“I was handcuffed, with a belt strapped down my waist, eight months pregnant. My ankles were shackled, and here I was, walking to the hospital to be checked by maternal care assistants. I gave birth to my baby boy in the hospital bed with an armed guard on my door and one in the room with me. That is not necessary,” said Marsha Curry-Nixon, executive director of Amiracle4sure, Inc. and a Council of State Governments (CSG) Justice Center board member. “There has to be some level of dignity. And that was stripped from me.”

Curry-Nixon was speaking at a congressional roundtable last month about her experience being pregnant and giving birth while in prison. The event, hosted by Rep. Karen Bass (D-CA) and Rep. Nancy Mace (R-SC), aimed to better inform congressional leaders about the distinct experiences and needs of women who are incarcerated, including the lack of adequate services and care for pregnant women and women’s increased risk of sexual abuse. In addition to Curry-Nixon, six other experts and women with lived experience in the justice system spoke about the need for gender-responsive programming in prisons and jails to improve outcomes for women.

The roundtable took place one day after the U.S. House Judiciary Committee passed The Pregnant Women in Custody Act, also introduced by Rep. Bass. The bill seeks to better address the needs of incarcerated individuals who are pregnant or postpartum, including providing appropriate services and programs and limiting the use of restraints and restrictive housing. It would also require the federal government to study and publish data on the health needs of, and services and protections for, incarcerated pregnant women.

The number of incarcerated women in the United States has grown tremendously. From 1980 to 2020, the number of women in jails increased over 475 percent. Yet most prisons and jails are designed for men as the “default prisoner,” said Carolyn Sufrin, director of the Advocacy and Research on Reproductive Wellness of Incarcerated People program. This means that many jails and prisons lack programs, services, and materials that address women’s needs, such as access to menstrual products, contraceptive care, and STI screenings.

Women who are incarcerated are also disproportionately low income and women of color and often have unaddressed physical, mental health, and substance use challenges. Prisons and jails tend to exacerbate these factors, and because of this, many women in custody are in a constant state of fight or flight, said Alycia Welch, associate director of the Prison and Jail Innovation Lab, during the panel.

“It’s so clear that the pathways for women to prison are so unique, but as a system, our responses to those pathways have been wholly inadequate,” said Josh Tewalt, director of the Idaho Department of Corrections.

Additionally, the majority of incarcerated women have children and are primary caregivers, while roughly 150,000 women who are incarcerated are pregnant. This presents challenges, as many jails and prisons lack gender-specific health care resources. The shackling of pregnant women, which Curry-Nixon spoke about, is prohibited in federal custody and in 40 states. Even in the states where it’s banned, however, it’s not always enforced.

When women are denied what they need while in custody, it increases their vulnerability to sexual abuse, including by correctional staff, said Julie Abbate, national advocacy director for Just Detention International.

Johanna Mills, program assistant at Just Detention International, drove this point home when she spoke about being raped by a staff work supervisor while she was incarcerated. After the assault, Mills received no medical or psychological care and was pressured by correctional staff to retract her accusation. The individual who assaulted her ended up receiving only 30 days in prison and a $100 fine.

Although the stories told during the panel were sobering reminders of the work that is still to be done, Dr. Ayesha Delany-Brumsey, director of behavioral health at the CSG Justice Center, said there is reason to hope. She cited multiple states like Maine and South Carolina that are engaging in gender-responsive and trauma-informed programming.

“Although the facts are bleak,” she said, “what these communities are doing and what the people on this panel are doing is working to create systems that not only address the needs of women who are incarcerated or at risk of incarceration, but also create systems that acknowledge their humanity and their uniqueness.”