I work as Director of Women's Health at Santa Rita Jail (Alameda Co., CA). I provide prenatal and gyn care for the women inmates (I have 20+ years of experience as a nurse midwife). I consult with an OBGYN physician by email and phone, who comes every 2 weeks to review charts and see patients when necessary (she is Chief of OBGYN at the County Hospital). I send patients to the County Hospital as needed, who need interventions I am unable to provide at the jail such as fetal monitoring. Those unfortunate enough to deliver while incarcerated are transported there, or to the community hospital if they must be taken to the closest hospital because of imminent delivery or other emergency. I am on call 24-7 for issues with pregnant women during booking or in the housing units or infirmary. The Perinatal Coordinator, a mental health counselor, provides counseling and social services, including help with custody of babies born while women are incarcerated. There is also a nurse who teaches childbirth classes and consults regarding methadone maintenance for opiate addicted pregnant women.
Right now we are working on a proposal for a doula program, as the women must labor and deliver alone due to the rules against informing family members when they are hospitalized. My dream (which may remain pie in the sky) is to have a program where they can keep their babies with them, as I believe exists in the US only at Riker's Island currently:
http://www.nyc.gov/html/doc/html/about/facilities_overview.shtml
(jail that is - there are several such programs in prisons). I have heard also, however, that this is not so unusual elsewhere in the world.
Lily Kay MS MPH
Certified Nurse Midwife, Family Nurse Practitioner