Arizona's governor, AG, condemn as 'barbaric' induced labor of pregnant prisoners without consent

Gov. Katie Hobbs and Attorney General Kris Mayes have condemned inducing the labor of pregnant prisoners against their will, after the incarcerated women’s claims were published by The Arizona Republic, part of the USA TODAY Network..

Three women incarcerated at the Perryville prison in Buckeye told The Republic they were induced before their due dates, not because of specific medical conditions, but for scheduling reasons that would protect the prison system from potential liability.

NaphCare, the company contracted to provide health care services inside Arizona's prisons, said it "absolutely" has no policy of forcing induced labor and insists that the decision rests "solely" with the pregnant woman. The company has repeatedly denied allegations that it has forced women in its care to deliver babies against their will.

But the denials have not tamped down outrage by Arizona politicians and medical experts.

Hobbs called inducing birth in women in corrections facilities without consent “wrong and inhumane."

“The choice of when and how to give birth is deeply personal and that does not change just because someone is incarcerated,” Hobbs said. “The reproductive rights of all women must and will be safeguarded and respected.”

Hobbs said she is committed to looking into the policy and “finding one that protects pregnant women in the care of ADCRR."

Mayes said her office would work with Hobbs “to ensure this barbaric treatment of incarcerated pregnant women does not continue moving forward.”

State Rep. Athena Salman, D-Tempe, who successfully advocated for a policy change guaranteeing free, unlimited feminine hygiene products at Perryville, pledged to introduce legislation protecting the autonomy of incarcerated medical patients.

She called forced induction “horrendous and cruel.”

“I just delivered my first child almost a year ago,” Salman said. “If I had had that choice taken away from me, I would have been absolutely devastated.”

Salman was also the original sponsor of what became Arizona’s version of the Dignity for Incarcerated Women Act. The law provides some safeguards for pregnant people in state prisons, and prohibits shackling of pregnant prisoners, but it does not specify an incarcerated person’s right to make decisions regarding the conditions of her labor.

Outside of prisons, consensual induced labor is common. Doctors and patients often agree to induce labor when the health of the mother or baby could be otherwise compromised. Studies show that by 2018, one in four pregnancies in the United States ended with induced labor.

It is the lack of patients' choice that concerns medical experts.

Dr. Katherine Glaser is an OB-GYN and sits on the Board of Directors of the Arizona Medical Association. She said the AMA is opposed to the forced induction of labor, and any physicians participating in such a procedure should stop.

“The right of patients to make informed decisions about their own health care is central to the patient-physician relationship,” she said. “Especially if you're talking about incarcerated persons who have literally lost their freedom − you want to be sure that you are respecting their autonomy related to their medical care.”

Glaser said informed consent was a core principle of medical ethics.

Dr. Shakira Henderson, president of the Association of Women's Health, Obstetric and Neonatal Nurses, says the decision to induce labor needs to come from a shared decision-making process.

“These women have a right to make choices that meet their individual needs,” Henderson said. “And those choices should be made in consultation with a health care provider, not to serve at the convenience of the correctional staff.”

Related information: Arizona inducing the labor of pregnant prisoners against their will

More women come forward

Since publishing the original investigation, more women have contacted The Republic with similar claims of forced inductions in Arizona prisons.

Kasandra Burnside said she was taken to the hospital on three occasions to have her labor induced against her will.

“I believe they wanted me to rush and have my child because we were seen as a liability in their eyes, not two lives that matter,” she said.

Burnside said at the first two hospital visits on Nov. 30 and Dec. 4, she voiced her opposition to induction.

“I was informed it causes harder labor,” Burnside said. “I explained I was very scared and said I was being made to be induced.”

Both times, Burnside said the doctor at the hospital told her she was in good health and sent her back without having done the procedure.

Burnside says a correctional officer at Perryville then threatened to shackle her and keep her in restraints during the birth if she refused to be induced again. Such treatment of pregnant women is explicitly prohibited by state law.

“I started crying because I didn’t understand why they were being so unreasonable to me,” Burnside said. “I had a really bad breakdown and was carrying a lot of stress and hopelessness and feeling so out of control.”

Burnside said the threat worked, and she relented.

“They were trying to intimidate me so that I would shut up and go have the baby at the convenience of the prison,” Burnside said. “It was very demeaning.”

She was taken back to the hospital and induced on Dec. 8. After what she described as a “tough” labor, she gave birth a day later on Dec. 9.

Excerpts of Burnside’s medical records obtained by The Republic show she was at the hospital for scheduled inductions on Dec. 4 and Dec. 8.

“This was very heart-wrenching for me,” Burnside said. “I was left feeling very unsafe and vulnerable.”

She said those feelings were exacerbated when she was only given 48 hours to be with her child, even though state law mandates that an incarcerated mother have 72 hours with their newborn.

A spokesperson for the Arizona Department of Corrections said that Burnside "was not eligible for the 72-hour baby bonding due to health reasons."

Upon her return to Perryville, Burnside said she was kept in a dirty cell in the reception unit of the prison and not allowed to shower for four days.

Health care: Federal judge orders health care reforms for Arizona prisons

“I sat bleeding without pads for hours at a time after having an 8-pound child and being stitched up,” she said.

She said the experience has left her with lasting psychological damage.

“This has caused a lot of stress, fear, anxiety and postpartum depression,” Burside said. “And I am so worried for future incarcerated women as well.”

Prison health care contractor denies claims

Arizona’s current prison health care provider, Alabama-based NaphCare, has repeatedly denied that its staff forced inductions.

Centurion, the previous prison health care contractor, did not respond to questions about the women who claim their labor was induced against their will during that company’s tenure in Arizona.

NaphCare took over health care operations at state prisons in Arizona on Oct. 1, with a five-year contract that is projected to generate $10 million in profits annually. Since that time, a NaphCare spokesperson said one incarcerated patient was induced “per hospital specialist’s orders as a maternal-fetal safety precaution due to a pre-existing condition.”

There are currently six pregnant patients in Arizona prisons, according to NaphCare.

When presented with the initial allegations, a NaphCare spokesperson said, “Any decision to induce is solely the patient’s choice.”

In response to the allegation from Burnside, a spokesperson said NaphCare “absolutely does not have a policy to induce labor."

"Although we do not have authority over hospital specialists, we can ensure that NaphCare physicians at Perryville clearly explain to each patient that the choice to induce labor is ultimately the patient’s," the spokesperson said. "The decision is made under the advisement of community hospital specialists, not NaphCare physicians.

"We ensure that all care given by NaphCare providers at the Perryville facility addresses the unique needs of women who are pregnant," the spokesperson continued, "including providing family planning, prenatal care, and postpartum care while incarcerated."

After finding Arizona's prison health care system unconstitutional, a federal judge recently ordered a set of reform measures to improve conditions for incarcerated people.

Have a news tip on Arizona prisons? Reach the reporter at jjenkins@arizonarepublic.com or at 812-243-5582. Follow him on Twitter @JimmyJenkins.

This article originally appeared on USA TODAY: Arizona Governor, AG, condemn induced labor of pregnant prisoners