Incarceration and Women

Between 1980 and 2010, the number of women incarcerated in state and federal prisons increased from 15,118 to 112,797. While this increase mirrors a general increase in incarceration over that time, the number of incarcerated women has grown at an even higher rate than the number of incarcerated men. Black and Latina women are incarcerated at 2.5 and 1.4 times the rate of white women, respectively.

Correctional facilities have generally been developed to house men, leaving many struggling to catch up with the specific needs of women inmates. Incarcerated women are more likely than woman in the general population and more likely than incarcerated men to suffer from chronic and communicable diseases like HIV, Hepatitis C, and sexually transmitted infections. They are also more likely than incarcerated men to suffer from mental illness, and are very likely to have histories of physical and sexual abuse.

In addition to treatment for physical, mental, and substance-related illness, female inmates require reproductive health care that may include pre- and post-natal care for pregnant women and family planning services. The Federal Bureau of Prisons guarantees the provision of such services, and most states have policies regarding reproductive health care for women. However, there is no comprehensive review of how these policies are implemented across the states and whether the care and services provided meet standards set by National Commission on Correctional Health Care, the American Congress of Obstetricians and Gynecologists, or the American Public Health Association. Additionally, 32 states have not banned the practice of shackling women in state prisons while they give birth and states who have banned the practice struggle with enforcement.

Incarcerated women are at high risk for unintended pregnancies upon release, and for having high-risk pregnancies due to lack of prenatal care and high rates of substance dependence.


Clarke, J. G., Rosengard, C., Rose, J. S., Hebert, M. R., Peipert, J., & Stein, M. D. (2006). Improving Birth Control Service Utilization By Offering Services Prerelease Vs Postincarceration. American Journal of Public Health, 96(5), 840–845. doi:10.2105/AJPH.2005.062869.

Feinauer, E., Lee, A., Park, J., & Walker, T. (2013). The shacking of incarcerated pregnant women: a human rights violation committed regularly in the United States. International Human Rights Clinic, University of Chicago School of Law.

Maruschak, L. (2008). Medical problems of prisoners. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

State Standards for Pregnancy-Related Health Care in Prison. American Civil Liberties Union. Accessed: August 2015.

Incarcerated Women. (2012). The Sentencing Project.

The items included below are a list of recent, more in-depth articles that take the reader deeper into the subject area. The list is neither comprehensive nor exhaustive, but is intended to help a reader dive deeper into the subject matter at hand. We will be updating articles on a monthly basis.

Establishing Construct and Predictive Validity of the Prison Inmate Inventory for Use With Female Inmates
Degiorgio L. Int J Offender Ther Comp Criminol. 2015 Feb.
“This study establishes the validity of the Prison Inmate Inventory for use among female inmates (N = 628). Contrast groups were used to establish construct validity; negative binomial regression analysis was used to confirm predictive validity. Female inmates who were arrested at a younger age demonstrated more severe problems with violence, antisocial traits, distress, adjustment to prison life, and judgment. Results from the negative binomial analysis revealed that inmate risk (low and severe) predicted expected counts of probation revocations, parole revocation, and escape attempts. Expected counts were not related to race/ethnicity in this sample.”

Comorbid antisocial and substance misuse proclivity and mental health service utilization by female inmates: Testing the worst of both worlds hypothesis with the PAI
Walters GD, Magaletta PR. Psychol Serv. 2015 Feb.
“The primary purpose of this study was to establish whether female inmates with comorbid proclivity for antisocial behavior and substance misuse, as measured by the Personality Assessment Inventory (PAI; Morey, 2007), use more mental health-related services than female inmates with either antisocial or substance misuse proclivity alone. A second purpose was to determine whether the effect of comorbid antisocial and substance misuse proclivity on mental health service utilization is cumulative or interactive. In a survey of 421 female federal prison inmates, it was noted that proclivity for both antisocial behavior and substance misuse was associated with significantly greater subsequent use of mental health services in female inmates than either proclivity alone, even after preexisting mental health diagnoses and treatment were controlled. In addition, the effect was additive rather than interactive. These findings provide further support for the “worst of both worlds” hypothesis, which holds that comorbid antisocial and substance involvement/proclivity portend poorer future outcomes than either antisocial or substance involvement/proclivity alone. The implications of these results for development of a comprehensive training model that provides mental health professionals with the skills to properly screen and effectively treat female inmates are discussed, along with the need to clarify the theory behind the “worst of both worlds” hypothesis.”

Disciplinary Responses to Misconduct Among Female Prison Inmates With Mental Illness, Substance Use Disorders, and Co-Occuring Disorders
Houser K, Belenko S. Psychiatr Rehabil J. 2015 Feb 9.
“Objective: Most female inmates have mental health, substance use, or co-occurring disorders (CODs), which can create greater difficulty adjusting to incarceration and higher rates of prison misconduct. The response of prison officials to institutional misbehaviors has important implications for female inmates’ experiences while incarcerated, their likelihood of parole, and the clinical course of their condition. This article examined whether disciplinary actions are more severe for women with CODs.
Method: Data were provided by the Pennsylvania Department of Corrections for all female state prison inmates incarcerated between January 1, 2007, and July 30, 2009 (N = 2,279). The final sample of 211 women included those who had committed a minor misconduct during their incarceration. Disorder categories were created based on intake assessments, and multivariate models were estimated to determine the effect of disorder category on whether the prison imposed a severe or minor disciplinary response to the misconduct.
Results: The odds of receiving severe disciplinary responses to minor misconduct was significantly greater for women with CODs than those with the singular disorders of mental illness or substance abuse disorders, or those with no disorders.
Conclusions and Implications for Practice: Findings suggest correctional institutions are responding in a punitive manner to the symptomatic manifestations of CODs in female inmates. These findings suggest the importance of screening instruments in correctional settings that assess for the presence of dual disorders. In addition, correctional administrators must implement training protocols for correctional officers and staff on the complexity of CODs and the ability to identify behavioral and emotional symptoms associated with this vulnerable subset of the offender population.”