“She’s Out of Sight”: Women, Healthcare, and the Prison System

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Monique Hassel

It’s no secret that the United States has a problem with its prison system. In 2009, one out of every 31 adults in the country was in prison, in jail, or on supervised release. What’s less talked about, however, is the fastest growing population behind bars: female prisoners. While it is important to distinguish the human right violations that female prisoners face, we should not think of these issues as “outside of the norm” or “special,” when discussing the treatment of prisoners in general. Yet scholarship on the prison industrial complex tends to focus on the alarming increase of men of color in prison, unintentionally neglecting female prisoners and their human rights. 

In 1873, Indiana established the first women’s correctional facility in the United States, aiming to “train the prisoners in the important female role of ‘domesticity.’”[1] Women fallen from the pedestal of delicacy and femininity were placed in cottages to re-learn domestic ways of life. Racial minorities were disproportionately represented in these facilities, and upon release, the women became housekeepers, nannies, and cooks for affluent households, instead of assuming the roles of “good wives and mothers” for which prison presumably trained them.

More than 100 years later, not much has changed. Fifteen years ago, women of color constituted more than 70 percent of the federal prisoner population but slightly less than a quarter of the U.S. population. Furthermore, the victim of a woman’s crime is often herself: most women in the world today are behind bars because of drugs.[2] From stealing a few dollars to score cocaine to selling their bodies, the amount of women behind bars has increased, while the number of violent crimes they commit has decreased.

These trends are starkly apparent in first-person accounts. Brenda Meyers, an African American woman, spent time behind bars in Chicago for prostitution. Like many other woman, Meyers began selling her body at a young age and fell into a cycle of criminality with no hope of escaping through governmental means. She explains,

There are 16,000 prostitutes here in Chicago and there are only 1 or 2 places where a woman can go if she’s trying to get out of prostitution. And here in Chicago prostitution is a felony upgrade, which means that if a woman is arrested for prostitution she gets an X on her record and she’s out-casted again because there are 52 jobs she can’t get a hold of. So, she’s gotta get a minimum wage job if she exits prostitution. She can’t get public housing because they don’t let people with felonies get public housing. She can’t get a PELL grant because she’s got that felony against her.

Brenda’s statement reveals that women in this situation, as another inmate explained to me, would rather gain a significant amount of money per hour than struggle in a McDonalds. These women, who are often poor and undereducated, face significant systemic barriers to escaping a life of poverty and crime. Girls as young as 17 and 18 years old convicted of prostitution and other non-violent crimes are behind the same bars as seasoned offenders. Older women in the “game” can easily spot these first time offenders, and teach them the tricks of the trade. Sometimes, as in Brenda’s case, the girls are offered a place to stay and other luxuries to become a “wife”—or a girlfriend of a pimp.

Helen Williams, a member of Narcotics Anonymous in Las Vegas, Nevada, worked with female prisoners suffering from drug abuse for 2 years before the program was cancelled. She explains:

The structure in most women jails/prisons doesn’t provide the female prisoner to retain or to obtain her own identity but instead gives her yet another identity of prisoner where she is still seeking acceptance by either now becoming hard as in becoming or still being gang affiliated, being weak to be protected or still using drugs as a coping tool to deal with her situation. Some of the major problems facing women behind the walls is that they are cut off from society and labeled which strips away their identity.

Helen’s statement serves as a testament to the lack of emotional and psychiatric support in American prisons. Even as far back as 1953, government officials recognized that many smaller crimes can be directly attributed to drug addiction.[3]  Yet instead of implementing comprehensive measures for inmates struggling with drug consumption, an emptiness filled by organizations like Narcotics Anonymous, the prison system today has resorted to perpetual, systematic imprisonment. For example, in 2005, in California, 70 percent of the women in prison needed drug treatment, but only 14 percent actually received treatment while in prison.[4]

The problem is further exacerbated when we take into account that, as documented by the World Health Organization, women are more likely to be addicted to harder drugs, which are often injected by needle. Between higher rates of sexually transmitted diseases, shared or dirty needles, and the prevalence of drugs which have fatal symptoms of withdrawal, female prisoners need access to preventive as well as immediate health care upon entry and throughout their stay.

Certainly, this practice could have saved Gina, a Latina woman who died from cervical cancer, which started as a treatable condition. Gina bled non-stop for 8 months, despite repeatedly asking officials for help. She was serving a 7-year sentence for stealing $200 in order to get money for cocaine.

From treatment of HIV to basic female needs, women in prison face administrative battles with authorities more frequently than their male counterparts. Even when preventative gynecological exams and pap smears are administered, lack of cleanliness and privacy, and inappropriately sized tools may all contribute to a general feeling of invasiveness, as described in one California prison.  Instead of maintaining the prisoner’s human dignity, as prisons by law are required to uphold, female inmates often find their pride and self-respect abandoned in the name of “justice.”  Exams might cost and/or require a written request. Basic needs like sanitary napkins during menstruation are not always available, free of charge, or easily accessible, requiring approval or management from bureaucrats in order to obtain them. [5] Instead of gaining an independent identity, women become ashamed of a natural bodily function.

One health measure the prison-industrial complex administers with pleasure is prescription drugs. Women are often prescribed more psychotropic drugs than males and medical staff members frequently prescribe these drugs without checking to determine if the inmate is pregnant.[6] One Native American woman in Montana related her experience in lockup, stating, “Haldol is a drug they give people who can’t cope with lockup. It makes you feel dead, paralyzed.”[7] Another inmate also described “faking” a mental illness when she was 18 years old to be given Elavil, a heavy antidepressant. This practice is particularly dangerous for two reasons: First, there is a significant risk of misdiagnosis, which can be particularly toxic for pregnant women. More importantly, as the warning label on Elavil suggests, women of such a young age (18-24) actually see an increase in suicidal thoughts when taking antidepressant drugs. By giving these drugs to women as frequently and freely as the system seems to do, prescription drug reliance (and profits for pharmaceutical companies) tends to rise.

While improper diagnoses and reliance on heavy medication are of great concern, these risks should not overshadow the very real and very serious mental illnesses women in prison battle. Around three out of every four women in state and local prisons have symptoms of mental illness, while only one in 10 in the general population exhibit such signs. Rates of self-harm and suicide are also higher in female prisoners than among the general populations, indicating a need for psychiatric support.[8]

There are many attempts to explain this phenomenon among women in prison. For example, women in prison often have experienced previous sexual abuse. But there may be another factor: the way women are treated in prison as an extension of their treatment in society as a whole. Take the case of Diana Delgado, a Latina woman who was forced to sign a document admitting she was an accomplice to her abusive boyfriend’s drug ring in order to allow her children to stay with family members instead of in the foster care system. Seven months pregnant, Delgado was at high risk, but was still held in prison for her day in court.  She describes walking through a clinic:

I was so humiliated, because you have to walk through regular people, and for them to see you shackled and handcuffed, you know, people looking at you, pulling their kids away…you can’t tell nobody when you’re having a baby. And for you to have stranger sitting next to you. And I was shackled and handcuffed for 19 hours through the labor pains. I couldn’t move. I couldn’t sit up. I couldn’t – I just had to lay there and deal with the pain and deal with having an officer next to me telling me to be quiet.

Pregnant women in prison often experience the extreme emotional pressure described by Diana, with little help from the bureaucrats who are supposed to care for them. Although The World Health Organization suggests that women in prison should have the option to see a physician without the presence of prison operational staff, Delgado’s experience while giving birth is not rare. After giving birth to her daughter without any family, she was finally allowed to call her grandmother and ask her to be the guardian of the new baby. Diana was elated she was allowed to spend the first five days with her new daughter. “I got a chance to spend some time with her,” she explains, “and the other women don’t get that. You are in there 24 hours and you’re taken back to the jail.”

In the United States, almost no prisons allow newborns or toddlers to stay with their mother, even though there are 120,000 mothers in prison. This is not the case everywhere: in the European Union, for example, there are some progressive prisons which allow children to stay with their mothers until they are three years old. Some facilities even provide care and education for the children until they are as old as six years. [9]

Brenda, Helen, Gina, and Diana are women. They are not a number, nor a statistic; a stereotype nor an exception. From drug addiction to emotional abuse, each of these women’s stories testifies to a sickness not only within our prison system, but in our society as a whole. As one prisoner stated, “without the uniform, without the power of the state, the [strip search] would be sexual assault.”[10] The implications of her statement are not limited to just the strip search, but to the entire condition of women in prison today.


[1] Davis, 71. [2] WHO, 13 [3] ibid, 23. [4] WHO, 26. [5] WHO, 22. [6] Tammy L Anderson, “Issues in the Availability of Health Care for Women Prisoners,” [7] Angela Davis, “Are Prisons Obsolete?” Seven Stories Press, New York: New York, 2003, 66. [8] WHO, 3. [9] WHO, 27. [10] Davis, 83.

5 responses to ““She’s Out of Sight”: Women, Healthcare, and the Prison System

  1. Please speak up and out for the woman,the women who can’t yet! Please their lives and importance depend on you,we,they!

  2. Pingback: Women in Prison Face Numerous Barriers to Healthcare | Our Bodies Our Blog·

  3. Pingback: “She’s Out of Sight,” Women, Healthcare, and the Prison System | Versus News·

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