Florida prisons poorly care for pregnant women, advocates say

Prison reform activists worry the U.S. Supreme Court’s decision to overturn Roe v. Wade, the landmark ruling that established a federal right to abortion, could lead to more pregnant people behind bars — a scenario some lawmakers in Florida have been trying to curb for years.

Horrific accounts of women being raped and impregnated by guards and giving birth alone in their cells paint a scary picture of what life can be like for pregnant incarcerated people in Florida. With Roe protections gone, and recent efforts by Florida legislators to further restrict abortion, activists fear a post-Roe world would mean more women criminalized and placed in institutions with a bad reputation of caring for them.

“It’s a horrible experience,” Debra Bennett-Austin, a formerly incarcerated person, said. She served her final five years at Lowell Correctional Institution in Ocala, where all of the state’s nine imprisoned pregnant women are currently located.

“The care [pregnant women] get inside Lowell is an absolute joke,” she said. “A doctor comes in once a month and all the pregnant women see him that day. It’s like a factory. They’re in, then they’re out. They get one ultrasound at the beginning and then they don’t get one again.”

Pregnant women accused but not convicted of crimes may also face challenges in receiving care at county jails, where policies concerning prenatal care and abortion access are determined by local officials.

Currently, Orange, Seminole and Osceola county jails have written policies that do mention abortion, but consultation referrals for the procedure are not a standardized practice across all Florida prisons and jails, and are commonly rendered only after the jail’s or prison’s consideration of the pregnancy, legal opinions and state laws.

DOC press secretary Paul Walker said pregnant women in Florida’s state prisons receive a complete physical examination including a pregnancy test.

“If an inmate is pregnant, they are referred to an obstetrician to establish an official expected date of delivery, to receive routine prenatal care (e.g., exercise, nutritional requirements, etc.), and to be screened for high-risk pregnancy,” he wrote in an email. “The obstetrician follows the inmate throughout her pregnancy and makes any necessary specialist consultation referrals. Both pre- and postpartum counseling is available.”

Bennett-Austin’s 19-year sentence ended in 2018, and she has since been advocating for supporting those in and out of prison through her nonprofit organization Change Comes Now.

Activists like Bennett-Austin and Denise Rock with Florida Cares Charity Corp. worry an abortion ban will unjustly subject women to criminal culpability when a baby dies.

According to the National Advocates for Pregnant Women, between 2006 and 2020, more than 1,300 women were punished by the law for reasons related to a pregnancy, such as for intentionally trying to induce an abortion or unintentionally harming the fetus through use of alcohol or illicit drugs.

In Florida, it’s considered a third-degree felony to willfully perform or actively participate in a termination of pregnancy that violates the state’s current criteria for abortion.

A 15-week abortion ban that signed into law in April also specified abortion providers would face fines, imprisonment and the loss of their medical license, but on Thursday, a state judge ruled it was unconstitutional. Gov. Ron DeSantis, speaking at a news conference in Sanford, said he would appeal.

Rock, whose nonprofit works with incarcerated people and their families said, the likelihood of women going to jail or prison increases when abortion is banned.

“The correctional system has the potential to become overwhelmed with the increase in pregnant women,” she said, “Especially those of marginalized communities who due to the health care disparities, have poor prenatal care prior to incarceration and have a higher maternal and infant mortality rates.”

The number of women in Florida prisons has been declining along with prison and jail populations, mainly due to emergency responses to COVID-19.

In 2021, there were 5,014 women incarcerated by the Florida Department of Corrections. About ten years ago, that number was closer to 7,000.

The number of women, on average, over the last 10 years across three Central Florida county jails also decreased. As of last month, there were nine pregnant women in Orange County Jail; four under the supervision of Osceola County Corrections; and one pregnancy was reported in the John E. Polk Correctional Facility in Seminole County.

Dr. Carolyn Sufrin, an assistant professor of gynecology and obstetrics at Johns Hopkins University, said access to health care is dependent on the infrastructure and what the prison or jail has available.

Sufrin led a research study that monitored abortion numbers and policy data from 22 state prison systems and six county jails between 2016 and 2017, and spent time as an obstetrician inside San Francisco’s jail from 2007 to 2013 while doing research for a Ph.D. in medical anthropology.

She said pregnant people who are incarcerated don’t get a choice of their provider or how frequently they can see them.

“Many patients in our research studies have described how they might get an ultrasound or a laboratory test and they don’t know what the results were,” she said.

“Being pregnant while incarcerated is very stressful and very anxiety provoking in part because of this uncertainty of the healthcare, uncertainty of what’s going to happen… who’s going to take care of your baby and whether you’ll be able to see them or even hold them at the hospital,” she said. “There are many things about the experience that are just categorically stressful, and for many people traumatizing.”

Widely politicized cases in Florida, like the one of Erica Thompson, whose baby died after she was forced to give birth inside Alachua County Jail, prompted the creation of Ava’s Law, legislation that aimed to reduce the number of pregnant people serving time in prison by giving judges the opportunity to defer their sentence until 12 weeks after delivery.

The bill, which was named after Thompson’s baby, failed to pass during this year’s legislative session.

“Florida’s prisons and jails have repeatedly shown that they are dangerously ill-equipped to provide adequate medical care to pregnant people, especially during labor and delivery,” said Daniel Tilley, legal director at the ACLU of Florida, which supported Ava’s Law.

Tilley urges that health providers follow the advice of the American College of Obstetricians and Gynecologists, which encourages doctors to work inside facilities to advise wardens and law enforcement officials and support efforts to expand access to adequate care behind bars.

He said that’s the best option, while pregnant people in Florida’s jails and prisons “wait for basic dignity and access to medical care, and bills like Ava’s Law to be codified into state law.”

Laws establishing ethical practices in treating pregnant people behind bars usually follow high-profile controversies.

For example, Tammy Jackson Healthy Pregnancies for Incarcerated Women Act, passed in 2020, generally prohibits involuntarily placing a pregnant woman in restrictive housing and safeguards healthcare guarantees. The woman it was named after gave birth alone in her cell at a South Florida special needs facility in 2019, after seven hours of unassisted labor.

Currently, if you are pregnant and sentenced to prison in Florida you will be sent to Lowell C.I. in Ocala, where about a year and a half ago, a U.S. Department of Justice report found incarcerated women had been subjected to sexual abuse for years.

Instances of physical abuse have also been reported at Lowell. In 2019, guards at Lowell broke the neck of Cheryl Weimar after she refused to clean a toilet, leaving her paralyzed. About a week ago, the Marion County State Attorney decided not to pursue charges, citing insufficient evidence.

“This is the most violent, negative, abusive prison in my whole incarceration and I’ve been to five different facilities,” Kimberley Morton, who is currently incarcerated at Lowell, said. Morton, 56, has been in prison for 39 years. “I’ll never believe pregnant women are getting the best healthcare, no one does here.”

Keiko Kopp, who is imprisoned at Lowell C.I., told WUFT in an October report that staff at the prison had ignored or delayed her requests for care and access to proper nutrition, antibiotics, supplements and an ultrasound while pregnant last year. Kopp, whose video posts on TikTok about the jail’s poor living conditions have attracted millions of views, gave birth to a baby girl who died shortly after.

In 2016, Anquanette Woodall was raped and impregnated by Florida prison guard Travis Hinson during her third year of a 15-year sentence for burglary and robbery at Gadsden Correctional Facility, a private state prison.

Breaking News

Breaking News

As it happens

Be the first to know with email alerts on important breaking stories from the Orlando Sentinel newsroom.

Hinson pleaded guilty to sexual battery and is serving a four-year sentence, while Woodall was moved from Gadsden Correctional Facility to Lowell C.I. and is now currently in Homestead Correctional Institution.

The Federal Prison Rape Elimination Act Standards requires authorities provide victims with “timely information about, and access to, all lawful pregnancy-related medical services.” After last week’s ruling, abortion consultation may not be mentioned to victims in states where it is banned.

Often times it’s also the pregnant individual who must cover the expenses of an abortion, leading some to follow through with unwanted pregnancies in prison conditions, because there are no other options.

Ava’s Law would have solidified postpartum assessments, data collection, and reporting requirements for pregnant women in Florida prisons. The Florida Senate’s bill analysis also found Ava’s Law could have reduced the costs of DOC, municipal and county detention facilities to cover prenatal care, delivery services, and postpartum care for pregnant women in prison.

Sufrin’s study found that roughly 15% of pregnancies in jails ended in abortion, which could decline steeply as states ban or restrict the procedure. She noted that abortions “are a lot cheaper than paying for prenatal care and childbirth.”

“There may be more people coming to prison or jail pregnant and these are institutions that are already not well equipped to adequately care for pregnant individuals, so if they see an increase in their volume, that’s going to constrain their abilities even more and potentially pose greater risks for these individuals,” she said.

arabines@orlandosentinel.com