I’m an OBGYN and I practice at a jail, where I take care of incarcerated women.
People often ask me, how did you come to work with incarcerated women? I was in the middle of my first year residency, delivering a baby. Everything was very familiar about the delivery scene; the nervousness, wondering if everything was going to be okay, helping the woman to push. But the one thing that was different is that she was shackled to the bed; she was a prisoner. And that moment troubled me so deeply that I developed an interest in learning more about these women.
Women make up a much smaller proportion of the correctional population than men — about 9% of everyone who is incarcerated. And 62% of [those] women are mothers to children who are less than 18 years old. Because women comprise such a small proportion, their gender-specific needs have been neglected. That’s particularly salient when it comes to their healthcare.
In theory, women do have the choice to have an abortion if they learn they are pregnant when they are in prison. There are constitutional guarantees — the 8th and the 14th amendments — and a number of judicial precedents, so it’s very clear that incarcerated women should have access to abortion. However, in practice, the people who are making the decisions have incredible discretion and many women lack access to abortion if they choose it.
About 1400-2000 births occur every year to women who are behind bars, and what they get for prenatal care is highly variable. There are standards that require prisons to have prenatal care onsite, but on the ground, some women have to be transported offsite and some women don’t even get prenatal care.
In labor, they usually get transported to an outside hospital. They can’t have any family support members in the room, and only 15 states have laws restricting the shackling of women in labor and delivery. A woman in labor, shackled, is what inspired me to work with this population. It’s inhumane and unnecessary, and it poses a lot of medical risks to the mother and the fetus. It also interferes with our ability to do emergent interventions if necessary.
People think prisons and jails are far away and we forget about the people who get locked up inside; we think they have nothing to do with us. So I hope I’ve given you some things to consider about what it’s like to be a woman when you’re in the grip of the prison or jail system.
From Dr. Carolyn Sufrin’s talk on incarcerated women and reproductive healthcare. Filmed at TEDxInnerSunset.
Staff are now rerouting women to one of three abortion clinics still operating in Austin, to Planned Parenthood’s surgical center in Dallas, to Houston or even out of state to New Mexico if they need an abortion past 16 weeks of pregnancy.
When applying for health insurance, you usually have to share personal information with each private insurance company to find out how much a potential health plan costs. In the Health Insurance Marketplace, you have a simplified way of finding health insurance, comparing plans and reviewing coverage options from different providers.
In the Health Insurance Marketplace, you will need to share your personal information just once and you’ll get:
- the ability to compare different insurance companies and buy the health insurance plan of your choice
- if you qualify, a new tax credit to help pay premiums for health coverage based on income level
- if qualified, support for Medicaid or the Children’s Health Insurance Program for Children (CHIP) based on income level
It is important to know that when you apply for health coverage through the marketplace, you need to give more information than is required by individual insurance companies. Additional information is needed to provide medical coverage based on income. In the marketplace, you will have to share the social security number of each family member, income information, details of your employer and any insurance you may have, including Medicare insurance.
By law, each person must have health insurance in 2014 or will pay a fine ($95 per adult, $47.50 per child or 1 percent of your income, whichever is the higher amount).
Ways to Register
There are four different ways you can register for health insurance through the Health Insurance Marketplace:
Health Insurance Marketplace
Department of Health and Human Services
465 Industrial Blvd
London, KY 40750-0001
By phone: Call 1-800-318-2596, available 24 hours a day, or 1-855-889-4325 (TTY).
In person: To find local help, search by city and state or zip code.
Online: You can apply online at healthcare.gov.
The open enrollment period in the Health Insurance Marketplace began on October 1, 2013 and ends on March 31, 2014.
Remember that no medical coverage obtained will begin before January 1, 2014.