Pregnant inmates have local jails scrambling to provide care

Dwyer said that baby, born in April 2016, was one of three delivered inside the jail in recent years because the mothers couldn’t be transported to the hospital in time. He said the jail routinely has six to 12 pregnant women among the approximately 178 female prisoners.

No statewide statistics are available, but county jail officials across the 11-county Dayton region reported an increase in pregnant prisoners that they say is tied to the overall increase in women inmates due to the opioid crisis. The rising number of women in jails places a greater burden on counties struggling to find space for them and to provide the specialized care a pregnant woman needs, particularly if the woman is addicted to drugs.

“There’s a noticeable increase in the amount of pregnant females who are battling a drug addiction or actively using drugs,” said Scott Springhetti, executive director of the Tri-County Regional Jail serving Champaign, Union and Madison counties.

Montgomery County Sheriff Phil Plummer said county jails assume the cost of taking care of both mother and unborn child, including specialized medical care, guarding the mother on trips to the doctor and, in some cases, paying for the child’s birth in a hospital.

“As the heroin epidemic has washed through Montgomery County we are seeing more and more female criminal defendants,” said Montgomery County Common Pleas Judge Mary Wiseman. “We are looking at people who are, quite frankly, your neighbors, your cousins, your nieces and your nephews who have gotten tangled up in the criminal justice system because they are addicted to heroin.”

New criminal cases rose 8 percent in Montgomery County between 2012 and 2016, but those involving female defendants grew by 32 percent, said Montgomery County Common Pleas Court Clerk Greg Brush. The number of women in the Montgomery County Jail rose 22 percent during that period.

“With the opioid epidemic we’ve had a skyrocketing amount of female inmates, not only on drug charges but all the other stuff that goes along with it, like shoplifting and things like that,” said Maj. Matt Haines of the Montgomery County Sheriff’s office.

When possible, pregnant moms are rushed from the jail to the hospital when they are about to deliver. But two babies in the past five years were born inside the jail because there was no time to get to the hospital. One came even before medics arrived, so the jail’s corrections and health care staff assisted the mother.

The jail currently has seven pregnant inmates among the 156 females serving time or awaiting trial in the jail, Haines said.

‘Second nature’

Women make up about 20 percent of the Montgomery County Jail population. The daily average in 2016 was 170 females out of of 831 inmates, according to statistics provided by Haines. He said the number would be even higher if women were not diverted to various treatment programs and the Montgomery County Women’s Therapeutic Court, a specialized docket for drug offenders run by Wiseman.

Greene County Sheriff Gene Fischer said 40 percent of the people admitted to his jail are women. As of Wednesday he had three pregnant inmates among 78 women. He had just shipped a fourth pregnant inmate off to state prison.

The Warren County Jail has had 17 pregnant inmates this year, said Sheriff Larry Sims. In Clark County, three of 47 women are pregnant. Preble County’s jail can house only 10 women prisoners, but Sheriff Mike Simpson said he once had two pregnant inmates at the same time.

“When I worked in the jail years ago as a deputy it was very rare to have a pregnant female in your custody. Now it’s become second nature,” said Lt. Michael Young of the Clark County Sheriff’s office. “Some of them are almost full term and they’re still using the drugs every chance they get.”

Miami County Sheriff Dave Duchak said four inmates had babies last year, although none of the deliveries occurred in the jail. He recalls at least two occasions when babies born to inmates were also addicted.

The Darke County Jail is over-capacity with 46 prisoners, said Capt. Ted Bruner, and two of the 11 women housed there are pregnant.

“It seems the heroin/meth epidemic is just as high here in Darke County as it is anywhere else,” Bruner said. “We do have female inmates in different stages of pregnancy. The best we can do with them is make sure they get proper vitamins, all their meals and to their doctor appointments.”

Women also make up an increasing percentage of the state prison population.

>>Mom feels blessed to have child with her in prison

As of April, Ohio had 4,166 female prisoners, just more than 8 percent of the total 50,150 prisoners in the system. The number of female inmates has increased by 229 — or nearly 6 percent — since 2010, according to data from the Ohio Department of Rehabilitation and Correction (ODRC).

The number of pregnant women admitted to prison has fluctuated. Last year, the prison system had 116 pregnant women, down from 147 in 2015, according to JoEllen Smith, ODRC spokeswoman.

Changing equation

Jail and court officials across the region say they have never faced a crisis as crippling as opioid addiction, even when compared to the 1990s crack-cocaine influx.

“I think it starts out as a coping mechanism and then it becomes this all-consuming thing that is unlike any substance of abuse the I’ve ever seen in my 30 years of social work,” said Jewell Good, who oversees Children Services as Montgomery County Job and Family Services assistant director.

Ohio leads the nation in heroin and synthetic drug overdoses, according to a new report by the Public Children Services Association of Ohio. In 2015, half of the children taken into custody by children services departments “had parental drug use as a removal factor,” and in more than half of those cases the drug was an opioid, the report said.

For those who deal with addicts everyday, the stress is frustratingly constant.

“Some of my staff say, “Just give me a dirty home….We can go clean that up. It’s easy to address,’” said Good. “There is nothing easy about dealing with addiction.”

Wiseman said the issue has gained urgency in part because so many people are dying as the synthetic opioid, fentynal, floods the market. Last year, 359 people in the county died of unintentional overdoses and the county is on pace to lose 800 people to overdoses this year, Plummer said.

“From the court’s perspective it’s a tsunami,” Wiseman said. “And there’s no end in sight.”

One way local jails used to deal with overcrowding was to ask judges to release non-violent prisoners on their own recognizance. It was also fairly routine to release women near the end of their pregnancies, which meant the county would not automatically have to foot the bill for the birth.

But allowing pregnant women to bond out puts the unborn child at risk if the mother continues using drugs, making early release of pregnant women less common.

“We’re seeing an uptick of judges wanting them to stay in because of their opiate crisis,” Dwyer said. “They don’t want them out because they know they will go back to shooting dope.”

People can be charged with a crime for abusing drugs in Ohio, but there “are no additional charges for a pregnant person who uses drugs,” said Greg Flannagan, spokesman for the Montgomery County prosecutor’s office. However, judges can set rules for people who are out of jail on bond or participating in treatment programs after they’ve been convicted.

Wiseman said judges began making successful participation in a treatment program part of bond terms about three years ago.

“We recognize that allowing people to just bond out was creating great risk to them,” she said. “So we’re not just standing by watching the avalanche and the disasters occur for when that person shows up back in front of us somewhere in the future.”

Earlier this year, Wiseman rejected a pregnant woman’s request for release from the Montgomery County Jail. The woman had already been convicted of a crime and was in jail after continuing to use drugs while participating in Women’s Therapeutic Court. The woman wanted to get out to have her baby.

“When she was not in jail her addiction was such that she continued to use illegal drugs while pregnant,” Wiseman said. “And so the decision had been made that for her health, as well as the safety of the unborn child, she needed to be incarcerated until she was ready to give birth.”

WATCH: Judge Wiseman discusses how her court helps addicted women

The child was born healthy in March and the woman is now out of jail and participating successfully in Wiseman’s program.

“It’s nice when they have a happy ending,” Wiseman said.

A pregnant inmate in the Greene County Jail several years ago asked to be released so she could have an abortion, Fischer said. Then-Xenia Municipal Court Judge Susan Goldie “absolutely refused,” he said, and “the judge gave us an order that we were to keep her in jail until that baby was born.”

The woman was released after the birth, according to Fischer, but the child was placed with Children Services.

‘This is an emergency’

Drug-addicted inmates who are pregnant require more care — and drive up more costs — because their fetuses are addicted and medically vulnerable, such as when the mother withdraws from drugs during her incarceration.

“We routinely have inmates who are pregnant that start detoxing from heroin and other opiates while they are in our care,” Haines said. “It’s very, very high risk.”

RELATED: Counties struggle to keep drugs out of their jails

Area jails have different policies on whether every prisoner going through withdrawal receives small doses of opioids used in medically assisted withdrawal. But jail officials said pregnant women are not required to detox cold turkey and are always under a doctor’s supervision.

“Because of the high risk to the fetus, every pregnant opiate-addicted inmate is sent to a hospital early in their incarceration, and most are administered prescriptions for the withdrawal as an inpatient at the hospital,” Haines said. “Methadone is currently the medicine of choice.”

While many adults going through opioid withdrawal feel like they are going to die, a fetus can die during detox, making medically-assisted withdrawal essential, said Dr. Marc Belcastro, chief medical officer at Miami Valley Hospital.

Once born, addicted babies suffer mightily.

“For a baby, it involves sweating, constant crying, excessive sucking, jitteriness, (and they are) inconsolable,” Belcastro said. “It can get as severe as seizures, but those are rare. Fast breathing, inability to sleep.”

Babies of drug addicts also are at risk of stillbirth or neonatal death, pre-term birth, low birth weight, cognitive developmental issues, learning disabilities and behavioral disorders, said Angelia Mickle, dean of the School of Nursing at Cedarville University and a family nurse practitioner.

“The heroin crosses the placenta within one hour of the mother doing it,” Mickle said. “The baby is actively getting all of that and becoming addicted too.”

Jail officials say they follow doctors’ orders closely when dealing with pregnant prisoners. Butler County’s Dwyer said that includes when a doctor recommends that labor be induced.

“We will not force that on anyone,” Dwyer said. “The doctor would suggest it and the patient would have to be compliant (before it is done).”

None of the jails in the region have nurseries for babies, so unless the mother is released from jail, the newborn goes home with a family member or is placed with Children Services, Good said.

The state prison system sends all pregnant prisoners to the Franklin Medical Center, the state prison hospital, where they stay until they give birth..

Most babies of state prisoners go home with family members, enter the foster system or are adopted. A few are in a special program that allows mother and baby to stay in a nursery at the Ohio Reformatory for Women in Marysville for up to 36 months.

Wiseman said the criminal justice system is struggling to address “what is essentially a public health crisis.”

Plummer agreed. “We need to wake up and say, ‘This is an emergency,’” he said. “We need all hands on deck to start fixing this problem.”

Powerful grip

With drugs like heroin and fentanyl devastating communities, counties have had to direct more money toward the opioid fight. Last year, Montgomery County Commissioners added $3.5 million to the $10 million they were already spending anti-opioid efforts, with at least some of that money aimed at programs for pregnant women and treatment for jail inmates.

RELATED: 5 things local leaders are doing to battle heroin and opioid addiction

Both the state and federal governments have boosted funding to assist communities with their anti-opioid initiatives.Ohio spent nearly $1 billion last year to help with the purchase of the overdose medicine naloxone, help fund drug courts, provide treatment and housing for addicts and to enforce drug laws, according to Ohio Gov. John Kasich’s office.

RELATED: Opioid crisis persists despite funding burst

Taxpayers are on the hook for addressing a crisis most of them did not cause and may struggle to understand. To a non-addict it may seem inconceivable for a person to continue to use heroin, methamphetamines or other illegal drugs at all, much less while pregnant.

But ignoring the crisis won’t make it go away, officials insist, and they say that overcoming opioid’s powerful tug is too much for many people to do on their own.

“It’s very sad to see the grip that this has on some people that come to jail carrying their child and are doing what they do to themselves and to the baby.” Dwyer said. “I’ve talked to them once they’re clean and they are very remorseful. I’ve not talked to one that wasn’t. But the grip of the addiction is so strong that they can’t find it within themselves to curtail that.”

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>>RELATED: Women living with babies inside Ohio prisons

ABOUT THIS PROJECT: See our story on one young mother who is raising her son in prison. We also took a closer look at that prison program and what a day in Women’s Therapeutic Court is like for women drug offenders. 

MORE ON TV: Today  WHIO Reports takes a look at this issue at 11:30 a.m. on WHIO-TV Channel 7.