
Note: to center the humanity of the women impacted, I’ll use terms like “women who are incarcerated”, “women experiencing incarceration”, and “women in detention” interchangeably throughout this blog instead of phrases like “incarcerated women” which can unintentionally reinforce harmful biases. Additionally, while I’ll primarily refer to women when discussing the studies and data cited throughout this piece, I want to acknowledge that abortion access impacts all people who may become pregnant, including cisgender women, transgender men, and non-binary people. Even more importantly, a reminder that behind every term, statistic, and figure, are real people with real stories and very real futures. By reframing our language to focus on people and their humanity, we can begin to dismantle the stigma and perceptions that exist around those who are incarcerated and focus on what really matters–the systemic inequities within our criminal justice system and healthcare systems.
The United States has the second highest rate of incarcerating women globally, with the number of women who are incarcerated increasing by more than 585% between 1980 and 2022. This is a disturbing distinction to have. As of March 2024, there were about 190,600 women and girls incarcerated in the United States, with 75% of them being of reproductive age. This increase in women in detention is occurring alongside increased restrictions on reproductive healthcare access, including abortion.
While there isn’t a lot of research on reproductive healthcare amongst women who are incarcerated, it is estimated that between 5-10% of women enter prison and jail pregnant, often first learning of their pregnancy upon intake. Based on those figures, it is estimated that somewhere around 2,000 babies are born to women experiencing incarceration each year.
Imagine being pregnant in a state where abortion is restricted while also having limited income. Now imagine this same scenario, but you’re behind bars. These aren’t just numbers and figures; these are real people facing often untold realities in a system that so often prioritizes punishment over humanity.
Women who are incarcerated face systemic barriers to accessing reproductive healthcare, including access to contraception and abortion care. While carceral institutions are legally and constitutionally required to provide access to healthcare, there aren’t any systems in place to hold these institutions accountable. This is extremely problematic, as the U.S. population of women facing incarceration has higher rates of sexually transmitted infections, mental illness, trauma, and substance use problems than the populations of nonincarcerated women or men facing incarceration.
The same lack of medical care and restricted access to abortion is even worse within jails and prisons. Even in states where abortion care is legal, some jails and prisons prohibit abortions through their ludicrous policies. For example, some institutions require pregnant individuals to pay for their own abortion (sometimes requiring full payment upfront). A requirement that is both cruel and often unobtainable considering that the majority of women prisoners (53%) and women in jail (74%) were unemployed prior to incarceration, and the ever-increasing cost of obtaining an abortion.
Abortions are also prohibited through delays in access. For example, Cuyahoga County Jail would not provide then 19-year-old K. Winston, who found out she was pregnant upon intake, an abortion because her sentence was “only 90 days”. However, upon release, that put Winston past Ohio’s gestational limit for abortion care. There’s also Yuriko Kawaguchi, who received an unusual six-month prison sentence from Judge Patricia A. Cleary who wanted to prevent Kawaguchi from having an abortion. Cleary allegedly gave Kawaguchi the “option” to either agree to carry the pregnancy to term and place the child for adoption, or spend two more months in prison, at which time she would also be past Ohio’s gestational limit for abortion care. These realities highlight the cruel and inhumane systemic barriers that lie at the intersection of women’s incarceration and reproductive healthcare.
Before the Dobbs decision, only four states had laws ensuring abortion access to people who are incarcerated. The lack of protections highlights the systemic barriers to reproductive healthcare within these institutions, forcing countless individuals to navigate an already dehumanizing system with even fewer resources. Ensuring that individuals who are incarcerated receive affirming and comprehensive reproductive healthcare is essential, not just for their well-being while facing incarceration, but also for their long-term health. This is critical because 95% of people in state or federal prison will eventually return home. The reproductive health care a person receives, or is denied, while in detention will inevitably have consequences that extend beyond their time incarcerated.
In 2025, it should no longer shock us that the U.S. prison system, like many other systems (the housing market, healthcare, education, and employment market to name a few), disproportionately impacts Brown and Black people. In 2022, the imprisonment rate for Black women was 1.6 times the rate for white women, and Latina women were imprisoned at 1.2 times the rate of white women. This disparity is a direct result of systemic and structural racism: over-policing and systemic cycles of poverty and imprisonment within these communities.
These systemic failures fueled by disproportionate sentencing exacerbate the impacts of reproductive inequities amongst Black and Brown women. It makes one wonder if there is intentionally a lack of research on the reproductive health of women facing detention… could it be to keep these harsh realities in the shadows?
For the women and families who experience this reproductive injustice, the lasting effects of the lack of reproductive healthcare while incarcerated can never be glossed over. The ripple effects of trauma, economic hardships, and split families are long-lasting and intergenerational. Addressing these effects requires more than prison reform, but broader changes to dismantle the systems that unfairly target and harm women of color.
So what can we do? Increasing public awareness about the quality, or lack thereof, of reproductive healthcare within prisons and jails is the bare minimum action that we can take. Many people are truly unaware of the traumatic conditions that people who are incarcerated are currently facing. Sharing stories and amplifying the voices of those who have been impacted can help change this.
We can also support folks and organizations that are already doing the work. The Advocacy and Research on Reproductive Wellness of Incarcerated People (ARRWIP) (evolved from the PIPS Project) team at Johns Hopkins University School of Medicine conducts research that addresses reproductive health care issues for people experiencing incarceration. Pregnancy Justice defends the bodily autonomy and rights of those who have been criminalized by advocating for change and shifting the public narrative. The ACLU’s National Prison Project advocates for the rights of individuals facing incarceration. At Equity Forward, we share and produce research on reproductive health rights and justice, particularly focusing on the anti-abortion actors (organizations, systems, and elected officials) and hold them accountable.
By raising awareness, supporting reproductive justice organizations whose work focuses on the most vulnerable communities, and advocating for systemic change (beyond prison reform), we can make strides towards a more equitable society. This is important because everyone, regardless of their incarceration status, financial status, employment status, or any other classifiable demographic, deserves the right and autonomy to make decisions about their own bodies.