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

Maria was five months pregnant when she was sent to a state prison for a nonviolent offense tied to her substance use. She had hoped, at the very least, that prison might offer stability—meals, a roof, a place to sleep. But what she didn’t expect was the fear she’d carry every day about whether her baby would survive.

The first time she asked for prenatal vitamins, the nurse told her they were “in short supply.” Her medical intake consisted of a five-minute conversation with someone who never looked her in the eye. When she started experiencing severe back pain and swelling in her legs, her requests for care were ignored for days. She was told she was exaggerating—just “being hormonal.”

Maria’s prenatal care consisted of inconsistent check-ups and lectures about how she should be grateful for any medical attention at all. She never had an ultrasound. No one explained what would happen when she went into labor. And no one told her that the moment her baby was born, they would be taken from her.

What Happens When a Woman Is Pregnant Behind Bars?

When we talk about maternal care, we often think about access to doulas, prenatal vitamins, ultrasounds, and safe birthing spaces. But for women who are incarcerated, pregnancy can be a terrifying and life-threatening experience, marked by neglect, punishment, and the complete absence of dignity.

Approximately 3–4% of women in U.S. prisons and jails are pregnant at intake, and yet our systems are largely unequipped—and often unwilling—to provide even basic care. The result? Serious consequences for maternal and fetal health, and long-lasting trauma that reverberates far beyond the prison gates.

Inconsistent and Substandard Prenatal Care

Prenatal care inside correctional facilities is inconsistent at best, and outright dangerous at worst. Many pregnant people are:

Denied timely access to OB-GYNs
Given inadequate nutrition or prenatal supplements
Ignored when reporting concerning symptoms
Unable to attend regular prenatal check-ups

According to the Pregnancy in Prison Statistics (PIPS) Project led by Dr. Carolyn Sufrin, many facilities don’t track pregnancy outcomes at all, making it difficult to hold institutions accountable or improve care.

The consequences can be devastating: premature births, untreated gestational conditions, and high-risk pregnancies managed without proper monitoring or emergency protocols.

Shackling During Labor

Despite advocacy and legal wins, the practice of shackling incarcerated pregnant women during labor still happens across the U.S. Even in states that ban it, enforcement is weak and loopholes are exploited.

Shackling is not only dangerous—obstructing medical interventions and increasing the risk of injury—it’s dehumanizing and traumatizing, especially for women already coping with abuse or sexual violence histories.

The Trauma of Forced Separation

For those who carry their pregnancies to term, birth is followed by immediate separation. Babies are taken away within hours or days, and mothers return to their cells physically and emotionally raw, with little to no postpartum support.

Most correctional systems have no infrastructure for postpartum recovery, let alone parenting. There are only a handful of prison nursery programs in the entire country. The rest? Forced separation and silent grief.

Layered Inequities

This is not just about poor healthcare. It’s about who is being denied care.

The majority of incarcerated pregnant people are:

Women of color
Living in poverty
Survivors of violence and trauma
Criminalized for substance use, survival economies, or mental illness

Their pregnancies are deeply impacted by layers of systemic oppression that continue behind bars.

Imagining Something Different

What would it mean to offer pregnant people behind bars care rooted in dignity, humanity, and healing?

It would mean:

Access to comprehensive prenatal and postpartum care
A ban on shackling and full enforcement of anti-restraint laws
Access to doulas, midwives, and trauma-informed practitioners
Opportunities for mothers to remain connected to their babies
A commitment to decarceration for pregnant people whenever possible

Because no one should have to give birth in chains. And no child should come into the world already separated from their parents because of a system that punishes poverty and survival.

Coming Up In our next post, we’ll take a closer look at mental health and trauma, and how carceral systems criminalize women’s pain rather than provide the care and healing they need.

Because the path to justice must include care for the body and the mind—especially for those who have already survived so much.