Pregnant women who are in custody at the Buzz Westfall Justice Center will get better prenatal and related health services, nutrition and physical accommodations during incarceration following an executive order signed Thursday, October 3 by St. Louis County Executive Sam Page.
Surrounded by female County Council members, current and former state lawmakers and health care providers who have been working on this issue, Page said the policies and treatment of those in the custody of St. Louis County should reflect the fundamental respect of dignity and human rights of each person. Women who are confirmed as pregnant will have full access to complete health services, nutrition, doula coaching and lactation and timely milk delivery for breastfeeding mothers.
“Today’s action is not about special treatment; it’s about fair treatment,” Page said about this facet of criminal justice reform, that is “updating policies and procedures to improve the way we operate day to day and then make sure we have proper care and support and treatment for those in custody, including those who are pregnant.”
The women thanked Page, who is an anesthesiologist, for his forward thinking to sign the executive order to make sure pregnant women get the proper health care and treatment.
Page said the public health and justice departments already have policies in place related to persons who are pregnant, but the county must make sure they are strictly enforced and that appropriate improvements are made. The executive order says, “All individuals entering the custody of Justice Services who are of childbearing age shall be screened and assessed for pregnancy.”
“However, the decision to not be screened will be honored, if they choose so,” Page said.
“A pregnant individual shall receive non-directive counseling and educational material pertaining to all pregnancy options and information on prenatal nutrition, labor and delivery, the postpartum period,” with “limitations on the use of restraints,” Page said.
The change in restraint protocol will also mean training for those who transport and escort pregnant inmates.
“At least one member of the corrections medicine provider team must be trained in pregnancy-related care,” Page said, “which shall include knowledge of prenatal nutrition, high risk pregnancies, addiction and substance abuse during pregnancy, and childbirth education.”
Additionally, county justice staff will be trained on and how to protect the expectant mother and her unborn child when officers use cuffs and other restraints.
“Throughout pregnancy and during postpartum delivery and recuperation, a pregnant or postpartum person shall be transported to and from medical providers and court proceedings in a vehicle with seatbelts, and the only restraint, using handcuffs in front of the body. Leg or waist restraints shall not be used on pregnant or postpartum persons,” he said, adding this limitation may be waived by justice services if it’s the best interest of the pregnant person or the safety of those involved in the court proceedings or the transportation.
“And the same limitations will apply to anyone who is in any stage of labor; they will not be transferred in shackles or waist restraints,” he said. “Only when necessary, with handcuffs in front of the body.”
The services of a doula will be allowed for pregnant women in custody. “Staff shall also make reasonable accommodations to allow doula services for pregnant persons and for six weeks after that person has given birth,” Page said. “Persons providing doula services must be granted appropriate facility access, and then must be allowed to attend and provide private assistant during labor and childbirth, wherever feasible.” Doulas must be approved in advance by justice services.
After delivery, mothers will not be subjected to isolation unless it a determination is documented that it is to avoid serious harm to the inmate or others, Page said. If so, isolation will be in an infirmary and evaluated by a mental health provider. “If a licensed healthcare professional determines that any person is suffering from postpartum depression,” he said, “then those mental health services will be provided by the appropriate mental health provider and clinician.”
Further, “If a person requires any health service that is not available at justice services center, the person shall be transported to the appropriate medical facility, and shall be given that care,” Page said. His order makes clear provisions during and after pregnancy.
“Pregnant or postpartum persons shall be provided with the clothing, undergarments and sanitary materials deemed appropriate by a licensed healthcare provider. Postpartum persons may be supplied with adequate materials for pumping, or when storing breastmilk, including access to a private space with a sink and if the person chooses,” Page said. “Jail and medical staff shall develop lactation policies to ensure the postpartum lactating people have an opportunity to pump, store and transfer milk in a timely manner, so the person caring for the inmate’s infant, up to one year of age.”
Page told The American there is currently one pregnant woman in custody. “And,” he said, “the numbers are dropping thanks to [St. Louis County Prosecutor] Wesley Bell.”