Pregnant Women in Prison Aren't Getting Care, and No One Is Keeping Track
Early in her second trimester, Linda Acoff was taken into custody for failing to complete court-ordered mental health treatment. After three weeks in the Cuyahoga County Jail in Columbus, Ohio, she began experiencing intensifying pressure, cramping, and bleeding. But despite her pleas for help, the nurse on duty offered only sanitary napkins and Tylenol. After banging on her cell door for hours, Acoff was eventually taken out of the jail's pregnancy pod on a stretcher—leaving behind the remains of her 17-week-old fetus.
A recent exposé from The Marshall Project revealed that Acoff had contracted chorioamnionitis, an infection of the fluid and tissues inside the uterus. Although considered a serious pregnancy complication that can threaten both the fetus and the mother, there was hope that Acoff's 17-week pregnancy could have been saved. "If there's early appropriate diagnosis and intervention, that baby can absolutely survive if the patient is treated promptly," Michael Baldonieri, an OB-GYN and assistant professor of reproductive biology at the Case Western Reserve University School of Medicine, told The Marshall Project.
In the end, Acoff lost her baby, and while the nurse on duty was ultimately fired, the tragedy has not inspired change in the way that Ohio handles incarcerated pregnancies or collects data on them. Unfortunately for Acoff, and the estimated 55,000 pregnant women who enter the nation's jails every year, little data exists on the impact incarceration has on pregnancy outcomes.
A 2024 report by the U.S. Government Accountability Office (GAO) found that "comprehensive data on pregnant women incarcerated in state prisons and local jails do not exist" even though the U.S. has "one of the highest maternal mortality rates" and "incarcerates women at the highest rate in the world."
This number is trending upward: between 1980 and 2022, the female prison population in the U.S. grew by more than 585 percent, more than twice the growth rate of the male prison population. Much of this increase has been attributed to more expansive policing, post-conviction barriers, and stiffer drug sentencing laws. Women have seen drug-related arrests increase by 317 percent since 1980, while men have seen a 69 percent jump. Today, more than half of the incarcerated women are serving time for drug and property offenses.
Sentencing for these offenses, which considers the nature of the crime and criminal histories, can disproportionately put pregnant women inmates in harm's way.
The Prison Policy Initiative estimates that in 2024, about 189,600 women and girls were held in state custody, and 93,000 were held in local jails across the country. Of this number, more than half of the women were held in jail while awaiting trial. Even after a conviction, women were more likely to be sentenced to jail, rather than to prison, compared to convicted men.
This distribution can be problematic, particularly for pregnant women, because jails are poorly positioned to provide proper health care and often offer fewer services than prisons. This discrepancy, plus negligent care, is ultimately what cost Acoff her pregnancy.
Given these grim statistics, tracking pregnancy outcomes in jails is essential, Dr. Carolyn Sufrin, board member of the National Commission on Correctional Health Care and fellow at the American College of Obstetricians and Gynecologists, told The Marshall Project. Otherwise, Sufrin believes, it's impossible to know whether the nation's 3,000 jails are failing pregnant women.
Sufrin is right to demand better data on how incarceration impacts pregnancies, but data alone will not stop the mass incarceration of Americans or reform policies that created the problem.
The post Pregnant Women in Prison Aren't Getting Care, and No One Is Keeping Track appeared first on Reason.com.
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Abortion opponents are coming for mifepristone using what medical experts call ‘junk science'
Packages of Mifepristone tablets are displayed at a family planning clinic on April 13, 2023, in Rockville, Maryland. (Photo illustration by) Using flawed studies and scientific journal publications, abortion opponents are building a body of research meant to question the safety of the abortion pill mifepristone, a key target for the movement. The effort comes as federal officials have expressed a willingness to revisit the drug's approval — and potentially impose new restrictions on a medication used in the vast majority of abortions. This report was originally published by The 19th. The Illuminator is a founding member of the 19th News Network. Mainstream medical researchers have criticized the studies, highlighting flaws in their methodology and — in the case of one paper published by the conservative think tank Ethics and Public Policy Center (EPPC) — lack of transparency about the data used to suggest mifepristone is unsafe. The vast body of research shows that the drugs used in medication abortion, mifepristone and misoprostol, are safe and effective in terminating a pregnancy. 'There's a proliferation of anti-abortion propaganda right now. I think it is a coordinated attack on mifepristone,' said Ushma Upadhyay, an associate professor at the University of California, San Francisco who studies medication abortion. Released in April, the EPPC paper suggests that mifepristone results in serious adverse events for 1 in 10 patients — substantially higher than the widely accepted figure of .3 percent complication rate most research has attributed to the pill. The paper appears to count what other researchers say are non-threatening events, such as requiring follow-up care to complete the abortion, or visiting an emergency room within 45 days of an abortion — even if the patient did not end up requiring emergency care — as serious adverse effects. That paper also did not go through peer review, a standard process for scientific research in which other scholars review a study's findings and methodology before it can be published. Another paper, a commentary piece published this week in the journal BioTech, challenges the commonly cited statistic that mifepristone has a lower complication rate than acetaminophen, or Tylenol, tracing the history of the comparison and arguing that it is mathematically flawed. The paper's author, Cameron Loutitt, is a biomedical engineer by training and director of life sciences at the Charlotte Lozier Institute, a research arm of the anti-abortion group SBA Pro-Life America. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'My hope is that this paper sparks action in my peers in the research and medical community to more critically evaluate these unfounded claims regarding abortion drug safety,' Loutitt said in a statement. Days later, a group of researchers from the institute published another study, this one arguing that emergency rooms are likely to identify medication abortions as miscarriages, which they say increases the risk of needing hospital care. A miscarriage and a medication abortion are medically indistinguishable, and patients will sometimes visit an emergency room to ensure the drugs worked, or if they suspect possible complications. In places where abortion is illegal, patients may also tell health care providers they experienced a miscarriage to minimize their legal risk. Studies like the Lozier Institute paper suggest complications from medication abortions are being undercounted. That study was rejected by another journal on April 12 before being published this week, noted Upadhyay, who had served as a peer reviewer in that rejection process. A similar paper written by many of the same researchers behind the Lozier Institute's was retracted a year ago by the journal that published it, along with two others suggesting mifepristone was unsafe. 'They keep trying to publish the same junk science,' Upadhyay said. James Studnicki, the Charlotte Lozier Institute's director of data analytics, who led the second of its new anti-abortion papers and the study retracted last year, did not respond to a request for comment. But a spokesperson for the institute said the organization is challenging last year's retraction through an arbitration process. This March, Studnicki said in a statement that the retraction placed 'politics over publication ethics.' These studies and papers all fall outside the scientific consensus. More than 100 studies over decades of research have found that mifepristone — and the medication abortion regimen as a whole — has a low complication rate and is very safe to use for abortions. Papers like these aren't new, and their scientific accuracy has long been questioned. But the bevy of new reports and analyses comes at a moment when abortion opponents may have more influence in shaping public policy. Mifepristone restrictions are a top priority for the anti-abortion movement. About two-thirds of all abortions in the United States are now done using medication. Even in states with abortion bans, pregnant people have increasingly turned to abortion medication, which they receive from health providers in states with laws protecting abortion. Nationwide, about 1 in 5 abortions are now performed using telehealth; almost half of those are for people in states with bans or restrictions. Mifepristone is currently approved for use through 10 weeks of pregnancy. Health and Human Services Secretary Robert F. Kennedy Jr. testified before a Senate committee that he has directed the Food and Drug Administration to review the approval of mifepristone, citing the EPPC paper specifically. Jim O'Neill, who is nominated for a deputy secretary role, has also said he is in favor of a 'safety review' of the drug — a move that could result in new restrictions on how it is prescribed. Meanwhile, physicians and researchers are highlighting the rigor of the FDA approval process. 'FDA approval of mifepristone must reflect the rigorous clinical evidence that has proven unequivocally that it is safe and effective for use in medication,' 13 reproductive medical organizations, including the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, said in a statement after Kennedy indicated the drug may undergo a new FDA review. 'Mifepristone has been used for decades for abortion and miscarriage management by millions of patients, and complications are exceedingly rare, minor, and most often easily treatable.' The International Institute for Reproductive Loss, an anti-abortion nonprofit, has explicitly prioritized the publication of research that supports restrictions on medication abortion. Presenting at an anti-abortion conference last September, that organization's science director, Priscilla Coleman, highlighted strategies that she said could help result in the retraction of studies showing mifepristone's safety, such as finding 'agenda-driven, poorly developed and conducted studies published in peer-reviewed journals' and writing to journal editors. Coleman did not respond to a request for comment. Though no scientific consensus has changed, anti-abortion lawmakers have rallied around the suggestion that complications are common. In a private Zoom meeting reported on by Politico, abortion opponents cited the EPPC paper as a potential tool to justify further restrictions on mifepristone — even while acknowledging that the report is 'not a study in the traditional sense' and 'not conclusive proof of anything.' Sen. Josh Hawley, a Republican from Missouri, cited the EPPC paper in a letter to FDA Commissioner Marty Makary, who had only a day before the report's publication indicated openness to reviewing mifepristone's approval if new evidence emerged. 'The time to act is now. It is time to revisit and restore the FDA's longstanding safety measures governing mifepristone,' Hawley wrote. His office did not reply to a request for further comment. 'They're producing this terrible 'science' because they don't have any real science that backs them up. And all they've gotten from the administration is, 'Yeah, we'll study it,'' said David Cohen, a law professor at Drexel University who has advised state legislatures on crafting abortion-protetctive laws. Through the courts and Trump administration, abortion opponents have pushed to reverse a 2021 FDA decision allowing mifepristone to be distributed via telehealth. In addition to calling for the in-person requirement to be reinstated, abortion opponents are asking for restrictions such as the dispensation of the drug to require three in-person visits, and for mifepristone to only be approved for use only in the first seven weeks of pregnancy. Many have also argued the drug should be taken off the market entirely. The Trump administration said on the campaign trail that it would leave abortion policy up to the states. So far, there has been little indication from the federal government that such changes are imminent. 'Pills are kind of just spreading, as we predicted, without almost any restriction and so far the anti-abortion movement hasn't figured out what to do,' Cohen said. SUPPORT: YOU MAKE OUR WORK POSSIBLE This story was originally reported by Shefali Luthra of The 19th. Meet Shefali and read more of her reporting on gender, politics and policy.
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Abortion opponents are coming for mifepristone using what medical experts call 'junk science'
Using flawed studies and scientific journal publications, abortion opponents are building a body of research meant to question the safety of the abortion pill mifepristone, a key target for the movement. The effort comes as federal officials have expressed a willingness to revisit the drug's approval — and potentially impose new restrictions on a medication used in the vast majority of abortions. Mainstream medical researchers have criticized the studies, highlighting flaws in their methodology and — in the case of one paper published by the conservative think tank Ethics and Public Policy Center (EPPC) — lack of transparency about the data used to suggest mifepristone is unsafe. The vast body of research shows that the drugs used in medication abortion, mifepristone and misoprostol, are safe and effective in terminating a pregnancy. 'There's a proliferation of anti-abortion propaganda right now. I think it is a coordinated attack on mifepristone,' said Ushma Upadhyay, an associate professor at the University of California, San Francisco who studies medication abortion. Released in April, the EPPC paper suggests that mifepristone results in serious adverse events for 1 in 10 patients — substantially higher than the widely accepted figure of .3 percent complication rate most research has attributed to the pill. The paper appears to count what other researchers say are non-threatening events, such as requiring follow-up care to complete the abortion, or visiting an emergency room within 45 days of an abortion — even if the patient did not end up requiring emergency care — as serious adverse effects. That paper also did not go through peer review, a standard process for scientific research in which other scholars review a study's findings and methodology before it can be published. Another paper, a commentary piece published this week in the journal BioTech, challenges the commonly cited statistic that mifepristone has a lower complication rate than acetaminophen, or Tylenol, tracing the history of the comparison and arguing that it is mathematically flawed. The paper's author, Cameron Loutitt, is a biomedical engineer by training and director of life sciences at the Charlotte Lozier Institute, a research arm of the anti-abortion group SBA Pro-Life America. 'My hope is that this paper sparks action in my peers in the research and medical community to more critically evaluate these unfounded claims regarding abortion drug safety,' Loutitt said in a statement. Days later, a group of researchers from the institute published another study, this one arguing that emergency rooms are likely to identify medication abortions as miscarriages, which they say increases the risk of needing hospital care. A miscarriage and a medication abortion are medically indistinguishable, and patients will sometimes visit an emergency room to ensure the drugs worked, or if they suspect possible complications. In places where abortion is illegal, patients may also tell health care providers they experienced a miscarriage to minimize their legal risk. Studies like the Lozier Institute paper suggest complications from medication abortions are being undercounted. That study was rejected by another journal on April 12 before being published this week, noted Upadhyay, who had served as a peer reviewer in that rejection process. A similar paper written by many of the same researchers behind the Lozier Institute's was retracted a year ago by the journal that published it, along with two others suggesting mifepristone was unsafe. 'They keep trying to publish the same junk science,' Upadhyay said. James Studnicki, the Charlotte Lozier Institute's director of data analytics, who led the second of its new anti-abortion papers and the study retracted last year, did not respond to a request for comment. But a spokesperson for the institute said the organization is challenging last year's retraction through an arbitration process. This March, Studnicki said in a statement that the retraction placed 'politics over publication ethics.' These studies and papers all fall outside the scientific consensus. More than 100 studies over decades of research have found that mifepristone — and the medication abortion regimen as a whole — has a low complication rate and is very safe to use for abortions. Papers like these aren't new, and their scientific accuracy has long been questioned. But the bevy of new reports and analyses comes at a moment when abortion opponents may have more influence in shaping public policy. Mifepristone restrictions are a top priority for the anti-abortion movement. About two-thirds of all abortions in the United States are now done using medication. Even in states with abortion bans, pregnant people have increasingly turned to abortion medication, which they receive from health providers in states with laws protecting abortion. Nationwide, about 1 in 5 abortions are now performed using telehealth; almost half of those are for people in states with bans or restrictions. Mifepristone is currently approved for use through 10 weeks of pregnancy. Health and Human Services Secretary Robert F. Kennedy Jr. testified before a Senate committee that he has directed the Food and Drug Administration to review the approval of mifepristone, citing the EPPC paper specifically. Jim O'Neill, who is nominated for a deputy secretary role, has also said he is in favor of a 'safety review' of the drug — a move that could result in new restrictions on how it is prescribed. Meanwhile, physicians and researchers are highlighting the rigor of the FDA approval process. 'FDA approval of mifepristone must reflect the rigorous clinical evidence that has proven unequivocally that it is safe and effective for use in medication,' 13 reproductive medical organizations, including the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, said in a statement after Kennedy indicated the drug may undergo a new FDA review. 'Mifepristone has been used for decades for abortion and miscarriage management by millions of patients, and complications are exceedingly rare, minor, and most often easily treatable.' The International Institute for Reproductive Loss, an anti-abortion nonprofit, has explicitly prioritized the publication of research that supports restrictions on medication abortion. Presenting at an anti-abortion conference last September, that organization's science director, Priscilla Coleman, highlighted strategies that she said could help result in the retraction of studies showing mifepristone's safety, such as finding 'agenda-driven, poorly developed and conducted studies published in peer-reviewed journals' and writing to journal editors. Coleman did not respond to a request for comment. Though no scientific consensus has changed, anti-abortion lawmakers have rallied around the suggestion that complications are common. In a private Zoom meeting reported on by Politico, abortion opponents cited the EPPC paper as a potential tool to justify further restrictions on mifepristone — even while acknowledging that the report is 'not a study in the traditional sense' and 'not conclusive proof of anything.' Sen. Josh Hawley, a Republican from Missouri, cited the EPPC paper in a letter to FDA Commissioner Marty Makary, who had only a day before the report's publication indicated openness to reviewing mifepristone's approval if new evidence emerged. 'The time to act is now. It is time to revisit and restore the FDA's longstanding safety measures governing mifepristone,' Hawley wrote. His office did not reply to a request for further comment. 'They're producing this terrible 'science' because they don't have any real science that backs them up. And all they've gotten from the administration is, 'Yeah, we'll study it,'' said David Cohen, a law professor at Drexel University who has advised state legislatures on crafting abortion-protetctive laws. Through the courts and Trump administration, abortion opponents have pushed to reverse a 2021 FDA decision allowing mifepristone to be distributed via telehealth. In addition to calling for the in-person requirement to be reinstated, abortion opponents are asking for restrictions such as the dispensation of the drug to require three in-person visits, and for mifepristone to only be approved for use only in the first seven weeks of pregnancy. Many have also argued the drug should be taken off the market entirely. The Trump administration said on the campaign trail that it would leave abortion policy up to the states. So far, there has been little indication from the federal government that such changes are imminent. 'Pills are kind of just spreading, as we predicted, without almost any restriction and so far the anti-abortion movement hasn't figured out what to do,' Cohen said. The post Abortion opponents are coming for mifepristone using what medical experts call 'junk science' appeared first on The 19th. News that represents you, in your inbox every weekday. Subscribe to our free, daily newsletter.
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9-year-old San Diego girl's death after dental procedure ruled an accident
More than two months after a 9-year-old San Diego girl died following a dental procedure, officials have released new details on her death. The San Diego County Medical Examiner's Office ruled the death of Silvanna Moreno an accident, according to an updated summary report. The girl died after she underwent anesthesia. The medical examiner listed her cause of death as "methemoglobinemia in the setting of recent nitrous oxide administration." Contributing conditions included the administration of multiple anesthetic medications. Methemoglobinemia is a very rare blood disorder that affects how red blood cells deliver oxygen, according to the Cleveland Clinic. Not everyone experiences symptoms, but nearly all people with the disorder have skin, lips or nails that are blue or purple. In some cases, it can be life-threatening. People can inherit the disorder, but it usually happens "when people use certain medications or recreational drugs or exposure to certain chemicals," according to the Cleveland Clinic. The dental procedure took place on March 18 at Dreamtime Dentistry in Vista. Dr. Ryan Watkins, the office's trained anesthesiologist, said methemoglobinemia can occur with the administration of nitrous oxide, commonly known as laughing gas. He said Silvanna never exhibited signs that something was wrong during the procedure. "If we had observed any indication of methemoglobinemia, we would have immediately discontinued the procedure and transported her to the hospital for emergency treatment," he said in a statement. The day before the procedure, Silvanna had a fever and was given children's Tylenol, People magazine reported, citing an autopsy report. The day of, she complained of a headache but did not appear to be distressed, it said. The dental procedure was three hours long, People reported. The dentist's office said Silvanna was a new patient and had been referred to them for a root canal on a molar. Doctors completed the root canal and restored the tooth with a crown. Some decayed "baby teeth" were extracted, as well as some decayed permanent teeth. One permanent tooth needed a crown, the office said, noting that three hours is normal for these procedures. Watkins said Silvanna was "a healthy 9-year-old with a history of regular medical checkups" and underwent the office's standard preoperative evaluation. He said he evaluated her as "an appropriate candidate for outpatient general anesthesia" and continuously monitored Silvanna throughout the procedure. Afterward, she was monitored in a recovery area "until she was awake with stable vital signs," he said. She was evaluated before she was released into her mother's care, he said. Silvanna's family could not be reached for comment on Friday. According to the medical examiner's summary report, Silvanna fell asleep during the car ride home and stayed sleeping upon her arrival. Family members put her in bed and checked on her throughout the day. Her family later found her unresponsive and called 911, according to the summary report. She was rushed to the hospital, where she was pronounced dead. Watkins said the office is conducting an internal review of the case and will consult with experts "to ensure we continue to provide the safest possible care for our patients." "We are profoundly saddened by the tragic loss of Silvanna Moreno, and our hearts continue to go out to her family during this incredibly difficult time," he said. Watkins was previously investigated by the Dental Board of California after a 54-year-old patient nearly died in 2016, according to NBC San Diego. State investigators said the man was put under anesthesia and was given two drugs, which led to his heart stopping. Investigators had said that one of the drugs should never have been given to the man. Watkins was put on probation from 2020 to 2023, according to a decision order. The man ended up filing a lawsuit against Watkins, which was later settled, NBC San Diego reported. This article was originally published on
