Labor and delivery in US prisons
[edit]
Incarcerated women face many challenges when they have to give birth in correctional facilities. The issue of shackling pregnant women and women in labor has recently come into the public spotlight, yet there are many other issues that receive far less attention. A woman in labor may struggle to convince correctional officers that she is even in labor. One 2015 study found "an astounding number of reported incidents in which correctional officials refused to accept that a pregnant woman was in labor."[9] And since a woman can only be transported to a hospital for delivery if a correctional official orders the transport, this issue in failing to establish labor can cause significant delays in transport, which subsequently delays the woman's pain management, or in the worst cases, can cause delivery to occur in a prison cell without adequate medical care, hygiene, and pain medication for the laboring woman.[9]
Giving birth in prison also presents issues relating to bodily autonomy and control. While women outside of the prison context makes dozens of decisions about their pregnancies and deliveries, such as what type and how much pain relief medication to take, the method and timing of delivery, and who is present in the delivery room, an incarcerated woman is not able to make many of those decisions.[9] Incarcerated women are not given adequate information to make informed decisions about their deliveries and treatment.[108] Instead, correctional personnel and medical staff make decisions regarding a laboring inmate's ability to access pain medication, and correctional facilities routinely schedule deliveries via cesarean section for women who have not requested them and do not require them due to medical complications.[9] Incarcerated women also have very little or no say about who is present in the delivery room,[9] and policies about whether or not they have access to a birthing attendant are arbitrary and inconsistent.[108]
Care after childbirth
[edit]
The structure of US justice systems makes development of maternal attachment nearly impossible. After the births of their children, many women are returned to the jail or prison, and their infant immediately enters foster or kinship care.[109][110] However, within many state policies, relatives are given less financial support, which can leave foster care to be more viable than kinship placement.[111] "For 50% of all incarcerated mothers, this separation becomes a lifelong sentence of permanent separation between mothers and their children."[112]
Some prisons have nurseries for the mother and child.[113] Women are only eligible to participate in a prison nursery if they are convicted of non-violent crimes and do not have a history of child abuse or neglect. Prison nurseries vary widely, but they provide an opportunity to breastfeed during a sensitive stage in development. They also provide time for a maternal attachment to be formed. Rates of recidivism are less for women who participated in prison nursery programs.[114]
An improvement from the alternative, prison nurseries still leave many gaps in care. "Reports from mothers with children in prison nurseries indicate that their babies' close proximity allows prison staff to coerce and manipulate a mother by threatening to deny her access to her baby".[115] Some advocacy groups argue for alternative sentencing, such as family-based treatment centers, where mothers convicted of non-violent crimes can learn parenting skills while receiving services and support to foster positive child development and build a foundation to re-enter society following her term with decreased risk for future incarceration.[116] The data difficulties associated with studying pregnancy outcomes in prisons are the same, if not worse, for studying infants born to incarcerated mothers. There is incredibly little data on the babies born to incarcerated women and the immediate course of their care after birth.[11]
Care of older women in prison
[edit]
The rise in the population of incarcerated women in recent decades has led to an unprecedented number of older women in US correctional facilities. According to the Bureau of Justice, there are more than 11,000 women over the age of 50 currently in the US prison system, with 30,000 more women in their 40s soon to become included in that figure.[82] This population of older women in prisons face the same aging-related health and accessibility concerns as aging women in the general population, such as mobility limitations, sensory decline, and cognitive disorders. However, aging in prison is made worse by the fact that many incarcerated women have underlying or chronic health issues that were not addressed prior to their imprisonment, and many "symptoms" of aging are also accelerated or subject to early onset due to the physical and mental effects of incarceration itself. Similarly, the overall poorer health of women in prison than in the general population gets magnified in elderly women due to a lack of access to specialized care or services, including education about health changes or resources for self-management of health.[117] The Human Rights Watch found in 2012 that on average, the annual cost of detaining an elderly person is $70,000. As a result, many states have implemented cost-saving policies and practices which result in a lack of care and a denial of treatment for elderly women.[82]
One 2014 study of 327 older women in seven different prisons in the southern United States found that as a baseline of their health conditions and needs, older incarcerated women have, on average, 4.2 chronic health problems, and very high rates of mental illness, for example with 46% of the women in the study experiencing high or serious levels of depression.[82] The most common chronic illness among the group were arthritis, hepatitis, hypertension, and heart conditions, as well as health issues related to menopause. Many women in the study also expressed concern over significant, abnormal weight gain due to the lack of control over their diet and unhealthy nature of prison foods.[82]
As a result of the neglect that older women in prison experience, they experience particular challenges in reintegrating into their communities following release from prison, for example in seeking housing or employment. "Intersecting hardships" such as age-related discrimination, sex-based discrimination, and the discrimination faced by any previously incarcerated individual can make it incredibly difficult for women to lead healthy lives once released.[117] Furthermore, mental and physical health issues that go unaddressed in prison are linked to women's continuing involvement in the system, as women with health issues turn to unhealthy, potentially harmful social or self-medicating outlets to address pain.[117]
Legal and policy considerations
[edit]
Constitutional standards of medical care for prisoners
[edit]
In the landmark Supreme Court case, Estelle v. Gamble (1976), the Court ruled that the government is required, under the Eighth Amendment's "cruel and unusual punishment" clause, to provide medical services for prisoners.[8] Though the Amendment was originally intended to ban torture and other "barbarous" forms of punishment, the Court broadened its scope in this case to include the complete denial of, or wholly inadequate provision of, medical care for prisoners.[118] However, the Court put a high bar on proving a constitutional violation in cases involving prison healthcare, making it difficult for prisoners to win their cases and for advocates to make significant changes. The requirement to prove a constitutional violation is that care must be withheld with "deliberate indifference," meaning that an "official knows of and disregards an excessive risk to inmate health or safety" and that "the official must both be aware of the facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference."[118] Proving this "deliberate indifference" piece is necessary for correctional officials to be held liable.
The Estelle case radically changed the legal avenues for advocating for better prison healthcare. Now, medical care is the most common issue involved in litigation on prisons.[119] Various cases in the area of women's healthcare in prison have made strides in strengthening the legal grounds for better care, such as Newsome v. Lee County (2006), Herrera v. Valentine (1981), and Goode v. Correctional Medical Services (2001).[120] Class action lawsuits pursued through Section 1983 have also been an important avenue for people seeking justice and improvements to the quality of health services in prisons.[120]
Constitutional rights of pregnant inmates
[edit]
There have been significant strides in maintaining and protecting the constitutional rights of pregnant inmates. For example, the US Court of Appeals for the Eighth Circuit in the case of Nelson v. Correctional Medical Services ruled in 2009 that shackling pregnant women to the bed during labor and delivery is unconstitutional. This decision was rendered after twenty-nine-year-old Nelson was taken to a local hospital in 2003 and had her legs shackled to opposite sides of the bed. She was shackled to the bed for several hours while in labor before she was taken to the hospital room. Nelson claimed the shackles caused her intense pain, discomfort, and severe cramps. She also was unable to change positions while in labor, which caused further discomfort. Although she remained the shackles were removed while she was delivering her child, they were immediately put back on post-delivery. Nelson also claimed that after delivering her child, she soiled the bed sheet because she could not get to the bathroom on time due to the shackles.[121] The Eighth circuit contended that shackling women to the bed during labor and delivery violated the Eighth Amendment since shackling during labor and delivery is cruel punishment. This judicial decision also deemed that the officer in charge of presiding over Nelson during her labor and delivery deliberately acted indifferently. As a result, the court ruled that showing indifference during a woman's labor and delivery or inflicting unnecessary pain or discomfort also violates the Eighth Amendment.[122]
Another important landmark case was Boswell v. Sherburne County. Wanda Boswell, who was six months pregnant and denied medical attention for abnormal bleeding, brought an action pursuant to 42 U.S.C. alleging that the prison staff neglected her medical needs. She claimed her constitutional rights under the Eighth and Fourteenth Amendment were violated. The court found that both of the correctional officials knew Boswell was bleeding and had severe cramps, yet failed to take action to reach out to medical professionals. Boswell's "clearly established right to medical care" was evidently violated. The court found Lero and Riecken responsible for this negligence. Under the Eighth Amendment, prisons are required to provide adequate medical care.[123]
Privatization of prison healthcare
[edit]
See also: Incarceration in the United States § Privatization, and Prison–industrial complex
A CoreCivic Facility in Houston, Texas
Many federal and state prisons have turned to private companies to run prison health operations as a cost-saving measure. As of 2012, over 20 states have installed private health groups to run their medical services, with the largest providers being Corizon Health and Wexford Health Services. Both of these groups have been scrutinized for inhumane treatment of inmates.[84] Private prison health groups also operate in private prisons themselves in addition to their functioning in state-run facilities which have outsourced. The two largest health groups that run services in private prisons are CoreCivic and GEO Group.[84] Unlike strictly government-run facilities, private corporations are incentivized to maximize their profit margins to please shareholders, so they often choose revenue over national standards for health care by spending as little as possible on their services. For example, CoreCivic has a documented history of denying hospital stays to patients as they are costly to the operator, and also of punishing inmates for making multiple medical requests. Yet, companies argue that in reducing costs they are both providing adequate care for prisoners and also saving taxpayers money.[124] These violations of standards are worsened by the fact that the records of private prisons are not subject to public access laws, so monitoring and regulating their health care activities is not possible.[84]
Most people agree that contracting to private groups to operate prison health systems negatively impacts the health of inmates. One 2008 study at the University of California, Santa Barbara found that inmate mortality rates are significantly higher under private groups, and that contracting out reduces both health care costs and quality.[119]
Effects on motherhood and family structure
[edit]
Christina Crain Unit, a state prison for women in Gatesville, Texas
Women's Huron Valley Correctional Facility in Pittsfield Township, Michigan
Lowell Correctional Institution in unincorporated Marion County, Florida
Prison can have an effect on relationships between prisoners and their children. As a general rule, except for with an experimental trial, a couple cannot enter the same prison. However, prisons have a problem with child care. 2.4 million American children have a parent behind bars today. Seven million, or 1 in 10 children, have a parent under criminal justice supervision—in jail or prison, on probation, or on parole.[125] Many of the women incarcerated are single mothers who are subsequently characterized as inadequate, incompetent, and unable to provide for their children during and after imprisonment. However, "separation from and concern about the well-being of their children are among the most damaging aspects of prison for women, and the problem is exacerbated by a lack of contact".[126]
According to the Bureau of Justice Statistics, "54% of mothers in state prisons as of 2000 had had no personal visits with their children since their admission".[127] Obstacles that inhibit contact between mothers and their children include geographical distance, lack of transportation, lack of privacy, inability to cover travel expenses, and the inappropriate environments of correctional facilities. Mothers in prison typically are unable to fulfill the role of mother due to the separation. Incarcerated mothers are restricted in their decision-making power and their ability to create a sense of home and family within the institution is limited.[128] Most children experience multiple risks across contextual levels for there is great importance in family environments. Children of incarcerated mothers are consistent with their high risk status and it can cause their intellectual outcomes to be compromised.[129] Statistics indicate "that a majority of parents in state and federal prisons are held over 100 miles from their prior residence; in federal prison 43% of parents are held 500 miles away from their last home, and over half of female prisoners have never had a visit from their children and very few mothers speak with their children by phone while incarcerated".[63]
Recent legislation has further impeded an incarcerated mother's ability to sustain custody of her children. The Adoption and Safe Families Act, enacted in 1997, "authorizes the termination of parental rights once a child has been in foster care for 15 or more months of a 22-month period. Incarcerated women serve an average of 18 months in prison. Therefore, the average female prisoner whose children are placed in foster care could lose the right to reunite with her children upon release".[130] These stipulations expedite the termination of parental rights due to the narrow time frame. A 2003 study found that "termination proceedings involving incarcerated parents increased from approximately 260 in 1997, the year of ASFA's enactment, to 909 in 2002".[131]
By examining post-incarcerated mothers, it is statistically and clinically proven that there is a positive effect of a healthy mother-child relationship and depression symptoms. There is also a positive effect of healthy peer and partner relationships on raising self-esteem for mothers who were previously incarcerated. This suggests that healthy relationships are essential to recovery from trauma and emotional well-being.[132]
According to a 2000 report by the Bureau of Justice Statistics, "1/3 of incarcerated mothers lived alone with their children and over 2/3 of women prisoners have children under the age of 18; among them only 28% said that their children were living with the father while 90% of male prisoners with minor children said their children were living with their mothers."[131]
The incarceration of parents affect family structures.[133] Mothers in prison were more likely to report that they were the primary caregivers of their children.[133] Maternal imprisonment affects children more harshly than the incarceration of their fathers. When the paternal figure of a home is convicted, children are affected, but they don't experience the same kind of attachment disparity as they do with their mothers. "When fathers go to prison, their children are more likely to remain in the care of their mothers; however, when mothers go to prison, not only are children separated from their mother but they more often transition to the care of a grandparent, or other family member, than to the care of their other parent ".[134] In the case that there is no family member able to take the children in, they are taken into non-familial care. Children who grow up without their parents tend to have a higher chance of engaging in "substance abuse and addiction, mental illness, and abusive familial relationships".[134]
There are limited employment opportunities after incarceration.[133] Reduced opportunities for parents means reduced opportunities for their children who cannot access those resources denied to their parents, such as food stamps or employment.[133] In addition, for communities where the majority of the population are targets for incarceration and where there are high incarceration rates, those economies are affected.[133] In addition to poor economies, limited employment opportunities, and high incarceration rates in those communities, there is the creation of a "criminogenic environment" which affects the children growing up in those areas.[133]
Women in the US criminal justice system are marginalized by race and class. Single mothers with low income go into the "underground economies" because of their inability to find a job that is stable and provides a good earning.[135] Many mothers end up trapped in drugs, prostitution and theft.[135] In many cases, incarcerated women who committed acts of violence are for self-defense against their abusive partners.[135]
Bureau of Justice reported that about 200,000 children under 18 had incarcerated mothers and that 1.5 million children had a parent behind bars.[135] Children face disruption and deleterious where they feel separated from the world such as their friends, school and community.(1) It can bring integration into their new world without their mother.[136] 6.7 percent of African American children have incarcerated parents, a rate that is seven-and-a-half times greater than that of white children. Hispanic children experience parental incarceration at nearly three times the rate that white children do (Glaze and MAruchak 2008)[135] Children feel the mother absences and experience disruption more than the absences of their incarcerated father. "64.2 percent of mothers in prison report they were living with their children before they went to prison, only 46.5 percent of incarcerated fathers did so."[136] "Men are more likely to rely on their children's mothers to care for the children during their incarceration than women can on the children father. 88 percent of fathers in prison report that their children are being cared for by their child's mother while only 37 percent of inmate mothers say their child is being cared for by the child's father" (PG.4 Disrupted childhoods: Children of women in prison.)[136] Children in most cases stay with relatives such as grandparents and 10 percent in foster care, group homes or social service agencies.[135] The Children often feel stigma for having a parent in prison where they may feel the need to keep it a secret where they are not able to adjust.[136] Most of the time these children are at risk of following their parents footsteps where they might become criminals by learning the behavior such as antisocial and criminal behavior. Caregivers and teachers see the child of inmates fighting more and becoming aggressive leading them to have a higher risk of conviction.[136]
Most prisons do not have public transport, restrictive policies governing visits and phone calls. Prisons have policies such as the removal of infants born to women in prison, speedy termination of child custody for incarcerated women, restrictive welfare policies that make it difficult for families to be reunited, and women repeated periods in custody.[135] Activists are trying to make a change and pass reforms that are going to help children and mothers deal with these consequences that are affecting them. One guideline that would help is a family connections policy framework to support and strengthen the relationship between incarcerated women and their children.[135] If women are able to see their children, it gives them motivation to try to get their lives back on track.[135]
There is 6.7 percent of African American children whose parents are incarcerated, a rate that is seven and half times greater than that for white children, and Hispanic children experience parental incarceration at nearly three times the rate that white children do.[135] Children feel the mother absences and experience disruption than their father. "Men are more likely to rely on their children mothers to care for the children during their incarceration than women can on the children father. 88 percent of father in prison report that their children are being cared for by their child mother while only 37 percent of inmate mothers say their child is being cared for by the child's father".[136] Children in most cases stay with relatives such as grandparents and 10 percent in foster care, group home or social service agency.[135] Children often feel stigma for having a parent in prison where they may feel the need to keep it a secret where they are not able to adjust.[136] Most of the time these children are at risk to follow in the footsteps of their parents where they might become criminals by learning the behavior. Caregivers and teachers see the children of criminals fighting more and becoming aggressive leading them to have a higher risk of conviction.[136]
Prisons prevent contact between the mothers and their children in many ways. The locations of the prisons might not have a public transport, restrictive policies governing visits and phone calls, the removal of infants born to women in prison, speedy termination of child custody for incarcerated women, restrictive welfare policies that make it difficult for families to be reunited, and women repeated periods in custody.[135] Some activist are trying to make a change and pass reforms that are going to help children and mothers to not deal with this consequences that are effecting them. One guideline that would help is a family connections policy framework to support and strengthen the relationship between incarcerated women and their children.[135] If women are able to see their children, it gives them motivation to try to get their lives back on track.[135]
Demographics of incarcerated parents and their children
[edit]
The most common age range for incarcerated parents is from age 25 to 35, followed by age 35 to 44 and age 24 and younger.[133] In mid-2007, 809,800 prisoners in the US prison system were parents to children 18 years of age or younger.[133] Of those prisoners, 744,200 were fathers and 65,600 were mothers.[133] In comparison to 1991, this data shows the number of women in prison has more than doubled and the number of fathers incarcerated has increased by seventy-seven percent.[133] According to studies by the Bureau of Justice Statistics, 1,706,600 children had at least one incarcerated parent in 2007.[133]
Children of incarcerated parents
[edit]
See also: Relationships for incarcerated individuals § Children of incarcerated parents
The most common age range for children with at least one incarcerated parent is from 0–9 years old, followed by children from 10 to 17 years old.[133] In terms of racial demographics of children with incarcerated parents, Latino children are three times more likely to have a parent in prison in comparison to white children.[133] Black children are about eight times more likely to have a parent in prison in comparison to white children.[133] Nearly half of the children with an incarcerated father are Black children.[133] This is data that has been published in scholarly and peer-reviewed articles,[137] but as the article "Children of Color and Parental Incarceration: Implications for Research, Theory, and Practice" states, "these data among racial minorities must be carefully interpreted because higher numbers may be a reflection of larger societal issues (such as relative degree of involvement in crime, disparate law enforcement practices, sentencing parole policies and practices and biased decision making... rather than a problem among certain groups."[133]
Education in prison
[edit]
Education is something that woman have been benefitting from for a long time.[138] Studies have found that there is a link between education levels and recidivism rates for women in prison.[138] Inmates who have a high school degree or higher are found to be less likely to be back in prison while those who did not have a high school diploma were found to have a higher recidivism rate.[139] Education programs for inmates has led to fewer disciplinary incidents while adults have been incarcerated.[139] Often for many female prisoners, prison is the first chance for them to receive basic education.[138] Education helps solve the problem of unemployment that many women face after they are released from prison. It ends up being more cost effective in the long run to allow prisoners education opportunities.[138] People are now realizing that in a lot of ways education is more cost effective than incarceration itself.[139] Even though there are benefits to having education programs in prison, few people actually qualify for these programs.[138] Some of the people that do qualify chose not to participate in these programs.[140] Inmates may not be able to complete the education programs due to being relocated to a different prison or because their sentence has been ended.[140] Many education programs do not address the needs that women have based on their gender.[138] Education programs can help women get connected to their community.[138] There used to be programs that helped prisoners get money for education. One of these programs was the Pell Grant programme which helped inmates with financial aid to pay for college, but this was discontinued in 1994.[139] As of July of 2023, the Pell Grant programme has been reinstated so that inmates in prison can have access to education during their incarceration.[141]
Barriers to reentering society
[edit]
Of women in US state prisons, 44% do not have a high school diploma or equivalent (GED).[63] As they reenter their communities, former inmates confront sparse job opportunities, limited options for stable and affordable housing, denials of public assistance, as well as the challenge of re-establishing relationships with family and friends.[142] However, relationships, in particular among family, provide an extremely beneficial support system for prisoners returning home upon their release. Difficulties with employment, housing, and ostracism can decrease successful transitions and lead to a cycle in and out of prison.[citation needed]
Some concerns that are faced by policy-makers and correction officials about women re-entering into the community after prison are motherhood and the struggle with substance abuse and mental health issues.
Scholars have found that women face negative perceptions such as being seen as inadequate and unable to provide a stable, loving home for their children when they are transitioning back from prison into motherhood. This separation of children from their mothers is harmful to both the child and mother and this is the main reason for stress inside of women prisons. For many women getting out of prison, the only aspect of life they consider to be motivating and hopeful is resuming motherhood and connecting with their children again. Without their children, many see no reason to stay away from drugs or prostitution. Women in these circumstances are understood to have a better life if they are offered proper nutritional and medical care so they could lead a more stable lifestyle.[143]
The struggle of addiction whether it be alcohol or drug abuse along with mental health issues are considered the three major factors that influence the success of women's transition back into the community. Women tend to take out their anger on themselves and in a self-mutilating or abusive way. Mood disorders, such as depression or anxiety, are seen to be more common among women than men. A study from 1990 found that 19 percent of women who suffer from depression, 31 percent of women who suffer from phobic disorders, and 7 percent of women that suffer from panic disorder also struggled with alcohol abuse. Women who have been released from prison face the struggle against addiction and could end up losing their children because of it.[143]
For women to successfully transition back into society, they must begin this preparation process at the beginning of their sentence. Although this is recommended, inmates tend to not have any preparation before being placed back into the community. All of the released women have tasks they must complete to re-establish a place in society and to stay out of trouble. These are things such as, follow parole regulations, provide health care for themselves and/or their families, become financially stable, obtain employment, and find a safe place to live, all while possibly battling addiction. Without support from the community, women under these circumstances tend to fall back into drugs or criminal activity.[143]
Advocacy organizations
[edit]
There are programs that have been established to help women after they are released from prison.[144]
System organizations that are used to help women's reentry into the community consist of mental health, alcohol and drug programs, programs to help survivors and sexual violence, family services, food shelters, financial help programs, employment services, child care services, and community service clubs.
A continuity-of-care approach is taken when forming these programs for women. This is the providing of treatment, recovery, and support services throughout the entire process of reentry for women.
Programs:
Helping Women Recover: Program designed for treating substance abuse. This focuses on issues such as self-esteem, parenting, relationships, and spirituality. The program addresses these issues using discussion, activities, and exercises.
Beyond Trauma: A Healing Journey for Women: This is 11 sessions long and teaches women what trauma is, and how it affects their thoughts and feelings as well as their behavior and relationships. The work is done on coping skills using exercises and videos.
The Sanctuary Model: This program addresses the issues of mental health, trauma, and substance abuse. This focuses on safety and grieving to build individual empowerment.
Seeking Safety: Program for women that have substance dependence and also PTSD. This focuses on five key elements: safety, treatment of PTSD and substance abuse, ideals, behavioral and interpersonal therapies, and therapist processes.
The Addiction and Trauma Recovery Integration Model (ATRIUM): psycho-educational 12-week-long program. This is designed to intervene on levels of the body, mind and spirit.
The Trauma Recovery and Empowerment Model (TREM): psycho-educational group that includes survival empowerment, self-soothing, and problem solving. This last 33 sessions over nine months.
These programs help women to not feel depressed or overwhelmed by the community once they are allowed to reenter them. There are two agencies that help these women as well, more well known as a settlement house.
Our Place: This is located in Washington D.C. and focuses mainly on family reunification. This helps women reunite with family, and find housing and employment. This program helps women find the help needed whether it be mental help or substance abuse treatment.
The Refugee Model: The Catholic Church works to assist the parolees and support their transitioning. This helps to make the women feel like someone is looking after them and encouraging them as they work to reenter the community. System organizations that are used to help women's reentry into the community consist of mental health, alcohol and drug programs, programs to help survivors and sexual violence, family services, food shelters, financial help programs, employment services, child care services, and community service clubs.
A continuity-of-care approach is taken when forming these programs for women. This is the providing of treatment, recovery, and support services throughout the entire process of reentry for women.[143]
Media portrayal
[edit]
Despite all the things that incarcerated women endure prior to, during, and after their imprisonment, people often have a certain mindset regarding who they are. This is as a result of the inaccuracy the media uses to portray women who are detained; perpetuating the idea that there is nothing more to them than violence and sexual tension. The media's tendency to highlight the aspects of prison life that they deem suitable or entertaining for viewers really serves to belittle and shed attention away from the real issues that incarceration has on the women living their 'truth'. The way that these women are portrayed in the media is crucial to our understanding of their struggles and our ability to empathize with the traumatic experience that is serving time in prison. Instead, they are portrayed with a 'babes behind bars' theme.[145]
Films such as The Big Doll House (1971), The Big Bird Cage (1972) and Caged Heat (1974) are examples of movies that depict these women as sex-crazed and distort our knowledge from the more universal and serious issues that come with being incarcerated. Such media leads to the misrepresentation of women's issues while incarcerated.[citation needed]
Very little factual representation is contained in these films. It is Hollywood, after all; they do not necessarily seek to educate—instead they aim to titillate: These tales of vulnerable young things navigating a harsh prison are largely vehicles for money shot–style images that are the films' raison d'être: a roomful of women being hosed down by their sadistic warden as punishment (1971's Big Doll House) . . . or a young reform-school inmate gang-raped with a plunger by her roommates (1974's Born Innocent)".[145]