On April 28, Andrea High Bear was the first woman in federal prison to die from the novel coronavirus. The details surrounding her death are deeply troubling.

High Bear, a 30-year-old Native woman also known by her married name of Andrea Circle Bear, was pregnant when she was taken into custody. Two months into her 26-month sentence in federal prison for “maintaining a drug involved premises,” she was hospitalized with a fever and placed on a ventilator. She gave birth a few days later in an emergency delivery. After testing positive for COVID-19, she died less than one month after her daughter was born.

While much of the media coverage surrounding coronavirus in prison has been framed as gender-neutral, Andrea High Bear’s tragic death reminds us that the particular challenges for incarcerated women have been left out of the story.

While much of the media coverage surrounding coronavirus in prison has been framed as gender-neutral, Andrea High Bear’s tragic death reminds us that the particular challenges for incarcerated women have been left out of the story. Women in prison are often invisible in the cultural narrative around incarceration, which focuses on men. But the effects of the COVID-19 crisis could be devastating for women behind bars, with spillover impacts for their children and extended families.

Women’s Health in Prison: Crisis, Meet Pandemic

Correctional facilities are hotbeds for the spread of the novel coronavirus. Close quarters in prisons make it physically impossible to practice social distancing. Jails are especially vulnerable because people cycle through with a high turnover. Hand soap is scarce, and hand sanitizer is contraband. The infection rates are staggering: thousands of inmates and staff have already tested positive. And on top of these immediate effects, the COVID-19 pandemic threatens to push underlying inequities faced by incarcerated women and their families into crisis territory.

Even in ordinary circumstances, women’s healthcare needs in prison levy a unique challenge. Access to reproductive health services in prisons has long been inadequate. Women risk undiagnosed gynecological and obstetric illness, a fate all too familiar for women of color, even outside of prison. Access to sanitary products is costly and limited. Tampons and other vital products may be available from the commissary at inflated prices, which can be cost-prohibitive, since incarcerated workers earn well below minimum wage. The ACLU reported that one box of tampons in a Colorado women’s prison costs two weeks of prison wages. Recently, women in an ICE detention facility reported a scarcity of sanitary napkins. Tight budgets and supply chains strained by the pandemic put women’s health in further jeopardy.

This global crisis is also likely to compound existing mental health needs in an already-overburdened system. Women in jails and prisons have experienced enormous adversity in their lives, even compared to men in jails and prisons. Prior to their incarceration, women disproportionately face poverty and homelessness. In one study by the ACLU of Virginia, women were twice as likely as men to report “economic need” as a motive for their crime. An alarming proportion of women in prison grapple with addiction, trauma, and a slew of mental health disorders. Over half of all women in state and federal prisons have experienced prior physical or sexual abuse.

An alarming proportion of women in prison grapple with addiction, trauma, and a slew of mental health disorders. Over half of all women in state and federal prisons have experienced prior physical or sexual abuse.

Criminologists describe these as “pathways” to incarceration for women. When we consider that most women are serving time for nonviolent crimes (nearly two-thirds of women in state prisons and over four in five women in jails), or are sentenced for decades as “co-conspirators” despite their nonviolent, or even unwitting, roles in violent crimes, we must ask whether the ends justify the means.

Additional Burdens on Children and Caregivers

As mothers, women in prison face outsized hardships. Eighty percent of women in jail are mothers, and over half of women in prison were the primary caregiver for their children prior to their incarceration. In my own research, women frequently expressed that being separated from their children was the hardest part of their prison sentence. In state women’s prisons, only one in six women say they are accustomed to near-daily contact with their children. Women in prison typically receive far fewer visits than men. Now, the suspension of in-person visits in response to the COVID-19 crisis places a huge emotional strain on families who are already struggling.

The suspension of in-person visits in response to the COVID-19 crisis places a huge emotional strain on families who are already struggling.

When it comes to children, arresting a parent means putting them at risk, too. As many as five million children have had an incarcerated parent. When mothers are incarcerated, their children go on to live with a grandparent or are disproportionately funneled into the foster care system, especially among Black mothers. This means uprooting children from stable housing, disrupting the continuity of at-home education, and creating undue emotional strain. Nationwide, women have disproportionately shouldered the brunt of childcare during school shut-downs, transforming into full-time homeschooling teachers on top of their work responsibilities. For families affected by a mother’s incarceration, those responsibilities fall onto the shoulders of temporary caregivers, whose resources are already stretched thin.

Reducing Incarceration Will Save Lives

We must view women in prison as a priority group with unique needs in our responses to the COVID-19 crisis. For policymakers, this means supporting initiatives to reduce the populations of jails and prisons. The first step is a concerted reduction of arrests, especially for nonviolent crimes. The next step is an initiative to decarcerate: to remove individuals from jails and prison. Correctional facilities that operate under capacity are safer for officers and staff, too. Amidst a groundswell of support for the release of elderly populations and those with serious underlying medical conditions, incarcerated women should also rise to the top of the list.

Those concerned about the ramifications for punishment should consider that two-thirds of individuals convicted of felonies already serve out their sentences in the community: on probation, on house arrest, or through fines, fees, and community service. Decarceration efforts do not jeopardize the criminal justice system’s ability to dole out punitive sanctions.

Working in tandem with practitioners, including community healthcare providers and community corrections departments, policymakers must devise release plans. Women released from prison are especially vulnerable to homelessness and unemployment compared to formerly incarcerated men. Release plans must allow for speedy access to healthcare and a safe space for a two-week quarantine.

Women released from prison are especially vulnerable to homelessness and unemployment compared to formerly incarcerated men. Release plans must allow for speedy access to healthcare and a safe space for a two-week quarantine.

For those who are not released, policymakers and practitioners should focus their efforts on ensuring a steady supply of sanitary products in prisons and jails, including access to menstrual products, soaps, and sanitizers.

The public can support efforts to decarcerate by donating to local bail funds. Many arrestees and ICE detainees await trial in detention because they cannot afford cash bail. The National Bail Out collective focuses their efforts on Black mothers and caregivers, with a special initiative on Mother’s Day. We can also rally behind legislators who are working to end mass incarceration.

As we work through the devastating effects of this global pandemic, we must consider how gender matters for the novel coronavirus in jails and prisons, and how these effects proliferate through communities. The COVID-19 crisis exacerbates longstanding problems for women in correctional facilities and their extended families. But this critical moment gives us an opportunity to address these preexisting problems in our pandemic response. The actions we take now can save lives.