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INCARCERATED WOMEN’S ABORTION ACCESS LIMITED BY VARYING POLICIES AND PRACTICES
Each year, millions of women—some of whom are pregnant—enter U.S. jails and prisons. For those faced with an unwanted pregnancy while incarcerated, access to abortion services varies widely, according to “Incarcerated Women and Abortion Provision: A Survey of Correctional Health Providers,” by Carolyn B. Sufrin et al., published in the March 2009 issue of Perspectives on Sexual and Reproductive Health. Incarcerated women wishing to terminate a pregnancy face numerous challenges; among them are facilities’ ad hoc responses to abortion requests, difficulties in making transportation or financial arrangements, and the requirement of obtaining a court order.
In a survey of health professionals who provide clinical care in correctional facilities, 68% of respondents indicated that inmates at their facility can obtain “elective” abortions. Eighty-eight percent of this group indicated that their facility provides transportation, but only 54% said they help arrange appointments; the remainder reported that women must schedule the appointment without help from correctional health providers.
Additionally, the study found that facilities in states with a Republican-dominated legislature or with a Medicaid policy that severely restricted coverage for abortion were more likely to have limited access to abortion services than were those whose state had a predominantly Democratic legislature or a Medicaid program that covered all or most medically necessary abortions. The authors suggest that the correctional health system should strive to consistently provide quality, comprehensive medical care to all inmates.
In the related Viewpoint “Abortion Access for Incarcerated Women: Are Correctional Health Practices in Conflict with Constitutional Standards?” Diana Kasdan summarizes the legal principles that are relevant for determining the constitutionality of correctional facilities’ approaches to abortion provision. She observes that although incarcerated women retain their right to have an abortion, the policies and practices of prison and jail officials, and the experience of pregnant women in their custody, differ dramatically from state to state, county to county and facility to facility. Kasdan advocates for identifying gaps in services for incarcerated women, and standardizing and enforcing policy guidelines that can help policymakers, administrators and health care providers develop appropriate standards of care for correctional facilities.