Incarcerating Eve: Women’s Health “Care” in Prisons and Jails

In Season 4 of the hit Netflix original Orange is the New Black, we get a glimpse into the healthcare issues that plague incarcerated women in prisons. The fifth episode of the new season focuses on the crisis that the characters face when the prison has a tampon and maxi pad shortage. This shortage of readily available menstrual products engenders a black market for tampons and inspires several of the inmates to create menstrual products of their own, using objects like eye masks, disposable medicine cups, and toilet paper.

Orange is the New Black poster. (Netflix)

Though the world of Orange is fictional and overly dramatized, the struggle to obtain basic sanitary supplies is one that women inmates face daily. According to a 2015 study by the Correctional Association of New York, 54 percent of women in prison report that they do not receive enough sanitary pads a month. Inmates also report that the mere 24 pads they are issued each month are poor quality and so thin that they don’t last long, making these “sanitary” pads quite the opposite. Though inmates can purchase supplies from the prison commissary when available, many cannot afford them and women have resorted to trading sex with correctional guards in exchange for the menstrual products they direly need. This issue is only one of the multitudes of health problems that incarcerated women face in correctional settings.

Despite the fact that men comprise the majority of individuals arrested and imprisoned, the percentage of incarcerated women still warrant attention, especially since women are currently the quickest growing segment of the incarcerated population, increasing at nearly double the rate of men since 1985. Between 1980 and 2014, the number of incarcerated women increased by more than 700 percent, rising from a total of 26,378 in 1980 to 215,332 in 2014.

Moreover, women of color are largely overrepresented in this statistic, with black and Hispanic women making up a total of 46 percent of incarcerated women. Along with the prevalence of sexual coercion and abuse at the hands of correctional officers, there continues to be a pervasive and overt medical neglect of women’s chronic health needs in prisons across the nation, a practice that can trace its roots far back into history.

Women Mississippi State Penitentiary inmates at the Parchman Post Office, c. 1930. (Mississippi Department of Archives and History/Flickr | Public domain)

In nineteenth-century America, prisons for women generally evolved in three main waves. The first wave involved imprisoning women in the “general population” alongside male prisoners. They resided in filthy and overcrowded settings where they were often subjected to harsh treatment, degradation, and sexual abuse by the hands of both correctional officers and male prisoners. In 1826, a female prisoner, Rachel Welch, became pregnant while in solitary confinement. Subsequent to giving birth, a prison official flogged her so brutally that she died as a result of her wounds. The guard who beat her was convicted of assault and battery, fined $25, and allowed to keep his job.

The second wave involved removing women from the general population, and housing them in separate quarters of male prison facilities. However, this action simply allowed for their general neglect, as they lacked many of the same resources as imprisoned men. At one point, as many as 70 women prisoners were locked in a one-room attic at the Auburn State Prison in New York. The conditions were so notably terrible that a prison chaplain once famously acclaimed, “to be a male convict in this prison would be quite tolerable; but to be a female convict, for any protracted period, would be worse than death.”

The third wave led to the creation of separate women’s prisons. These separate women’s prisons didn’t appear regularly until the 1870s, and they worked to reinforce normative virtues of femininity, focusing on making their women residents traditional and “true” women. The women were trained to cook and sew and most were eventually released on parole to work as domestic servants. However, the conditions of these prisons continued to remain inhumane and overcrowded. Women were too often gagged and straightjacketed as a means of punishment.

Additionally, the idea that incarcerated women were not “true” women continued with the emergence of the new Reformatory Prison in the 20th century. These prisons intended to “morally cure” women through education, work, hard labor, or the arts. Many prisons even attempted to use the natural attachment between a mother and child to indoctrinate these women into traditional gender roles. The creation of sex-segregated incarceration simply succeeded in implementing gender stereotypes through the inclusion of sexist programming.

(Collage using detail from Lucas Cranach the Younger’s Adam and Eve, c. 1537)

Prisons have long been a harmful and non-inclusive environment for women, largely because of the persistent societal belief that the female criminal is a “double-deviant,” an Eve-like character. She not only violated the law, an extension of society’s high-held morals, but she also, and possibly more gravely, violated society’s definition of a woman as “pure and moral.”

This phenomenon is explained by historian L. Mara Dodge, in the Journal of Social History, “Because women were viewed as being more pure and moral by nature than men, the woman who dared to stray or fell from her elevated pedestal was regarded as having fallen a greater distance than a male, and hence as being beyond any possibility of reformation” (908). Thus, prisons have focused more on “reforming” the behavior of the woman than providing her with any healthcare, resources, or services that she may require to overcome her social circumstances.

The United States criminal justice system, originally established to serve a mostly male population, does little to accommodate for the unique healthcare concerns of women. Women enter the criminal justice system with far higher rates of drug abuse, sexual violence, childhood abuse, mental illness, and experiences with homelessness. Women inmates also face many difficulties obtaining comprehensive prenatal care, STI testing and treatment, access to abortion, substance abuse and mental health services, and have limited access to medical providers for gynecological and obstetrical medical care. As many as one in 10 incarcerated women in the United States are pregnant before incarceration or become pregnant in prison, and those who choose to continue their pregnancies are often grossly mistreated.

Photo from a 2009 protest against the shackling of pregnant women in prisons. (Correctional Association of New York)

Federal prisons often employ the use of shackles throughout pregnancy and even during labor to restrain women’s legs and wrists. This practice can cause serious complications for both the mother and baby, including hemorrhage, decreased fetal heart rate, or even deadly falls. These atrocious facts exhibit how incarcerated women are not only punished for their crimes, but also for being women, parallel to the biblical tale: To the woman he said, “I will surely multiply your pain in childbearing.” (Genesis, 3:16).

Though Orange is the New Black misrepresents many of the issues that female prisoners face, they did get one important thing right this season: prisons fail to identify, address, or provide the services needed to tackle women’s health issues. Through the application of both a gender and human rights lens in criminal justice policy, we must work towards creating a criminal justice system that ensures that women are treated humanely and with dignity and respect. We must work to empower women in prison, and address both their medical and social needs, instead of punishing them as “double deviants.” We can start by ensuring that all women inmates who require menstrual products are provided with the proper access to them, because access to them is not a luxury, it’s a basic human right.

It’s Undergraduate Week at Nursing Clio! All this week we’re proud to bring you amazing work written by students at Macaulay Honors College, CUNY. Students wrote their essays as part a course, “The Politics of Women’s Health,” taught by Elizabeth Reis.

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