Federal and State Laws on Mental Health Care for Incarcerated Pregnant and Postpartum People
Carly Pytel1, Mollee K Steely Smith1, Karenna K Thomas2
1Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Abstract:
Incarcerated pregnant and postpartum people experience poor mental health. Conditions of confinement (e.g., inadequate prenatal care, shackling, isolation, stigma) exacerbate distress, contributing to new or worsening psychological challenges. Although awareness of perinatal mental health needs is increasing, the extent to which federal and state laws address these needs remains unclear. To address this gap, we conducted a systematic search in WestLaw through July 2025, combining the terms pregnancy, postpartum, and incarceration. The search returned 545 statutes from 48 states and the federal government. Using a deductive codebook of maternal health topics, we extracted and analyzed legislative text related to mental health screening and treatment. Ten states had statutes addressing mental health care for incarcerated perinatal people. Nine mandated access to mental health treatment but varied in scope, screening, and conditions addressed. Five states referenced pregnant people only, three included both pregnant and postpartum people, and two focused exclusively on postpartum populations. Two states required specialized mental health training for carceral staff. Few states mandate availability of mental health care for incarcerated pregnant and postpartum people despite national clinical guidelines. Limited statutory guidance may hinder early identification and treatment, increasing the risk of adverse maternal outcomes, including postpartum depression, suicide, and recidivism.
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