“The strongest pain reliever, if you’re getting anything while you’re incarcerated, is extra strength Tylenol. [The prison] had essentially been giving [my mom] Extra Strength Tylenol for years for what ended up being stage four metastatic colon cancer,” said Gabrielle Perry.
Stories like these are all too familiar at women’s carceral institutions throughout the country. Because women’s prisons often lack the same baseline healthcare afforded to incarcerated men, incarcerated women are uniquely vulnerable to mistreatment by the carceral system.
Perry’s mother’s experience informs Perry’s activism today. So does her personal experience as a previously incarcerated woman. In 2021, Perry founded the Thurman Perry Foundation, a nonprofit dedicated to assisting women in the carceral system. Perry’s work with incarcerated women and her own experiences have exposed her to the punitive struggles of women in and out of prison–excessive criminalization, inadequate access to essential supplies and services, and draconian policies
However, Perry sees these issues as symptoms of a deeper problem: the systemic erasure of women in conversations about incarceration. “Nobody’s thinking about women in terms of incarceration,” Perry disagnoses. This oversight leaves women in prison vulnerable to neglect, abuse, and criminalization, all while remaining invisible to a system designed primarily for men, a trend that’s only evolving.
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Broadly speaking, incarceration has traditionally been perceived as a man’s issue. While there are significantly more incarcerated men than women, sheer numbers often obscure the unique challenges women face in custody and the distinct ways women interact with the criminal justice system. Since President Ronald Reagan started the War on Drugs, the number of men in prison has increased 416%. But the number of women in prison has increased by over 832%.
This large increase in the female incarcerated population is driven in part by the way drug laws are used to target pregnant women and mothers. Women are often held to a higher standard in an effort to protect children, an effort that jails mothers instead of treating them.
Pregnant women, in particular, are victims of this punishment. Any indication that a pregnant woman has used drugs can result in excessive policing. Michelle Godwin, author of article “Pregnancy and the New Jane Crow” and Professor of Constitutional Law and Global Health Policy at Georgetown Law School, gave an example of this situation, telling the story of Black South Carolina resident Regina McKnight.
When McKnight was homeless and pregnant, she used cocaine once. After her completely unrelated stillbirth, the hospital took advantage of her intellectual disability to drug test her, something that prosecutors would use to pursue a case against her months later. Despite there being “no proof that showed that her stillbirth was actually connected to the fact that she had used an illicit drug during pregnancy,” the police used this evidence to improperly arrest her, a decision that would be overturned years later. This case exemplifies how stringent criminalization unfairly targets pregnant women and weaponizes their situation against them.
The criminalization of pregnancy often impacts Black women the most. “Even before the overturning of Roe…black women [were] disproportionately criminalized for substance use issues in pregnancy,” Sufrin explained.
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Criminalization of pregnancy is just the start of how the state weaponizes gender against women. Sufrin, who worked extensively with reproductive care inside prisons, explained that when it came to reproductive healthcare, “there are no mandatory standards and no mandatory systems of oversight and accountability. And so that means that healthcare and carceral facilities for everybody, but especially for pregnant and postpartum individuals, is highly variable.”
Sufrin explained that many pregnant women have “delivered in their jail or prison cell.” Some are even “shackled while in labor,” a practice still legal in Utah, Nebraska, Kansas, Indiana, Georgia, and South Carolina.
Incarcerated pregnant women face dangerous health risks even before giving birth. Since prisons are required to provide only rudimentary healthcare, women’s facilities often lack prenatal care or maternal health services. Frequently, pregnant women are “not informed about what’s happening with their medical care [and] their pregnancies,” according to Sufrin. Care is so limited that women very rarely see a healthcare professional, meaning that women are often unaware of the condition of their baby, the steps they need to take to ensure its health, or when they’ll go into labor.
Even for nonpregnant women, the lack of adequate women’s health resources poses dangers to their health and wellbeing. Since prisoners are often given just 2 sanitary pads a month to deal with their period, Perry explained that many use “tampons beyond their vitality.” This can lead to disastrous consequences like emergency hysterectomies and debilitating infections.
Further, Perry noted that incarcerated women often resort to “cutting up socks, cutting up their clothes, cutting open their prison issued mattresses to use the stuffing to shove inside themselves” because they lack access to sufficient hygiene products while menstruating.
She also explained how “some of the women will allow themselves to be raped and sexually assaulted in exchange for more menstrual products just to be able to try to menstruate with some kind of dignity.”
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The recent reversal of Roe v. Wade only worsens the situation for women when it comes to the carceral system.
For incarcerated women, the reversal of Roe v. Wade means a deterioration in the already limited healthcare afforded to them. Specifically for women that desire abortions, Dobbs threatens their autonomy since their movement is limited. Because prisons and jails largely just transfer inmates to neighboring hospitals, statewide abortion bans can mean “that community hospital may refuse to provide that treatment because of state laws.”
Even if an incarcerated woman was not seeking an abortion, a large number of lifesaving procedures that risk the fetus’s viability may be refused in states with abortion bans, as doctors are fearful of being held criminally liable for terminating a pregnancy. For pregnant women facing life threatening emergencies, this means that hospitals might “send that individual back to the prison or jail, and prisons and jails are not equipped to handle impending obstetrical emergencies, so it’s sending them back to an unsafe environment where they also don’t have the freedom of movement to get themselves to another state to get the right health care.”
Roe’s reversal has profound complications for the criminalization of women, enabling prosecutors to bring more charges against pregnant women.
Wanda Betram, Communications Strategist for the Prison Policy Initiative, explained that though drug arrests often drag pregnant women into the criminal justice system, prosecutors often stack even more charges onto women once they have been brought to the authorities attention. “Oftentimes a drug arrest is just what pulls somebody into the system. They can then be charged with many other things, including fetal endangerment…negligence of a child, domestic violence issues,” Bertram explained. With the Dobbs decision, prosecutors have one more weapon they can use against pregnant women.
Dobbs has also changed the lives of the over 800,000 women who are out on parole or supervised release. Betram explains that women under parole limitations are “very limited in where [they] can go. [They] can’t leave the state, which, in many places, means [they] can’t seek abortion care.”
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In light of the unfair treatment of incarcerated women by the American criminal justice system, organizations like Gabrielle Perry’s work to improve the lives of women entering and exiting the system. To alleviate the barriers to accessing menstrual products, she has donated 283,000 organic menstrual products to incarcerated women and provides menstrual products to transitional programs for women leaving the system.
Moreover, transitional programs do exist to rectify some of the challenges women face coming out of the carceral system. Perry described a transitional housing program in Dallas County, Texas which humanizes and brings young women and girls back into society: “Everything is theirs. They’re allowed to have locks on their closets, the code that only they know. There’s seven on-site therapists.” However, there’s a “300 person waiting list,” and facilities like this are often underfunded.
While a housing program and 283,000 donated sanitary products are life changing, they won’t solve deep-rooted problems that exist for women within the criminal justice system. We first must reckon with the problem Godwin sets out: Incarcerated women are still invisible. Until incarcerated women’s unique experiences, struggles, and obstacles are acknowledged, substantial progress remains impossible.