Addressing the Needs of Pregnant Youths

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Author: Zoe Ades is a junior studying Political Science and Sociology at The George Washington University in Washington, D.C. She is currently interning at the Coalition for Juvenile Justice. 

The video of Diana Sanchez writhing and screaming as she endures labor and the birth of her child alone in a cell with no medical attention or help has rightly gone viral, attracting attention to the underpublicized experience of incarcerated pregnant people. 

For far too many individuals who give birth behind bars, the experience is marked by inadequate medical care, an increased likelihood of obstetric complications, and dangerous birthing conditions. For youths in the juvenile system, the situation is remarkably bleak. The juvenile justice system is designed to accommodate male inmates, who make up the majority of incarcerated youth, and has been slow to adjust to growing numbers of female inmates. Thus, the needs of pregnant youths are overlooked by a system not designed to deal with them. However, thanks to years of advocacy in the juvenile justice space, legal changes to address the needs of system-involved pregnant youth give reasons to be optimistic. In December 2018, Congress passed HR 6964, the Juvenile Justice Reform Act of 2018, reauthorizing the Juvenile Justice and Delinquency Protection Act (JJDPA) for the first time in 16 years. This legislation, which goes into effect October 1, 2019, will fundamentally change and improve the way pregnant youth are treated in our nation’s juvenile justice systems.

There are no concrete or current nationwide figures on the number of pregnant youths who are justice-involved. However, there is clear evidence that the rates of teenage pregnancy among incarcerated youths are significantly higher than those of the general population. A 2004 Juvenile Facilities Census found that 2.1% of girls in juvenile justice facilities are pregnant at any given time. The Juvenile Justice Reform Act promises to deliver more accurate reporting on the number of pregnant youths experiencing incarceration by requiring the recording of annual data on the number of youths in juvenile facilities who report being pregnant.

Many facilities are ill-equipped to provide needed support and medical attention to these individuals. The same 2004 study found that up to one-quarter of juvenile justice facilities do not offer obstetric services. Another similar study found that prenatal services were lacking in one-third of juvenile justice facilities. As a result of the insufficient medical attention pregnant girls receive, 60% of facilities reported at least one obstetric complication. In the male-centric juvenile justice system, pregnant inmates are often sent off-site for obstetric care. These appointments are planned well in advance, limiting emergency care and access to health education as the pregnancy progresses. Again, change appears to be on the horizon. The reauthorized JJDPA expands the definition of “delinquency prevention programs” that can be funded through Title V’s Youth Promise grants to include “training and education programs for pregnant teen and teen parents” inside or outside of facilities. In addition, the reauthorization expands the allowable program categories under the state formula grants to include “programs that address the needs of girls in or at risk of entering the juvenile justice system, including pregnant girls [and] young mothers.”

One of the greatest threats to pregnant youth are birthing conditions made unsafe by the use of shackles and restraints. Currently, only 19 states have laws preventing the use of restraints on youths. In states without such laws, incarcerated youths are often subjected to shackling while being transported to and from medical appointments, immediately after giving birth, and arguably most significantly, during labor. The use of restraints during labor impedes upon the need to move around freely and shift into positions to aid delivery and cope with the pain of childbirth. Both the American Congress of Obstetricians and the American Medical Association have called the shackling of pregnant inmates “dangerous and inhumane.” Not only is shackling a risk to the parent and child’s health, but it has not been proven to be necessary for preventing harm or escape attempts, which is presumably its purpose. Thankfully, the reauthorized JJDPA mandates the elimination of restraints on pregnant youths in labor, delivery, and post-partum except in exceptional situations. States must develop a plan for how they will eliminate the use of restraints within one year of the Act’s passage and implement the plan within two years of the Act’s passage.


While more needs to be done to ensure that pregnant youths experiencing incarceration receive proper medical attention and are able to remain safe and healthy throughout their pregnancy, the Juvenile Justice Reform Act is a strong step in the right direction. To continue progress, Congress and/or state legislatures should take up legislation to ensure the need for altered activity schedules, changes in menu options, and treatment for postpartum depression for pregnant and parenting youth in the juvenile justice system is addressed.