322 12 Corrections and Prison Practices—Family Forensics
it is an institution-by-institution battle. For example, the inmates at Bedford Hills
Correctional Facility in New York brought a class-action lawsuit against the institu-
tion for inadequate medical care. The Court found that the level of medical care was
adequate, but the administrative and record-keeping procedures were not. There-
fore, the inmates were denied medical attention for significant lengths of time. The
Court ruled that the institution had to devise plans for better access to the medical
care the facility provided (Todaw v. Ward, 1977).
Although these lawsuits reflect more general rulings regarding health care, the
pregnant inmate benefits greatly because she usually has many more health concerns
than the typical pregnant woman. Pregnant inmates are often exposed to more ill-
nesses and diseases, including sexually transmitted diseases. These women tend to
have backgrounds filled with abuse, poverty, poor nutrition, and drug use. These
factors all contribute to increased risks for pregnancy complications (Safyer & Rich-
mond, 1995). Incarcerated women also tend to smoke cigarettes and drink alcohol
during pregnancy, they do not seek prenatal care until later in their pregnancies,
they have fewer prenatal care visits, and this prenatal care is usually inadequate (S.
L. Martin, Kim, Kupper, Meyer, & Hays, 1997). There are also the psychological
adjustments these women must face, not only with the pregnancy, but with adapting
to the prison environment, typically with a lack of familial or social support (Safyer
& Richmond, 1995). The prison milieu is a stressful place with women being ex-
posed to violence, aggression, and isolation. If support systems are created, they
may be opposed to the prison authorities, decreasing the likelihood for pregnant
inmates to seek prenatal care, especially if medical staff are viewed as part of the
authority system (Hufft, 1992).
According to j. S. Wilson and Leasure (1991), the medical standards that have
been developed in prisons focus only a small percentage on women's needs, and
these standards typically are not very specific with regard to implementation. They
suggest that it prenatal care is not provided on-site, then women often miss their
prenatal appointments and classes because transportation for taking inmates to court
appointments receives higher priority. They also note that pregnant inmates often
do not have adequate knowledge about options available to them.
To determine what types of services are available for pregnant women within
prisons, Wooldredge and Masters (1993) conducted a survey of facilities and found
that only 48% of the institutions had actual policies in writing regarding health care
for pregnant inmates. Programs for pregnant prisoners included prenatal counseling,
lighter work loads, separate housing areas, assistance with infant placement, and
postnatal counseling. These initiatives were improvements over what had been
availed in the past, yet they were offered in only 21% of the facilities. The authors'
survey also found that there were no programs which dealt specifically with the
psychological aspects of being a pregnant inmate. Wardens from the prisons surveyed
offered their opinions about the types of problems that existed for this population.
These problems included poor resources for situations such as false labors, premature