Incarcerated People's Perceptions of Reproductive Health Care in a San Diego County Women's Jail: Interview Findings from an Exploratory Study

By Evelyn F. McCoy, Azhar Gulaid

This study aimed to understand the state of reproductive health care access and quality in a jail in California after early stages of the implementation of Assembly Bill 732 (A.B. 732). A.B. 732 was passed in September 2020 with the goal of increasing reproductive health care access and quality for incarcerated people and pregnant incarcerated people in state prisons and county jails.

WHY THIS MATTERS

People in jail—especially women, nonbinary people, and transgender people—have specific and significant reproductive health needs. Most people in jail are in their peak reproductive years, have histories of physical and/or sexual violence, and enter jail with more significant reproductive health care needs than the general population. Incarcerated people are more likely than the general population to have STIs, human immunodeficiency virus, and viral hepatitis, as well as higher rates of cervical and breast cancer and irregular menstrual cycles. Unsanitary conditions in jail, coupled with limited access to reproductive health care, can worsen health outcomes for people in jail. Despite this, reproductive health and health care for incarcerated people, as well as policies implemented to improve these areas, are understudied and overlooked.

WHAT WE FOUND

Study participants experience significant delays between requesting services and delivery of services, and have even experienced nonresponsiveness after multiple medical requests.Study participants face significant challenges in the delivery and quality of care, including having medical staff who are inexperienced with basic medical procedures such as blood draws, having inconveniently timed procedures, and getting little to no follow-up or information after procedures.Study participants noted that they have experienced dismissiveness from medical staff, have needed to exaggerate requests as emergencies to receive care, and have even experienced mistreatment and punishment from staff.Most study participants shared that they have never received general information about reproductive health care or services and do not know what is available to them.Half of study participants shared that they do not feel comfortable or safe receiving services from jail medical staff. Discomfort comes from private medical information being discussed in jail common spaces and officers being present at medical appointments, including procedures that require undressing.Nearly a third of study participants have experienced bias or pressure from staff about reproductive decisions.Our study also identified findings in the following areas, as detailed in the report:preventive caremenstruation supportcontraceptive care and abortionpregnancy and postpartum carereentry preparation and parenting classes

HOW WE DID IT

We conducted semi-structured, individual, in-person interviews with 34 incarcerated people in a women’s jail in California to learn about their experiences accessing and receiving reproductive health care since A.B. 732 was passed.Washington, DC: Urban Institute, 2024. 83p.