Medical Care Behind Bars

In 1984, Wanda Boswell was arrested for operating a vehicle under the influence of alcohol. During booking, the jailer learned that Boswell was 6 ½ months pregnant, and having a difficult pregnancy. Boswell began bleeding and notified jailers, who locked her in a cell without calling a doctor. The bleeding worsened and she requested a doctor. She was left locked in the jail cell overnight. In the morning, Boswell was cramped, bleeding, and in pain, and again requested a doctor. The jailer refused and told Boswell she would be released when she posted bail. Boswell was allowed to call her mother-in-law who told the jailer that even if she was able to raise the money to for bail, it would take quite some time to travel to the jail. The jailer continued to insist that she needed "$ 150 to let Boswell out." When a local police officer (and emergency medical technician) stopped by the jail before his shift, he heard Boswell’s cries. While looking in on Boswell, he noticed the bleeding and demanded an ambulance which transferred Boswell to a hospital. Her baby, Joseph Boswell, was born at the hospital, where he died thirty-four minutes later. (Boswell v. County of Sherburne, 849 F.2d 1117. (8^th Cir., 1988)).

The health concerns of incarcerated women do not differ markedly from those outside the prison walls. However, a woman in prison has no power to care for herself. Her incarceration completely restricts her liberty, including access to any and all medical care. Due to an inmate’s complete dependence on prison officials, deliberate indifference to an inmate’s serious medical needs is considered “cruel and unusual punishment” and a violation of the Eighth Amendment.

Between 1977 and 2007, the female prison population has increased by 832% (according to the Bureau of Justice Statistics). Two-thirds of these women are incarcerated for non-violent – mostly drug and property-related – offenses. While the numbers are shocking enough on their own, the implications of the flood of women into the prison system are even more so.

Like many institutions, the criminal justice system is structured by and for men: from sentencing and punishment to prison programming and the provision of medical care. Women have specific medical needs that do not vanish once the prison gate locks: gynecological care and education, access to prenatal care or abortion services, and (more often than men) counseling for prior sexual abuse. If incarceration is at least in part about rehabilitation, an inmate’s health is vital to achieving this goal.

The physical and emotional pain Wanda Boswell experienced should be part of no one’s sentence. Reading case after case of such abysmal treatment, it’s difficult to see a light at the end of the tunnel. If prisons fail to adopt and implement procedures to meet the needs of their new inmates, the only means of redress seems to be the one Boswell had: in court, after enduring several hours of pain and the death of her son. Although that’s certainly better than nothing, the better alternative – for all involved – is to realize the reality that women’s health needs do not disappear upon incarceration and the value of investing in caring for these women.