Anna Chen
- Apr 23
- 3 min read

Menstruation in Prisons: A Cruel Form of Punishment

Ironically known as the “Land of the Free,” the United States houses about twenty percent of the world’s incarcerated individuals, despite representing a mere 4.2% of the world’s population (1). Of those incarcerated, about 170,000 are housed in women’s jails (2). A majority of those housed in these jails are below the age of 55, meaning that every month, every time they menstruate, they are subjected to additional dehumanization, humiliation, and punishment.

Simple supplies, such as pads and tampons, are sparingly provided. While the allotted amount differs between jails, some have reported as little as “one pack of pads and five regular-sized tampons monthly” (3). For heavy bleeders, this supply simply isn’t enough, and to access more supplies, one must pay. In contrast to the average price of about eight dollars for a box of tampons at drugstores, some prisons charge a hefty fee of fifteen dollars. Without a steady source of income, this price can’t easily be paid. So what choice are they left with? They must stuff their underwear with toilet paper (which is also rationed) and hope they don’t bleed through.

However, this lack of access to supplies often isn’t an issue of stock but rather one of power. Testimonials have come out of various prisons, including Rose M. Singer Center, stating that the distribution of these supplies is left to individual officers. While some “report no issues”, others “have to beg for it” (4). In other words, these supplies were only given to those who had a good relationship with the officers. One prisoner even recalled witnessing an event where a correction officer threw a box of tampons into the air, watching inmates scramble to grab them.

This problem of supplies isn’t the only way menstruation is used as a form of punishment in prisons. TIME magazine collected testimonials from incarcerated individuals and compiled below:

“A guard can supply a woman with her allotment of pads, but deny her the underwear she needs in order to wear the pad in the first place.

Someone on their period may be given supplies, but denied trash cans to dispose of soiled items.

During strip-searches, women are corralled into one area where a guard will order anyone menstruating to remove their tampons. One woman described routinely stepping onto other women’s menstrual blood on the floor.

A menstrual blood stain on a prison uniform becomes a reason to be singled out, called “lazy” and shamed by guards.

There is no privacy behind bars. Even changing your pads or tampons is an occasion for guards to watch.”

In an attempt to reconcile this horrific treatment, lawmakers have introduced various bills surrounding the issue of menstrual care for the incarcerated. One such successful measure was the First Step Act, which codified that prisons must provide period products free of charge.

However, these changes are often made on the federal level and thus only affect federal-level prisons. This leaves about 90% of women incarcerated, those in state-level prisons, without the benefits of these legislations (5). Currently, over 35 states lack menstrual care protections (3).

The treatment of menstruation in jails is, simply put, a horrific and cruel abuse of power. No matter your beliefs on incarceration, no one should be subjected to this level of dehumanization and humiliation. Menstruation is intrinsically related to human dignity. When people can’t access safe and effective care, we are violating their human rights. We are making these women hate their bodies. Thus, it’s vital that there is more awareness surrounding the issue of menstruation care. Only with an outroar of voices will lawkmakes be propelled to make the necessary changes to improve the situation of the incarcerated and to treat them as humans.

Edited by: Sam Shi

Graphic Designed by: Harris Upchurch

References

Olivia Kim
- Apr 23
- 3 min read

Treatment for miscarriages under Dobbs v. Jackson

After having no issues with her pregnancy before her third trimester, Marny Smith and her husband were excited to meet their son Heath in a matter of weeks.1 One evening, before falling asleep, her son wasn’t kicking like usual at that time of day. When the next morning came around, and there was still no movement, Smith knew her baby was gone. She and her husband called her physician, and they were told to go to the hospital immediately.

Smith had to endure the pain and wounds of childbirth, along with the pain of having a stillborn child. In the U.S., there are 21,000 stillbirths2 every year, and approximately 15-20%3 of all pregnancies will result in a miscarriage or stillbirth. If a pregnancy is determined to be a miscarriage,4 the treatment is the exact same as one for an abortion.

After the ruling of Dobbs v. Jackson Women’s Health Organization, physicians in many states are left wondering how to treat miscarriages. An abortion pill can be used earlier on in a pregnancy, but when the pregnancy has gone into its third trimester, dilation and curettage surgery is often necessary.4

Pharmacists have admitted reluctance to fill prescriptions for abortion medications in the case of miscarriages out of fear of being prosecuted,5 and that’s still only if the physician has even prescribed it. Not only are pharmacists and physicians at risk of prosecution for treatment for miscarriages; so are the mothers.

Even before Roe v. Wade was overturned, women who had miscarriages were prosecuted for engaging in risky behavior during pregnancy. One woman in California sat in jail for 15 months while facing murder charges because she took hard drugs during her pregnancy, following years of addiction. Legal analysts warn that women will be prosecuted even in cases of miscarriages and stillbirths.6 And in cases where treatment is received, clinicians are at legal risk, too.

Not only does the legality of treatment for miscarriages and stillbirths leave women and providers in a gray area, but postpartum mental health services for women have also not improved. Medicaid covers 4 in 10 births, but only eight states have explicit programs to provide maternal mental healthcare.7 Maternal mental health is often overlooked, but it is especially important for women who have suffered through a miscarriage or stillbirth to have access to assistance following the loss of a pregnancy.

Most women and physicians report believing that mental health services after losing a pregnancy are important, but most women don’t have access to them. Inability to receive counseling after such a traumatic event often results in women being too afraid to become pregnant again.8 Nearly 20% of women who had a miscarriage became symptomatic of anxiety and depression, and for most of these women, these symptoms lasted for years.8

Women should not lose clinical support when they become pregnant. Because more women are likely to face more arduous miscarriages than before in states with restrictive abortion treatment access, finding ways to assist these women better is essential. Women should not be blamed for miscarriages and prosecuted for it, and physicians should be able to perform routine clinical care for those instances.

Edited by: Elissa Gorman

Graphic Designed by: Alejandra Gonzalez-Acosta

References

Smith, M. (2022, January). After a death, bringing stillbirth prevention to the US. Health Affairs. Retrieved April 12, 2023, from https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.00745
Centers for Disease Control and Prevention. (2022, September 29). What is stillbirth? Centers for Disease Control and Prevention. Retrieved April 12, 2023, from https://www.cdc.gov/ncbddd/stillbirth/facts.html#:~:text=Stillbirth%20affects%20about%201%20in,stillborn%20in%20the%20United%20States.
Pregnancy loss - New York. Pregnancy Justice. (2022, December 22). Retrieved April 12, 2023, from https://www.pregnancyjusticeus.org/issues/pregnancy-loss/#:~:text=No%20matter%20what%20a%20pregnant,in%20a%20miscarriage%20or%20stillbirth.
Pradhan, R., & Knight, V. (2022, June 28). Five things to know now that the Supreme Court has overturned Roe v. Wade. KFF Health News. Retrieved April 12, 2023, from https://kffhealthnews.org/news/article/five-things-to-know-now-that-the-supreme-court-has-overturned-roe-v-wade/
Reingold, R. B., Gostin, L. O., & Bratcher Goodwin, M. (2022, November). Legal Risks and Ethical Dilemmas for Clinicians in the Aftermath of Dobbs. Jama Network. Retrieved April 12, 2023, from https://jamanetwork.com/journals/jama/fullarticle/2797863
Baldwin III, R. (2022, July 3). Losing a pregnancy could land you in jail in post-Roe America. NPR. Retrieved April 12, 2023, from https://www.npr.org/2022/07/03/1109015302/abortion-prosecuting-pregnancy-loss
Usha Ranji, I. G. (2022, May 19). Medicaid coverage of pregnancy-related services: Findings from a 2021 State Survey - Report. KFF. Retrieved April 12, 2023, from https://www.kff.org/report-section/medicaid-coverage-of-pregnancy-related-services-findings-from-a-2021-state-survey-report/
Nynas, J., Narang, P., Kolikonda, M. K., & Lippmann, S. (2015, January 29). Depression and anxiety following early pregnancy loss: Recommendations for Primary Care Providers. The primary care companion for CNS disorders. Retrieved April 12, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468887/

Abby Cortez
- Apr 10
- 4 min read

Mitochondria and Maternal Health

If you ask anyone what they know about biology, at least one of the things they say is probably going to be: “the mitochondria is the powerhouse of the cell.” But what does that actually mean? And what happens if the powerhouse shuts down?

The mitochondria is a type of organelle, a word which refers to things contained within human cells, and it produces the energy (in the form of ATP, Adenosine Triphosphate) needed for the body to function. The mitochondria is special because it has its own DNA separate from the DNA in the nucleus of the cell that makes up most of our genetics. This DNA is crucial for the function of the mitochondria and this the function of the body.

If mutations occur within the DNA of the mitochondria they can cause mitochondrial diseases that have drastic impacts on health causing things like blindness, cardiovascular issues, or neurological issues like seizures. These diseases are not only inheritable, but almost unavoidable because mitochondrial DNA is only passed down on the maternal side. Paternal mitochondrial DNA (mtDNA) is degraded in embryos leaving only the mother’s mtDNA for the child, thus if she has a mutation, her children will likely have it too.

Mitochondrial issues can not only impact fetal vitality but also maternal health throughout her pregnancy. Mitochondria regulate the metabolism and energy in the human body, a process complicated by supporting a fetus. Thus, it’s important for the organelle to work properly. Women with mitochondrial disorders tend to have increased risk of, among other things, gestational diabetes, hypertension, difficulty breathing, tachycardia, muscle weakness, anemia, and preterm delivery.

Concerning maternal health, there is not yet a way to eliminate these genetic diseases, instead support mechanisms are used to aid mother’s feeling the effects. Things such as vitamin supplements or nutrition help. In terms of the fetus, the options are more controversial.

There is the option for use of a donor egg, which would be free from inheritable mitochondrial disease, but this does not allow the mother to be genetically related to her child. In recent years, research has been done about mitochondrial replacement techniques (MRTs), which in essence remove the mitochondria from a mother’s egg, replace it with donor mtDNA, and allow the mother to be the main source of maternal genes for her baby. But of course, it isn’t that simple.

There are two main types of MRTs: Maternal Spindle Transfer (MST) and Pro-Nuclear Transfer (PNT). MST involves removing the nucleus of the donor egg and replacing it with the nucleus of the maternal egg, before fertilizing it with the sperm of the father. PNT instead has the father’s sperm fertilize both the donor and maternal egg, before switching the nucleus of one to the other. The use of MRTs in general is highly debated, as well as whether one technique is more or less permissible than another.

Supporters of the techniques argue that it is a great way to help the mother feel like her child is her own, because it still has genes that are shared by her. There are arguments suggesting that the use of an MRT has an element of selectiveness similar to the idea of genetically engineering a child, because parents are choosing an mtDNA donor. However, counter arguments suggest that particularly with the use of PNT, because the fertilization event has already occurred, the same child will be born regardless of if the mtDNA replacement occurs or not, thus the method is ethically permissible.

It is of course also important to consider that the use of an MRT could be considered destruction of an embryo, which also has complicated ethics. Some argue that the creation of a donor embryo simply to be destroyed makes the process unethical.

Then the child must be considered. This is a new technique and children born with the use of an MRT may be subject to routine doctor check ins throughout their lives they were unable to consent to. Further still, because mtDNA is passed on to children, MRTs could be considered altering the germline, or heritable, genes of the child, which can be dangerous if the effects of the change are not understood.

As this debate continues, so does research. The UK was one of the first countries to allow both MST and PNT for women whose cases have been approved with licensed clinicians, but there remain a vast majority of countries, the United States among them, that restrict the use of these techniques. Discussion should continue about the ethical considerations of MRTs so that we can work towards finding a way to aid mothers who suffer from mitochondrial diseases.

It’s crucial that options for treatment continue to be researched so a technique, whether it be MRTs or not, can become an option for mothers who need it. The option to have a child free of mutated mtDNA who was still genetically their own is a very important thing for a mother.

As genetic technology improves and new methods come about, it will be important to continue to evaluate and ensure that the research remains ethical and high quality. It may also be important to be aware of the socioeconomic disparity the popularization of these techniques may pose should they be expensive. In short, there remain many unanswered questions about these MRTs and about potential solutions to mitochondrial disease inheritance as well, but they can never be answered if we don't ask.

Edited by: Anne Sacks

Graphic Designed by: Shanzeh Sheikh

References

DMEJ

Duke Medical Ethics Journal