Lawmakers Vow to Improve Care for Pregnant Women in Jails

This article was published in partnership with NBC News.

Lawmakers around the country, moved by harrowing stories of pregnancies in jail, are calling for new measures that make sure women and babies get the medical help they need.

Officials in Congress and in states from Pennsylvania to California said they were alarmed by a Bloomberg Law/NBC News investigation detailing systemic failures that allow vulnerable women to give birth in jail cells — sometimes with deadly results.

The proposals aim to keep pregnant women out of jail, monitor the cases of those who do get locked up, and get them proper health care.

“The allegations are really, truly, gutting,” said Pennsylvania state Sen. Amanda Cappelletti, a Democrat, who is proposing legislation in her state after reading the investigation.

Bloomberg Law and NBC News found more than 50 women across the U.S. who said they endured horrific endings to their pregnancies while in jail. The accounts included miscarriages, stillbirths and delivering babies who lived only days. Most of the women were locked up for petty crimes and held because they could not pay bail fees as low as $125. Some gave birth alone on jail cell toilets or bled for days before they received proper health care. Two pregnant women died in their cells.

In three cases in Pennsylvania, women said they endured dangerous pregnancy complications without adequate medical care.

Cappelletti said the issue is “very personal.” She has suffered three miscarriages and is expecting her second child in the spring.

“You think about what those poor individuals went through and the state of mind that they must be in even today,” she said.

She is writing a bill that would allow pregnant women accused of nonviolent offenses to stay out of jail while they await trial.

Keeping pregnant women out of jail is what women’s health advocates and some law enforcement officials say is the clearest solution to the problem. While some states have taken steps in this direction, such reforms remain rare. How often pregnant women are jailed is unknown because the government does not comprehensively track pregnancies in local jails. There is no nationwide requirement that jails track when detainees are pregnant — or report when a baby dies after being born behind bars. At least 22 states don’t track pregnancy outcomes in jail, the investigation found.

“We need to encourage life and help promote life, so this is a good reminder for all of us that even for women who are incarcerated we should make sure the circumstances they find themselves in are positive,” said Kentucky state Sen. Julie Raque Adams, a Republican who has sponsored measures that sought to improve the treatment of incarcerated pregnant women.

An attempt to close the gap is underway in Congress, where Rep. Sydney Kamlager-Dove, D-Calif., has been trying since 2023 to pass a bill to improve health care for incarcerated women. She plans to introduce a new version of her Pregnant Women in Custody Act next month.

The bill would require the federal government to collect data on pregnancies in jails, evaluate local and state policies and teach corrections staff about the risks faced by pregnant detainees and prisoners. It would also require the federal Bureau of Prisons to provide special care to pregnant inmates and curtail the use of restrictive housing at federal facilities and immigration detention centers.

“They’re in the custody of the government, and we have a responsibility to make sure people aren’t leaving our care in worse shape than when they came in,” Kamlager-Dove said. “There is no reason I should ever read a story about a baby who was born in a toilet of a jail cell.”

Sen. Jon Ossoff, D-Ga., introduced similar legislation alongside Sen. John Kennedy, R-La., in February that would require states to report pregnancy data to the attorney general, including whether births took place in a facility or at a hospital. Ossoff, in a statement, called the crisis “one of the most extreme civil rights problems happening in the country today.”

State lawmakers are also trying to create data-collection programs. In Virginia, state Del. Rae Cousins, a Democrat, is working on a measure that would require jails and prisons to report the number of pregnant people in custody, along with the number of emergencies and deaths. Cousins, who called the findings “gut wrenching,” also wants to expand on a law passed in May that requires judges to consider a woman’s pregnancy when deciding whether to release them before trial. She wants the state to set higher standards of care for incarcerated pregnant women and require that they be given home electronic monitoring if convicted.

Next year, Texas jails will be required to release a first-of-its-kind report on maternal health, pregnancy complications and mortality rates — a template advocates hope will be used in other states. State Rep. Mary González said she expects the data to confirm that women have inadequate access to prenatal care behind bars, information she hopes will help make the issue a priority among policymakers.

“There is still a lot of work to do, and I’m ashamed it’s taking so long,” González, a Democrat, said.

Dr. Carolyn Sufrin, an OB-GYN at the Johns Hopkins University School of Medicine and a leading researcher on reproductive health care for incarcerated women, said she was encouraged by lawmakers’ plans but said oversight and enforcement are key.

“If we have decided that we are going to lock up pregnant individuals, then we have to make sure those places aren’t doing them harm,” Sufrin said.

That can include local efforts such as training sessions for jail staff and doula programs.

The Arlington County Detention Facility in Virginia, for example, has a doula program tailored to the needs of pregnant detainees.

Kenda Denia, founder and executive director of Birth in Color, the nonprofit that helps run the program, said Arlington County Sheriff Jose Quiroz was the only jailer in the state who responded to her offer of doula services for jailed mothers-to-be, reflecting a broader lack of interest and resources.

Denia has been a doula for four women at the jail since early 2024, helping them not only navigate pregnancy and birth but their lives as mothers after they leave custody.

“When you are helping people who others have given up on, it gives you a sense of satisfaction because you’re fighting to give them a better life,” Denia said.

In California, reporters found seven cases of pregnant women and their families alleging mistreatment in jail, including Elisa Serna, a pregnant 24-year-old woman who died in a San Diego County jail in 2019 after her drug withdrawal symptoms allegedly went untreated. A Bloomberg Law/NBC News documentary explored how her death haunts Serna’s mother and daughter, even after a multimillion-dollar settlement and promises of reform.

State Assemblymember Sharon Quirk-Silva, a Democrat who represents parts of Los Angeles and Orange counties, has tried and failed to keep pregnant women out of jail. She introduced a bill this year that would have required counties to collect pregnancy data and delayed sentencing for women during their pregnancies, but the measure stalled amid cost concerns and opposition from district attorneys who said the proposal restricted judges’ discretion. She said she plans to reintroduce the bill.

“It’s unconscionable,” Quirk-Silva said of Bloomberg Law and NBC News’ findings. “We need to do better by women.”

In Wisconsin, a bill that would restrict shackling inmates while in labor — something most states already ban — has repeatedly failed to pass the state Legislature. State Rep. Lisa Subeck, a Democrat, said she hopes the investigation will help build more support.

“It’s very easy to shove it aside when it doesn’t seem real,” Subeck said. “This is a real issue affecting moms and babies. That’s something where we should be able to overcome our partisan divide.”

Michelle Rick, who sits on the Michigan Court of Appeals and is immediate past president of the National Association of Women Judges, is pressing her organization to establish a program to teach members about the risks of sending pregnant women to jail.

“Everyone who has a touch point with the justice system should be entitled to respect, dignity and family preservation in some fashion or another,” Rick said.

In Texas, González said she also wants to explore ways to steer nonviolent pregnant women away from jail. The accounts uncovered by Bloomberg Law and NBC News show “there is a dehumanizing system in our jails for women who are pregnant and their babies,” González said.

Adams, the Kentucky Republican, said the investigation was part of “an awakening that we should do things better.”

She thinks state corrections contracts should be examined to see if medical providers live up to what she called Kentucky’s “pro-life standard” for helping women who are planning to give birth.

Kelsey Love, who gave birth alone in a Kentucky jail cell in 2017 after pleading for help, said she was grateful for the lawmakers’ efforts and the growing public awareness about the dangers pregnant women face while locked up.

She said she’d also like lawmakers to require jails to provide medical treatment for pregnant women who are withdrawing from drugs.

“Give us a chance,” Love said. “Give the baby a chance. Give the mom a chance. We deserve a chance to live.”