that are already being imagined and implemented by those closest to the struggle. Because real justice demands that we center not only the voices of women impacted by incarceration—but also their health, their dignity, and their right to be whole.

We hope this series sparks new conversations, challenges old assumptions, and makes one thing clear: Women's health justice includes incarcerated women. Always.