Commentary: What the prenatal care bill means for incarcerated pregnant Tennesseans.

Imagine being pregnant — you’re thinking about your child’s health and nutrition and your own health and safety.

Now imagine being pregnant in jail or prison in Tennessee, where policies around prenatal care and nutrition are as varied as the county jails and prisons across the state. “Being pregnant and incarcerated was the hardest thing I ever had to do,” Patti Hall wrote in a 2011 letter to Free Hearts. Patti, who suffered serious complications with her pregnancy and was denied adequate prenatal care while in prison, remains currently incarcerated in Tennessee.

Now, in the midst of a global pandemic that’s spreading through the country’s prison system and infecting incarcerated people at a rate of five times higher than the general public, incarcerated pregnant people face an especially dire reality.

I’m working to change that. This year, Healthy and Free Tennessee — a statewide reproductive freedom coalition — and Nashville-based Free Hearts, founded by and for incarcerated and formerly incarcerated mothers, women, girls, and femmes have been working tirelessly to improve the rights and conditions of pregnant incarcerated people. In our state, this looks like protections against the shackling of pregnant people and access to breastfeeding and breast pumps, as well as prenatal care.

Thanks to a new law, signed by Governor Lee late last month, we’re one step closer. The prenatal care law provides minimum standards of care for prenatal care, consistent with the American College of Obstetricians and Gynecologists and the National Commission on Correctional Health Care standards, including HIV screening, exams, laboratory testing, mental health and substance use care among other things. It also includes requirements that incarcerated pregnant people receive nutritionally appropriate meals and supplemental provisions.

It also requires that jails and prisons notify pregnant incarcerated people of their right to receive this care and meals as well as allow pregnant people to return to their communities for up to six months to give birth and bond with their child. With pregnant women facing greater risk for hospitalization, ICU admission, and ventilation from COVID-19, this furlough provides temporary relief for pregnant incarcerated people, especially as COVID-19 cases spike in Tennessee jails and prisons. In a state that just passed the most restrictive anti-abortion law in the country that was blocked by federal a judge minutes after being signed, this is a huge step in protecting the health of incarcerated pregnant people at a critical time.

As national conversations about police and prison abolition continue, there is more work to be done to address the systemic issues facing prisons or contribute to the project of abolition in Tennessee. This new prenatal care law provides an important opportunity to challenge who is centered in reproductive freedom work. By uplifting the voices and experiences of those most marginalized, incarcerated pregnant people – who are disproportionately Black and brown – state policies like these embody our values.

Our partnership with Free Hearts provided invaluable opportunities to practice deep listening, translating personal stories and hopes into legislation. For example, Free Hearts members reported that in addition to nutritionally appropriate meals, they needed more than the pregnancy “snacks,” sometimes just an orange or an extra container of milk, provided during a long wait between meals. We added language to the bill to mandate supplemental provisions to ensure access to substantive food while pregnant. Especially when the data on the problem is sparse and obscured, these stories provided the foundation for the solutions and statewide changes to ensure a more just world for pregnant Tennesseans.

We know stigma about incarceration is deeply rooted in our society and not only do we need to ensure Tennesseans are aware of the prenatal care bill, we also need to counter that stigma. While working on this bill, I heard from too many people about whether incarcerated people really “deserve” this health care – as if it were not a moral and legal imperative. We can all work to chip away at a system that deems some people, and their reproductive health, disposable by challenging these beliefs and amplifying the voices of incarcerated and formerly incarcerated people. When reproductive freedom advocates center the leadership and wisdom of those most affected, we can and do win.