An incarcerated young woman receives prenatal care.
A motion at today’s Los Angeles County Board of Supervisors meeting calls on county agencies and other stakeholders to develop a strategy to end the incarceration of pregnant youth.
In 2017, 1,039 girls were booked into L.A. County juvenile detention facilities. Fifty had a positive pregnancy test upon intake, and one gave birth while incarcerated, according to a June report from the Department of Health Services.
Thirty-four of those 50 young women were “crossover” youth, meaning they are under supervision by the child welfare system as well as probation.
“Improving their care is a matter of reproductive justice,” reads the Board motion, authored by Supervisors Janice Hahn and Hilda Solis.
In L.A. and across the state, reducing youth incarceration has been at the top of reformers to-do lists. This year, California passed a law banning detention for youth 11 and younger, and in L.A., the county is hoping to ban 12- and 13-year-olds from incarceration in most cases as well. In 2017, L.A. County instituted a sweeping pre-arrest diversion plan, establishing the Office of Youth Diversion and Development (YDD).
“The County has shown substantial commitment toward reducing the number of youth in detention,” the motion reads. “However, a collaborative and concerted effort should focus keenly and specifically on keeping pregnant girls out of detention.”
Women are the fastest growing population in prison and are the subject of significant reforms proposed in the federal First Step Act. The health impact of being incarcerated while pregnant varies widely.
“Pregnancies among incarcerated women are often unplanned and high-risk and are compromised by a lack of prenatal care, poor nutrition, domestic violence, mental illness, and drug and alcohol abuse,” according to the American College of Obstetricians and Gynecologists.
For women in risky situations on the outside, incarceration can offer some protections, according to a report on prison prenatal care by pediatric researchers at the University of Minnesota. These include shelter, three meals a day, and access to hygiene, as well as a barrier from abusive men.
Still, the psychological stress, physically restrictive settings and loss of social supports caused by incarceration can all have negative effects on pregnancy health and birth outcomes.
Medical and correctional experts say the fact that these pregnancies are high-risk to begin with means the women should receive high-quality, individualized services — but that often can’t happen.
“Significant barriers exist to providing care by these standards in a jail environment: Neither our patients nor our health staff control clinical visit schedules; appropriate clinical care is often stymied by court dates, security lock-downs and other facility challenges,” the July 2018 report from L.A. County says.
A 2015 report based on interviews with incarcerated youth in L.A. highlighted some aspects of detention that proved problematic for the pregnant girls inside, including not having enough food to maintain a healthy pregnancy and the use of chemical restraints.
“One youth at Camp Scudder described being hit with indiscriminate pepper spray and how the staff responded to health concerns for her pregnancy after the incident,” the report says. In another anecdote from the same camp, rations were so scant that youth snuck food from their own trays to ensure their pregnant peer had enough to eat. Even the double portions she was allotted weren’t enough.
Currently, certain accommodations to protect pregnant youth from the adverse effects of incarceration are in place, according to the July 2018 report, such as housing pregnant youth with medically fragile youth and providing prenatal vitamins and a special diet with at least 2,600 calories. They have a right to prenatal medical care, including abortions.
The motion calls for policies around mental health access for pregnant incarcerated youth as well as culturally competent policies on reproductive rights around prenatal care, delivery, postpartum and family planning.
A coalition of county agencies, including YDD, Probation and the Department of Children and Family Services must report back to the board in 180 days with these new policies and their plan to phase out incarcerating pregnant youth.
Correction: This article originally misidentified Sup. Sheila Kuehl as a co-author of the motion, which was in fact authored by Sups. Janice Hahn and Hilda Solis.
