How Real Is Orange is the New Black’s Take on Prison Pregnancy?

Victoria Law June 12, 2015

In a still from season 3 of Orange Is the New Black, a visibly pregnant and worried Daya (L) is comforted by Gloria (R).

Sea­son Three of Orange is the New Black comes out today, and this sea­son, Daya Diaz (Dascha Polan­co) reach­es her due date.

Daya’s preg­nan­cy is no longer a secret from guards and fel­low pris­on­ers. She’s vis­i­bly preg­nant (although no one seems to know how far along she is) and every­one knows the rea­son for her plus-size uni­form. We see her moon­ing over the cor­rec­tion­al offi­cer who impreg­nat­ed her and plan­ning their future togeth­er. We see her wor­ry­ing about who will take care of her baby. We see her con­tin­u­ing to scoop out eggs and slop to the hun­dreds of women on line at the pris­on’s cafeteria.

What we don’t see is Daya receiv­ing any med­ical atten­tion whatsoever. 

Con­sid­er­ing that she’s appar­ent­ly some­where between her sec­ond and third trimester, in real life, this would be a cause for con­cern. The gen­er­al rec­om­men­da­tion for preg­nan­cy-relat­ed care—whether inside or out­side prison — is once a month for the first six months, twice a month dur­ing the sev­enth and eighth months, and week­ly dur­ing the final month. But this rec­om­men­da­tion isn’t always fol­lowed behind bars.

As part of an ongo­ing inves­ti­ga­tion for In These Times, I have inter­viewed near­ly a dozen women across the coun­try about their expe­ri­ences of preg­nan­cy and child­birth in pris­ons and jails. Their sto­ries, which include long waits for med­ical care, dis­missed con­cerns and some­times out­right neglect, show that Daya’s appar­ent lack of pre­na­tal care is not as far from real­i­ty as one might think.

Pat­ti Hall was 18 weeks preg­nant and had just learned she was hav­ing a girl when she was arrest­ed, in 2011, on fed­er­al drug charges. She spent over three years at the local jail in Nashville as she fought a poten­tial sen­tence of 25 years.

The jail had made head­lines three years pri­or when Jua­na Vil­le­gas, an undoc­u­ment­ed immi­grant who was arrest­ed dur­ing a rou­tine traf­fic stop for dri­ving with­out a license, was shack­led to a bed dur­ing child­birth. Shack­ling dur­ing birth is a com­mon prac­tice in many jails and pris­ons. But, because Vil­le­gas’s expe­ri­ence stemmed from the Nashville police depart­men­t’s par­tic­i­pa­tion in the fed­er­al gov­ern­men­t’s 287(g) pro­gram allow­ing local police to enforce immi­gra­tion law, it stirred con­tro­ver­sy. The David­son Coun­ty Sher­if­f’s Depart­ment sub­se­quent­ly issued a pol­i­cy end­ing the shack­ling of preg­nant women in custody. 

But Hall faced oth­er prob­lems with preg­nan­cy care while in cus­tody. When she was sev­en months preg­nant, she began bleed­ing vagi­nal­ly. She had suf­fered a mis­car­riage the pre­vi­ous year and feared that she was mis­car­ry­ing again. But when she told this to one of the jail’s nurs­es, She just looked at me like I was crazy; like I was mak­ing some kind of lie up,” Hall recalls. I had to show her the pad.”

The nurse, she says, sim­ply told her that she had too much pro­tein in her urine and rec­om­mend­ed that she not drink the Kool-Aid served for lunch.

After that, Hall says, her body began to swell. I swelled up so bad I could­n’t wear shoes,” she described. I could­n’t even grip any­thing with my hands because I lost some of the feel­ings in my arms and my hands.” The women around her had to car­ry her food tray, she says, and even feed her, because grip­ping the uten­sils became impos­si­ble. Still, she says, she was not giv­en any med­ical atten­tion. Accord­ing to Hall, anoth­er woman held in the jail, who had worked as a nurse before her arrest, told the offi­cer that Hall was exhibit­ing signs of preeclamp­sia, a preg­nan­cy com­pli­ca­tion char­ac­ter­ized by high blood pres­sure and signs of organ dam­age, which, left untreat­ed, can have fatal com­pli­ca­tions for both moth­er and baby. The only cure for preeclamp­sia is deliv­ery of the baby. Nev­er­the­less, Hall says, the med­ical staff did nothing.

The swelling got so bad that it start­ed to cut the feel­ing off,” she says. I could­n’t feel anything.”

In July, near­ly four months after she arrived at the jail, Hall went into labor. I sat in labor for almost three days,” she says. But when she told med­ical staff, she says, they refused to believe her. They told me, If your water is not bro­ken, if your mucus plug has not fell out, and you are not dilat­ed, you are not in labor.’” Three days lat­er, on July 5, she was tak­en from the jail to the Nashville Gen­er­al Hos­pi­tal at Mehar­ry for an ultra­sound. Once at the hos­pi­tal, she refused to leave unless she was seen by an ob-gyn. I was going to take the chance of hav­ing them tack­le me to the floor or beat me up or what­ev­er, to try to risk all that just to be able to see the doc­tor,” she says.

When the doc­tor arrived, he saw that she was in labor and rushed her into the oper­at­ing room for an emer­gency C‑section. For­tu­nate­ly, Hal­l’s baby was born healthy. Hall was allowed to stay in the hos­pi­tal with her new­born daugh­ter for three and a half days before being tak­en back to the jail.

Cor­rect Care Solu­tions, the pri­vate con­trac­tor that pro­vides health­care at the jail, and the Metro Nashville Health Depart­ment, which over­sees it, declined to com­ment on Hall’s case, cit­ing patient privacy.

While the lack of care Hall describes is extreme, inad­e­quate pre­na­tal care is not uncom­mon in jails and pris­ons. For exam­ple, a five-year study of repro­duc­tive health­care in New York pris­ons, released in Feb­ru­ary by prison watch­dog group Cor­rec­tion­al Asso­ci­a­tion of New York, sug­gest­ed that preg­nant women face delays in get­ting health­care upon arrival. Although prison pol­i­cy dic­tates that preg­nant women must see the pris­on’s ob-gyn with­in four days of admis­sion, near­ly 40 per­cent of the 18 women sur­veyed who entered prison preg­nant said that get­ting the first appoint­ment took more than two weeks.

The Cor­rec­tion­al Asso­ci­a­tion found that most women then received pre­na­tal care at rough­ly the rec­om­mend­ed fre­quen­cy. But, as Pat­ti Hal­l’s sto­ry illus­trates, this is not the case in every jail or prison. Emi­ly Spaloss entered Ari­zon­a’s Mari­co­pa Coun­ty Jail in Phoenix in Jan­u­ary 2013 when she was two months preg­nant. There, she says, she caught what she thinks was the flu. But she nev­er found out, she says, because med­ical staff refused to see her dur­ing that time, advis­ing her to drink water. I suf­fered hot and cold sweats, throw­ing up, headaches, and all oth­er flu-like symp­toms,” she recalls. The Mari­co­pa Coun­ty Depart­ment of Cor­rec­tion­al Health Ser­vices declined to com­ment on her case, cit­ing privacy.

But med­ical care isn’t the only preg­nan­cy-relat­ed need that goes unmet in Orange is the New Black—or in real-life jails and pris­ons. We see Daya ladling tray after tray with food in her prison cafe­te­ria job, but we don’t see her receiv­ing the addi­tion­al food and nutri­ents need­ed by preg­nant women to ensure healthy preg­nan­cies. Is this a Net­flix over­sight or a reflec­tion of reality?

At the Nashville jail, Hall was not giv­en pre­na­tal vit­a­mins despite repeat­ed requests, she says. The only addi­tion­al food she received was a small car­ton of milk, like the kind you would get at a school,” with every meal.

The lack of ade­quate food for preg­nant pris­on­ers comes up again and again in jails and pris­ons across the coun­try. In New York state, each of the 18 preg­nant woman inter­viewed by the Cor­rec­tion­al Asso­ci­a­tion stat­ed that she was not giv­en enough food dur­ing her pregnancy.

I was preg­nant and starv­ing,” says Tina Tinen, who was incar­cer­at­ed at the Bed­ford Hills Cor­rec­tion­al Facil­i­ty in New York. She describes going hun­gry dur­ing the long stretch between the 5 p.m. evening meal and the 7 a.m. break­fast. Although the prison issues issued a preg­nan­cy snack, con­sist­ing of an eight ounce car­ton of milk, a piece of fruit and a sand­wich with cold cuts, she still recalls feel­ing hun­gry all the time.

Her expe­ri­ences were echoed by the oth­er women. I remem­ber going to bed hun­gry many, many nights,” one woman told the Cor­rec­tion­al Asso­ci­a­tion. Those preg­nan­cy snacks don’t do much for a preg­nant woman.”

At Mari­co­pa Coun­ty Jail, Spaloss says, only one hot meal a day was served, and the preg­nan­cy snack was one extra piece of bread and one extra serv­ing of milk. She lost sev­en pounds dur­ing the one-and-a-half months she spent in the jail, she says. She might have lost even more weight had she not been able to order from the can­teen. But the choic­es there, she says, were lim­it­ed to hon­ey buns, chips, crack­ers, cran­ber­ry juice and water.

Mari­co­pa Coun­ty Sher­if­f’s Office did not respond by dead­line to a request for com­ment on the food avail­able to pris­on­ers. The N.Y. Depart­ment of Cor­rec­tions and Com­mu­ni­ty Super­vi­sion not­ed that pris­on­ers can pur­chase com­mis­sary food in addi­tion to meals and preg­nan­cy snacks, and direct­ed In These Times to a doc­u­ment about preg­nan­cy care that read, in part, Dieti­cians are involved to ensure nutri­tion­al­ly and calor­i­cal­ly ade­quate diet to all inmates, includ­ing those with spe­cial dietary needs.”

Even when laws man­date ade­quate nutri­tion and pre­na­tal care, change can be slow in com­ing. In 2014, Mass­a­chu­setts passed the Act to Pre­vent Shack­ling and Pro­mote Safe Preg­nan­cies for Female Inmates. But Lau­ren Petit, attor­ney with Pris­on­ers’ Legal Ser­vices of Mass­a­chu­setts, and Rachel Roth, a wom­en’s health pol­i­cy expert, have been mon­i­tor­ing the imple­men­ta­tion of the act and say that the food avail­able often falls short of what doc­tors, mid­wives and preg­nan­cy guides rec­om­mend to women on the outside.

Preg­nant women are advised to eat four to five serv­ings of veg­eta­bles, three to four serv­ings of fruit, sev­er­al serv­ings of whole grain breads or oth­er high-com­plex car­bo­hy­drates, three serv­ings of dairy, and three serv­ings of pro­tein each day. The snacks offered behind bars in Mass­a­chu­setts range from milk and a gra­ham crack­er; to milk, white bread and cheese; to milk, car­rot sticks, one fruit, and a peanut but­ter and jel­ly sand­wich. Some jails offer snacks twice a day, while oth­ers offer them only once.

Giv­en that 3 to 4 per­cent of women in pris­ons are preg­nant and 5 per­cent who enter jails are preg­nant, inad­e­quate med­ical care and insuf­fi­cient nutri­tion affect hun­dreds of women in the U.S. — and their fetuses.

So yes, Netflix’s depic­tion of Daya’s expe­ri­ences is more than plau­si­ble. What we don’t see Daya receiv­ing in sea­son 3 is what many women don’t get in U.S. jails and pris­ons. And while we may be con­cerned for Daya, we should be even more alarmed that real-life women aren’t able to access the basic preg­nan­cy care they need.

Vic­to­ria Law’s inves­ti­ga­tion of preg­nant people’s treat­ment behind bars will appear in the Sep­tem­ber 2015 issue of In These Times. This report­ing is fund­ed by the Good­man Insti­tute for Inves­tiga­tive Reporting.

Vic­to­ria Law is a free­lance jour­nal­ist focus­ing on women’s incar­cer­a­tion. She is the author of Resis­tance Behind Bars: The Strug­gles of Incar­cer­at­ed Women (2012) and co-author of forth­com­ing Your Home Is Your Prison (New Press).
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