The Feministing Five: Carolyn Sufrin

Medical anthropologist and OBGYN Carolyn Sufrin’s new book Jailcare: Finding the Safety Net for Women Behind Bars explores the complexities of healthcare for incarcerated pregnant women.

Medical anthropologist and OBGYN Carolyn Sufrin’s new book Jailcare: Finding the Safety Net for Women Behind Bars explores the complexities of healthcare for incarcerated pregnant women.

Using ethnographic fieldwork and her experiences as a healthcare provider at the San Francisco County Jail, Sufrin examines prison as a paradoxical site of both care and punishment for pregnant women, many of whom would not have had access to any kind of reproductive care in the outside world.

Sufrin takes care to maintain that medical care behind bars is often woefully inadequate and even harmful (she sees her experience in San Francisco as very much an exception to this rule) as she explores jail as a healthcare “safety net”, filling a void for many women living in poverty.

For this week’s Feministing Five, I caught up with Carolyn Sufrin about the process of this project, what she learned about reproductive justice along the way, and how allies can support incarcerated women.

Senti Sojwal: An interesting fact I learned in your book is that prisoners are the only segment of the US population with a constitutional right to health care, and that millions of people, of course, have health care for the first time only while incarcerated. What were some of the personal tensions you experienced in exploring jail as a site of both violence and care for incarcerated women?

Carolyn Sufrin: So many personal tensions. There are tensions just in the argument that I’m making — that jail can be a safe space and a space of punishment and of violence. Medical care of course completely varies in jails and prisons across the country, and is by no means perfect, but is relatively much better than in many other places. Making the argument that for some people jail is a safer space and a safety net — that is a source of personal tension. I’m not saying jails are good or good for women. There is tension that I felt constantly while providing medical care — of treating patients in prison like you would anyone else, but also working within the rules of that system so I could be continuing to provide care. There’s the tension I felt of being someone who is in many ways part of the system but also disagrees with much of it and the ways our society locks people up. Even in my critique of the system, I am still in some ways part of it. I felt tension in my own position as a privileged white woman working with women who were predominantly women of color. I never resolved that, and I don’t think it should be resolved, but I need to be aware of that always.

Senti Sojwal: How has the process of writing this book and doing this research shaped your understanding of what reproductive justice means?

Carolyn Sufrin: I feel like I learned about reproductive justice through working inside a jail. I didn’t know much about the framework until I started within this system. It just hits you in the face. You can’t ignore it. For me, what that looked like as an OBGYN and medical anthropologist researcher, much of how I approached this process has to do with reproductive rights and the politics of reproduction, how charged that is in our society. I was aware that the framework of choice had limitations, but it wasn’t until working in the jail where people are so stripped of their ability to make choices in their day to day life that I really began to understand that. Incarcerated women do retain their constitutional right to health care, but in many prisons and jails across the country, they’re denied access to abortion simply because the people in charge decide so, in flagrant disregard of what women’s true rights are. They say an abortion is an “elective medical procedure” and that we are only required to take care of “serious” medical needs. An abortion is not elective. Everyone uses that terminology — even the medical community and reproductive rights activists. Understanding those limitations within the prison system — the word “elective”, the word “choice”, is illuminating. When you talk to these women and hear their stories, it’s impossible to ignore that so many of them are parents and the state is interfering with their ability to parent in the ways they want to. I learned so much from these women and their stories, and about my own conception of reproductive justice, which of course women of color have long been talking about it.

Senti Sojwal: What is your hope for how this book can specifically serve medical providers?

Carolyn Sufrin: I have several hopes for this book. First of all that it will help the general public as well as medical providers to recognize that there are women behind bars, and pregnant women behind bars. So often in conversations about criminal justice reform, of healthcare in prisons and jails, women are disregarded or assumed to be interchangeable with men. They are absolutely not on so many levels. Another hope is that people will recognize that there is tremendous variability in the care that all people, especially pregnant people, receive behind bars. Even though there is this constitutional right to healthcare that imprisoned people have, there is no delineation of what that healthcare means. No specificities. What you get is prisons and jails coming up with their own systems, and there is no mandatory standardization. I hope that seeing what it looks like in one space versus another will help healthcare professionals realize that we need to work harder to make advances in this system for incarcerated people.

Senti Sojwal: What was the greatest challenge of undertaking this project?

Carolyn Sufrin: One of the greatest challenges was figuring out how to navigate my dual roles as a physician in the jail and as an anthropologist. At one point I thought it would be easy to compartmentalize those roles. Women in the prison, however, knew about the roles I was occupying and when they would see me as a patient, they wanted to tell me more of their stories because it would be useful for my research. It was harder to put up boundaries around those roles. When I was working as an anthropologist, people still saw me as a doctor. It’s probably why they let me be in so many different parts of the jail. I realized that the challenge was just in embracing both of those roles at the same time.

Senti Sojwal: What are some concrete ways Feministing readers and other allies can support incarcerated women who are pregnant or mothers?

Carolyn Sufrin: The bigger part of the answer to that question is a daunting one, which is how we reform our criminal justice system so that we’re not incarcerating as many people, and women and pregnant people in particular. That is a huge task and not something I feel I’m qualified to answer on my own, but I do think comprehensive bail reform is a critical step. So many people in jail are pre-trial and haven’t even been convicted of anything but are there because they are already poor and cannot afford to not be there. Until we can radically change the way our society relies on jails and prisons, there are things we can do to support pregnant people who are incarcerated. Not everyone can provide direct support services, but what we can all do is recognize the humanity in these people and recognize that these are people in our society. They are not just “criminals”. They have lives and stories outside of this system. The best thing we can do is try and understand their experiences, humanize them, learn from them, and listen to them. We also all need to support alternatives to incarceration, especially for nonviolent offenders and for pregnant people. That involves paying attention to local politics and electing District Attorneys who have a broader vision of criminal justice reform and are open to alternatives. There are also amazing national efforts like Mama’s Bail Out Day. Please support initiatives like that!