State Defends Care for Pregnant Inmates : Suits by Women Prompt Hearing on Complaints

Despite allegations of incompetent medical care, pregnant state prisoners receive care that meets “nationally recognized standards that everybody follows,” the chief medical officer for the state prison system told a legislative committee Monday.

But Dr. Nadim Khoury and other Corrections Department officials, citing pending lawsuits, declined to respond to several prisoners’ allegations of insufficient care during and following their pregnancies at the California Institution for Women.

Both prisoners and prison officials testified before the California Legislature’s Joint Committee on Prison Construction and Operations, chaired by Sen. Robert B. Presley (D-Riverside) at the California Rehabilitation Center, the medium-security state prison in Norco. The hearings continue there today.

Hearing’s Dual Purpose

“I hope to accomplish two things” with the Norco hearings, Presley said in an interview. “One is to find out if there is any validity to the allegations . . . and if we do find out there is any validity, we move to make corrections.”

The allegations came to light in October, when a class-action lawsuit was filed in U. S. District Court on behalf of pregnant prisoners at the state’s only all-women’s prison, the California Institution for Women in southwest San Bernardino County.

The plaintiffs named in the suit, some of whom also testified before Presley’s committee, charged that mistreatment and neglect of symptoms they experienced while in prison led them and other women to suffer miscarriages, stillbirths, infant deaths and defects, and unnecessary hysterectomies.

Better prenatal care, several witnesses testified, is not only more humane but also more economical than allowing already high-risk pregnancies to become more complicated. One of those testifying was Anita Arriola, a staff attorney with Public Advocates Inc., a national public-interest law firm based in San Francisco.

Infants Are Innocent

“It is clearly more cost-effective to provide dollars and resources and staff to give adequate prenatal care to these pregnant women prisoners than to deal with and treat the complications of pregnancy after they occur,” Arriola said.

“Regardless of what these women are incarcerated for, regardless of what crimes they have committed, their infants have committed no crimes,” she said. “And there is simply no justification to sentence these pregnant prisoners’ infants to a death sentence by incarcerating them at facilities that do not provide adequate medical care.”

Dr. Wilbert Gonzales-Angulo, chief of obstetrics and gynecology at Riverside General Hospital, said the state’s two women’s prisons “have made adequate steps in correcting problems” in delivering care and have developed a cooperative relationship with his hospital.

Riverside General provides medical services--including gynecologic and obstetric care--that the infirmaries at the California Institution for Women and the California Rehabilitation Center cannot.

The doctor rebutted the inmates’ charge that prison officials often fail to take them to scheduled appointments at Riverside General. And answering a question from Presley about overall prenatal care at the institution, he said: “In general, I would say it has been adequate, yes.”

But although he has provided prison officials with criteria for identifying high-risk pregnancies and requested that they receive care “as soon as is feasible,” Gonzales-Angulo said, the Corrections Department never even showed him the new procedures it instituted for prenatal and postpartum care.

Presley suggested--and Khoury agreed--that those procedures should be reviewed by the state Department of Health Services. “It isn’t required,” the senator said, “but it just makes good sense.”

Corrections officials recently have taken several other steps toward improving medical care in the state prisons, Khoury said.

Pregnancy Wing Planned

The California Institution for Women has dedicated a wing of its infirmary building to housing pregnant inmates and has, after looking for several months, established a contract with an outside obstetrician-gynecologist to visit the institution weekly.

The California Rehabilitation Center already has a visiting obstetrician-gynecologist, officials said.

Currently, there are 39 pregnant women in the two prisons, said Lt. George Morgan, public information officer for the California Rehabilitation Center.

One registered nurse employed there stood before the committee to say she was embarrassed by an inmate’s statement that some prison nurses do not know how to perform such basic diagnostic procedures as monitoring fetal heartbeats or measuring cervical dilation.

“As a nurse here, I am going to speak out,” Faye Culpepper-Caesar said. “I don’t want to see any more deaths. . . . The bottom line is, we have got to do something now.”

“I think they’re well on the way, already,” Presley said.

Suit Filed Jointly

The lawsuit that led to the two-day hearing was filed jointly by the American Civil Liberties Union Foundation of Southern California, a San Francisco-based group called Legal Services for Prisoners With Children and a private San Francisco law firm.

One of the named plaintiffs, Linda Billington, said Monday that she gave birth by Caesarean section three months ago and has not been taken back to Riverside General or examined by any medical personnel since.

Follow-up visits are normally scheduled two weeks and six weeks after a Caesarean section delivery, Gonzales-Angulo said.

Earlier in the hearing, Daniel J. McCarthy, director of the Department of Corrections, said his employees “won’t respond to any specific case” described by inmates either in their lawsuits or at Monday’s hearing.

“Some of these people are current litigants, (and) some are probably future litigants against the department, so therefore our responses will be limited to current practices, policies and operations as we do things now without direct referral to any specific case,” McCarthy said.