Assessing Health Care of Women in NY Prisons

A five-year study of women's prisons in New York State found low standards for reproductive health and poor health care oversight, leaving pregnant women particularly vulnerable. (Image courtesy of and Copyright of Correctional Association of New York)

A five-year study of women’s prisons in New York State found low standards for reproductive health and poor health care oversight, leaving pregnant women particularly vulnerable. (Image courtesy of and Copyright of Correctional Association of New York)

For the most part, women in prison deal with the same health issues as women in the community: periods, pregnancy, menopause, HIV/AIDS. But reproductive health care and health education in New York’s prisons is sorely lacking, according to a report released last week by the Correctional Association of New York.

The only independent organization with unrestricted access to New York’s prisons, the Correctional Association produced the study by conducting surveys and visiting women’s correctional facilities between 2009 and 2013. The report finds that many problems specific to women – a scarcity of sanitary napkins; no access to birth control, even for medical issues – are dismissed by the New York State Department of Corrections and Community Supervision (DOCCS), which oversees the state’s correctional facilities.

Not all findings were negative, however. In fact, one of the main issues cited is that the quality of health care women reported varied widely due, in part, to a lack of clear policies and training of corrections officers. Most women had annual OB-GYN checkups, but some women reported waiting months for follow-ups on cancer treatment. Most women reported receiving information about HIV and STDs, but HIV-positive women said they were still subject to stigmatizing treatment from some officers. Bedford Hills Correctional Facility, which houses most pregnant inmates in New York, was praised for its nursery program where women can stay with their children for up to a year after giving birth, but the Correctional Association reported that many women were unfairly denied access.

Most egregiously, the Correctional Association alleges that, in spite of moves toward reform, the safety of pregnant inmates remains at risk: Pregnant women continue to be placed in solitary confinement or similar isolation and are routinely subject to unlawful shackling during childbirth. (This practice was the subject of an op-ed in The New York Times in July.)

Tina Tinen, one of the women whose story made it into the Times this summer, was two months pregnant when she landed in Bedford on non-violent drug charges in March 2011. In a recent telephone interview, she described the inadequate diet, squalid dorms and the difficult daily strip searches she endured during her pregnancy. She was frequently shackled while moving around and worried about falling and injuring herself or the baby.

When Tinen was finally ready to give birth that November, she said corrections officers shackled her to her hospital bed, despite protests from the medical staff. Tinen said she asked to call her mother and her request was denied. With her arm lashed to the bedpost, Tinen was unable to sit up to push and unable to hold onto the bed without the shackle cutting into her wrist.

She knew this was not how she was meant to give birth. “They made me feel like an animal,” Tinen recalled through tears.

She didn’t learn until she got out that it was also illegal.

Since the 2009 anti-shackling law prohibited shackling during and after childbirth, at least 23 women in New York prisons have been subject to such restraints, according to the Correctional Association’s report. Disregard for anti-shackling laws has been reported in other states as well.

A spokesperson for the New York State Department of Corrections and Community Supervision (DOCCS), which oversees all state prisons, said the department doesn’t have a statement on any of the concerns raised in the Correctional Association’s report at this time and may not issue one in the future.

Tamar Kraft-Stolar, one of the authors of the report, said she and DOCCS officials had a “productive dialogue” about the Correctional Association’s findings before the report was published, however. She said officials expressed a willingness to listen to testimonials from women like Tinen, even though they have denied all but one of the shackling violations reported. While the anti-shackling law requires the department to keep records of when women have been shackled, it does not require them to make those records public.

“That’s something we’ll want to change in the legislation,” said Kraft-Stolar, who said the Correctional Association is working to introduce amendments to strengthen the law this year, including a training requirement and a mandate to inform women of their rights.

Many of the health issues raised in the report are not regulated by law or even by clear policies, however. When confronted about the shortage of sanitary napkins, DOCCS officials attributed it to the fact that women use the pads for other things, like cleaning or fixing noisy doors, Kraft-Stolar said.

“They’re skeptical that it’s a widespread problem,” said Kraft-Stolar, “but our research shows otherwise.”

As far as placing pregnant women in solitary confinement, the DOCCS has attempted reform, but Kraft-Stolar said it’s been underwhelming. Following a class-action suit challenging solitary confinement last year, DOCCS issued a memo saying pregnant women should rarely be placed in the tiny Special Housing Units typically associated with solitary confinement, but recommended Keeplock – isolation within their own cells – as an alternative.

The report finds that pregnant women are subject to the same housing conditions as those in the general population, which often means dorms that overheat in the summer and are freezing in the winter with reports of bugs and mice. Pregnant women also eat the same food as their fellow inmates and DOCCS has no written policy on their nutrition. While two of the prisons the Correctional Association visited said they offered an extra “snack” at dinner, about half of the women surveyed at those prisons said they didn’t receive it.

Kraft-Stolar said the biggest takeaways from the past five years of surveying health care in women’s correctional facilities were the lack of oversight and “how degrading the system is.”

Tinen, now on the outside and in custody of her son, said she’s not just telling her story for pregnant women. “No woman, pregnant or not, should have to go through what I went through,” Tinen said.

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