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Abortion access for incarcerated women: are correctional health practices in conflict with constitutional standards?

Article Excerpt
Does a pregnant woman who is in prison or jail still have the constitutional right to decide whether to continue her pregnancy or to have an abortion? The simple legal answer is yes. Of course, this provides little, if any, insight into what actually happens when thousands of women each year must make this decision while living behind prison walls. * But gaining such insight in any systematic manner has long presented a challenge to health professionals, researchers and advocates. The ways in which prisons handle a woman's abortion request are often shielded from public scrutiny, and they can be enormously varied. Women are incarcerated at the federal, state and local levels. Accordingly, policies and practices of prison and jail officials, and the experience of pregnant women in their custody, may differ dramatically from state to state, county to county, and facility to facility Despite these challenges, understanding incarcerated women's ability, or inability, to access reproductive health care, including abortion, is key to developing strategies to advance their reproductive health and rights.

In this issue of Perspectives on Sexual and Reproductive Health (page 6), Sufrin, Creinin and Chang present results from a nationwide survey of correctional health care providers that describe trends in abortion access and barriers. This is one of the very few published studies to provide a national snapshot of the availability of abortion for incarcerated women. The responses confirm that the degree to which incarcerated women are able to obtain abortions varies significantly among institutions. Notably, while a very small minority of participants--3%--reported that by law, their state specifically restricts incarcerated women from obtaining abortion: ([dagger]) only 68% responded affirmatively to the question "Are women at your facility allowed to obtain an elective abortion if they request one?" This discrepancy suggests that a significant proportion of facilities refuse to allow abortion access despite the absence of any actual, or perceived, legal barriers. Additionally, even among respondents who indicated that their facilities do allow access to abortion, many said that women receive little or no logistical assistance in arranging, paying for and getting to the appointment.

These findings are consistent with the experience of advocates representing incarcerated women. For instance, over the years, my colleagues at the American Civil Liberties Union and I have received calls and letters from, or on behalf of, incarcerated women desperately seeking help after their requests for abortion care have been denied, delayed or ignored. But beyond our direct experience, it is hard to measure how often facilities thwart women's attempts to get abortion care. Only a fraction of incarcerated women succeed in obtaining legal help, and among those who do, often the problem is resolved informally and without a public record. Thus, relatively few cases make it to court. Yet, cases that have reached the courts have almost uniformly met with success.

Despite the legal consensus that...

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