ABSTRACT
Objective(s)
Incarcerated individuals have an unmet need for contraception, yet have also been
subject to coercive permanent contraception practices. Data do not exist on prison
and jail policies around access to permanent contraception or how often it occurs
among women in custody. We sought to describe permanent and reversible contraception
policies at U.S carceral institutions and the frequency of these procedures.
Study Design
We surveyed a convenience sample of 22 state prison systems and 6 county jails from
2016 to 2017 about female permanent contraception and reversible contraception policies.
In addition, 10 prisons and 4 jails reported 6 months of monthly data on the number
of postpartum permanent contraception procedures performed on women who gave birth
in custody. We analyzed results for descriptive statistics.
Results
Eleven prisons (50%) and 5 jails (83%) permitted female permanent contraception; 7
of these prisons and 3 of these jails allowing permanent contraception did not have
a written policy about it. Six prisons and no jails provided access to permanent but
not reversible contraception. Over 6 months, 3 women from 2 prisons and 4 women at
2 jails received postpartum permanent contraception.
Conclusion(s)
The majority of prisons and jails in our study allowed incarcerated women to have
permanent contraception in custody, often without formalized policies in place. Postpartum
permanent contraception occurred during the study period. Given the inherent lack
of autonomy of incarceration and history of sterilization abuses in this marginalized
group, policy-makers should advance policies that avoid coercive permanent contraception
and increase access to reversible contraception in carceral settings.
Implications
Many carceral institutions permit women to undergo permanent contraception but provide
no access to reversible contraception; this practice raises concern for compromised
autonomy and further reproductive marginalization of a group with limited access to
quality reproductive health care.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ContraceptionAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Current contraceptive status among women aged 15–49: United States, 2017–2019.National Center for Health Statistics, Hyattsville, MD2020 (Dec. Report No.: NCHS Data Brief, no 388) (accessed December 10, 2020)
- Sterilized in the name of public health: race, immigration, and reproductive control in modern California.Am J Public Health. 2005; 95: 1128-1138
- Time and time again: the reincarnations of coerced sterilisation.J Med Ethics. 2021; (Jun 14; medethics-2020-106924Online ahead of print https://doi:10.1136/medethics-2020-106924)
- Killing the black body: race, reproduction, and the meaning of liberty.Pantheon Books, New York1997
- Contraception need and available services among incarcerated women in the United States: a systematic review.Contracept Reprod Med. 2020; 5: 2
- Reproductive justice disrupted: mass incarceration as a driver of reproductive oppression.Am J Public Health. 2020; 110: S21-S24
- “If They Hand You A Paper, You Sign It”: a call to end the sterilization of women in prison.Hastings Womens Law J. 2015; 26: 7-49
- Female prison inmates sterilized illegally.California audit confirms. Center for Investigative Reporting, 2014 (http://cironline.org/reports/female-prison-inmates-sterilized-illegally-california-audit-confirms-6471 (accessed July 19, 2021))
- Whistleblower Alleges “Medical Neglect,” questionable hysterectomies of ICE detainees.NPR. 2020; (accessed July 20, 2021)
Estelle v Gamble. Vol. 429 U.S. 97. 1976.
- Aligning correctional health standards with Medicaid-covered benefits.JAMA Health Forum. 2020; 1 (e200885–e200885)
- But who oversees the overseers?: the status of prison and jail oversight in the United States.Am J Crim Law. 2021; 47: 207-273
Carson EA. Prisoners in 2019. Washington, DC: Department of Justice, Bureau of Justice Statistics; 2020. Report No.: NCJ 255115.
- Jail inmates in 2019.U.S. Department of Justice, Bureau of Justice Statistics, Washington, DC2021 (Report No.: NCJ 255608)
- Pregnancy outcomes in US prisons, 2016–2017.Am J Public Health. 2019; 109: 799-805
- Pregnancy prevalence and outcomes in U.S. jails.Obstet Gynecol. 2020; 135: 1177-1183
- Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inform. 2009; 42: 377-381
- Equitable care for pregnant incarcerated women: infant contact after birth-a human right.Perspect Sex Reprod Health. 2020; : 211-215
- American College of Obstetricians and Gynecologists. Committee Opinion No. 695: sterilization of women: ethical issues and considerations.Obstet Gynecol. 2017; 129: e109-e116
- American College of Obstetricians and Gynecologists. Committee Opinion No. 830. Reproductive health care for incarcerated pregnant, postpartum, and nonpregnant individuals.Obstet Gynecol. 2021; 138: e24-e34
- Soft sterilization: long-acting reversible contraceptives in the carceral state.Affilia. 2020; 35: 218-230
- Long-acting reversible contraceptives for incarcerated women: feasibility and safety of on-site provision.Perspect Sex Reprod Health. 2015; 47: 203-211
- Incarceration, community health, and racial disparities.J Health Care Poor Underserved. 2013; 24: 78-88
- Race and criminalization: black Americans and the punishment industry.Pantheon Books, New York1997
- The New Jim Crow: mass incarceration in the age of colorblindness.New Press, New York2010
- Policing the womb: invisible women and the criminalization of motherhood.Cambridge University Press, Cambridge2020
- Black maternal and infant health: historical legacies of slavery.Am J Public Health. 2019; 109: 1342-1345
Inmates are excluded from Medicaid – here's why it makes sense to change that. https://ihpi.umich.edu/news/inmates-are-excluded-medicaid-%E2%80%93-here%E2%80%99s-why-it-makes-sense-change. (accessed July 20, 2021).
- Amendments of 1965. Pub. L. No, 89-97. 1965
- Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy.Contraception. 2013; 88: 691-696
- Adding injury to injury: ethical implications of the Medicaid sterilization consent regulations.Obstet Gynecol. 2014; 123: 1348-1351
- Using deliberative and qualitative methods to recommend revisions to the medicaid sterilization waiting period.Womens Health Issues Off Publ Jacobs Inst Womens Health. 2020; 30: 260-267
SB-1135 Inmates: sterilization. 2014. https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1135. (accessed July 20, 2021).
AB-1007 Forced or Involuntary Sterilization Compensation Program. 2021. https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202120220AB1007. (accessed July 20, 2021)
SB-1433 Incarcerated persons: contraceptive counseling and services, 2016. https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB1433. (accessed July 20, 2021).
Article info
Publication history
Published online: August 13, 2021
Accepted:
August 2,
2021
Received in revised form:
July 20,
2021
Received:
February 9,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
