1. The Health of Women Prisoners: Global
Challenges and Solutions
Nancy Stoller
University of California,
Santa Cruz

3. Health Problems for Women
in California Prisons
• Very long sentences
• Overcrowding
• Lack of preventive care, mental health
services, drug rehabilitation, access to
children
• Poor nutrition
• Delayed access to medical care
• Poor dental services
• High levels of psychotropic medication

4. Health Problems on Release
• Loss of rights
• Continuity of care challenges
• Housing, income, identity, employment
• Family reunification

5. Reproductive and mothering rights of
prisoners across the U.S…
PRENATAL CARE
• 38 states -have no or inadequate policies on prenatal
care
• 43 states -do not require a medical exam as part of
prenatal care
• 41 states do not require nutritional counseling or
pregnancy diet
• Source: Mothers Behind Bars: Report from National Women’s Law Center
and Rebecca Project for Human Rights (October, 2010)

7. Reproductive and mothering rights of
prisoners across the U.S… cont’d.
SHACKLING
• 33 states -do not adquately limit shackling during
labor and delivery, recovery, or transport when in
labor
• 22 states have no policy at all on shackling pregnant
women
Source: Mothers Behind Bars: Report from National Women’s Law Center and
Rebecca Project for Human Rights (October, 2010)

8. U. S. DOJ Bureau of Statistics

9. Federal Prisons
Women in custody in federal prisons:
14,000
• 2008: announced ban on shackling
during pregnancy
• Limited (58 women p. year) mother-
child alternative program

10. ICE (Immigration and Customs
Enforcement)
• No unified medical services
• Uses private prisons, local jails, state prisons
• Contracts medical services in its own units
• No consistent standards or services for care
for women

11. World Health Organization
Health in Prisons Project
• Founded in 1995
• 44 countries, west, south, east and
northern Europe
• Yearly meetings
• Special reports
• Declarations
• Awards

12. WHO HIPP
Philosophical and action base:
• “Health is a state of complete physical,
mental and social well-being and not merely
the absence of disease or infirmity.”
• UN declarations of rights of prisoners,
women, children.

13. A global view from WHO
Women in prison have more health problems
than men
• Multiple chronic conditions
• Higher rates of drug dependency and co-
morbidity; mental health issues; physical and
sexual abuse histories
• Reproductive health needs: menstruation,
pregnancy, menopause, reproductive
cancers, breastfeeding

14. WHO-HIPP Declaration concerning
women’s health in prison
• 1. A gender-sensitive criminal justice
system is an essential first step to
ensure that all stages of the criminal
justice system take into account
gender-specific needs and
circumstances.

15. • 2. A gender-sensitive prison policy has to
be developed for every prison system to
meet the basic health and welfare needs of
women in prison
• Meeting women’s special health care needs-
including for girls and women.
• Gender-sensitive training.
• Appropriate female-male staff balance

16. • 3. The human rights of women and of
their children must always be
dominant; principles of equivalence
and of appropriateness of facility and
and health care must be recognized.
The needs of any child involved must
be dominant.

17. • 4. Specialist health care must be
provided: for instance, for mental
health, including help with a legacy
of abuse; for HIV, hepatitis C,
tuberculosis and other infectious
diseases; for drug and alcohol
dependence; for learning disabilities;
and for reproductive health.

18. • 5. Pre-release preparations must be
planned and provided to ensure
continuity of care, and access to
health and other services after
release must be a clear part of the
programme preparing for release.

19. Strategies of improvement
• Independent Monitoring
• Source of health care is from a health-
focused agency, e.g. public health
department
Prioritize and advocate for health as more important than
custody
Breaking down isolation of prisoners and of medical staff
Remove the profit motive by rejecting privatization
Examples: National Health Service - Britain; San
Francisco Dept. of Health; US BOP Public Health
Service

20. Current California Projects
• Transitions clinic - San Francisco, focus on
continuity of care for chronic health problems
after release
• Community Health Worker training and
placement with ex-prisoner focus
• Legal Services for Prisoners with Children-
advocacy training, research reports, family
connections
• A New Way of Life- housing, referrals, mental
health services on release, advocacy

21. Current California Projects,
continued…
• Litigation… Shumate, Plata, current
receivership, overcrowding challenges
• All of Us Or None- advocacy and activism for
released prisoners
• CURB (Californians United for a Responsible
Budget)
* Stop All Prison and Jail Construction.
* Reduce Overcrowding and Release our Tax Dollars.
* Stop the Cuts and Invest in Our Future.

22. Public Health Initiatives
• APHA
– Prisoner Health Committee-- links public health
professionals working in correctional settings,
research, advocacy throughout the U.S.
– Women’s Caucus
– International Human Rights Committee
– Standards for Health Services in Correctional
Institutions
• World Federation of Public Health Associations
initiative
– Goal: Prioritize the health of the
marginalized,especially those in jail and prison

23. From 1979 slide show on women’s health in
prison

25. Women prisoners at FCI Lexington after a discussion
about activism and change -1979

26. QuickTime™ and a
decompressor
are needed to see this picture.
Women at Valley State Prison, California, 2008