After lawsuit, prenatal clinic to open at jail

Pregnancy care called vital with more women in cells

The state's largest jail will by Christmas start operating an on-site prenatal clinic for treating pregnant inmates.

The obstetrics and gynecology program at the Pulaski County jail involves a partnership with the University of Arkansas for Medical Sciences in Little Rock.

The clinic will include video equipment, a fetal heart-rate monitor and an ultrasound machine in the medical unit at the jail. The partnership also includes once-per-week visits by an advanced-practice nurse from UAMS and a virtual link between the jail and UAMS using telemedicine technology via the hospital's Center for Distance Health.

The telemedicine program will allow doctors at UAMS to visit with and monitor pregnant inmates at the jail during off hours and in emergencies using a secure video link.

The jail will also hire a registered nurse trained in prenatal health who will be a county employee.

The program will cost $150,000 a year through a contract with UAMS and roughly $55,000 a year for the county-employed nurse.

"We understand that there are people in our care, and we have an obligation to ensure that their medical condition is treated and that we need to provide them with the appropriate and necessary drugs and medical care," Pulaski County Sheriff Doc Holladay said.

"Pregnancy is another critical condition that we need to do the best job we can [with] to ensure that those women receive the treatment they need, leave here better than they came in and their child is growing. That's what we are trying to do."

On Monday, there were 1,131 inmates at the jail, and 233 of them were women, Holladay said. Four of those female inmates were pregnant.

A lawsuit filed by seven women in 2014 against Holladay, as well as several county jail employees and contractors, centered on allegations of a lack of proper medical treatment while the women were pregnant and incarcerated at the jail. That suit was dismissed in May after a $179,500 settlement.

The Central Arkansas Risk Management Association covered the settlement, according to court documents.

The lawsuit said that several jail employees and contractors "failed to provide proper medical treatment to each plaintiff ... [which] resulted in serious physical and emotional injuries to [the plaintiffs]" and the death of an infant born at the jail.

The episodes occurred between July 2012 and December 2013, the lawsuit said.

Holladay said discussions involving the treatment of pregnant inmates started right after the first problems arose.

"As we were looking at these cases as they happened, we began to ask ourselves: 'What do we need to do better?'" he said.

"We look at every death that occurs in the facility and say: 'What could we have done differently?' Whether it's a pregnancy or a suicide. Fortunately, we don't have a lot [of deaths], but anytime you have one you wonder if we should have done something differently."

The jail has seen an increase in female inmates in the past 15 years.

In 2000, 5,596 female inmates were booked into the jail; in 2014, 11,387 female inmates were booked into the jail.

The jail is on track this year to eclipse those 2014 numbers for female inmates, said Maj. Matthew Briggs, who is second in command at the jail.

An increase in female inmates means more pregnant inmates, and sometimes the expectant mothers have not taken care of themselves and their unborn child, he said.

"What we found ... is somebody would be seven or eight months pregnant, and they've never visited an [obstetrics and gynecology doctor] and they have no pregnancy plan, haven't taken good care of themselves. So we were ... months behind the game because they weren't taking care of their end of the business."

UAMS offers a similar obstetrics and gynecology program at the Arkansas Department of Correction's Wrightsville Unit.

The program is one of about 25 offered through the Center for Distance Health at UAMS.

Offering an obstetrics and gynecology program for pregnant inmates is a good idea for several reasons, said Tina Benton, Center for Distance Health oversight director.

With remote medicine, there's no transportation involved with the inmates, thereby cutting down on manpower hours for guards and wait times for pregnant inmates.

Plus, there is no public safety concern since the care is administered at the jail or prison.

However, the main intent of the program is "to provide really good care," Benton said.

"That's what we are about. I don't care if you're a millionaire or a prisoner. You're a human being, and we're going to take really good care of you."

State Desk on 11/27/2015

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