Pregnant People Are Shackled and Abused in Harris County Jail

Each year, an estimated 55,000 pregnant people are admitted to jails in the United States. Many languish behind bars before trial simply because they can’t afford to pay cash bail. Nearly half of U.S. states now criminalize abortion care, forcing them to carry their pregnancies to term and give birth under conditions of grossly deficient medical care. Their babies are then immediately taken from them––a profoundly traumatizing experience.

The full extent of this crisis remains largely unknown. Although jails and prisons have a constitutional obligation to provide adequate health care to all people in their custody, the absence of mandatory care standards and adequate oversight systems renders these protections largely meaningless. Some jails and prisons provide relatively good pregnancy services, but many others provide “care” that is grossly harmful, negligent, or altogether nonexistent. Owing to a lack of transparency and basic data collection, many medical harms inflicted inside jails will never never come to light.

Texas Jail Project, a nonprofit focused on advocating for the incarcerated in the state, has discovered growing evidence of abusive practices against pregnant people at Houston’s Harris County Jail. They are among the many casualties of a politically manufactured crisis that has led to abysmal conditions at the jail, including at least 28 in-custody deaths last year. Four people have died there so far this year as well. Using information gathered from whistleblowers among jail staff and local officials and from the families of those affected, Texas Jail Project has compiled and corroborated numerous reports documenting abuses suffered by pregnant people in the facility. The policy choices fueling the crisis at the jail, along with the county’s failure to hold officials accountable, have allowed repeated violations of pregnant people’s civil rights and basic dignity.

One recent instance of mistreatment at the Harris County Jail involves M.S., who was 12 weeks pregnant with twins when she was arrested in June 2022. She couldn’t afford to pay 10 percent of the $80,000 bond required for her release, so she was stuck in jail. According to M.S. and her mother, M.S. faced extreme abuse from jailers and other incarcerated people. Jailers detained her in a cell with broken air vents (a violation of minimum jail standards), repeatedly placed her in shackles, and gave her a blanket that she said was covered in feces and infested with bed bugs. In one incident, officers shoved her face-first against a wall. Two weeks later, due to dehydration, vomiting, vaginal bleeding, and abdominal pain, she was taken to the hospital and informed that she had miscarried one of the twins. She was then taken back to the jail.

M.S. reports that during the next 10 days other incarcerated people repeatedly sexually assaulted her in her cell. She was then taken to the hospital again and sedated. When she woke up, she learned that doctors had terminated the second fetus without her knowledge. She was transported back to the jail and confined in a solitary cell. For hours, she received no pads, towels, or anything else to clean herself. A few weeks later, she attempted suicide. After all of this, on Aug. 30, 2022, the District Attorney’s Office dismissed the charges on which M.S. had been arrested and jailed. She was released in the middle of the night on Sept. 1.

Texas Jail Project reported M.S.’s mistreatment to the Texas Commission on Jail Standards in July, and the commission launched an investigation. The investigation found that jailers inappropriately placed M.S. in shackles at least once and that she received a “soiled” blanket from jail staff. The commission said that the sheriff had taken unspecified disciplinary action against staff in response to the shackling incident and that M.S. had received a clean blanket after staff noticed that the first one was dirty.

A second, ongoing case involves a 24-year-old woman, H.S. Texas Jail Project first heard her story from a jailer who was alarmed by her treatment. According to whistleblowers, court records, and interviews with her family, H.S is a survivor of sex trafficking and suffers from serious mental illness. Originally arrested for possession of less than one gram of a controlled substance, H.S. spent months in jail waiting for a bed to become available in a residential rehabilitation program. While in jail, other people in her unit routinely beat her. She psychologically decompensated to the point that, in May 2021, she was found incompetent to stand trial. In July 2021, she was released with an ankle monitor to an outpatient competency-restoration program.

For reasons that are unclear from court records, H.S. was taken back into custody in October 2021 and a judge reinstated her original $25,000 bond. She was pregnant at the time of her arrest. Three months later, in January 2022, she was placed on court-ordered psychiatric medication––something typically done only when an individual is exhibiting severe psychotic symptoms.

In May 2022, H.S. gave birth alone in a solitary cell, ignored by the jailers who were responsible for ensuring her safety and making sure she got proper medical care. According to whistleblowers, she repeatedly pressed the red call button in her cell to request help. When no one came to her aid, H.S. was forced to sever the umbilical cord herself. Hours later, jailers discovered H.S. had given birth and she, along with her newborn, were then transported to a hospital.

According to court paperwork filed the day H.S. gave birth, H.S. was suffering from such severe psychiatric symptoms that she was expected to need up to 12 months of inpatient psychiatric care. Two days later, the Houston Police charged H.S. with “intentionally and knowingly” harming her child—a felony—while the newborn was in the hospital. According to reports from H.S.’s family, however, the infant, who is now in their care, is unharmed and doing well.

Local media coverage of H.S.’s case has primarily focused on the violent and sensational nature of the charges alleging that she harmed her child. But this coverage has largely failed to interrogate the jail’s claims, or to ask how this could have happened in the first place: Why was a woman with severe mental illness allowed unsupervised access to a newborn in the hospital, and how could she allegedly harm her newborn while under the custodial care of a Harris County Sheriff’s deputy? If she did hurt her infant, who should bear responsibility for that?

Because the jail keeps such incidents shrouded in secrecy, we will likely never know exactly what happened after H.S. gave birth. Nonetheless, it is clear that H.S. is a victim of the jail and of the local mental health authority’s failure to provide adequate care for a pregnant person suffering from severe psychiatric disability. Also, according to jail staff members, Harris County jail authorities never officially documented the fact that H.S. went into labor and delivered her child while alone in a solitary cell. The failure to report this sort of incident is a violation of the jail’s own policies. Despite all this, H.S. is the only one facing legal repercussions for any of the events surrounding the birth of her child.

H.S. remains in the jail’s mental health ward today, now held on a $100,000 bond. Concerned staff have said that she is frequently getting into fights and “being beat up” as she continues to decompensate. She is awaiting transfer to a maximum security unit at a state mental hospital, but the waiting list for a bed is approximately two years long.

Even when pregnant people are released from custody in time to give birth in a hospital, they often suffer lasting trauma. B.M. was eight months pregnant when she was arrested on an out-of-county warrant for alleged misdemeanor theft. She was taken to jail because she couldn’t pay a $1,000 secured bond. For two days, she sat in the booking area, waiting to be processed. During this time, she was denied access to proper food, water, showers, medications, and medical evaluation. Hours after being placed in solitary housing, her water broke.

B.M. repeatedly asked for medical attention, but jail staff instead responded by rushing to discharge her from the facility, leaving her on the street less than two hours after she alerted them that she was going into labor. She had no phone, no money, and no opportunity to notify her family or doctors that she was about to give birth.

Texas Jail Project learned about this incident because an advocate with the organization happened to be outside the jail conducting interviews when B.M. was discharged. B.M. was in obvious distress as the Jail Project advocate provided her with water and food and helped her find care at a nearby hospital. B.M. gave birth later that evening. According to hospital records, her labor lasted for a total of 28 hours. The baby was breech and suffered from health complications that appear related to the delay in B.M.’s care. The child spent three weeks in the NICU before being released from the hospital.

In an interview with Texas Jail Project conducted on the morning of B.M.’s release, a woman who was detained with B.M. and witnessed her water break corroborated B.M.’s account of her treatment in the jail. When we reached out to jail officials about the incident, they denied that B.M.’s water had broken in the facility. They claimed she had simply soiled herself, stating that such “accidents” are common among people who use drugs. Routine toxicology screenings performed while B.M. was in the hospital for the delivery found no illicit substances in her system.

Texas Jail Project has notified the jail of all these events involving pregnant prisoners. The organization also sent the jail a list of recommendations that could improve the situation at the facility, such as launching a specialized unit staffed by officers trained to work with pregnant people and equipped to provide support services to assist with pre- and post-natal care and education, breastfeeding support, case management, and post-release planning. Although the head of the jail has since resigned, nothing has changed inside the facility as far as Texas Jail Project is aware.

It’s also important to note that in each case mentioned above, existing policies should have, in theory, prevented these abuses. Clearly, policy reform is not sufficient if it leaves untouched the underlying problem: lawmakers’ continued reliance on jails and prisons, which foster a culture of abuse and neglect, when what people and communities need is supportive care.