Originally published in Ms. Magazine by Kristie Puckett-Williams, Crytal Hayes, and Lauren Kuhlik. 

The use of solitary confinement for incarcerated pregnant people is an indefensible and cruel practice. Unfortunately, it’s more common than you might think.

While prisons and jails are designed by and for men, incarceration rates for women are on the rise. Since the 1980s, incarceration rates for women have increased by over 800 percent. Yet people incarcerated in women’s facilities, especially pregnant people, are ignored, with few legal protections or policies that address their special needs—particularly pregnancy and reproductive care.

In many cases, there are more legal protections and oversights concerning the protection of captive wild animals and the care and handling of farm animals then there are for incarcerated pregnant people in the United States. In Colorado, for example, a pregnant pig cannot be confined to a cage for more than 12 hours a day. But in most states, no such protections exist for pregnant people.

Solitary confinement refers to confinement in a cell for all or nearly all of the day—resulting in deprivation of meaningful social contact, physical activity and environmental stimulation. Solitary confinement of any length, but particularly prolonged solitary confinement for more than 15 days, can cause serious emotional, psychological and physical harm to people, especially vulnerable populations such as those who are pregnant or have mental illness.

The harms associated with solitary confinement are so serious and well-established that a number of state laws and federal court orders limit or prohibit the practice when applied to vulnerable populations. Given their unique needs, and already high risks due to trauma, poor health and substance abuse, incarcerated pregnant and postpartum people are at particular risk in solitary confinement.

According to The American College of Obstetricians and Gynecologists, pregnant people need to move as often as possible to avoid the development of blood clots, which is why they advise against bed rest for pregnant people. It is unconscionable to think of incarcerated pregnant people in solitary confinement—where they are left alone in a prison cell that is usually no bigger than the standard closet, with very little mobility, poor nutrition, lack of healthcare or access to other human beings for prolonged periods of time.

Out of sight should not mean out of mind – and heart. But the tragedy for women in prison is that it often does.

We at Ms. want women in prison to know they are seen and valued. That’s why we started the Ms. magazine Prison and Domestic Violence Shelter Program. Because domestic violence shelters can be almost as isolating as prisons – and often lack libraries or any reading material, just as many prisons do – we include women in those shelters too.

We hope to keep growing this meaningful program—but we need your help. Together, let’s show women in prisons and domestic violence shelters that they have not been forgotten. 

This harm is not just theoretical. A number of pregnant women, including a seriously mentally ill pretrial detainee, have been forced to give birth alone while in solitary confinement. The psychological torture of solitary confinement, the inability to access sufficient exercise or nutrition and the impediments to accessing necessary care combine to place pregnant people in solitary confinement at serious risk.

Standards promulgated by the National Commission on Correctional Health Care, the leading organization that sets standards for and accredits prison and jail health care programs, prohibit the placement of pregnant people in solitary confinement for any period of time. Both the United States Department of Justice and international standards condemn the use of solitary confinement on pregnant and postpartum people as well.

But according to information received by the ACLU of North Carolina (ACLU-NC), incarcerated pregnant people in the state, including those who are detained pretrial and have not been convicted of any crime, are routinely locked up in solitary confinement.

Public records show that there were a total of 256 pregnant people incarcerated at the North Carolina Correctional Institute for Women (NCCIW) in 2018, and that 66 of them were pretrial detainees who had been transferred to the prison as safekeepers. In general, safekeepers are transferred from jail to prison when the jail cannot provide for their medical or mental health needs, but North Carolina has a practice of transferring pregnant people as safekeepers to the prison without first determining whether the jail can meet their medical needs or whether the person can safely be released to the community until trial.

Under North Carolina policy, safekeepers are kept in conditions that are commonly understood as solitary confinement: they regularly get out of their cells only to shower three times a week and for one hour of exercise out-of-cell per day; they have only non-contact visitation and they are generally not permitted to eat meals or engage in programming out-of-cell. No exceptions are made for pregnant people.

This is alarming and yet we still do not know the full scope of this problem in North Carolina or around the country. The information provided to the ACLU-NC did not include how many pregnant people were placed into solitary confinement for protective custody, disciplinary, or administrative reasons. North Carolina also made headlines in 2018 after it was reported that two women at NCCIW were forced to give birth in shackles despite an existing prison policy that prohibits the use of shackles during labor and childbirth.

Fortunately, the North Carolina legislature has the opportunity to act. The Dignity for Incarcerated Women Act addresses the urgent pregnancy-related problems in the state by prohibiting the use of shackling and solitary confinement for pregnant and postpartum people. It also requires adequate nutrition and programming for these individuals, increases family visitation requirements and provides menstrual products at no cost for those who need them. If made law, this bill would immediately help a vulnerable population access the care, social interaction, nutrition and exercise that they desperately need in order to keep themselves and their pregnancies healthy.

Pregnant people in North Carolina and across the country deserve to have healthy and safe pregnancies. The legislature has the chance to take a huge step in the right direction with the Dignity for Incarcerated Women Act.