The San Diego County Sheriff’s Office is pushing back on a recent study that found reproductive health care at the region’s only women’s jail to be lacking.
Conducted by the Urban Institute, a nonpartisan research organization, the study found that women incarcerated at Las Colinas Detention and Reentry Facility in Santee face numerous challenges when trying to access reproductive care, including significant delays in treatment, deputies being present during examinations, inexperienced staff and what the study describes as “punishment and mistreatment” for seeking care.
“We found one recurrent story across all the types of reproductive health care services examined in this study, whether preventive care or support during pregnancy: that incarcerated people reported experiencing significant barriers in requesting care and lengthy delays in receiving care,” the authors conclude.
The Sheriff’s Office issued a statement in response to the study, arguing that the findings “are not complete or reflective of our standards and practices” and that researchers interviewed only 34 women at the jail, too small of a sample to be significant.
“The findings rely exclusively on subjective accounts that were not corroborated by medical records, staff testimony or independent verification,” the statement says.
The names of the women who participated in the study were not included in the report.
The statement goes on to say that the department takes the report’s criticisms seriously “and are reviewing our practices to ensure consistent service delivery.”
An Urban Institute spokesperson told the Union-Tribune that the authors stand by their research and believe the women provided valuable insight into how reproductive health services at Las Colinas can be improved.
“We stand by the integrity and independence of our research and recognize the importance of the perspectives it captures,” Shrita Hernandez wrote in an email. “Our team followed rigorous research standards and documented all limitations and context in the report.”
Hernandez said researchers were transparent with jail staff and Sheriff’s Office leadership. They had hoped to access medical records to corroborate accounts but failed to reach an agreement with the Sheriff’s Office over access to those records.
“We remain open to continued dialogue with the Las Colinas Detention and Reentry Facility and the San Diego County Sheriff’s Office to ensure the findings contribute to positive change and better health care access, quality and outcomes for all incarcerated individuals,” she said.
The catalyst for the study was Assembly Bill 732. Authored by then-Assemblymember Rob Bonta and signed by Gov. Gavin Newsom in 2020, the legislation sought to improve the quality of reproductive health care in state prisons and county jails.
In describing the need for the bill, Bonta wrote, “While institutions of incarceration should be meeting all the health needs of people behind bars, reproductive and health care needs are often unique and time-sensitive.”
AB 732 particularly sought to improve conditions for pregnant detainees and banned the use of shackles and restraints during delivery.
The study notes that it is the first to examine the law’s impact on a single jail “and one of the few to examine incarcerated people’s perceptions of reproductive health care access and quality in jail.”
In addition to delays in receiving care, women described a lack of privacy during clinic visits and when receiving test results.
One woman told researchers that staff informed her in front of other detainees that she had tested positive for a sexually transmitted disease that she contracted after being raped.
Multiple women told researchers that the lack of privacy caused them to withhold information from medical providers.
“There’s a lot of stuff that I don’t say because of the fact that they’re standing right there. It’s embarrassing,” she said.
Women said they were often dismissed by staff or were accused of faking symptoms. And when they were able to access care, they did not always receive follow-up information or were prescribed medication without being told what it was for.
While roughly half of the interviewees shared positive experiences with medical staff and counselors, others described “a general lack of awareness and communication around reproductive health care services available to incarcerated people,” the report says.
Ten of the 34 interviewees said they had been pregnant while incarcerated. Two had given birth while in custody and four were currently pregnant.
One interviewee said she felt pressure to give her child up for adoption. Another said women who chose adoption were told that a closed adoption, in which the mother would have no contact with the child, was the only option.
“I don’t like hearing a lot of girls that come back in the unit talking about it and crying about it,” one woman said. “It’s a different feeling once you push that baby out and then you hold that baby for those few seconds. Then it’s like, you’re like, damn. I should have thought about this.”
The same interviewee said there were no options besides adoption for pregnant women who lack family or friends willing to take the baby.
The study’s authors came up with more than a dozen recommendations to improve all aspects of reproductive health care at Las Colinas, starting with providing detainees with an intake packet that describes available services.
Recommendations also include allowing women to select the gender of their health care provider, offering at least a privacy curtain during exams, training staff on how to talk to incarcerated women about reproductive decisions and boosting postpartum support services.
