Access to Reproductive Health Services for Women Incarcerated in the United States: A Federal and State Policy Review

Introduction The United States (US) has the highest incarceration rate in the world. Women's incarceration has grown significantly since 1980, disproportionately affecting marginalized communities. Most individuals experiencing incarceration are of reproductive age, yet studies have suggested limited access to reproductive health services. State and federal policies could be a mechanism to ensure access to reproductive health services during incarceration. Methods We conducted a policy review using WestLaw in August 2023 and March 2024 of federal and state statutes and regulations addressing individuals who are incarcerated containing language on reproductive health, including pregnancy testing, pregnancy options counseling, contraception, and abortion. Results Policies in eight states mandated pregnancy testing ranging from universal testing to the option to opt‐out. Four states and the federal government mandate pregnancy options counseling for positive tests. Two states mandate the provision of contraceptives outside of sexual assault; Texas and the federal government mandate the provision of emergency contraceptives in the case of sexual assault. Five states and the federal government limit or prohibit the use of sterilization during incarceration. Four states and the federal government mandate provision of abortion care. No statutes or regulations provided mechanisms to enforce carceral facilities' compliance with stated policies. Conclusion Policies ensuring reproductive health services for individuals experiencing incarceration are extremely limited across the country. States and the federal government should consider passing laws codifying access to pregnancy testing, pregnancy options counseling, contraceptives, and abortion, with clear enforcement mechanisms to protect the reproductive autonomy of this marginalized population.