Healthcare

In Collin County Jail, a Woman Begged for Medical Care. She Lost Her Pregnancy, Anyway.

According to a lawsuit, a pregnant woman was denied proper prenatal care while in Collin County jail
According to a lawsuit, a pregnant woman was denied proper prenatal care while in Collin County jail Larry D. Moore, CC BY-SA 3.0, via Wikimedia Commons
Early in the summer of 2019, as the bleeding got worse and the abdominal pain more severe, Lauren Kent knew something was wrong. She says she asked politely, then begged and even screamed out in pain, but the guards and private medical staff at a Collin County jail in McKinney didn’t believe she needed help.

She was a few months pregnant when she arrived at the jail, already showing so much that she at times suspected she may have twins on her hands. If she ended up having only the one boy and lined up a family to adopt the child, she hoped to remain a part of the child’s life, even if she couldn’t raise him herself.

By July, she'd lose the pregnancy, joining an unknown number of people around the country who have either experienced miscarriages or delivered stillborn babies while incarcerated.

She had been locked up for illegally using someone else's debit card. She regrets it, but she insists she meant well: She’d purchased groceries for a down-and-out family she counted among her friends.


Being pregnant in jail is stressful, she explained. Still, when she first went behind bars on May 29 that year, she felt certain she’d receive the proper prenatal care. A little more than three weeks after she arrived, something felt wrong.

Kent had taken two children to term in the past, and she knew bleeding was a red flag. The stomach pain was growing worse, too.

But no one would line her up an appointment with a physician, according to an 88-page lawsuit she’s now filed. Staff told her she wasn't bleeding enough to cause concern, the complaint says. “They kept putting me off, not even really making eye contact,” Kent told the Observer. “It just didn't matter to them.”

"They kept putting me off, not even really making eye contact." - Lauren Kent

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By July 1, her desperation was mounting. The cramping had become more painful, and she noticed a blood clot in the toilet after peeing, she wrote to the staff in an electronic message. "I'm spotting a lot and cramping," she wrote. "I haven't felt my babies move in over 24 hours."

Four and a half hours later, nurse Julia McBride replied, informing Kent that her request had been received and that she could see a medical professional when the next open appointment came, according to the lawsuit.

“Please be advised that you will be subject to a $10 nurse sick call fee,” read the message, which is included in the suit. “If referred to the provider, you will be subject to an additional $15. All medications prescribed are $3 per medication. Thank you.”

Kent sent off more messages, her tone growing more pleading, but the nurse told her that she needed to “saturate more than two pads” in a half-hour period. At one point, Kent was threatened with disciplinary action if she continued asking for medical attention, the lawsuit alleges.

It wasn’t until July 4 that Kent saw a physician’s assistant, according to the lawsuit. During that meeting, the physician’s assistant treated her for a bladder infection. The next day, Kent delivered a stillborn child while sitting on the toilet, alone in her cell around dinnertime.

**

"Thanks and God bless," McBride concluded one of her messages to Kent, which is also included in the lawsuit. The nurse signed off, “We are here to serve you.”

The way attorney Scott H. Palmer sees it, those words ring hollow. A little more than three weeks after losing the pregnancy, Kent left the jail. Once out, she found an attorney in a phonebook, and he put her in contact with Palmer.

To Palmer, the case is as troubling as it was preventable. "If you're bleeding that much, it needs to be treated immediately," he told the Observer.

Filed on May 29 this year, the lawsuit names Collin County, Wellpath LLC, Southwest Correctional Medical Group INC (which was purchased by Wellpath) and four individuals who worked for the companies.

The lawsuit claims the alleged medical neglect boils down to cost saving. "There was no legitimate government interest in denying Ms. Kent adequate medical care," it states, adding that Kent was "denied her basic human needs."

Collin County outsources medical treatment for inmates to Wellpath. In June 2019, a CNN investigation found that the company (formerly known as Correct Care Solutions) had won government contracts for more than 500 facilities in 34 states nationwide, making it the "largest for-profit provider of healthcare to correctional facilities."

The CNN exposé examined internal documents, autopsy reports, emails and audits, among other records, and concluded that "the company has provided substandard care that has led to deaths and other serious outcomes that could have been avoided." (The CNN report is referenced widely in Kent's lawsuit.)

"Collin County denies the allegation made in this lawsuit and will vigorously defend itself in this litigation." - Collin County spokesperson

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The lawsuit also claims that cost saving while someone is in need amounts to an unconstitutional practice, adding that Collin County also encouraged onsite treatment to prevent too much spending.

The "cost containment program," the lawsuit says, "required nurses in the jail to refuse, deny and avoid
transferring inmates to offsite medical providers for the purpose of reducing costs," which left Kent "to suffer in excruciating pain, and ultimately to lose her baby."

The Collin County Sheriff's Department operates the jail and the county "contracts with a third-party medical provider for all medical services" in the jail, a press officer told the Observer. "Collin County denies the allegation made in this lawsuit and will vigorously defend itself in this litigation."

In an email to the Observer, Wellpath said it is "aware of the referenced lawsuit," but declined to comment further because the "litigation is ongoing and involves detailed personal and medical information regarding a patient, we are unable to comment or provide details at this time.”

**

It’s difficult to determine how many pregnant people end up in jail or prison each year. There’s no central reserve of data, and many city and county jails around the country don’t report numbers.

It’s also difficult to know how those pregnancies turn out, how many children are delivered successfully and how many don’t make it. (Lauren Kent recalls a handful of other women who were pregnant while she was in the Collin County jail, but she couldn’t put a number on it.)

Known as Advocacy and Research on Reproductive Wellness of Incarcerated People (ARRWIP), a group of researchers out of Johns Hopkins University tried to gather as much data as they could on the number of pregnant inmates around the country. 

They roped in statistics from 22 state prison systems, the Federal Bureau of Prisons, six other jails and three juvenile justice systems. Altogether, around 4% of those incarcerated in prisons were pregnant between 2016 and 2017, while some 3% in jails were.

In six counties, including Dallas and Harris, they found that the jails admitted pregnant individuals more than 1,600 times.

Although most of the pregnant inmates were cut loose, at least 224 pregnancies ended in jail. Altogether, the researchers identified 41 miscarriages – nearly one in five pregnancies, a number comparable to the miscarriage rate outside – two stillbirths and one newborn death.

Carolyn Sufrin, an ob/gyn and medical anthropologist, serves as ARRWIP's director. "One of the shocking things about why it's so hard to collect these numbers from jails is because we actually don't know how many jails there are in this country," Sufrin said.

Without more comprehensive data, Sufrin explained, it's "impossible to know what services and care" pregnant people in lockup need.

"It is very difficult on so many levels," she said. "You're isolated from your usual support network. The physical environment of the jail is not necessarily one that is comfortable if you're pregnant."

**

After she lost the pregnancy, Kent said, staff at the jail put the stillborn child, whom she named Dakota Lee, in a red bag and phoned an ambulance. It was at the hospital, Baylor Scott and White Medical Center, that she first felt as if she was treated like a human.

“They took care of me there,” she said. “I got his handprints and his footprints, and they wrapped him in something nice and we prayed.”

But two armed guards stood nearby in the room all the while, she said. “They were very upset that they had to be there,” she recalled. “They were not happy.”

"I got his handprints and his feet prints, and they wrapped him in something nice and we prayed." - Lauren Kent

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After some 10 hours, they drove her back to the jail. Back in her cell, the guards and jail staff began treating her differently, she explained. “They were so nice to me afterwards,” she said. “They knew they had messed up.”

She remained behind bars for nearly three more weeks, she said, until a friend came down and paid her bond. In the end, it only took $125 to get her out.

Nearly two years have passed since she lost the pregnancy in the jail cell that summer. She has another child, a 9-month-old boy named Nova-James. "I love him so much," she said, "and I think about Dakota all the time, how they would be brothers."
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Patrick Strickland is the news editor at the Dallas Observer. He's a former senior reporter at Al Jazeera English and has reported for the New York Review of Books, The Guardian, Politico EU and The New Republic, among others.