Abortion Access for Incarcerated People

Abstract

OBJECTIVE: To understand abortion incidence among incarcerated people and the relation to prison and jail pregnancy policies. METHODS: We collected abortion numbers and policy data from convenience sample of 22 state prison systems, all Federal Bureau of Prisons sites, and six county jails that voluntarily reported monthly, aggregate pregnancy outcomes for 12 months in 2016–2017. Sites also completed a baseline survey of institution characteristics and pregnancy policies, including abortion. We reported facility policies and abortion incidence according to state-level abortion characteristics. RESULTS: Only half of state prisons in the study allowed abortion in both the first and second trimesters, and 14% did not allow abortion at all. Of the 19 state prisons permitting abortion, two thirds required the incarcerated woman to pay. Four jails of the six study jails (67%) allowed abortions in the first and second trimesters, and 25% of those required the incarcerated woman to pay for the procedure. The three prisons and two jails that did not allow abortions were in states considered hostile to abortion access. In the state and federal prisons studied, 11 of the 816 pregnancies (1.3%) that ended during the study time period were abortions. Of the 224 pregnancies that ended at study jails, 33 were abortions (15%), with more than half of those (55%) occurring in the first trimester. The abortion ratio (proportion of pregnancies ending in abortion) was 1.4% for prisons and 18% for jails. CONCLUSION: Although some incarcerated individuals have abortions, many prisons and jails have restrictive policies surrounding abortion, either through self-payment requirements or explicit prohibition. Findings from this study should prompt further inquiry into abortion incidence in these settings and address interventions to ensure incarcerated people, in accordance with legal requirements and health equity, have access to abortion.

The Intersection of Abortion and Criminalization: Abortion Access for People in Prisons

“…The US-based Pregnancy in Prison project found that only 1% of pregnancies among federally incarcerated women resulted in abortion. 8 A 2021 study of pregnancy outcomes in state prisons and county jails found an abortion rate of 4.2%, 9 while yet another study among county jails found a rate of 15%. 10 In 2019 the CDC found that 16% of pregnancies that did not miscarry ended in abortion among the general US population 11 - a rate vastly higher than what was observed in the federal prisons.…”

Abortion and contraception for incarcerated people: A scoping review

“…In 34 studies, the population was currently incarcerated [ 2 , 4 , 5 , 12 – 31 , 33 , 35 , 41 , 43 , 44 , 45 – 48 , 50 ]. Two studies included formerly incarcerated people [ 32 , 34 ]; four studies included prison staff [ 37 – 40 ]; one included people under community supervision [ 49 ]; and one included people involved in the criminal legal system broadly defined [ 36 ]. Additionally, Erickson et al, (2017) [ 51 ] focused on sex workers; we included this study because 27% of respondents reported being formerly incarcerated, and sex work is criminalized in Uganda, the site of the study.…”

“…One study [ 35 ] analyzed distances between abortion clinics and prisons among 75 state prisons and 20 federal prisons. Twenty-four studies used quantitative methods, including 14 surveys [ 5 , 14 , 15 , 17 – 19 , 22 , 24 – 26 , 29 , 30 , 37 , 45 ]; four secondary data analyses [ 21 , 31 , 40 , 48 ]; one randomized control trial [ 13 ]; four prospective studies [ 4 , 40 , 41 , 43 ] and one study using geo-localization [ 35 ]. Our results also included 14 qualitative studies [ 2 , 12 , 20 , 23 , 28 , 32 , 34 , 38 , 39 , 46 , 47 , 49 – 51 ], four cross-sectional studies [ 18 , 36 , 42 , 44 ], and one mixed-methods study [ 33 ].…”

“…Kim et al (2021) surveyed three juvenile centres, in which eight pregnancies occurred and one resulted in abortion [ 41 ]. Sufrin et al (2021) found that among the 22 state prisons and 6 county jails surveyed, there were 1,040 pregnancies that ended during the study time period, and 4.2% resulted in abortion [ 40 ]. In a large study (n = 1396), Sufrin et al (2019) found only 1% of pregnancies among people in federal prisons resulted in abortion [ 4 ].…”

“…Further, availability to people inside a facility will always be subject to the restrictions on availability presented by jurisdictional regulations. Sufrin et al (2021) found in their study of institutional abortion policies that the most restrictive were in facilities located in states already “hostile” to abortion [ 40 ]. Post-Dobbs, this hostility is now more threatening.…”