While four inmates were conceiving inside the California Youth Authority's Camarillo facility in the past year, 10 more prisoners were arriving pregnant at CYA gates--and entrusting themselves to a medical system that operates under a cloud of controversy.
Authorities inside the Youth Authority acknowledge that pregnant prisoners are a difficult clientele, but they defend the institution and say many of those mothers get better care than they would on their own.
The Camarillo facility's clinic is staffed by Medical Director Dr. Hung Do and, on most shifts, three nurses. An obstetrician-gynecologist visits monthly, as do a dermatologist and an eye doctor. Critics have concentrated on the facility's handling of medical records and its prenatal attention to expectant mothers.
Expectant mothers are usually taken to Ventura County Medical Center for births, but some move to halfway houses that contract with the state.
One such prisoner, 29 weeks pregnant, was transferred last month to Allied Fellowship in Oakland. Pat Marrone, the organization's executive director, cited that case as exemplary of the flaws in the CYA medical program.
"We have no medical records on her," Marrone said. "And yesterday we took her to the doctor and we discovered that she's already dilated two centimeters. We're concerned, because we don't know anything about her medical history. . . . That makes things very difficult for us, especially when a girl comes to us late in her pregnancy."
Marrone noted that missing information about allergies, prescription medication or past drug abuse can make crucial differences in how doctors treat a pregnant patient.
"One girl who came to us from the Youth Authority was 5 1/2 months pregnant," Marrone said. "She learned shortly after her arrival that her baby had less than a 1% chance of surviving. The doctors clearly told her that had she received adequate medical care during her first trimester, something could have been done to help her baby."
CYA officials contend that female prisoners often arrive with scant medical histories. Nurses keep a ledger book that records new female prisoners' test results: pap, pregnancy, urinalysis, iron deficiency, syphilis, tuberculosis, eyes, ears, pelvis.
About one-third of the prisoners, nurses noted, take prescription psychotropic drugs to regulate their behavior.
But until now, the Youth Authority has not passed along medical records to other institutions because of confidentiality concerns, nurses said. That policy, they added, is changing now.
When the question of prenatal attention is raised, critics allege that mothers have been allowed to deliver children in the Youth Authority facility, instead of being taken to a fully equipped hospital, as policy dictates.
Jamata Gray, a 19-year-old mother now in an Oakland halfway house, is one such case. She entered the Ventura School near Camarillo at age 16, pregnant, in 1988.
"I had my son in Ventura . . . in my room," she said in a recent interview. "When I went into labor, I went to the clinic, and they told me I wasn't in labor. So I went back to my unit and, 10 minutes later, I had my baby."
Youth Authority officials answer that youth offenders are almost by definition a high-risk population. Through the Youth Authority's attentions, asserted Ventura School obstetrician-gynecologist Dr. Terry Cole, "these women, I find, have become low-risk. The nurses are very attentive."
As for deliveries in custody, he said, "that's happened about twice that I can think of" in nine years. "Sometimes, women just go incredibly fast, whether it's in an institution or my wife on the way to the hospital . . . If anything, the nurses call too early and too often. The last thing they want is to be embarrassed."
Of the 10 pregnant prisoners to arrive at the Camarillo facility in the past year, five have delivered, four are still pregnant and one chose to have an abortion, medical director Do said.