Investigations Human Rights

Deprived of Care, Incarcerated Women Suffer Miscarriages, Stillbirths, Ectopic Pregnancies

Sharona Coutts & Zoe Greenberg

Rewire has identified at least a dozen instances of women experiencing miscarriages, stillbirths, and ectopic pregnancies in jails and prisons across the country, in circumstances that show a shocking lack of medical care from the professionals charged with providing it.

This is the second article in Rewire’s Women, Incarcerated series. You can read the other pieces in the series that have been published so far here.

On the morning of September 11, 2011, Krystal Moore thought she was dying. Sharp pain stabbed at her stomach, so much so that she curled up into a fetal position on her bed. She didn’t know what was happening. Though she was pregnant, she was only six months along, not nearly ready to give birth.

She couldn’t simply call the family doctor. She was an inmate, serving time at the Jerome Combs Detention Center in Kankakee, Illinois, for smoking marijuana while on probation. But in the early hours of that Sunday morning, her pain was escalating quickly.

“I woke up hurting,” she told Rewire. “I tried to get in the shower, and I couldn’t.”

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She asked to go the hospital. She had spoken to some other inmates, and she began to think she was having contractions. The pressure on her stomach was getting worse.

Krystal Moore

Krystal Moore

A guard telephoned the jail nurse, Ivetta Charee Sangster, to tell her that Moore was having stomach pains. Sangster was on duty that Sunday, though she wasn’t actually at the detention center, which, like many jails, doesn’t have full-time medical staff available, despite housing a sick and vulnerable population. Even if Sangster had been there, she was only a licensed practical nurse, a role that generally involves providing only very basic medical care, like taking a patient’s blood pressure or changing a bandage. She would not have been able to give Moore the urgent care she required for what had become a serious infection of her womb.

Meredith Manning—Tennessee, 2004

Twenty-three-year-old Manning began to miscarry in a Corrections Corporation of America facility. She bled for two days before she was taken to the hospital, where she gave birth to a baby that died shortly after. This case settled for $250,000.

Sangster sounded irritated on the phone, according to the transcript of the call that later appeared in a lawsuit filed by Moore.

“Krystal Moore, she’s—in my opinion, a lot of times she’s full of shit,” Sangster told the guard. “You can go eyeball her and call me back if you want. She’s probably full of shit. But you can let her know that she can see the doctor tomorrow if she’d like.”

Our attempts to contact Sangster were unsuccessful.

By 2:30 that afternoon—at least eight hours since she first alerted guards to her pain—Moore began bleeding while sitting on a toilet. Screaming out of pain and fear, she was finally taken to a local hospital, but not before being forced to walk down the stairs from her cell to the ambulance, according to a court opinion from December 2013.

Moore was fully dilated by the time she arrived at the hospital, where she says she was shackled to the hospital bed. Then, around 5:20 p.m., she gave birth to twins. Had she been taken to hospital earlier, there was a possibility that the babies could have survived, according to an expert who provided evidence for the lawsuit. Instead, one baby lived for only a day; the other survived for 16 days.

“I remember it clear as yesterday. I think about my twins every day and every night. How would they be?” Moore said.

Shela Williams—Texas, 2014

Williams was 18 weeks pregnant when she entered a Texas jail. She had a high-risk pregnancy but did not receive adequate obstetric care while incarcerated. When a doctor finally did examine Williams, he told her that her child “wasn’t going to make it.” She went to a nearby hospital, where she delivered her stillborn; she was not allowed to attend his funeral.

Moore’s case settled last year for $620,000, according to her lawyer. But in a five-month investigation, Rewire found that her story is not unique. After reviewing more than 200 legal cases, as well as the Human Rights Defense Center’s database of “Deaths in [Corrections Corporation of America] Custody,” Rewire identified at least a dozen instances of women experiencing miscarriages, stillbirths, and ectopic pregnancies in jails and prisons across the country, in circumstances that show a shocking lack of medical care from the professionals charged with providing it.

This number is most likely a dramatic under-representation of the problem. In addition to the shame and grief that many women feel at the loss of a pregnancy, incarcerated women often fear complaining about their miscarriages behind bars because they do not want to compromise ongoing cases or face retribution from jail or prison staff, according to community activists and researchers who work closely with incarcerated women.

Bethany Cajúne—Montana, 2009

Although Cajúne was pregnant, and both her doctor and drug treatment counselor had prescribed her continued use of Suboxone (a medication that suppresses withdrawal symptoms) in jail, the doctors and nurses there would not give her the prescription. She went through immediate withdrawal, losing ten pounds in less than two weeks. She feared she would lose her baby. Finally, after nine days, a public defender intervened and she received the treatment. This case settled in 2011.

To be sure, low-quality prenatal care is a symptom of the larger problem of poor medical care in corrections facilities in the United States, as has been documented in California, Arizona, and Florida and through thousands of lawsuits against prisons and the private contractors that sometimes run them.

Prison health services were so bad in the 1960s and 1970s that in 1976 the U.S. Supreme Court ruled that failure to provide appropriate medical care to prisoners amounted to a violation of the U.S. Constitution’s prohibition on cruel and unusual punishment. As a result, incarcerated people are the only group in the United States with a constitutional right to medical care.

But with the swelling number of women behind bars, the failure to provide prenatal care is becoming a major concern.

The cases we examined were strikingly similar to Moore’s: pregnant women waiting weeks to see doctors, nurses instructing women to take antibiotics for labor pains, and inmates miscarrying in toilets or on cell floors. Sangster’s comments would have fit into any of the cases that we read. Again and again, we saw women inmates in need of prenatal care ignored, silenced, and disbelieved.

Gretchen Harbison—Indiana, 2010

Harbison could not feel her fetus move for three days. She was eventually transferred to a hospital, where she delivered a stillborn. Harbison alleges that the prison doctor failed to treat her pregnancy with any urgency, despite knowing that she had four complicated deliveries in her past.

“I feel like that jail done killed my kids,” said Moore. “I’ve been feeling that since the day I gave birth.”

Prenatal Care Is Crucial—and Missing—Behind Bars

At the end of 2012, there were more than 200,000 women in prisons and jails, comprising 9 percent of the nation’s incarcerated population. Based on current trends, the number of women behind bars is expected to grow.

The median age of women in state and federal prison is 34, and the majority of incarcerated women are of reproductive age, according to a study by the Bureau of Justice Statistics. Many women in prison have high-risk pregnancies, complicated by problems including poor nutrition, domestic violence, mental illness, and drug and alcohol abuse.

Poor prenatal care in corrections facilities is a grave concern, especially since those facilities have become one of the major providers of health care for marginalized communities, according to Brad Brockmann, executive director of the Center for Prisoner Health and Human Rights at the Miriam Hospital in Providence, Rhode Island, an affiliate of Brown University.

“For many of the individuals who come into the system, their first physical as adults is when they enter prison or jail, because prior to January 2014 Medicaid was not available to many, with only safety-net programs available in the community,” Brockmann said.

Tiffany Pollitt—Pennsylvania, 2010

An inmate hit Pollitt in the stomach; she repeatedly reported the incident, but no doctors or nurses took her seriously. She continued to say she was in serious pain. Corrections officers told Pollitt to “grow up,” asked her what she expected them to do, and told her “better luck with next shift.” Then Pollitt bled all over the floor of her cell. Finally, she was transferred to a nearby hospital, where she delivered a stillborn baby.

The quality of prenatal care provided by prisons or jails varies wildly between and within states, with most facilities providing very poor care, according to a 2010 review of state policies by the National Women’s Law Center and the Rebecca Project.

The survey graded all 50 states on their treatment of mothers behind bars. Thirty-eight states received a failing grade in the category of prenatal care. The researchers reported that 43 states do not require medical exams as part of prenatal care for women in confinement. Forty-eight states don’t offer pregnant women screening for HIV.

And this review only examined what states said their policies were; there were no on-site inspections. “Paper reviews are of limited value in a corrections context,” said Amy Fettig, senior staff counsel for the ACLU’s National Prison Project.

The reality is, no one is looking closely at what is happening in practice on a national scale when it comes to the care of incarcerated pregnant people, experts told Rewire.

DeShawn Balka—Georgia, 2012

Balka was about 24 weeks pregnant when she entered the jail. She experienced nausea, cramping, bleeding, and vaginal discharge, which she reported to jail guards. No one examined her. Then she began experiencing extreme pain and cramping. She sat on the toilet in her cell and pressed the emergency call button; no one responded. Ultimately she gave birth into the toilet. Her baby was pronounced dead at the hospital a few hours later.

For instance, there are no clear answers to some fundamental questions, such as how many women are pregnant during incarceration each year in the United States. A 2011 report by the American Congress of Obstetricians and Gynecologists put the number at 6 to 10 percent of incarcerated women, while a 2008 study by the Bureau of Justice Statistics estimated that between 4 and 5 percent of women admitted to state and federal prisons that year were pregnant.

There are also no comprehensive data for the number of pregnant women in jails, which typically house people prior to conviction or sentencing, or sometimes for immigration matters or for shorter sentences.

And there is simply no national picture of pregnancy outcomes—miscarriages, abortions, stillbirths, and live births—for incarcerated women, experts told us. The most recent data we could find came from 1998, when the Government Accountability Office reported that there were about 1,400 births in prisons that year.

Only two states require collection of data on pregnancy outcomes for incarcerated women—Delaware and Oregon, according to the Rebecca Project report. Delaware did not respond to our request for records, but Oregon provided information recorded about the only state prison that houses women, Coffee Creek Correctional Facility, between July 2012 and November 2014.

Countess Clemons—Tennessee, 2011

Eighteen-year-old Clemons started miscarrying in a prison in Tennessee. After leaving her in a cell for almost three hours, guards took Clemons to a hospital, where she delivered a baby who died soon after he was born. This case settled for $690,000 in 2014. The Corrections Corporation of America was also issued a sanction for destroying video evidence of the delay in treatment.

That data say there were 51 pregnant prisoners during that time, but give little insight into the type of care provided to these women, apart from the indication that some women were assessed to see whether their pregnancies were high-risk. Of these pregnancies, 37 resulted in births while incarcerated. Eleven women had c-sections, and three women’s labor was induced. There was one miscarriage and one abortion, and an additional four women returned a negative pregnancy test after earlier indicating that they were pregnant. At the time the data were provided, seven of the pregnant prisoners remained incarcerated, while at least two had been released prior to giving birth.

The data do not cover jails, which are governed separately by each of Oregon’s 36 different counties, according to Wendy Smith, a spokesperson with the state’s Health Services Administration.

Another data set comes from Texas, which tracks how many pregnant inmates are booked into county jails—last month, there were 382. A draft bill would require Texas jails to collect data on prenatal care, as well as the use of solitary confinement or restraints on pregnant inmates.

It’s therefore reasonable to imagine that thousands of women around the country are experiencing a wide range of pregnancy outcomes while in jails and prisons, with no oversight mechanism to track the care they receive.

But most states do not collect data on incarcerated pregnant woman, and there is no national set of data about prenatal care or pregnancy outcomes for incarcerated people.

Experts say this lack of national and local data is no coincidence.

“It’s one of the many areas where the lack of data points to the invisibility of incarcerated people, and specifically incarcerated women,” Tamar Kraft-Stolar, director of the Correctional Association of New York’s Women in Prison Project told Rewire.

Nicole Guerrero—Texas, 2012

Guerrero began to experience pain, bleeding, and cramping, and alerted medical staff. Guerrero was put in solitary confinement, where she went into labor by herself on the floor of her cell. The umbilical cord was wrapped around the baby’s neck, and the baby was later pronounced dead. Guerrero was made to stay in solitary confinement while the infant was taken away.

Despite the lack of comprehensive national data, our investigation found that, with few exceptions, prenatal care in prisons and jails across the country is shockingly inadequate.

In addition to insufficient food and inappropriate living conditions for pregnant people, our research underlines what health experts and women’s rights advocates have said for years: Prisons and jails are among the most dangerous places to be while pregnant.

“A Near-Death Sentence” for Writing Bad Checks

For Laila Batts, poor prenatal care behind bars came close to ending her life.

In early January 2007, Batts was detained for ten days at the Elmwood Complex Women’s Facility, in Santa Clara, California, after writing a bad check to pay some bills.

Batts was in her first trimester of pregnancy the day she entered jail, and that night she began to experience spotting and severe cramping. For the next ten days, Batts complained to nurses about her pain.

By Monday, January 8, Batts told jail staff that she wanted to go to the hospital, because her condition was getting worse. Her request went unfulfilled. On January 9, a nurse saw Batts bleeding on the floor of her cell and complaining that her symptoms were getting dramatically worse, but the nurse did not send for emergency help. When Batts finally saw a doctor the next day, January 10, the doctor noted that she was suffering from an abnormal pregnancy, was at risk of an ectopic pregnancy, and required care, according to records produced in the lawsuit. But instead of providing that care, the doctor sent Batts back to her cell. Batts thought she was suffering a painful miscarriage.

“What started out as a request for modified community service in light of her pregnancy turned into a near-death sentence, bringing Ms. Batts within hours—perhaps minutes—of losing her life,” court filings said.

The day after she was released from jail, Batts woke in excruciating pain and was rushed by ambulance to the emergency room, where, she told Rewire, surgeons removed her ectopic pregnancy, as well as a fallopian tube. Ectopic pregnancies are extremely dangerous, and require immediate attention to avoid potential death of the pregnant person.

Latish Durden—Georgia, 2012

Durden had a high-risk pregnancy and had surgery on her cervix while at the jail. She required constant monitoring. She began experiencing cramping, bleeding, and discharge, but she was not treated. Eventually she was taken to the hospital, where she delivered a stillborn baby.

Batts settled her case, but declined to say how much she was awarded.

What is unusual in her lawsuit is that the complaint focused on the physical and mental pain that she endured. The vast majority of cases we examined focused on the loss of the fetus, not on the suffering of the pregnant woman, because the law tends to focus more on permanent losses—the death of a “viable” fetus—than on temporary pain experienced by the woman. For this reason, we found more cases involving stillbirths (a loss of pregnancy after 20 weeks’ gestation) than miscarriages, which occur prior to 20 weeks.

And because many miscarriages are difficult, if not impossible, to prevent, it is extremely difficult for women who have suffered them while incarcerated to prove any fault on the part of the authorities. This makes mistreatment of miscarriage tough to detect, with even grassroots community advocates struggling to identify where it has occurred.

Diana Claitor, executive director of the Texas Jail Project, says she usually doesn’t hear about a miscarriage from the woman who suffered it.

“Mostly we get a grandmother calling,” Claitor told Rewire. “The first call I got was an elderly Hispanic woman asking, ‘Is there any way we can get the body of our dead grandchild and put it in the family plot?’”

“Sanctity of Life in Texas Looks Like This”

Many of the cases of miscarriage or stillbirth we found occurred in states that have recently introduced laws that claim to protect fetuses, even at the expense of the woman bearing them.

For example, miscarriage in Texas is treated differently if it does not happen behind bars.

Last year, Dallas police swarmed a high school after a fetus was found in a toilet. They launched an investigation, reviewing video footage and interviewing teachers to find the “suspect.”

But two years earlier, no such attention was given to the case of Autumn Miller, who in the summer of 2012 miscarried into a toilet while serving a one-year sentence at the Dawson State Jail, also in Dallas.

Miller, who in pictures has light brown hair and a warm smile full of straight, white teeth, was already the mother of three children. She had entered the jail in February, after violating probation on a drug possession charge, not realizing she was pregnant.

Throughout May and June, Miller complained of cramps and fatigue, and requested a pregnancy test and Pap smear. She never received either from the jail.

On the night of June 14, Miller began bleeding, and experiencing pain so severe that she couldn’t walk, according to a lawsuit filed against the Corrections Corporation of America. Miller told guards she felt like she was having a baby.

Guards brought her to a medical unit where a nurse waited on a telescreen (like the jail in Kankakee, there was no full-time medical staff on-site). But Miller could barely explain what was happening before a guard turned off the screen, handed her a menstrual pad, and locked her in a segregated cell.

Screaming, Miller gave birth into a toilet. She was then handcuffed, shackled, and transported to the hospital separately from her newborn. Miller named the infant Gracie Robinson; she barely weighed a pound. Gracie died four days later.

“They had her locked in a cell down in the medical area, all by herself, when she was laboring, unbeknownst to her,” Miller’s lawyer, Paula Sweeney, told Rewire. “Then they couldn’t find the key to get the door open when it became apparent what was going on. Then, as she’s laying there on the cot, with blood everywhere, in terror and agony, the male guards start taking pictures with their cellphones.”

Miller’s case was settled in January 2014, and the facility that housed her has since been shut down because of budget cuts as well as increased scrutiny about what was going on behind the prison walls.

“Texas runs around bragging about the sanctity of human life, until you get a chance to see it in real life,” Miller’s lawyer told us. “Sanctity of life in Texas looks like this.”

No Role for Prosecutors in Prenatal Care

Experts have a wide range of recommendations to improve pregnancy care in prisons and jails, including laws that require tracking and reporting pregnancy outcomes, the elimination of solitary confinement for pregnant prisoners, and an increase in inmates’ access to OB-GYNs.

In Texas, a coalition of groups, including the Texas Jail Project and the ACLU of Texas, is pushing for a bill that would mandate tracking of prenatal care and treatment of pregnant prisoners in the state’s approximately 250 county jails.

The bill has caused unease among some women’s advocates, however, because of fears that gathering data on pregnant inmates could lead to more punitive action by the state.

“There is legitimate fear from legislators that are interested in doing this kind of tracking that those numbers will be used to punish pregnant women for drug use,” Mathew Simpson, policy strategist at the ACLU of Texas, told Rewire. “When it comes down to it, if we don’t know the birth outcomes, we can’t make an assessment of where the gaps are.”

The broader picture, however, is that jails and prisons are generally the wrong place to house pregnant women, given that they frequently lack the appropriate staff or facilities, and are fundamentally geared toward punishment, not care.

“Judges and prosecutors think that it’s a good idea to empower jail guards—whose job is to punish criminals—to give prenatal care,” Lynn Paltrow, the executive director of National Advocates for Pregnant Women, told Rewire. “There has to be a very clear consensus that there is no role for prosecutors to be involved in prenatal care.”

Analysis Human Rights

From Protected Class to High-Priority Target: How the ‘System Is Rigged’ Against Unaccompanied Migrant Children

Tina Vasquez

Vulnerable, undocumented youth who pose no real threat are being stripped of their right to an education and instead sit in detention awaiting deportation.

This is the first article in Rewire’s two-part series about the U.S. immigration system’s effects on unaccompanied children.

Earlier this month, three North Carolina high school students were released from a Lumpkin, Georgia, detention center after spending more than six months awaiting what seemed like their inevitable fate: deportation back to conditions in Central America that threatened their lives.

Wildin David Guillen Acosta, Josue Alexander Soriano Cortez, and Yefri Sorto-Hernandez were released on bail in the span of one week, thanks to an overwhelming community effort involving pro bono attorneys and bond money. However, not everyone targeted under the same government operation has been reprieved. For example, by the time reports emerged that Immigration and Customs Enforcement (ICE) had detained Acosta on his way to school in Durham, North Carolina, the government agency had already quietly deported four other young people from the state, including a teenage girl from Guatemala who attended the same school.

Activated in January, that program—Operation Border Guardian—continues to affect the lives of hundreds of Central American migrants over the age of 18 who came to the United States as unaccompanied children after January 2014. Advocates believe many of those arrested under the operation are still in ICE custody.

Department of Homeland Security (DHS) Secretary Jeh Johnson has said that the goal of Operation Border Guardian is to send a message to those in Central America considering seeking asylum in the United States. But it’s not working, as Border Patrol statistics have shown. Furthermore, vulnerable, undocumented youth who pose no real threat are being stripped of their right to an education and instead sit in detention awaiting deportation. These youth arrived at the border in hopes of qualifying for asylum, but were unable to succeed in an immigration system that seems rigged against them.

“The laws are really complicated and [young people] don’t have the community support to navigate this really hostile, complex system. That infrastructure isn’t there and unless we support asylum seekers and other immigrants in this part of the country, we’ll continue to see asylum seekers and former unaccompanied minors receive their deportation orders,” said Julie Mao, the enforcement fellow at the National Immigration Project of the National Lawyers Guild.

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“A Grossly Misnamed” Operation

In January, ICE conducted a series of raids that spanned three southern states—Georgia, North Carolina, and Texas—targeting Central American asylum seekers. The raids occurred under the orders of Johnson, who has taken a hardline stance against the more than 100,000 families who have sought asylum in the United States. These families fled deadly gang violence in El Salvador, Honduras, and Guatemala in recent years. In El Salvador, in particular, over 400 children were murdered by gang members and police officers during the first three months of 2016, doubling the country’s homicide rate, which was already among the highest in the world.

ICE picked up some 121 people in the early January raids, primarily women and their young children. Advocates argue many of those arrested were detained unlawfully, because as people who experienced severe trauma and exhibited symptoms of post-traumatic stress disorder, generalized anxiety, and depression, they were disabled as defined under the Rehabilitation Act of 1973, and ICE did not provide reasonable accommodations to ensure disabled people were not denied meaningful access to benefits or services.

Just a few weeks later, on January 23, ICE expanded the raids’ focus to include teenagers under Operation Border Guardian, which advocates said represented a “new low.”

The media, too, has also criticized DHS for its seemingly senseless targeting of a population that normally would be considered refugees. The New York Times called Operation Border Guardian “a grossly misnamed immigration-enforcement surge that went after people this country did not need to guard against.”

In response to questions about its prioritization of former unaccompanied minors, an ICE spokesperson told Rewire in an emailed statement: “As the secretary has stated repeatedly, our borders are not open to illegal migration. If someone was apprehended at the border, has been ordered removed by an immigration court, has no pending appeal, and does not qualify for asylum or other relief from removal under our laws, he or she must be sent home. We must and we will enforce the law in accordance with our enforcement priorities.”

DHS reports that 336 undocumented Central American youth have been detained in the operation. It’s not clear how many of these youth have already been deported or remain in ICE custody, as the spokesperson did not respond to that question by press time.

Acosta, Cortez, Sorto-Hernandez, and three other North Carolina teenagersSantos Geovany Padilla-Guzman, Bilmer Araeli Pujoy Juarez, Pedro Arturo Salmeron—have become known as the NC6 and the face of Operation Border Guardian, a designation they likely would have not signed up for.

Advocates estimate that thousands of deportations of low-priority migrants—those without a criminal history—occur each week. What newly arrived Central American asylum seekers like Acosta could not have known was that the federal government had been laying the groundwork for their deportations for years.

Asylum Seekers Become “High-Priority Cases”

In August 2011, the Obama administration announced it would begin reviewing immigration cases individually, allowing ICE to focus its resources on “high-priority cases.” The assumption was that those who pose a threat to public safety, for example, would constitute the administration’s highest priority, not asylum-seeking high school students.

But there was an indication from DHS that asylum-seeking students would eventually be targeted and considered high-priority. After Obama’s announcement, ICE released a statement outlining who would constitute its “highest priorities,” saying, “Specifically individuals who pose a threat to public safety such as criminal aliens and national security threats, as well as repeat immigration law violators and recent border entrants.”

In the years since, President Obama has repeatedly said “recent border crossers” are among the nation’s “highest priorities” for removal—on par with national security threats. Those targeted would be migrants with final orders of removal who, according to the administration, had received their day in court and had no more legal avenues left to seek protection. But, as the American Civil Liberties Union (ACLU) reported, “recent border entrant” is a murky topic, and it doesn’t appear as if all cases are being reviewed individually as President Obama said they would.

“Recent border entrant” can apply to someone who has been living in the United States for three years, and a border removal applies “whenever ICE deports an individual within three years of entry—regardless of whether the initial entry was authorized—or whenever an individual is apprehended by Customs and Border Protection (CBP),” explained Thomas Homan, the head of ICE’s removal operations in a 2013 hearing with Congress, the ACLU reported.

Chris Rickerd, policy counsel at the American Civil Liberties Union’s Washington Legislative Office, added that “[b]ecause CBP refuses to screen the individuals it apprehends for their ties to the U.S., and DHS overuses procedures that bypass deportation hearings before a judge, many ‘border removals’ are never fully assessed to determine whether they have a legal right to stay.”

Over the years, DHS has only ramped up the department’s efforts to deport newly arrived immigrants, mostly from Central America. As the Los Angeles Times reported, these deportations are “an attempt by U.S. immigration officials to send a message of deterrence to Central America and avoid a repeat of the 2014 crisis when tens of thousands of children from Honduras, El Salvador and Guatemala arrived at the U.S. border.”

This is something Mao takes great issue with.

“These raids that we keep seeing are being done in order to deter another wave of children from seeking asylum—and that is not a permissible reason,” Mao said. “You deport people based on legality, not as a way of scaring others. Our country, in this political moment, is terrorizing young asylum seekers as a way of deterring others from presenting themselves at the border, and it’s pretty egregious.”

There is a direct correlation between surges of violence in the Northern Triangle—El Salvador, Guatemala, and Honduras—and an uptick in the number of asylum seekers arriving in the United States. El Salvador, known as the murder capital of the word, recently saw an explosion of gang violence. Combine that with the possible re-emergence of so-called death squads and it’s clear why the number of Salvadoran family units apprehended on the southern border increased by 96 percent from 2015 to 2016, as Fusion reported.

Much like Mao, Elisa Benitez, co-founder of the immigrants rights’ organization Alerta Migratoria NC, believes undocumented youth are being targeted needlessly.

“They should be [considered] low-priority just because they’re kids, but immigration is classifying them at a very high level, meaning ICE is operating like this is a population that needs to be arrested ASAP,” Benitez said.

The Plight of Unaccompanied Children

Each member of the NC6 arrived in the United States as an unaccompanied child fleeing violence in their countries of origin. Acosta, for example, was threatened by gangs in his native Honduras and feared for his life. These young people should qualify as refugees based on those circumstances under international law. In the United States, after they present themselves at the border, they have to prove to an immigration judge they have a valid asylum claim—something advocates say is nearly impossible for a child to do with no understanding of the immigration system and, often, with no access to legal counsel—or they face deportation.

Unaccompanied children, if not immediately deported, have certain protections once in the United States. For example, they cannot be placed into expedited removal proceedings. According to the American Immigration Council, “they are placed into standard removal proceedings in immigration court. CBP must transfer custody of these children to Health and Human Services (HHS), Office of Refugee Resettlement (ORR), within 72 hours.”

While their court proceedings move forward, HHS’s Office of Refugee Resettlement manages the care of the children until they can ideally be released to their parents already based in the country. Sometimes, however, they are placed with distant relatives or U.S. sponsors. Because HHS has lowered its safety standards regarding placement, children have been subjected to sexual abuse, labor trafficking, and severe physical abuse and neglect, ThinkProgress has reported.

If while in the care of their family or a sponsor they miss a court date, detainment or deportation can be triggered once they turn 18 and no longer qualify for protections afforded to unaccompanied children. 

This is what happened to Acosta, who was placed with his mother in Durham when he arrived in the United States. ICE contends that Acosta was not targeted unfairly; rather, his missed court appearance triggered his order for removal.

Acosta’s mother told local media that after attending his first court date, Acosta “skipped subsequent ones on the advice of an attorney who told him he didn’t stand a chance.”

“That’s not true, but it’s what they were told,” Benitez said. “So, this idea that all of these kids were given their day in court is false. One kid [we work with] was even told not to sign up for school because ‘there was no point,’ it would just get him deported.”

Benitez told Rewire the reasons why these young people are being targeted and given their final orders of removal need to be re-examined.

Sixty percent of youth from Central America do not ever have access to legal representation throughout the course of their case—from the time they arrive in the United States and are designated as unaccompanied children to the time they turn 18 and are classified as asylum seekers. According to the ACLU, 44 percent of the 23,000 unaccompanied children who were required to attend immigration court this year had no lawyer, and 86 percent of those children were deported.

Immigration attorneys and advocates say that having a lawyer is absolutely necessary if a migrant is to have any chance of winning an asylum claim.

Mao told Rewire that in the Southeast where Acosta and the other members of the NC6 are from, there is a pipeline of youth who arrived in the United States as unaccompanied children who are simply “giving up” on their valid asylum claims because navigating the immigration system is simply too hard.

“They feel the system is rigged, and it is rigged,” Mao said.

Mao has been providing “technical assistance” for Acosta and other members of the NC6. Her organization doesn’t represent individuals in court, she said, but the services it provides are necessary because immigration is such a unique area of law and there are very few attorneys who know how to represent individuals who are detained and who have been designated unaccompanied minors. Those services include providing support, referrals, and technical assistance to advocates, community organizations, and families on deportation defense and custody issues.

Fighting for Asylum From Detention

Once arrested by ICE, there is no telling if someone will linger in detention for months or swiftly be deported. What is known is that if a migrant is taken by ICE in North Carolina, somewhere along the way, they will be transferred to Lumpkin, Georgia’s Stewart Detention Center. As a local paper reported, Stewart is “the last stop before they send you back to whatever country you came from.”

Stewart is the largest detention center in the country, capable of holding 2,000 migrants at any time—it’s also been the subject of numerous investigations because of reports of abuse and inadequate medical care. The detention center is run by Corrections Corporation of America, the country’s largest private prison provider and one that has become synonymous with maintaining inhumane conditions inside of its detention centers. According to a report from the National Immigrant Justice Center, Stewart’s remote location—over two hours away from Atlanta—hinders the facility from attracting and retaining adequate medical staff, while also creating barriers to visitation from attorneys and family members.

There’s also the matter of Georgia being notoriously tough on asylum seekers, even being called the “worst” place to be an undocumented immigrant. The Huffington Post reported that “Atlanta immigration judges have been accused of bullying children, badgering domestic violence victims and setting standards for relief and asylum that lawyers say are next to impossible to meet.” Even more disconcerting, according to a project by Migrahack, which pairs immigration reporters and hackers together, having an attorney in Georgia had almost no effect on whether or not a person won their asylum case, with state courts denying up to 98 percent of asylum requests. 

Acosta, Cortez, and Sorto-Hernandez spent over six months in Stewart Detention Center before they were released on baila “miracle” according to some accounts, given the fact that only about 5 percent of those detained in Stewart are released on bond.

In the weeks after ICE transferred Acosta to Stewart, there were multiple times Acosta was on the verge of deportation. ICE repeatedly denied Acosta was in danger, but advocates say they had little reason to believe the agency. Previous cases have made them wary of such claims.

Advocates believe that three of the North Carolina teens who were deported earlier this year before Acosta’s case made headlines were kept in detention for months with the goal of wearing them down so that they would sign their own deportation orders despite having valid asylum claims.

“They were tired. They couldn’t handle being in detention. They broke down and as much as they feared being returned to their home countries, they just couldn’t handle being there [in detention] anymore. They’d already been there for weeks,” Benitez said.

While ICE claims the average stay of a migrant in Stewart Detention Center is 30 days, the detention center is notorious for excessively long detainments. Acosta’s own bunkmate had been there over a year, according to Indy Week reporter David Hudnall.

As Hudnall reported, there is a massive backlog of immigration cases in the system—474,000 nationally and over 5,000 in North Carolina.

Mao told Rewire that the amount of time the remaining members of the NC6 will spend in detention varies because of different legal processes, but that it’s not unusual for young people with very strong asylum cases to sign their rights away because they can’t sustain the conditions inside detention.

Pedro Arturo Salmeron, another NC6 member, is still in detention. He was almost deported, but Mao told Rewire her organization was able to support a pro bono attorney in appealing to the Board of Immigration Appeals (BIA) to stop proceedings.

Japeth Matemu, an immigration attorney, recently told Indy Week’s David Hudnall that “the BIA will tell you that it can’t modify the immigration judge’s ruling unless it’s an egregious or obvious miscarriage of justice. You basically have to prove the judge is off his rocker.”

It could take another four months in detention to appeal Salmeron’s case because ICE continues to refuse to release him, according to the legal fellow.

“That’s a low estimate. It could be another year in detention before there is any movement in his case. We as an organization feel that is egregious to detain someone while their case is pending,” Mao said. “We have to keep in mind that these are kids, and some of these kids can’t survive the conditions of adult prison.”

Detention centers operate as prisons do, with those detained being placed in handcuffs and shackles, being stripped of their personal belongings, with no ability to move around freely. One of Acosta’s teachers told Rewire he wasn’t even able to receive his homework in detention.

Many of those in detention centers have experienced trauma. Multiple studies confirm that “detention has a profoundly negative impact on young people’s mental and physical well-being” and in the particular case of asylum seekers, detention may exacerbate their trauma and symptoms of post-traumatic stress disorder. 

“People are so traumatized by the raids, and then you add detention on top of that. Some of these kids cannot psychologically and physically deal with the conditions in detention, so they waive their rights,” Mao said.

In March, Salmeron and fellow NC6 member Yefri Sorto-Hernandez received stays of deportation, meaning they would not face immediate deportation. ICE says a stay is like a “legal pause.” During the pause, immigration officials decide if evidence in the case will be reconsidered for asylum. Sorto-Hernandez was released five months later.

Benitez said that previously when she organized around detention, a stay of deportation meant the person would get released from detention, but ICE’s decision to detain some of the NC6 indefinitely until their cases are heard illustrates how “weirdly severe” the agency is being toward this particular population. Mao fears this is a tactic being used by ICE to break down young people in detention.

“ICE knows it will take months, and frankly up to a year, for some of these motions to go through the court system, but the agency is still refusing to release individuals. I can’t help but think it’s with the intention that these kids will give up their claims while suffering in detention,” Mao said.

“I think we really have to question that, why keep these young people locked up when they can be with their communities, with their families, going to school? ICE can release these kids now, but for showmanship, ICE is refusing to let them go. Is this who we want to be, is this the message we want to send the world?” she asked.

In the seven months since the announcement of Operation Border Guardian, DHS has remained quiet about whether or not there will be more raids on young Central American asylum seekers. As a new school year approaches, advocates fear that even more students will be receiving their orders for removal, and unlike the NC6, they may not have a community to rally around them, putting them at risk of quietly being deported and not heard from again.

News Human Rights

What’s Driving Women’s Skyrocketing Incarceration Rates?

Michelle D. Anderson

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

Local court and law enforcement systems in small counties throughout the United States are increasingly using jails to warehouse underserved Black and Latina women.

The Vera Institute of Justice, a national policy and research organization, and the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge initiative, released a study last week showing that the number of women in jails based in communities with 250,000 residents or fewer in 2014 had grown 31-fold since 1970, when most county jails lacked a single woman resident.

By comparison, the number of women in jails nationwide had jumped 14-fold since 1970. Historically, jails were designed to hold people not yet convicted of a crime or people serving terms of one year or less, but they are increasingly housing poor women who can’t afford bail.

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

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Overlooked: Women and Jails in an Era of Reform,” calls attention to jail incarceration rates for women in small counties, where rates increased from 79 per 100,000 women to 140 per 100,000 women, compared to large counties, where rates dropped from 76 to 71 per 100,000 women.

The near 50-page report further highlights that families of color, who are already disproportionately affected by economic injustice, poor access to health care, and lack of access to affordable housing, were most negatively affected by the epidemic.

An overwhelming percentage of women in jail, the study showed, were more likely to be survivors of violence and trauma, and have alarming rates of mental illness and substance use problems.

“Overlooked” concluded that jails should be used a last resort to manage women deemed dangerous to others or considered a flight risk.

Elizabeth Swavola, a co-author of “Overlooked” and a senior program associate at the Vera Institute, told Rewire that smaller regions tend to lack resources to address underlying societal factors that often lead women into the jail system.

County officials often draft budgets mainly dedicated to running local jails and law enforcement and can’t or don’t allocate funds for behavioral, employment, and educational programs that could strengthen underserved women and their families.

“Smaller counties become dependent on the jail to deal with the issues,” Swavola said, adding that current trends among women deserves far more inquiry than it has received.

Fred Patrick, director of the Center on Sentencing and Corrections at the Vera Institute, said in “Overlooked” that the study underscored the need for more data that could contribute to “evidence-based analysis and policymaking.”

“Overlooked” relies on several studies and reports, including a previous Vera Institute study on jail misuse, FBI statistics, and Rewire’s investigation on incarcerated women, which examined addiction, parental rights, and reproductive issues.

“Overlooked” authors highlight the “unique” challenges and disadvantages women face in jails.

Women-specific issues include strained access to menstrual hygiene products, abortion care, and contraceptive care, postpartum separation, and shackling, which can harm the pregnant person and fetus by applying “dangerous levels of pressure, and restriction of circulation and fetal movement.”

And while women are more likely to fare better in pre-trail proceedings and receive low bail amounts, the study authors said they are more likely to leave the jail system in worse condition because they are more economically disadvantaged.

The report noted that 60 percent of women housed in jails lacked full-time employment prior to their arrest compared to 40 percent of men. Nearly half of all single Black and Latina women have zero or negative net wealth, “Overlooked” authors said.

This means that costs associated with their arrest and release—such as nonrefundable fees charged by bail bond companies and electronic monitoring fees incurred by women released on pretrial supervision—coupled with cash bail, can devastate women and their families, trapping them in jail or even leading them back to correctional institutions following their release.

For example, the authors noted that 36 percent of women detained in a pretrial unit in Massachusetts in 2012 were there because they could not afford bail amounts of less than $500.

The “Overlooked” report highlighted that women in jails are more likely to be mothers, usually leading single-parent households and ultimately facing serious threats to their parental rights.

“That stress affects the entire family and community,” Swavola said.

Citing a Corrections Today study focused on Cook County, Illinois, the authors said incarcerated women with children in foster care were less likely to be reunited with their children than non-incarcerated women with children in foster care.

The sexual abuse and mental health issues faced by women in jails often contribute to further trauma, the authors noted, because women are subjected to body searches and supervision from male prison employees.

“Their experience hurts their prospects of recovering from that,” Swavola said.

And the way survivors might respond to perceived sexual threats—by fighting or attempting to escape—can lead to punishment, especially when jail leaders cannot detect or properly respond to trauma, Swavola and her peers said.

The authors recommend jurisdictions develop gender-responsive policies and other solutions that can help keep women out of jails.

In New York City, police take people arrested for certain non-felony offenses to a precinct, where they receive a desk appearance ticket, or DAT, along with instructions “to appear in court at a later date rather than remaining in custody.”

Andrea James, founder of Families for Justice As Healing and a leader within the National Council For Incarcerated and Formerly Incarcerated Women and Girls, said in an interview with Rewire that solutions must go beyond allowing women to escape police custody and return home to communities that are often fragmented, unhealthy, and dangerous.

Underserved women, James said, need access to healing, transformative environments. She cited as an example the Brookview House, which helps women overcome addiction, untreated trauma, and homelessness.

James, who has advocated against the criminalization of drug use and prostitution, as well as the injustices faced by those in poverty, said the problem of jail misuse could benefit from the insight of real experts on the issue: women and girls who have been incarcerated.

These women and youth, she said, could help researchers better understand the “experiences that brought them to the bunk.”

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