CLEVELAND, OH (WOIO) - At any one time, about 10 percent of the inmates in the Cuyahoga County Jail are pregnant, constituting what the corrections medical director calls the definition of a high-risk pregnancy.
"From day one, we have two patients - even if there's not a complication of a mom that's been using alcohol or opioids, that raises the bar, too, that raises the bar a little bit, too," said Dr Thomas Tallman, the medical director of the Cuyahoga County Corrections facility. He showed Cleveland 19 around the jail's maternity ward.
All female inmates are given pregnancy tests when they are admitted to the jail, and if an inmate is pregnant, she joins the rest of the pregnant inmates on one floor of the jail.
"These by definition - I think if you have a definition of a high-risk pregnancy - I think it is these women," said Tallman.
He said not only are the women pregnant behind bars, but they also many times have had little to no pre-natal care before entering jail, an expectant mom may have no idea about the date of conception and may also be dealing with addiction issues.
"I look at this as an opportunity. If this happens to be a mom that was not getting a lot of regular pre-natal care, we have an opportunity now that we're going to maintain it by the book," said Tallman. "Especially in the case, if there was behavior that was related to maybe it was the opioid use or Heroin, you're in this setting. You're clear minded, you're thinking clearly if you weren't thinking about it before I think it's going to hit you."
Tallman said expectant moms also get regular exams and ultrasounds while behind bars.
"I think once you're pregnant you're still a mom, and there's a component of that you may still be dealing with an illness like opioid addiction , that's a separate issue, but that means that you haven't solved that yet but now you still have a baby that you're responsible for," said Tallman. "Who hasn't made some mistakes before and you know sometimes you have an opportunity now to give them resources that maybe they didn't have. It's not just the OB care that they need - it's also treatment."
He said it's up to people like him at the jail to not just take care of these moms, but also to give them the tools they need to succeed as moms out in the real world.
"You're actually giving them a means to not just go back to behavior that they were doing before and, I'm not saying they're all having addiction, but that's fairly common," said Tallman. "It's not just your time in jail, it's where are you going to go from here."
If an inmate is identified as being pregnant when admitted to the Cuyahoga County Jail, some very specific steps immediately kick in.
"Any time you're dealing with children it can be a very emotional situation," said Holly Mack, the child advocate at the Cuyahoga County jail. Mack explained that one of the most important steps she takes it to try to identify a safe place the infant can go within 24 hours of birth.
"Most of [the expectant inmates] are upset. It's a scary situation to be separated from your newborn baby. Our goal is to find a caregiver who will be able to provide for that baby's basic needs, and to keep the baby safe while mom is incarcerated and the ultimate goal is for when mom is able to be reunited with her baby," said Mack.
She said in the pregnant inmate's third trimester she identifies three potential people who can care for the baby until mom is related from jail. Mack said that those three people would each have to be approved. Each would have to go through a home study, and make sure no children have been previously removed from the home. The child would only go into the foster care system as a last resort if one of the three suggested suitable custodians do not pass the approval process.
Mack said the majority of the female inmates in the Cuyahoga County Jail, whether they're pregnant while incarcerated or not, have children. She said they also very much care about their children.
"Their situation might not reflect it, but they really do care about their kids," said Mack. "We don't judge, we just kind of deal with what's at hand."
Mack said it's usually not difficult for moms who give birth while behind bars to regain custody of their children, but it is done on a case-by-case basis.
Just because a mom is behind bars when she gives birth doesn't mean that a Children and Family Services case is opened. Cleveland 19 was told if no concerns were identified during a home study, then the case would be closed. If anything appeared to jeopardize the safety of the child or signs pointed to possible abuse or neglect in the home then the case would remain open and the Department of Children and Family Services would contact the mother when she was released from jail.
Both Mack and Tallman said that they have both seen mothers who gave birth behind bars return to the jail. Mack said the women who have relationships with their kids are less likely to come back to the jail. Tillman said he has seen both cases - moms who use the experience to never come back, and moms who don't.
"It's like most programs, if you have one or two or three really good success stories that you're able to talk about you figure that's giving everybody a shot and those that take advantage of it will," said Tallman.
Download the Cleveland 19 News app.