Our favorite journalism about the criminal legal system in 2025

And some commentary and editorial writing, too.

by Wanda Bertram, December 22, 2025

We asked staff of the Prison Policy Initiative to share the stories about the criminal legal system — other than ours — that stood out to them this year. In an eventful year, when there was a lot of essential journalism, here were some of our favorite pieces.

The Prison Next Door, Bolts

Brian Nam-Sonenstein, Senior Editor and Researcher, says:

An incredible long read by Lauren Gill about residents of Franklin County coming together to protest a new mega-prison being forced through by Arkansas state government. The coalition’s fight to stop the prison — and to protect land that residents hoped to leave to their children — highlights consequences of prison-and jail-building that we often don’t think about. In the course of the story, the budget for the prison doubles from $470 million to $825 million, and state lawmakers realize (long after locals had pointed it out) that the cost of upgrading water infrastructure for the prison could be astronomical. The lack of transparency, rushed planning, and unpredictable costs associated with Arkansas’s new mega-prison are an important reminder that prisons are political projects.

TIGER, the algorithm banning Louisiana prisoners from parole, Verite News

Wendy Sawyer, Research Director, says:

One of a wave of recent “tough on crime” reforms to Louisiana’s prison system means that only incarcerated people deemed “low-risk” by an algorithm are eligible for parole release. As Richard Webster chronicles, in practice, that leads to tragedies like this story: A 70-year-old man who is nearly blind, who has been preparing for years for his chance to go home, is told he is no longer eligible because the algorithm deemed him a “moderate risk.” Parole has been at the front of our minds this year as many states have taken steps to curtail it (and because we published a two-part report about it), and this law represents the worst of the regressive changes: a state culling people from parole rosters based on factors totally outside of their control.

Reporting on cities’ and counties’ collaborations with ICE

Jacob Kang-Brown, Senior Researcher, says:

From coast to coast, writers and reporters have helped to uncover the on-the-ground dynamics of the Trump administration’s mass deportation agenda, which often bely local and state “sanctuary” policies. Some of my favorites: Inadvertent documenting the Glendale City Jail contract with ICE, which the city canceled after their reporting; WTTW exposing 17 Illinois jails whose contracts with the U.S. Marshals allowed collaboration with ICE; Unraveled reporting on the Chicago Police Department providing crowd control at raids; and Judah Schept and Jack Norton, in n+1, explaining how rural jail expansion has created new infrastructure that ICE can take advantage of.

No Exit, Inquest

Danielle Squillante, Development and Communications Associate, says:

Imprisoned people are sold the idea that if they develop a deep insight into why they committed their crime, demonstrate remorse, engage in prison programming and education, and maintain a relatively clean disciplinary history — what prisons call rehabilitation — they will become good candidates for parole. But as Bobbi Cobaugh compellingly articulates, this is a fallacy — one that sows disillusionment in the minds of imprisoned people and their loved ones. As she writes, parole boards focus heavily on static factors that incarcerated people can’t change, like the crime itself, depriving incarcerated people of the second chances they earn.

In North Carolina Prisons, a Missed Opportunity in the Battle Against Opioids, Prison Journalism Project

Danielle Squillante, Development and Communications Associate, says:

As we argued in our article Addicted to punishment, prison administrations would rather invest in punitive responses to drug use than provide medication-assisted treatment, clinical treatment, and peer recovery groups — despite the fact that so many imprisoned people struggle with substance use disorders. As K.C. Johnson writes, prisons not only fail to provide treatment options for people so they can become more stable, but they also fail to curb the influx of drugs into the prisons, putting imprisoned people who use drugs at risk of overdosing. It’s a crisis of their own making, one that has serious consequences for people in prison.

Scorching Cells, Reuters

Regan Huston, Digital Communications Strategist, says:

Everyone knows that summer heat can be intense, but not everyone has felt the sweltering conditions of prison cells – this immersive piece gives readers a glimpse at just how dire the situation can be. The scroll-through animations paired with thorough storytelling provide a unique approach to an often-overlooked issue.

Video explainers from MLK50’s Creator In Residence, Amber Sherman

Regan Huston, Digital Communications Strategist, says:

With more people getting their news from social media, MLK50: Justice Through Journalism, an outlet in Memphis, is meeting audiences where they are at by starting a “Creator In Residence” position in their newsroom. Their Creator in Residence, TikToker Amber Sherman, has an impressive following and an easy rapport with her audience, along with the support of a trustworthy outlet. Her explainers about Memphis’s courts and jails — such as this one about the city juvenile court concealing its proceedings — break down complex issues in the criminal legal system.

@aisforafro Why is juvenile court trying to block people from seeing public court proceedings? 👩🏽‍🏫 #policymadesimple #creatorinresidence In collab w/@MLK50:JusticeThroughJournalism ♬ original sound – AisforAfro

Kentucky Parole Board series, Northern Kentucky Tribune (parts one, two, three and four)

Leah Wang, Senior Research Analyst, says:

How do parole boards work and what principles guide their decisions? We set out to answer these questions this year in our report Parole in Perspective; meanwhile, journalist R.G. Dunlop tackled the same questions — and put a human face to them — in his four-part series on parole in Kentucky. The series is about a lot more than parole, though, diving into the difficulties of aging in prison and the costs — fiscal and moral — that Kentucky has taken on by handing out so many life sentences.

Beth Shelburne’s Substack Moth to Flame

Leah Wang, Senior Research Analyst, says:

Beth is an independent journalist and co-produced the stunning HBO documentary The Alabama Solution. Her Substack, like most of her reporting, focuses on Alabama, which is good because there is a lot to say about Alabama’s broken and deadly prison system. She has touched on corruption and failures of accountability within ADOC, deaths in Alabama prisons and the families who grieve, and following the money behind ADOC contracts and lawsuits. But she’s also a human and that element comes through between her deep investigative stories.

High-priced lawyers for Alabama DOC using AI to file motions (parts one, two, and three), AL.com

Mike Wessler, Communications Director, says:

This series by John Archibald ties together a lot of threads that show how deep the problems in the criminal legal system really are. First, it is based in Alabama, which consistently has one of the highest incarceration rates in the world. Next, it highlights that the state is so used to being sued for the inhumane conditions of its prisons that it has enlisted the help of a high-priced law firm to handle the issue, costing taxpayers big time. It also shows the unreasonable hurdles that incarcerated people face when seeking protection from the courts, and the ways that the system defaults to siding with prison officials over the incarcerated. And finally, it highlights the truly insidious ways that artificial intelligence is quickly creeping into the criminal legal system, almost always in ways that will make the lives of incarcerated people and their loved ones even worse.

Reported Crime May Be Falling At A Historic Rate In The US, Jeff-Alytics

Sarah Staudt, Policy and Advocacy Director, says:

We’re seeing an expansion of the carceral state in 2025: ICE raids, counties forcing through massive new jails (and states building new prisons), expansions of electronic monitoring. So it’s important to remember that amid all this, crime is actually at a historic low. Jeff Asher’s levelheaded Substack is a great source of perspective on crime-related issues and trends. In this piece he explains that crime across several categories fell at historic rates in 2025. With everyone from big-box retail stores to the Trump administration claiming that crime is on the rise, and that this merits even more investment in incarceration, this kind of historic view is critical.

Michigan inmates struggle to get help from little-known $19M fund for prisoner needs, Detroit Free Press

Wanda Bertram, Communications Strategist, says:

In Michigan, revenue from incarcerated people’s purchases on commissary and phone calls goes into a “Prisoner Benefit Fund.” But the money has largely sat idle, reporter Paul Egan found. The fund held $19 million at the end of 2024, and has sometimes gone toward maintenance costs, like an $86,500 roofing project. Meanwhile, incarcerated people — who have little say in how the money is spent — have gone without basic needs like toothbrushes, deodorant, and envelopes. This is a great piece highlighting how prisons squeeze incarcerated people and their families to fund operations, laundered through the notion of a charitable fund. (For more on these “welfare funds” in prisons, see our 2024 report Shadow Budgets.)

Priced Out of Phone Calls Home, Bolts

Peter Wagner, Executive Director, says:

Phillip Vance Smith, writing from Neuse Correctional Center in North Carolina, compellingly lays out the consequences of the FCC abruptly suspending its 2024 caps on prison phone and video calling rates. Just after these caps went into effect in the spring, the agency suspended them, yanking an economic justice victory away from millions of families who would have benefited. (After publication, the FCC doubled down, with an October order gutting its 2024 rules.) Smith explains the seriousness of this defeat: People he knows will go on paying hundreds of dollars every month to communicate with a single incarcerated loved one, and those on the inside, who often cannot shoulder the cost of calls, will lose family connections over time.

Our most important research and advocacy work in 2025

Highlights of our work include exposing the role jails are playing in Trump’s mass deportation agenda, a new report detailing the current state of youth confinement, and a deep dive into discretionary parole systems.

by Danielle Squillante, December 11, 2025

2025 was a challenging year. Not only were many states returning to the failed policies that created the nation’s mass incarceration crisis, but a new administration came to D.C., threatening to use the power of the federal government to make the criminal legal system even worse. The Prison Policy Initiative rose to these challenges, pushing back on and exposing these misguided policies, and continuing to produce cutting-edge research that shines a light on the dark corners of the criminal legal system in America.

Here’s just a taste of some of our most important work this year:

Updates to our bedrock Whole Pie reports

We released the 2025 edition of our flagship report, Mass Incarceration: The Whole Pie. The report offers the most comprehensive view of the nearly 2 million people incarcerated in the U.S., showing what types of facilities they are in and why. It also included, for the first time, a section that breaks down which states are driving the growth in incarceration. We also released an update to our Youth Confinement: The Whole Pie report, which provides the most up-to-date picture of how many youth are detained and committed in the U.S., highlighting the persistent overincarceration of Black and Indigenous youth in a system that, in recent decades, has made great strides in reducing youth confinement overall.

New resources highlighting how the federal government is impacting the criminal legal system

Since taking office, the Trump administration has issued numerous executive orders and used its bully pulpit and control over federal spending to coerce state and local governments into expanding the size and brutality of their criminal legal systems. To help people make sense of these rapid-fire actions, we released a new tool that tracks the administration’s efforts and connects the dots on its strategy to make the criminal legal system harsher, less effective, and even more unfair. We also released a primer on the traditional role of the federal government in shaping the criminal legal system, to help advocates know where state and local lawmakers can push back on the administration’s actions.

Hiding in Plain Sight: How local jails obscure and facilitate mass deportation under Trump

Local jails, even in some sanctuary cities and states, are playing an essential role in President Trump’s mass detention and deportation plan. This report breaks down the complicated overlap between local criminal and immigration systems, and reveals that the Trump administration is circumventing sanctuary policies by referring immigrants to the shadowy U.S. Marshals Service, whose contracts with jails to hold pretrial detainees have often gone overlooked.

Highlights from our advocacy work

While we’re best known for our research and reports, that’s not all we do. In 2025, our advocacy department partnered with dozens of organizations in over 25 states to provide custom research and strategy support to on-the-ground efforts that are transforming our criminal legal system. This year, we testified in legislatures in Massachusetts and Colorado on the importance of protecting in-person visitation in prisons and jails and presented to the Hawai’i Correctional Oversight Commission about the pitfalls of new jail construction. We also presented two webinars, each with hundreds of attendees, that covered how best to interpret recidivism data and how to fight unnecessary local jail construction.

Parole in Perspective: A deep dive into discretionary parole systems

This two-part report pulls back the curtain on parole release systems, providing the most accessible and comprehensive source to date for comparing how these essential — and often dysfunctional — release mechanisms are set up in 35 states. The first part explores the makeup of boards and how they conduct hearings. The second dives into new data on hearings and grants, and the factors that boards consider — including their discretion — in determining whether someone will be released.

Bad Behavior: How prison disciplinary policies manufacture misconduct

Every prison system has a lengthy disciplinary policy laying out the rules incarcerated people must follow, as well as the procedures and punishments they’ll face if they don’t. These policies are supposed to ensure safety, security, and order by deterring and punishing misconduct. In practice, however, prison discipline is a system of petty tyranny with devastating, long-term consequences. Our report, Bad Behavior is the broadest review of disciplinary policies to date, and draws on original research as well as testimony from 47 currently incarcerated people, providing an essential look at how prisons are run in the age of mass incarceration.

Cut-rate care: The systemic problems shaping ‘healthcare’ behind bars

In correctional healthcare systems, care is secondary to controlling costs and avoiding lawsuits. For this report, we pored over research, news investigations, government reports, and contractor documents to better understand the “big picture” relationship between healthcare providers, government agencies, and incarcerated people, and to identify system-level targets for improving care outcomes. Importantly, we combined testimonies from incarcerated people in state and federal prisons with this in-depth research and analysis to tell a fuller story of how deeply flawed health care systems are.

States of Women’s Incarceration: The Global Context 2025

This report offers a crucial lens through which to view the criminalization of women, who are a small minority of all incarcerated people in the U.S., but whose incarceration rates today are at near-historic highs. It provides a comprehensive women’s incarceration rate for every U.S. state — including prisons and jails, youth confinement facilities, tribal jails, immigrant detention centers, and other types of incarceration — comparing states to each other and to countries of the world.

New national data help fill 20-year data gap: Offense data for people in local jails

Millions of people are arrested and booked into jail every year, but existing national data offer very little information about the actual criminal charges for which they are detained. In this briefing, we worked with the Jail Data Initiative to fill that gap and provide a new “snapshot” of people in jail by offense type using the most up-to-date nationally representative sample available.

Fourteen states ripe for prison gerrymandering reform

Everyone is supposed to have an equal voice in their government’s decisions, but an outdated and misguided Census Bureau policy that counts incarcerated people in the wrong place gives a few residents of each state a megaphone. It is a problem known as prison gerrymandering, and state lawmakers can fix it. We recently released a series of reports focused on states ripe for ending prison gerrymandering — Alaska, Florida, Georgia, Kansas, Kentucky, Louisiana, Michigan, North Carolina, Oklahoma, Oregon, Texas, Vermont, West Virginia, and Wyoming. Not only do these states have significantly prison-gerrymandered districts, but this problem has a significant impact on their Black, Native American, or Latino residents.

This is only a small piece of the important and impactful work we published in 2025, and our work is far from over. We’ve got big things planned in 2026, when we’ll continue to expose the broader harms of mass criminalization and highlight solutions that keep our communities safe without expanding the footprint of the carceral system.

Menstruation as misconduct: How prisons punish people for having their periods

Our analysis of prison rules and sanctions across all fifty states and the federal system — as well as accounts of incarcerated people — reveal troubling trends in how the carceral system punishes people for a physiological process they have no control over.

by Miriam Vishniac and Emily Widra, November 12, 2025

Prisons are primarily designed to confine and control men, which makes managing menstruation extraordinarily difficult, uncomfortable, and often downright dangerous for people inside. Incarcerated people are routinely denied the basic dignity of having the sanitary products and practices they need to care for themselves. When they band together and try to cope by engaging in survival strategies such as sharing supplies, they often fall prey to prison disciplinary systems used to target them for cruel punishment. To make matters worse, those punishments erect even greater barriers to menstrual health and hygiene.

Prison disciplinary systems lay out the wide-ranging rules that govern nearly every aspect of prison life, as well as the power of corrections officers to identify rulebreaking, enforce arbitrary rules, and determine the consequences. While corrections departments justify these far-reaching disciplinary systems as necessary to ensure safety, security, and order by deterring and punishing “misconduct,” in practice, they grant corrections officers wide and virtually unchallenged discretion to turn everyday behaviors into “rule violations” that jeopardize access to important programming and services.

Source: Prison Policy Initiative analysis of data from the Bureau of Justice Statistics’ 2016 Survey of Prisoners, The state prison experience: Too much drudgery, not enough opportunity.

In recent years, more attention has been paid to how people in prison and jail are denied access to menstrual products and are made to suffer for menstruating behind bars. Prisons punish people with periods in a number of ways, including by restricting access to necessary products either by legislation, policy, or by price at the commissary. A 2014 federal investigation of Alabama’s only women’s prison, for example, found that period products, laundry, and clean uniforms were “severely limited” and that staff used supplies to coerce, exploit, and punish incarcerated people. Other reports from carceral facilities across the country highlight how incarcerated people are subjected to assault, withholding of supplies, and humiliation while menstruating, in addition to being forced to live in unsanitary and unsafe conditions. While accounts from people in prison sometimes touch on disciplinary sanctions related to menstruation, prison systems themselves do not collect data on how often people are subject to punishments for period-related infractions. Our analysis is one of the first to systematically explore how prisons operationalize their disciplinary processes to punish people menstruating behind bars.

In this briefing, we analyze prison rules and sanctions from every state, the District of Columbia, and the federal Bureau of Prisons to explain how many of them allow corrections departments to unjustly punish people for the normal bodily process of menstruation. We are making these findings available in two appendix tables at the end of this briefing. While the rules in question are not explicitly about punishing menstruation, they are so broad and vague as to leave open the possibility that they can be used toward those ends. Importantly, the issue is not just that such rules are in place, but that correctional officers are allowed to practically unilaterally interpret and enforce them. In her extensive research into menstruation in prisons, lead author Miriam Vishniac (of the Prison Flow Project) collected invaluable reports from directly impacted people on their experiences of menstruating in prison. These are crucial data points because there is very little data available on this subject, and analyzing policy alone cannot explain how these discipline systems are weaponized against menstruating people. To better understand the reality facing people who menstruate, we include some firsthand reports from Vishniac’s research and other sources. Throughout this briefing, these accounts from incarcerated and formerly-incarcerated people are shared in blockquotes formatted like this:

“They were not getting what they needed and then often being ridiculed or punished for not having adequate equipment to take care of their periods…” – A.K. (Vishniac, 2025)

In Vishniac’s analysis of prison disciplinary policies, we found that at least six types of rules that can be used against people for menstruating:¹

• Damaging property: Rules designed to prevent damage to prison property result in punishing people for bleeding on prison-issued property, using more menstrual products than allotted, and supplementing their limited menstrual products with other materials like toilet paper, paper towels, or rags. ⤵
• Maintaining personal hygiene: Rules that mandate tidiness and personal cleanliness can be used against people who are menstruating when they have inadequate menstrual products and limited changes of clothing. ⤵
• Contraband: Rules restricting the type of property people can have in their cell, as well as the amount of allowed property that people can have in their cell and how that property is used, can turn basic or makeshift hygiene products into prohibited items. ⤵
• Movement: Rules that govern the physical movement of people throughout prisons inevitably impact people who are menstruating by limiting access to bathroom, shower, and laundry facilities. ⤵
• Work assignments: Rules requiring participation in work assignments — or impose sanctions for unauthorized absences — unfairly punish people who are menstruating and cannot maintain their usual job performance or tolerate being at work. ⤵
• “Feigning” illness: Rules supposedly designed to reduce the unnecessary and expensive use of healthcare resources undoubtedly results in the dismissal of real, severe symptoms experienced in menstruation. ⤵

In addition to rules that put people who menstruate in the crosshairs of the disciplinary system, many of the sanctions for breaking them further restrict access to menstrual products,² including:

• Confiscation: A common sanction for being found in possession of “contraband” is confiscation — and it is easy to see how prisons can classify menstrual products as contraband if people have more than the allotted number of products, have traded for menstrual products, or use products acquired in an unauthorized manner. ⤵
• Work assignments: Sanctions that result in the loss of work assignment or lowered pay can make it even more challenging for people to afford menstrual products, and requiring additional labor as a punishment can be impossible for people who do not have access to menstrual products or who are experiencing menstruation-related symptoms and medical conditions, including pain and heavy bleeding. ⤵
• Fines, fees, restitution and assessed costs: Sanctions requiring monetary payment disproportionately impact women, trans, and nonbinary people, who tend to enter prison with fewer financial resources than men, and who need to spend what little they have on menstrual products from the commissary. ⤵
• Loss of privileges: Revoking access to the commissary prohibits people from accessing menstrual products (when it is the sole provider of them) and disallows people from safely supplementing the menstrual products they have when needed. Other privileges are often revoked as well, including visitation, recreation, and programming, all of which are tied to lower rates of prison misconduct and recidivism. ⤵
• Restrictive housing: Sanctions that confine people to their cells or restrict access to personal property inevitably limit access to necessary menstrual products when they are otherwise unavailable in restrictive housing or disciplinary segregation. ⤵

Basic menstrual care runs afoul of several common prison rules

Prisons typically have many rules, many of which may seem mundane — or even reasonable — that can cause serious issues for people menstruating behind bars.³ Combined with officer discretion, the general lack of oversight in prisons means even the most basic rules can be weaponized. As it stands, research shows that women are more likely to be written up and disciplined for breaking prison rules, and receive disproportionate punishment for minor, subjective infractions like “disrespect.”⁴

While in prison, having a record of rule violations of any kind can exclude people from placement in less-restrictive housing units, program participation, and other services that could benefit them. In addition, pathways to release like parole and clemency proceedings take disciplinary records into consideration, so even the most minor infractions can influence how long someone spends in prison.⁵

Rules governing possession, damage, and misuse of property

Carceral settings often limit access to any and all items for people behind bars. Prison administrators argue that having “too much” property could pose safety risks in small cells (fires, clutter, sanitation), make people targets for theft, or create opportunities for incarcerated people to accrue money or leverage among others.⁶ While there may be some merit to these concerns, the tight restrictions of people’s property offers an additional tool of control and prevents people from having the things they need in the necessary quantities, inflicting real pain on people in response to imagined scenarios.

Damaging state property. Almost every single prison system has a rule about damaging property belonging to the state or the prison system.⁷ However, an inevitable consequence of restricted access to menstrual products like tampons and pads (as well as necessary hygiene products like toilet paper) is inevitably the “damage” (i.e., staining) of property, whether that be prison-issued clothing, bed linens, or upholstered chairs.

“I remember a time when I bled through the pad and I was working at my job. So now the chair has blood all over it. And I’m like, ‘Oh my gosh, what am I gonna do?!’” – A.K. (Vishniac, 2025)

“If you bleed all over state property they can charge you for destruction of state property. You know?’” – Ann (Vishniac, 2025)

Crucially, many rules about property explicitly disregard intent, stating that even “negligently” damaging property is a rule violation.⁸ In some prison systems, there are also rules about damaging “personal property” belonging to the individual or another incarcerated person, meaning that even if menstrual blood “damages” or stains property that is not state-owned, people are still at risk of disciplinary action.⁹

Wasting state property. Poor quality menstrual products are typical in prisons and result in people needing to use more pads and tampons. People menstruating in prison must request additional products and take the risk that they will be punished for “wasting” them by running through their allotted tampons and pads too quickly.¹⁰ Even when prisons do provide free menstrual products, people report that the free pads need to be changed more frequently than every 30 minutes on days of heavy flow.¹¹ In a 2023 survey of women involved in the criminal legal system, almost half of respondents reported using menstrual products for longer than they wanted (presumably because of quality issues) while incarcerated, and nearly a quarter of respondents reported negative health outcomes associated with prolonged use and limited supplies.

Misusing or altering state property. Prisons are places of extreme neglect. Incarcerated people often cope by finding ways to meet their own needs however they can — including using makeshift materials as menstrual products. People report using mattress stuffing,¹² dirty rags, socks, pillowcases, toilet paper, and shirts as menstrual products. Using these materials as makeshift menstrual products is an example of “unauthorized” use or using an item for something other than its “original intent or purpose.”¹³ In the same 2023 survey of women, more than one-third of respondents reported using materials other than pads and tampons to stanch menstrual bleeding. Even toilet paper has its limits as a supplement to menstrual products: most facilities only give women as much as they give men, meaning they have about one-third to half as much as they need once menstruation is taken into account (due to changes in bowel movements that often accompany menstruation), even if they don’t need to use toilet paper in lieu of pads or tampons.

“If you are using toilet paper, and you don’t have a sanitary napkin, that is also considered an infraction.’” – Jane (Vishniac, 2025)

Of course, using toilet paper or any other piece of property as a makeshift menstrual pad or tampon is a “misuse” of property and subject to disciplinary write-up and sanction,¹⁴ in addition to the punishment of physical discomfort, humiliation, and the cost of purchasing more toilet paper from the commissary.

Rules about personal hygiene and sanitation

Over thirty prison systems in the country have rules about personal hygiene and sanitation. The most generous interpretation of these rules may be to incentivize keeping shared spaces clean and encouraging sanitary practices like showering and hand-washing. However, the broad subjectivity of these rules allows them to be weaponized against people menstruating in prison, who already lack many of the resources they need to maintain basic hygiene while menstruating.¹⁵

“You see women being forced to free bleed because they don’t have access to anything else, but then they get told that they’re not being hygienic and they get put on lock [disciplinary housing] because they’re free bleeding.” – L.B. (Vishniac, 2025)

The exact time when menstruation begins is not predictable, and not having access to products leads to a situation in which people who bleed on themselves are disciplined, even though it is — inside and outside of prison — unavoidable. People in prison do not have sufficient access to menstrual products at baseline, let alone sufficient access to proactively wear pads and tampons before their menses begin.¹⁶

In addition to rules mandating personal hygiene, most prison systems have a rule violation associated with exposure to “bodily fluids.” Such rules are occasionally accompanied by a definition that restricts the violation to instances of “spitting” or “throwing,” which would obviously exclude unintentional bleeding on furniture or clothing during menstruation. At the same time, such vague rules coupled with practically unchecked officer discretion could — especially in cases where it is not explicitly limited by intentionality — be used to punish people who menstruate. For example, in New York, corrections unions cited concerns around “splashings” if menstrual cups were provided, essentially arguing that access to menstrual products should be limited.

Rules about possessing “contraband”

While most people think of drugs and weapons as “contraband” in prisons, the reality is that the definition is far more expansive. Behind bars, “contraband” also includes permitted items that a person may use for an unintended purpose, give to another person, or have in excess of what’s allowed.¹⁷ In other words, practically anything can become “contraband” if an officer says so, and therefore opens a person to the possibility of punishment.

Excess property. People report serious punishments in prison for trying to be prepared with more than the allowed number of menstrual products, including losing the ability to call their children. In one case, the excess property in question was 30 tampons, which is fewer than are in most boxes of tampons available outside prison.¹⁸

Unauthorized acquisition or exchange of property. As we previously noted, prisons frequently prohibit people from sharing items under the justification that it may create power disparities. Unfortunately, this also means that incarcerated people are not allowed to help each other deal with the facility’s failure or refusal to provide enough menstrual products.¹⁹ Even those few people who can afford additional products from the commissary are not allowed to share those items.

“You could ask somebody [for menstrual products], but if you got caught giving that to one another, even though it was a state-issued product, uh, you’re, you’re gonna get disciplinary ‘cause you’re not allowed to give each other stuff.” – J.T. (Vishniac, 2025)

Incarcerated people are forced to watch others be humiliated and punished just for menstruating, negatively impacting their mental health and emotional well-being — especially the large proportion of incarcerated women, trans people, and nonbinary people who are survivors of abuse.

In addition, because prisons are largely staffed by people who do not menstruate, there is no institutional understanding that people need access to these products at all times and in all locations. People in programming, in treatment for mental and physical conditions, at work, and in disciplinary housing may have restricted access because menstrual products are not included in the list of acceptable items for those locations, making them “contraband” in that specific context.

Rules regulating movement

Nearly all state prison systems and the federal prison system have rules that prohibit people from being “out of place” or in an “unauthorized area.” The physical movement of people in prison is highly regulated and scrutinized, and in the context of menstruation, these rules can seriously restrict the health and hygiene of people menstruating. People who are menstruating require more trips to the bathroom, either to change products²⁰ or due to changes in bowel movements, yet many prisons strictly limit bathroom, laundry, and shower access.²¹

“I had a fibroid on my uterus, so I had a lot of bleeding. But, the pads are so cheap and they don’t absorb well. I would go through three of them a night and still bleed through my clothes onto my sheets. It was so embarrassing and shameful, I would get up early and wash myself, my clothes, and my sheets, even though this was against the rules. I would get in trouble, but I couldn’t just stay with my clothes and sheets like that. It made me feel less than a human being, let alone a woman. Even though we are in prison, we are still women.” – Evelyn (Texas Criminal Justice Coalition, 2018)

People who are menstruating — and particularly those who experience irregular or heavy flows — not only have to worry about being punished for bleeding on themselves and their bedding, but must also face potential rule violations if they try to clean themselves up in the bathroom or access the laundry facilities without prior authorization.

Rules about work assignments

The majority of prison systems have rules about failing to meet expectations in work assignments²² or about absences from work or programming assignments.²³ Without prior authorization, people in prison cannot miss work assignments without risking a write-up. People can also be disciplined for not meeting job performance and productivity expectations. Outside of prison, almost half of women have taken time off work in the last 12 months due to menstrual symptoms. But in prison, people with work assignments do not get any sick leave. In fact, they are often required to work while sick, unless a healthcare provider officially excuses them.²⁴

“We are not allowed to take days off from work to rest, and we must adhere to a strict daily schedule in which virtually all of our movement is controlled.” – Kelsey Dodson (2025)

“I used to get terrible menstruation cramps! Bad! There was a long time, especially when I first came into the system, that they did not sell ibuprofen. They did not sell it. You could ask the officers for one Tylenol tablet that came in this little mini little envelope, right? And you couldn’t have more than six in your possession. So I would dread when I started my period because the pain would go almost all the way down to my knees. And I would have to work out in the heat.” – J.T. (Vishniac, 2025)

It’s unclear how people can access menstrual products while at work or required programming because incarcerated people are not able to carry property with them from their housing unit. Incarcerated people may be forced into a disciplinary catch-22: attend mandatory programming and face possible sanction for bleeding on themselves, or refuse to attend and be sanctioned for being absent or “out of place.”

Rules against “feigning” illness

More than one-third of all prison systems have rules condemning “faking” or “feigning” illness or injury.²⁵ These rules reflect a disturbing assumption by prison systems, correctional healthcare providers, and correctional staff that people in prison routinely lie about their healthcare needs in an effort to better their circumstances by, for example, avoiding work assignments, transfers to a different facility or new cell, etc. This presumption of ‘malingering’ can have dire consequences for incarcerated people in general, but more specifically among menstruating people:

“The nurses are just like, ‘You’re trying to get something out of us. We don’t wanna do the paperwork.’ And they make it challenging for people to get what they need and they never look at the source of the problem.” – S.B. (Vishniac, 2025)

Even though it is widely understood that menstruating people experience serious and painful cramps, it’s often dismissed or overlooked inside and outside of the carceral context.²⁶

Sanctions for rulebreaking further restrict access to menstrual products

In prison disciplinary systems, rule violations are punished based on the severity classification of the offense. Lower-level infractions may result in warnings, reprimands, probation, “agreements” or informal resolutions, and other more lenient responses.²⁷ The rules discussed above are considered lower-level infractions in most prison systems, but even this involves equating different types of rulebreaking that are in no way comparable.²⁸

In addition, most prison systems will consider repeated rule violations as a higher level of violation (and therefore subject to more severe sanctions).²⁹ Given that menstruation occurs approximately every month, menstruation-related rule violations are likely to occur repeatedly, especially for people who experience particularly heavy flow, painful cramps, or irregular menstruation. While correctional leaders often frame repeatedly breaking certain rules as evidence of antisocial behavior, it can also be interpreted as a sign of rules that are impossible to follow in a system where constant punishment and humiliation is the point.

As we previously mentioned, women, trans, and nonbinary people are more likely than men to be written up and disciplined for breaking prison rules: eight in ten women who reported being written up for a violation in the past year also reported receiving some form of disciplinary action.³⁰ These harsh, punitive sanctions, which include solitary confinement and restrictive housing,³¹ loss of good time credits,³² fines and fees,³³ forced labor,³⁴ and lost access to programming³⁵ and visitation,³⁶ are destabilizing and traumatizing. But what’s important to understand here is that many sanctions actually further restrict access to menstrual products, leading to a dangerous cycle of violations and punishments that inhibit access to hygiene products.

Confiscation of property

At least 20 state prison systems and the federal Bureau of Prisons have sanctions on the books that include “confiscation,” “loss of authorized property,” “dispose of property,” or “loss of personal property.”³⁷ These sanctions are primarily associated with contraband-related rule violations, but when the “contraband” in question are menstrual products, incarcerated people are left without enough supplies as their period approaches.

“If you had more than [the allotted number of pads] you got a disciplinary case for it. So the women that, that bled heavily, you know […] they would hoard those things. And they would get them confiscated.’” – J.T. (Vishniac, 2025)

Carla, a formerly incarcerated woman, described cell searches and arguing with prison staff: “‘Wait a minute. I’m just getting ready to bleed. Why are you taking it?’ ‘Why do you have excess?’ ‘Well, I’m a heavy bleeder.’ You know? And, they just, they would take it.” (Vishniac, 2025)

In many places, personal property — including authorized property — can be confiscated in response to a rule violation (even rule violations not related to that personal property).³⁸ And while some states prohibit the confiscation of “personal hygiene items,”³⁹ menstrual products are frequently left out of the definition of those items.

Work-related sanctions

More than three-quarters of prison systems have sanctions that include “extra duty” or “extra work assignment,”⁴⁰ and at least twenty prison systems — including the federal Bureau of Prisons — have sanctions that result in “change or loss of work assignment” or “work without pay.”⁴¹ Losing a job or being punished with unpaid labor can also mean incarcerated menstruators are left unable to purchase the items they need from the commissary. Additional labor can be a problem for the same people who struggle to perform heavy labor without access to tampons or who struggle with pain and other menstruation-related conditions. On top of the physical discomfort and exhaustion, jobs used as punishment may require significant movement, meaning the need for additional menstrual products could be even greater due to the impact of exercise on menstrual flow.

Fines, fees, restitution, and assessed costs

Almost every prison system imposes financial sanctions like fines, fees, restitution, or assessed costs.⁴² In at least 16 prison systems, we found policies specifically referencing fines and/or fees as punishment when someone is found or pleads guilty to a disciplinary violation. In many cases, the severity classification determines the amount of the fine, but in other cases there is a “flat” charge. In either case, charging fines means that some of the most innocuous behaviors — like making “loud or disturbing noises” in Kansas prisons — have a price tag. Even fines that may seem small to people on the outside — like the $15 maximum fine for a low-level rule violation in Oregon — can be devastating in a situation where people have extremely limited access to money and, when they are paid for their labor, make mere pennies per hour. Sanctions can also include “restitution,”⁴³ “repayment for damages,”⁴⁴ and “forfeiture of cash monies.”⁴⁵ And because women, transgender, and nonbinary people tend to enter prison with fewer resources than their cisgendered men counterparts, financial sanctions are likely far more significant for them.⁴⁶ Ultimately, punishing people with fines, restitution, and assessed costs leaves them with less money for the basic essentials, including menstrual products at the commissary:

“To put in perspective now, to think that a box of pads or tampons could cost my income for how many days? Like, there’s no way. You know, it’s like buying tampon boxes for hundreds of dollars a box.” – A.K. (Vishniac, 2025)

Loss of privileges

Almost all prison systems limit privileges as a punishment for rulebreaking, and at least 32 prison systems have sanctions that explicitly restrict access to the commissary (including loss of commissary while in disciplinary restriction).⁴⁷ Some of these sanctions include caveats for “personal hygiene items,” but again, they often do not define what is considered a “personal hygiene item.”⁴⁸ We found only three state prison systems that specify that the loss of commissary privileges must not restrict access to menstrual products in their sanctions,⁴⁹ while an additional eleven state prisons systems prohibit restrictions on the more general category of “hygiene” or “essential” items, without defining those terms to include menstrual products. When all basic necessities are dispensed through the commissary, lost access can easily lead to a cycle of rule violations as people subsequently barter for menstrual products, damage state property, or are seen as “unhygienic.” The loss of other privileges (visitation, phone calls, exercise and recreation, programming)⁵⁰ can also have a serious impact on people’s lives and wellbeing in prison, as visitation can reduce prison misconduct and recidivism, exercise and recreation can improve physical health, and educational programming is associated with reduced recidivism.

Restrictive housing, solitary confinement, and movement restrictions

Every prison system — except Arizona — has some sort of restrictive housing available as a punishment for rulebreaking. This includes disciplinary detention, confinement to cell, or other types of restrictive housing.⁵¹ In some cases, even low-level rule violations can lead to such placements: in Iowa, for example, a “minor” rule violation like “unsatisfactory work performance” or “minor insolence (abusive language, cursing, obscene language)” can result in restriction to the cell.

“When I was in SHU [special housing unit], every day, you’re not allowed to keep anything in your cell. So every morning they have something called ‘go-around’ and if you need pads that day they will give you two in the morning go-round. That’s it. That’s all you have for the whole day. And if you miss the go-round, you can’t ask them for pads later in the day.” – S.B. (Vishniac, 2025)

When someone is confined to disciplinary housing or their quarters, they tend to also lose access to the commissary and the normal distribution of items like menstrual products. Only six state prison systems have language on the books explicitly requiring access to menstrual products while in restrictive housing.⁵²

Conclusion

There is no “safety and security” interest in denying people the basic sanitary products they need to manage normal bodily functions. In all of our research — combing through state statutes, department policies, and facility handbooks — we found no documentation explaining how exactly menstrual products could threaten safety. When pressed on this issue, corrections officials have been unable to provide any further clarity.

Punishing people for menstruating is cruel, dehumanizing, and unnecessary. This practice damages their self-esteem and mental well-being, triggering serious consequences both in prison and once released. As we have said, survival practices like sharing hygiene products is prohibited, in-part, due to a supposed fear of creating power imbalances inside. But this overlooks the simple fact that these practices create other devastating power imbalances: from 2011 to 2021, there were at least five substantiated incidents of correctional staff using their power over access to menstrual products to abuse people in their custody.⁵³ It is not enough just to enact laws that make pads and tampons free in prison or change the rules being used to discipline incarcerated menstruators:

“Because, if you have these laws, the people that work at the prisons always get the last say and can just overpower them.” – L.B. (Vishniac, 2025)

Effectively ending the mistreatment of those who menstruate in correctional facilities also requires oversight and accountability of prisons, and an end to mass criminalization of women and other menstruating people.

Almost half of all incarcerated people are in rural jails and prisons and at risk of losing access to hospitals

The Trump administration's One Big Beautiful Bill Act will result in the closure of many rural hospitals, leaving people in the surrounding communities — including those in prisons and jails — facing elevated healthcare costs and limited access to necessary healthcare.

by Emily Widra, October 28, 2025

Nearly a million incarcerated people depend on rural hospitals for routine off-site and emergency medical care.¹ Almost 60% of people in prisons and 25% of those in local jails are confined in rural counties, which are home to 3,000 of the nation’s correctional facilities. Following massive cuts to Medicaid passed by Congress this year, many rural hospitals will be forced to scale back operations or close entirely. As a result, critical, lifesaving healthcare will be further out of reach for huge swaths of the incarcerated population and those who live and work nearby, making an already bad situation far, far worse.

Rural and jail prison population estimates are based on an analysis of Vera’s Incarceration Trends jail data and the Bureau of Justice Statistics’ Census of State and Federal Correctional Facilities, 2019. The percentage of rural hospitals at risk of closure in each state as of August 2025 comes from the Center for Healthcare Quality and Payment Reform’s report, Rural Hospitals At Risk of Closing. See the methodology for more details.

The divisive “One Big Beautiful Bill Act” imposes significant cuts to Medicaid that slash funding for rural hospitals,² which are largely dependent on federal subsidies to stay afloat.³ Closing rural hospitals has disastrous consequences for entire communities, but especially for incarcerated people who have no choice about where they receive medical care. Rural communities can expect limited access to emergency care, higher costs for healthcare, and less-timely and more geographically distant medical treatment. The resulting loss of jobs and healthcare providers risks escalating poverty, unemployment, and disability rates, exacerbating an already dangerous cycle that often leads to incarceration.

Policy TrackerHow Trump is making the criminal legal system worse

In this briefing, we present our estimates of the number of people in prisons and jails who are locked up in rural counties and explain how rural hospital closures would spike healthcare and incarceration costs while worsening public health. We are also making these state-by-state estimates available in an appendix. Additionally, we examine how a weakened rural hospital system can make healthcare delivery even worse than it already is for people on the inside. Finally, we highlight ways in which the consequences of rural hospital closures — unemployment, inadequate healthcare access, poverty — are felt across entire rural communities, not just behind bars.

The incarcerated population is disproportionately sick, aging, and locked up in rural areas

With more than half of prisons and around a quarter of local jails situated in rural counties, rural hospital closures pose real risks to incarcerated people’s health and wellbeing.⁴ Incarceration has a negative impact on the health of people behind bars and shortens life expectancies — a state of affairs that is especially worrisome given the increasingly elderly and sick incarcerated population.⁵ Researchers warn that closing rural hospitals “can increase the risk of bad outcomes for conditions requiring urgent care, including that for high-risk deliveries, trauma, and heart conditions.” These bad outcomes are particularly likely among the incarcerated population, where some of these conditions are common: for example, about 2% of women entering jail are pregnant and many jail births are high risk. Additionally, heart conditions are the second leading cause of death in prisons and jails. Many correctional facilities already struggle to provide basic healthcare to incarcerated people and have disturbingly high mortality rates. These issues will inevitably worsen with the loss of important medical infrastructure nearby.

The impact on state prison systems

In almost every state, thousands of people in prison who need emergency and routine off-site medical care (such as imaging and x-rays, surgeries, and specialist care) rely on nearby rural healthcare systems that are now threatened by Medicaid cuts. This is particularly alarming in states that almost exclusively hold incarcerated people in rural areas, like Idaho, where 91% of people in prison are in rural counties.⁶ But the scale of the problem is worse in states with some of the largest prison systems — like Texas, Florida, California, Georgia, Pennsylvania, Arizona, and New York — where between 30,000 and 117,000 people in rural prisons rely on those hospitals in each state. Nationally, more than 783,000 people are in prisons in rural counties.⁷

People in prison already have to contend with delayed referrals to medical specialists, which (along with understaffing) contribute to higher mortality (death) rates on the inside. The carceral system is notorious for denying and slow-walking medical care, and for the convoluted, lengthy process required to be seen by a healthcare provider — practices that undoubtedly contribute to higher mortality rates on the inside.⁸ In rural facilities, these conditions are often exceptionally bad.

Prisons vs. jails Learn more about the difference.

In Louisiana — where 42% of the state prison population is incarcerated in rural counties — the prison mortality rate is more than double the national rate in state prisons, according to the most recent national data. From 2001-2019, Louisiana had the highest prison mortality rate overall, as well as for deaths related to heart disease, cancer, AIDS-related illnesses, and respiratory disease. Such severe healthcare needs require ready access to emergency and specialist care at a nearby hospital, and yet the Center for Healthcare Quality and Payment Reform estimates that 46% of Louisiana’s rural hospitals are at risk of closure, with at least nine at immediate risk of closure due to federal funding cuts.

Impact on local jails

Nationally, almost 170,000 people are incarcerated in rural jails. In 19 states, more than one-third of the statewide jail population is confined in rural counties. Six of those states confine more than half of their entire jail population in rural counties.⁹ Even in states with large rural populations overall, the share of the jail population in rural counties still stands out: for example, in Mississippi, where about half of the statewide population lives in rural areas, almost 70% of people in jail are held in rural counties. In Kentucky, where around 40% of the state lives outside of metropolitan areas, a disproportionate 67% of the statewide jail population is confined in rural jails.

Each year, more than five million people are arrested and booked into jail and they are more likely to have serious health needs — including mental illness, substance use disorders, HIV, Hepatitis B or C, cirrhosis, and heart conditions — than people who are not jailed. Troublingly, small, predominantly rural jails consistently report the highest jail mortality (death) rates in the country.¹⁰

The medical care that people receive inside jails is terrible in most places, but it is particularly bad in states with mostly rural jails and prisons. These facilities compete with community healthcare systems for limited resources, including qualified staff, and their failure to provide adequate medical care on the inside puts additional strain on local hospitals. When patients arrive from the jail or prison, their care has often already been delayed, making their health issues more severe and likely to require emergency or specialized treatment.

For example, in Virginia, where about 40% of the state’s prison and jail facilities are in rural areas, there have been at least three civil rights cases related to healthcare in prisons and jails since 2010. In U.S. vs. Piedmont Regional Jail Authority (2013), the U.S. Department of Justice alleged that the rural regional jail in Prince Edward County was permitting unqualified staff to evaluate medical conditions, inadequately screening for medical issues on admission, and providing subpar mental healthcare. The lawsuit resulted in the appointment of a court monitor to oversee the jail’s efforts to address these issues, but subsequent jail deaths suggest problems persisted. Similarly, in West Virginia — where 53% of the jail population is in rural counties — formerly incarcerated people already report serious healthcare issues on the inside, including delays in cancer screenings, lack of access to insulin, and abrupt discontinuation of prescription medication. Accordingly, West Virginia also had the second highest jail mortality rate in the nation at last count in 2019.

Rural hospital closures are associated with rising healthcare and incarceration costs, and worse public health outcomes

In the past decade, more than 100 rural hospitals have closed and more are at risk: the Center for Healthcare Quality and Payment Reform reports that in most states, over 25% of rural hospitals are at risk of closing, and in 10 states, at least half are at risk as of August 2025. Aside from providing crucial emergency care, inpatient medical care, and laboratory testing and diagnostics, rural hospitals are often where the community receives routine primary care and inpatient rehabilitation services. These closures can “wreak irreparable havoc on rural communities” and will, in turn, make it harder to reverse local population declines, threatening to turn these communities into “ghost towns.”

Beyond the community-wide effects of hospital closures – including unemployment (including in non-healthcare industries), lower income levels, and slower economic growth – the tendency of police to target poor and chronically ill populations means that people who fall through the cracks as a result of these cuts to crucial federal subsidies risk being swept into the system. With evidence that high county jail incarceration rates are associated with a rise in county-wide deaths, Medicaid cuts risk accelerating a dangerous cycle of poverty, illness, incarceration, and death in rural communities.

Medicaid cuts also stand to make already-costly medical care for incarcerated people far more expensive by placing services further out of reach. People living in rural areas live an average of 10.5 miles from the nearest hospital (roughly twice the distance in other areas), and over one-third of rural hospitals that closed between 2013 and 2017 were more than 20 miles from the nearest hospital. States, counties, and municipalities are ultimately on the hook for the high and steadily rising costs associated with medical care for incarcerated people. In Cheshire County, New Hampshire, for example, the county jail already budgets $50,000 for healthcare outside of the facility, which is expected to cover medical care for 100 people in jail, including one person who requires dialysis to the tune of $6,000 every month. In Virginia, 27% of the prison healthcare budget in 2015 was spent on off-site hospital care.

In particular, the costs of transporting incarcerated people to hospitals for off-site or emergency care are already extreme. In Michigan, the cost for 224 ambulance trips to the rural Chippewa County Correctional Facility is upwards of $430,000.¹¹ Meanwhile, in New Hampshire, Department of Corrections expenditures on ambulances rose by 176% from 2022 to 2023. Requiring transport to hospitals that are further away will cause these costs to climb even higher, and will incentivize corrections departments to avoid doing so as much as possible.¹² Prisons and jails already engage in this practice because of untenably high transport and staffing expenses.¹³ In Allegheny County, Pennsylvania, (which is not even a rural county), medical transport from the jail “takes two correctional officers out of the jail for up to 10 hours.” In a survey of jail staff in southeastern states, one jail employee reported that they “try and get rid of dialysis patients as quickly as [they] can, too, because they don’t wanna have to transport them three days a week to dialysis.” In addition to delaying offsite transportation as much as possible, corrections authorities may also try to deflect rising costs onto their (typically poor) incarcerated patients. As the National Consumer Law Center notes, jails in at least 25 states already engage in such practices:

“When an incarcerated person suffers from an acute medical issue that requires care that the jail cannot provide in-house, some sheriffs will release the person on “medical bond” before transporting them to a hospital so that the jail will not have to pay the medical bills. Once the person receives treatment and recovers, the sheriffs then often quickly move to rearrest and book the person back into jail.”

The failure to address people’s health needs while incarcerated exerts pressure on the remaining healthcare infrastructure as sick people leave correctional facilities and return home. For example, people on probation and parole face higher rates of substance use disorders, mental health diagnoses, chronic conditions, and disabilities than the general population, and over a quarter of people on community supervision have no health insurance, further limiting their access to adequate healthcare in the community.

Conclusion

The latest cuts to Medicaid pose substantial risks to both rural communities and the people who are incarcerated within them. Healthcare for incarcerated people is already abysmal, and jails and prison systems have been complaining about the rising medical costs for years. Medicaid cuts will pour fuel on this fire by forcing many rural hospitals to close. Further restricting timely access to routine off-site and emergency medical care will stoke worse health outcomes and higher mortality rates for an aging confined population. Given that most incarcerated people will eventually return to the community, these problems will exacerbate larger public health issues, impact community-wide mortality, and further burden the existing, limited emergency medical services in rural communities. Taken together, these factors paint a grim picture of the future for all people in rural communities as the combination of poor health and poverty makes rural communities more of a target for policing and incarceration. The destruction of rural public health infrastructure is a policy choice that inevitably favors using jails and prisons to manage increasingly poor, sick, and neglected populations through punishment rather than care.

Can they do that? A primer on the powers — and limits — of the president and federal government to shape the criminal legal system

The Trump Administration has made a lot of claims about how it will change the criminal legal system. We explain where the president and federal government have full control over the system, where they have some influence, and where their power ends.

by Mike Wessler, June 11, 2025

Sections

By the numbers

Independence of state & local authorities

Federal influence

The president & executive branch

Control over federal spending

Federal policing and prosecutions

Enforcement of civil rights laws

Pardons and commutations

Appointments

The bully pulpit

Congress

Federal courts

These are not normal times

Impacts on state and local governments

There is little question that the President of the United States is the most powerful person on the planet. They can launch military strikes, shake the foundation of the economy, and dramatically alter our international alliances, all with a stroke of their pen. And if you have heard President Trump speak about the criminal legal system lately, you’d likely think the office also has the power to control who is arrested and incarcerated, and what the conditions are like when they get there. The truth, though, is much more complicated.

It is important to remember that the United States doesn’t really have a single, unified criminal legal system. It has thousands of smaller systems, and state and local governments have direct authority over the vast majority of them. However, while the president and the federal government don’t have direct control over most of these systems, they have many tools at their disposal to indirectly impact how they are operated.

In this briefing, we explain the federal government’s traditional role in the United States’ criminal legal system, highlighting where it has direct control, ways it can exert indirect influence, and the relative size and scope of its power. It is important to note that, in this piece, we rely on how our government normally works, when limits on federal power are honored and where the president obeys court orders. We don’t explore every nuance of federal law or possible tools that the federal government could hypothetically deploy.¹ Instead, we aim to help you understand the avenues of influence it has traditionally exercised.

Actions and statements from the Trump administration raise serious doubts about whether these limits will be respected. Understanding the contours of power and authority outlined in this briefing can provide clues about what to expect in the future and serve as a helpful barometer of how far actions by the administration have deviated from the standards of recent decades.

The federal criminal legal system: By the numbers

While the president and members of Congress may talk a lot about crime, prisons, and incarceration, the truth is they directly control only a small sliver of the overall carceral system.

As we explain in the latest edition of our flagship report, Mass Incarceration: The Whole Pie, there are roughly 2 million people incarcerated in the U.S. on any given day.² Of those, only a relatively small portion are under the direct control of the federal government:

• Approximately 204,200 are in federal prisons or jails;
• Roughly 48,000 are in immigration detention facilities.³⁴

In total, about 13% of incarcerated people — approximately 252,200 people — are under the direct control of the federal government. For context, the federal incarcerated population is only a little larger than the number of people in prisons in jails in the single states of Texas, which has 11% of the national incarcerated population, and California, which has 10%. Those numbers show that, rather than being a massive monolith, the federal carceral system is roughly the same size as the criminal legal systems in some of the larger states in the country.

Make no mistake, 252,200 people under direct federal control is a lot, but it represents only a relatively small portion of the total number of people behind bars on any given day in this country.

So, who has direct authority over the other 87% of people incarcerated in this country? State and local governments.

Independence of state and local authorities

State prisons and local jails hold the vast majority of people who are incarcerated in this country. Those facilities and systems are operated and overseen by state and local governments and are largely independent of the federal government. You should think of state prisons and local jails as systems that operate in parallel (and occasionally overlap) with the federal system, rather than as subsidiaries of it.

State legislators write laws that dictate what actions are considered crimes and the possible punishments for those actions. Police and prosecutors — operated by both state and local governments — enforce those laws by carrying out arrests and prosecutions. County sheriffs operate local jails. And the state government runs the prison system that confines people sentenced to incarceration by state courts.⁵

Generally speaking, state and local governments hold the vast majority of the control in the criminal legal system, and the federal government plays a relatively small role.

Examining recent progress towards decriminalizing marijuana offers a helpful — albeit unique — example of how state and local governments operate in parallel with the federal government when it comes to law enforcement. Currently, 24 states have made the recreational use and possession of marijuana legal. That means that state and local law enforcement cannot arrest or prosecute someone for simply possessing or using marijuana.⁶

However, the possession of marijuana remains illegal under federal law. Even if you are in a state that has made recreational use of marijuana legal, the federal government could, in theory, still arrest and prosecute you for it. Usually, though not always, the federal government has respected states’ ability to write their own criminal laws, and in doing so, has avoided prosecutions that are contrary to state law.

Importantly, if someone is sentenced to incarceration, the entity that prosecuted them usually determines where they serve their sentence. If they’re prosecuted under state law, as most people are, they’ll usually serve their sentence in a state prison. If they’re prosecuted under federal law, they’ll likely serve their sentence in federal prison.⁷

Federal influence over state and local policy

While the federal government has direct control over a relatively small portion of the nation’s criminal legal systems, the president, Congress, and the federal courts have many ways to exert indirect influence over how states and local governments address public safety, prosecute crimes, operate their prisons, and more.

It is essential to recognize that the federal government’s influence and power to shape state and local criminal legal system policy is not inherently good or bad. This power has been used to both shrink and grow the carceral footprint in America. Understanding the contours of these powers can help you see how they’re being used.

The president and the executive branch of the federal government

The president and the executive branch of the federal government likely have the most tools at their disposal to influence how state and local governments operate their criminal legal systems. Some of these mechanisms are direct actions that essentially force the hands of state and local governments by using the promise of providing or eliminating funding or threatening legal action, while others rely on the prominence and prestige of the presidency to exert pressure and encourage specific actions.

Control over federal spending

While Congress controls the amount of money budgeted for various federal government programs,⁸ the president has immense discretion over how that money is spent and how laws are implemented. From the money allocated by Congress, presidents can often direct money to their own priority programs, while offering fewer resources to programs that are less important to them. These choices can dramatically impact state and local criminal legal systems.

Policy TrackerHow Trump is making the criminal legal system worse

A prime example of this is the Department of Justice’s Office of Justice Programs. This office provides millions of dollars in grants to state and local governments, as well as other organizations that provide services related to the criminal legal system. How this money is spent and what programs receive money have huge impacts on state prison populations and local police activities.

Under President Biden, many of these grants were awarded to organizations and programs designed to keep people out of the criminal legal system, reduce violence, and support victims of crime. However, shortly after taking office, the Trump administration cancelled roughly $820 million in Biden-era grants, indicating that they didn’t align with the administration’s priorities. The administration has said this money will instead be allocated toward programs that align with its focus areas, which many people assume means it will result in more money for policing and prison construction.

Additionally, the Department of Justice provides funding to state and local law enforcement through a series of grants and other programs. Many of these programs require state and local officials to comply with federal policing standards and collaborate with federal authorities on certain criminal investigations and prosecutions. This funding allows federal authorities to expand their reach and exert new pressure on local elected and law enforcement officials.

Another example of how executive branch agencies use money to shape state criminal justice policy is the Justice Reinvestment Initiative, which is partially funded by the U.S. Department of Justice. This program connects state leaders with experts to help them develop strategies to reduce crime, improve services for people with substance use disorder and mental health issues, and reduce spending on prisons and jails. Through this model, the federal government helps to lay the groundwork for state policy reforms. This framework allows the federal government, despite not having a direct voice in the decision-making for states, to influence state policies.

While the president cannot directly instruct states on how to operate their criminal legal systems, making funds available for specific uses can push them to take actions that the president wants. The money can motivate officials to follow the federal government’s lead, and conversely, when money dries up, force them to abandon strategies that aren’t in line with the president’s priorities.

Federal policing and prosecutorial power

The president appoints the attorney general of the United States to head the Department of Justice. Over the last fifty years, presidents have generally respected the independence of their attorneys general, based on the recognition that law enforcement should not be influenced by politics or personal grievance. The Trump administration has made clear it will no longer respect that independence.

While the attorney general is generally considered the top law enforcement official in the nation, they only have direct policing and prosecutorial power over allegations that federal crimes have been committed. As we explained above, this has traditionally been a relatively small portion of the total criminal cases around the country, with state and local governments maintaining jurisdiction over the vast majority.

It is important to note that the attorney general has incredibly wide discretion over which cases the Department of Justice pursues. There are a lot of actions that are criminalized by both the state and federal governments. However, in the vast majority of these cases, state and local authorities take the lead on arrests and prosecutions.

In theory, however, an attorney general could direct federal law enforcement to take primary authority over far more cases than it has traditionally pursued. This would swell the federal prison population and the federal government’s role in the criminal legal system. The fear of federal intervention in the criminal legal system can be used to coerce states to more aggressively pursue prosecutions that the president and federal government have prioritized.

Enforcement of civil rights laws

One of the most powerful ways that the federal government has positively impacted state and local law enforcement and prisons is through the enforcement of civil rights laws.

Even when state or local officials are responsible for policing or incarceration, they must still abide by civil rights protections in the U.S. Constitution. If they don’t, the U.S. Department of Justice can bring a federal lawsuit against the prison, police department, or other government body. These lawsuits often focus on things like racist policing practices, inhumane prison or jail conditions, and police brutality.

Often, these cases are resolved by consent decrees, in which the state or local government entity agrees to take specific actions to resolve the practices that violated federal law. In a break with the past, the Trump administration has announced that it is abandoning many of these efforts to rein in abuse in prisons and jails and by law enforcement.

Pardons and commutations

Presidents have the power to pardon or commute the sentences of people convicted of federal offenses. A pardon absolves a person of their criminal conviction, ending any remaining time in prison or on probation and wiping the conviction from their record, like it never happened. A commutation, on the other hand, reduces a person’s sentence, but doesn’t remove the conviction from their criminal record.

It is important to note that a president can only grant pardons and commutations to people convicted of federal crimes. They have no power to change the criminal sentences of people convicted of state crimes, which means most criminal convictions in the country are outside of their reach.

Appointments to courts, agencies, commissions, and more

The people who run the day-to-day operations of the federal government matter, and the president appoints a significant number of judges, agency heads, and members of regulatory boards that shape criminal legal system policy in this country.

The president nominates people to fill vacancies in federal courts,⁹ including the United States Supreme Court. By nominating people who share their worldview on public safety, prison conditions, crime, and other issues, the president indirectly shapes how federal courts rule on these issues for decades to come. Importantly, these courts will also regularly be asked to weigh in on whether state or local policies violate the U.S. Constitution, giving them considerable influence on what and how criminal legal system policies are implemented.

Presidents also appoint the heads of most federal departments and most agencies in the executive branch. The people appointed to these positions are the ones managing the day-to-day operations of the federal government, making the specific choices about how money is spent, where staffing resources are focused, and how the administration implements federal laws.

Finally, the most overlooked appointments that presidents make are to the various rule- and regulation-making boards and commissions scattered throughout the government. These bodies are tasked with filling in the details of how specific legislation is implemented, giving them immense power to shape both the federal and state criminal legal systems. Recent examples include:

• The Federal Communications Commission: In 2022, Congress passed the Martha Wright-Reed Just and Reasonable Communications Act, which tasked the Federal Communications Commission with issuing new regulations reducing the cost of phone calls from prisons and jails. The Commissioners took sweeping action to do just that. This impacted nearly every prison or jail in the country, regardless of whether it was run by the federal, state, or local government.
• The Federal Trade Commission: Under President Biden, the commission took action to address junk fees that private companies charge to incarcerated people — even those not in federal custody. While the final proposed rules didn’t go nearly far enough to protect people in prison and jail, they demonstrate the far-reaching impacts of actions by this body.
• The Postal Regulatory Commission: Postal mail remains a critical way that incarcerated people stay in touch with their loved ones on the outside. This commission sets the cost of postage and other rules around this service.

The bully pulpit

When all else fails, the president can also use their prominence in government, ability to garner media coverage, and public platform to influence how the public views and thinks about issues, even if they have no direct power over those issues. This is sometimes referred to as “the bully pulpit.”

There are few people more famous than the person sitting in the Oval Office. They have hundreds of media outlets clamoring for interviews. They can give speeches and statements that directly reach the public. And they usually have social media followings that reach hundreds of millions of people in the U.S. and worldwide.

While they don’t directly dictate policy, these are powerful tools, and when the president wants to, they can use them to raise awareness of issues they care about, pressure officials to take specific actions, or shift public sentiment and thinking broadly.

President Obama and President Trump have both used their bully pulpits — in far different ways — to discuss policing and influence the actions of local law enforcement:

• In a 2014 speech, after a grand jury failed to indict a police officer who killed Michael Brown, President Obama gave a speech encouraging calm in the wake of that decision, giving voice to the frustration that communities of color feel with police, and encouraging local law enforcement to work to build public trust by improving their practices. President Obama had no direct say over the practices of local police departments, but by using the bully pulpit, he helped to draw public attention to the need for improvement in policing.
• Meanwhile, during his first term, President Trump was speaking before a group of police officers in New York when he appeared to encourage more violence by law enforcement and urged them not to “be too nice” to people who are arrested. Again, President Trump had no authority over the specific policing practices of local departments, but his words provided a permission slip to officers to be more violent towards people in their custody.

Presidents have little direct authority over how local police officers do their jobs, but by using their bully pulpits in drastically different ways, one called on police to be part of a solution that improves trust in law enforcement, and the other encouraged more police violence. Both remarks helped to sway public opinion and police actions.

Congress

The president isn’t the only one with the power to influence the broader criminal legal system. Congress, through its control of federal spending, can pressure state and local governments to adopt its preferred policies on crime, policing, and incarceration. While it generally doesn’t have the power to tell state and local governments exactly what to do, it regularly uses federal funding to both incentivize actions it wants and punish actions it doesn’t.

The most infamous example of this is the 1994 Crime Bill.¹⁰ While this measure took many steps to expand the federal criminal legal system, arguably its most notorious impact was how it incentivized states to lock up more people for longer periods of time. The bill included financial payments for states that adopted so-called “tough-on-crime” policies. States that adopted these misguided policies were given billions of dollars to fund the construction of new prisons.

This is far from the only time Congress has flexed its financial power to get state governments to make their criminal legal systems harsher. Other examples include:

• A 1991 law that threatened to withhold billions of dollars of federal highway funding for states that didn’t automatically revoke the drivers’ licenses of people convicted of drug offenses.¹¹
• A 1996 law that permitted the federal government to enter into agreements with local law enforcement agencies to enforce federal immigration law, with a pot of money available to entice government officials to join this effort.

Congress has also used this power for good by incentivizing or otherwise encouraging state and local governments to take meaningful steps to promote alternatives to incarceration, improve their criminal legal systems, and make their prisons and jails safer and less deadly:

• The Prison Rape Elimination Act is a bipartisan law that sought to end sexual assaults against incarcerated people. It not only established standards for the elimination of sexual assault behind bars, but it also offered financial incentives for prisons and jails to comply with those standards and to report data on their progress to the federal government. Finally, and unrelated to money, the law mandates that it be publicly announced which states are complying with the law and which are not, which serves as an additional motivation for states.
• The Deaths in Custody Reporting Act sought to bring transparency to the deaths of incarcerated people by threatening to reduce federal funding to states that did not report certain information to the federal government when someone dies in one of their facilities.
• The Juvenile Justice and Delinquency Prevention Act offered financial incentives to stop states from incarcerating young people for “status offenses” such as curfew violations, stop states from incarcerating young people with adults, and address racial disparities in the incarceration of young people. States that comply with the law receive additional federal funding.

While Congress’s power to directly change state and local policy is limited, it understands that many cities, states, and counties rely on federal money to function. This provides Congress with a powerful tool to exert its influence far beyond Capitol Hill.

Federal courts

Federal courts — including the U.S. Supreme Court — have jurisdiction over a relatively small number of criminal cases, and they only directly adjudicate the guilt or innocence of people accused of federal crimes. Despite this, their rulings can have reverberations throughout state and local criminal legal systems.

That’s because federal courts have the authority to rule on whether state laws violate the U.S. Constitution or other federal laws.

During the latter half of the 20th century, federal courts regularly used their authority to make the criminal legal system fairer and less harsh, telling states they cannot:

• incarcerate people in cruel and inhumane conditions;
• prosecute people for having a substance use disorder;
• jail someone simply because they are too poor to pay a fine; and much more.

These rulings have been particularly impactful because federal court decisions are binding on all levels of government, including presidents, governors, and all lower courts. Presidents and other government officials are constitutionally bound to follow these orders.

In recent years, however, the Supreme Court in particular has become increasingly reluctant to exercise this authority and has become more likely to defer to the executive branch to answer questions in this realm, rather than acting as a true check on its power.

These are not normal times

It is important to remember that everything written in this piece reflects how things normally operate. Anyone who has been paying attention since the start of the second Trump administration knows that we are living in decidedly not-normal times.

For example:

• It is normal for the president to appoint an attorney general, but for that attorney general to essentially act as the president’s personal lawyer is not normal.
• It is normal for the president to exercise discretion on how money allocated by Congress is spent, but the president’s refusal to spend funds that Congress appropriated for a specific purpose is not normal.
• It is normal for the president to disagree with court rulings, but to refuse to follow court orders is not normal.
• It is normal for the president to have a preference about what governors and state legislators do in their states and what individual mayors and city councils do in their cities, but threatening governors and mayors with prosecution over these policy disagreements is not normal.

These unprecedented times make it hard to predict what is going to happen in the criminal legal system and in the numerous gray areas where the authority of different parts of the government overlaps. In normal times, it’s possible to guess how some of these conflicts would play out, but at a time when one branch of government is seeking to the trample the powers of the other branches and of the individual states — and those other branches and the states are largely letting it happen — all the normal bets are off.

What does this mean for the criminal legal system at the state and local level?

While the federal government has many tools at its disposal to influence policies related to crime, policing, and incarceration, the truth is that most of the power over these issues is in the hands of state and local officials.

As the Trump administration works to expand its reach in the criminal legal system, it is easy to feel that we’re helpless. That couldn’t be further from the truth.

By recognizing that state and local leaders make most of the decisions in this area, advocates can push them to stand up to the pressures of the federal government. They can urge them not to cooperate with unconstitutional and immoral actions by federal law enforcement. They can ask them to forgo funding that federal officials might use as leverage to coerce them into implementing harsh and misguided policies. And they can take action to work to make the criminal legal system fairer, smaller, and less punitive, even if the federal government has abandoned that cause.

State and local leaders are not powerless in these situations. It may be up to us to remind them of this fact.

Footnotes

1. One area we do not cover that is of particular concern to many is the use of the Insurrection Act of 1807. This is an intentional choice because of rare use of this law, and its complexities and vagueness. To learn more about this measure, we encourage you to review this explainer from the Brennan Center for Justice.  ↩

2. For consistency, in this explainer, we’re referencing numbers from the most recent edition of our report, Mass Incarceration: The Whole Pie 2025. This is important because, since that report was released there has likely been significant changes in the number of people in custody of the federal government for immigration-related reasons. Because of this, the numbers in this report related to immigration are almost certainly an under-count.  ↩

3. In this briefing, we don’t discuss the immigration system in detail. This is intentional. We at the Prison Policy Initiative are quite familiar with the criminal legal system, but are not experts on immigration policy. If you want to understand how the immigration system has changed under the Trump administration, we have put together a guide of organizations and resources to jumpstart your research.  ↩

4. It is worth noting that some of these people, while under the jurisdictional control of the federal government, are physically held in local jails that have rented space to Immigration and Customs Enforcement (ICE) or other federal law enforcement agencies.  ↩

5. Some people sentenced to incarceration for shorter times are held in local jails, instead of prisons.  ↩

6. It is worth noting that most states have rules around the possession and use of marijuana, and violating those rules could still get a person in trouble with the law. Most commonly, these rules ban the use of marijuana in public places. For example, in most states, smoking pot in a public park could still result in criminal arrest or citation.  ↩

7. If you’re not sure whether a prison is run by the state or federal government, it can be helpful to look at the facility’s name. If the name contains the letters FCI (Federal Correctional Institution) or USP (United States Penitentiary) it is a federal prison. While the vast majority of federal facilities start with these acronyms, there are some federal facilities whose names don’t include these letters.  ↩

8. We dive deeper into this later in this piece.  ↩

9. We discuss the role and influence of federal courts in the criminal legal system later in this piece.  ↩

10. It is worth noting there is considerable debate about the impact this law had on state prison construction. The subsidies for prison expansion weren’t massive, and academics dispute whether states would have made their sentencing laws harsher anyway (and some states claim that the subsidies had no effect). And the 1991 highway bill, which is mentioned below, both threatened to withhold a significant amount of money from states and made it incredibly simple for them to opt out of the requirement without losing their funds. But in both cases, Congress clearly expressed an opinion as an attempt to exert some influence on state governments.  ↩

11. In one of our earliest campaigns, Prison Policy Initiative worked to end this practice. Learn more about this practice and our efforts on our driver’s license suspension campaign page.  ↩

New data on pregnancy prevalence, outcomes, and programs in prisons are welcome additions, but raise new questions

The Bureau of Justice Statistics published 2023 data on pregnancy prevalence and outcomes in prisons, as well as the prison systems that offer relevant prenatal and postnatal accommodations, supports, and programming.

by Emily Widra and Emmett Sanders, May 7, 2025

A new Bureau of Justice Statistics report offers updated data on pregnancy among people in state and federal prisons. This important new dataset includes the prevalence of pregnancy among incarcerated people, pregnancy outcomes, and some limited data on the types of services, medical care, and support offered to incarcerated pregnant people. The findings from Maternal Healthcare and Pregnancy Prevalence and Outcomes in Prisons, 2023 are based on data collected for the first time in 2024 as a supplement to the annual National Prisoner Statistics survey. While this report is a welcome contribution to a shamefully understudied experience during incarceration, the data it provides raises almost as many questions as it answers.

Women’s incarceration has grown at twice the pace of men’s incarceration in recent decades but there is often too little data to explain this growth or to elaborate the specific effects incarceration has on women and their health, including their experience of pregnancy.¹ Previously, the most recent national data on pregnancy in prisons from the Bureau of Justice Statistics was collected in the Survey of Prison Inmates in 2016 and was published in 2021. Since then, researchers from Johns Hopkins University collected detailed data on pregnancy outcomes in a smaller set of 22 state prison systems and the federal Bureau of Prisons from 2016 to 2017 as part of the Pregnancy in Prison Statistics (PIPS) study. Even though the PIPS study covered only about half of state prison systems surveyed by the Bureau of Justice Statistics, the findings offered a closer look at pregnancy outcomes in prison than were available from the Survey of Prison Inmates. In this new publication, the Bureau of Justice Statistics surveyed 50 state departments of corrections and the federal Bureau of Prisons regarding:

1. the number of pregnancy tests provided and found positive upon admission to prison,
2. the number of pregnant people in prison at year-end,
3. the outcomes of the more than 700 pregnancies that ended in prison in 2023, and
4. the availability of specific kinds of pre- and post-natal support across jurisdictions.

Yet the data raises a series of new questions. There are unexplained differences in the prevalence of pregnancy behind bars compared to the PIPS report, as well as a lack of basic data on the outcomes of live births, and a failure to report how often pregnancy-related services and accommodations are actually used. The report also helpfully touches on services like prison nursery programs; however, crucial details about their implementation are left out — a gap we attempt to fill in this briefing using our own research. This new report is a step in the right direction, but much more work needs to be done to provide an accurate and useful portrait of pregnancy in prison.

Fewer people in prison report being pregnant when entering prison

The prevalence of pregnancy in prisons is measured in two ways: the number of pregnant people admitted to prison over the course of the year and the number of pregnant people in prison on a single day. The Bureau of Justice Statistics reports that 2% of women tested upon admission were pregnant in 2023.² This is surprisingly low compared to findings from previous data collection. In 2016, twice as many women (4%) admitted to prison each month were pregnant, according to the Pregnancy in Prison Statistics (PIPS) study. Past surveys from the Bureau of Justice Statistics that asked incarcerated women whether they were pregnant at admission (regardless of what year they were admitted) also found higher rates, from 6% in 1991 to about 4% in 2016. While the PIPS project surveyed only 22 state prison systems, it seems unlikely that this difference in the sample would explain the inconsistency in the data.³

We see this same issue in the point-in-time count of incarcerated pregnant people. According to the Bureau of Justice Statistics, on a single day in 2023 , there were 328 pregnant people in state (0.5%) and federal (0.3%) prisons, representing a total of 0.5% of all women in prison. This is much lower than we would expect based on the 2016 Pregnancy in Prison Statistics (PIPS) data, which found there were 350 pregnant people in just the smaller group of state (0.7%) and federal (0.3%) prisons they surveyed, for a total of 0.6% of the combined prison population. In other words, the actual number of pregnant incarcerated people was higher in the PIPS report that covered half as many state prison systems (22 states) as the Bureau of Justice Statistics report. It’s unclear what accounts for this substantial difference in the datasets.

The new Bureau of Justice Statistics report also offers new data on the race and ethnicity of pregnant people in prison on a single day. Compared to the overall population of women in prison,⁴ white, Black, American Indian and Alaska Native, and Asian women are overrepresented in the population of pregnant people in 2023. Meanwhile, Hispanic and “other” women were underrepresented.

Certainly, some decline in the number of pregnant people in prison could be expected, given that the national pregnancy rate in the United States has been steadily falling over the past two decades.⁵ However, this trend does not explain the dramatic reduction in the number of pregnant women in prison between the PIPS 2016 study and the Bureau of Justice Statistics’ 2023 report. Given the limited data available, we do not have any clear understanding of why there are so many fewer pregnant people reported in this Bureau of Justice Statistics publication.

First national data on pregnancy outcomes in prisons

This Bureau of Justice Statistics report is significant in that it offers the first national data on pregnancy outcomes in prisons — a welcome if overdue development. More than 700 pregnancies ended while the mother was in custody in 2023, and almost all of these were live births (91.5%),⁶ with 6.5% ending in miscarriage and 2.1% ending in abortion.⁷ Additionally, there were four stillbirths and ectopic pregnancies. These percentages are largely consistent with the outcomes of pregnancies reported in the Pregnancy in Prison Statistics (PIPS) study from 2016, however the counts are once again surprisingly low: in 2016, PIPS found 816 pregnancies ended in 22 state prison systems and the federal Bureau of Prisons, but in 2023, the Bureau of Justice Statistics reported 89 fewer pregnancies ending in prison (727 total) across the federal system and 48 state departments of correction.

Nationally, data on pregnancy outcomes regularly includes information about the outcomes of live births, including if they were preterm, early term, C-sections, or low birthweight, as well as if there was neonatal death (within 28 days) or maternal death following the birth. Although the U.S. Centers for Disease Control and Prevention regularly collects and publishes these data for non-incarcerated people, the Bureau of Justice Statistics survey did not request this information from correctional authorities, despite our recommendation during the public comment period. Basic national statistics on pregnancy in prison can and should include these outcomes. Elevated rates of chronic and infectious diseases – as well as substance use disorders – and limited access to necessary healthcare among incarcerated people make more detailed data about live births critical to understanding the experience of pregnancy in prison. Such data can also inform the interventions and medical treatments required to promote health before, during, and after birth for this population.

Some prisons fail to provide even the most basic prenatal and postnatal care

Pregnancy poses a number of short-term and long-term risks to health. Globally, the United States has one of the highest rates of pregnancy-related complications among developed nations,⁸ with a disproportionate burden falling upon women of color and low-income women.⁹ Addressing such risks is particularly important in prisons, where women already face higher rates of chronic health conditions, substance use disorders, and mental health conditions, as well as a history of poor healthcare access. Decarceration is the most important tool we have to address these risks, however as long as our society incarcerates pregnant people, prisons must be prepared and equipped to provide them with adequate healthcare and support before, during, and after delivery.

Most prison systems reported they train staff to care for pregnant people (88%) and have an onsite infirmary (96%) or 24/7 or on-call medical care (98%). The majority of prison systems also reported that they provide medical appointments to pregnant people within two weeks of a positive test (96%), routinely throughout the pregnancy (100%), and within three weeks of delivery (96%). Prison systems claimed that these services are available, however there is no information in the report about their actual utilization. Does every pregnant person have an appointment within two weeks of a positive pregnancy test and within three weeks of delivery? Do all staff receive training regarding pregnancy, or only healthcare staff? These questions are arguably more important than whether these services and practices technically exist.

It is particularly troubling that six state prison systems (Alaska, Hawaii, Iowa, Maine, Nevada, and Washington) reported that they do not provide any staff training regarding pregnant people in prison. No state prison system is immune from admitting a pregnant person, and these six states accounted for around 5% of the almost 50,000 women admitted to prison in 2021.¹⁰ At the very least, corrections and healthcare staff should receive training regarding emergency responses that may be required with a pregnancy.

Postpartum depression is another serious risk facing pregnant people. Nationally, postpartum depression diagnosis rates have been climbing: across all racial and ethnic groups, the rate of diagnosis increased from 9% in 2010 to 19% in 2021. Undoubtedly, this trend persists behind bars, where women face a number of risk-factors for postpartum depression. This includes previous mental illness diagnosis,¹¹ a lack of social support, poor prenatal and perinatal healthcare, separation from the newborn, and experiencing partner violence. In one study of 58 people who gave birth while in prison, researchers found that more than one-third of participants met the diagnostic criteria for moderate to severe depression during pregnancy or postpartum. Yet four state prison systems (Alabama, Iowa, Massachusetts, and Washington) said they do not provide depression screenings during pregnancy or postpartum. Not screening for depression at all during pregnancy and the postpartum period is a failure to meet the most basic standards of pregnancy-related care.

The Bureau of Justice Statistics report also provides information about which state prison systems provide certain accommodations and support services to people before and after delivery. Prison systems universally reported furnishing at least two accommodations for pregnant people: lower bunk placement¹² and prenatal vitamins.¹³ Most (but not all) prison systems offer a special diet during pregnancy (86%) and consultation with social workers (92%) or psychologists (88%). Prenatal diets require increased calories and a particular balance of nutrients that are likely not met by the typical prison diet. Accessible, appropriate mental health services for pregnant people behind bars are also vitally important, and most standards for pregnancy-related health care in correctional settings emphasize the need for counseling and psychosocial support.

Other extremely basic accommodations are less common in prison systems. These include a special postpartum diet (60%), doula support (35%),¹⁴ extra pillows during pregnancy (69%), and breast pumps (78%). These relatively simple interventions can have a tremendous impact during pregnancy and postpartum. For instance, the recommended postpartum diet is associated with fewer symptoms of postpartum depression and can positively impact infant health. People in prison are regularly issued only one pillow, but pregnant people may require more to be comfortable and avoid sleep deprivation, which has been associated with longer labor, elevated perception of pain and discomfort during labor, higher cesarean rates, preterm labor, and other adverse outcomes. While policies may be in place for breast pumping accommodations in most prison systems, the actual accessibility and utilization of breast pumps may be a different story. Some prison systems operate lactation programs that allow incarcerated people to pump breast milk for their babies. However, these programs often have onerous requirements for the incarcerated person’s friends and family, who have to apply for approval to visit and collect the milk. In Florida, for example, incarcerated people are only eligible for this program if there is an approved guardian for the child and the child is not placed in state custody. Reports suggest that when there is no lactation or pumping program, incarcerated people are sometimes not allowed to breastfeed after giving birth,¹⁵ and are not provided with anything to help manage an unused milk supply or information about what to expect.

It’s undoubtedly helpful to know which jurisdictions offer these services, but there is once again no information regarding their actual utilization. In 2016, self-reported data from incarcerated people revealed that half of people pregnant upon admission had not received prenatal care in the form of special testing, dietary changes, or childcare instruction. It’s great that prison systems have policies in place to provide these necessary services, but it is not clear at all how they are being implemented and how many pregnant people actually receive them.

Only 11 states and the federal system operate prison nursery programs where newborns can reside with their parents in custody

The Bureau of Justice Statistics reported that ten states and the federal Bureau of Prisons run prison nursery programs, which are residential programs where people can live with their newborns. Although reducing the incarceration of pregnant people is the best approach to this issue, prison nurseries can be another option that allows incarcerated mothers to avoid separation, and to be with and care for their newborn children. Since the data collection period ended for this report, an eleventh state — Missouri — opened their prison nursery program. Even though there were 665 live births in prisons across the U.S. in 2023, only 86 people were participating in prison nursery programs at the end of the year. In Nebraska and West Virginia, there were no nursery program participants at the end of the year.

There are a number of details about these prison nursery programs lacking in the Bureau of Justice Statistics report. For example, how many people participate in the programs each year and for how long? What programming is available to the participants while in the nursery program? How is eligibility determined for participating in these programs? Again, while data on the number of nurseries is helpful, it’s arguably more important to know how they are being used. So, to better understand how prison nursery programs actually work, we looked at the eligibility requirements and restrictions for prison nursery programs in 11 states and the federal Bureau of Prisons.

We found that in all but one of the prison nursery programs, participation requires release dates within 12 to 36 months of the expected delivery date.¹⁶ A number of factors can influence eligibility, including offense types, prison disciplinary history, medical or mental health status, prior Child Protective Services involvement, and prison security designation or classification. In Illinois, for example, any child that requires “more than normal well child health care” or any parent requiring “more than normal” prenatal or postnatal care can be excluded from the program. In California, Illinois, Indiana, Ohio, and West Virginia, the incarcerated mother must have sole legal custody of the child. To our knowledge, there are no data available about how often a child born to an incarcerated parent remains in their custody, but there is historical evidence to suggest that this is likely rare, or at the very least, complicated.

Eligibility requirements and considerations for prison nursery programs

Unfortunately, because the Bureau of Justice Statistics report does not include information on the sentence length, offense type, prior convictions, or classification status of pregnant people in prison, it is difficult to estimate how many pregnant people in prison would be eligible for these programs. These potentially beneficial programs are a vast improvement over the common practice of simply removing newborn children from their parent at birth.¹⁷ However, access to nurseries is still seriously limited, and ultimately, the best option would be to implement caregiver mitigation and diversion laws and prevent the incarceration of pregnant people.

Conclusion

This Bureau of Justice Statistics maternal healthcare report marks an important step toward filling the huge data gap regarding the incarceration of pregnant people in prisons. Given their particular healthcare needs and the challenges to a healthy pregnancy imposed by the prison environment, these data can help inform interventions that lead to better outcomes for incarcerated pregnant people. Although the data answer some of our initial questions about how many pregnant people enter prison and what jurisdictions have policies offering specific supports, significant questions remain. In addition to getting to the bottom of why the findings in the Pregnancy in Prison Statistics study differ so substantially from the Bureau of Justice Statistics survey, future researchers can make important contributions by answering questions such as:

1. What are the trends in pregnancy in prison over time? Why are these estimates of the prevalence of pregnancy in prison lower than prior estimates?
2. How many people actually receive the services that these jurisdictions report offering?
3. What barriers do prison systems face in providing the most basic prenatal and postnatal care, like depression screenings?
4. Why are so many pregnant people incarcerated (i.e, for what offenses) and for how long (i.e., sentence length)?
5. What are the outcomes of the live births counted in this report (i.e., preterm, early term, C-sections, low birthweight)? What are the rates of neonatal death and maternal death among this population?

Data on maternal healthcare and pregnancy outcomes should continue to be collected and published on a regular basis by the Bureau of Justice Statistics. Doing so — especially in greater detail — would shed light on an important and understudied healthcare experience in prison.

New national data help fill 20-year data gap: Offense data for people in local jails

Our analysis of Jail Data Initiative data offers the first detailed, national view of the criminal charges for which people are jailed since the Bureau of Justice Statistics’ 2002 survey. We look at the one-day jail population as well as bookings over a full year; ‘top’ charges versus all charges; and break down trends by sex, jail size, and region.

by Emily Widra, April 17, 2025

Millions of people are arrested and booked into jail every year, but existing national data offer very little information about the actual criminal charges for which they are detained. In fact, the most recent national offense data published by the government about people in jail is from 2002, so we worked with the Jail Data Initiative to fill that gap using the best, up-to-date nationally representative sample available.¹ We now have a new “snapshot” of people in jail, by offense, on a given day; new insights about how low-level offenses like misdemeanors and supervision violations impact “jail churn” over the course of a year; and we were able to analyze some variation in offenses by sex and, for the first time, by region and jail jurisdiction size.

One-third of annual jail admissions are for misdemeanor charges

The “massive misdemeanor system” in the U.S. is an important but overlooked contributor to overcriminalization and mass incarceration. An estimated 13 million misdemeanor charges – for behaviors as benign as jaywalking or sitting on a sidewalk – sweep droves of Americans into the criminal legal system each year (and that excludes civil violations and traffic offenses, like speeding).

The Jail Data Initiative data reveal that misdemeanor charges accounted for more than 2.7 million jail admissions (35%) in 2023. This is a much higher percentage than the Bureau of Justice Statistics’ snapshot of the jail population on a single day in 2023 shows: the Bureau reports that only 20% of people in jail were held for misdemeanor offenses.⁵ The difference is explained by “length of stay” or how long people are held in jail for different kinds of offenses. People charged with felony offenses show up disproportionately in single-day snapshots because they spend more time in jail than those facing misdemeanor charges.⁶ Longer jail stays associated with felony charges are due in part to higher bail amounts for felony offenses.⁷ Because of these differences, single-day snapshots make it easier to overlook just how many people are jailed for low-level, misdemeanor offenses each year.

Misdemeanor charges may sound trivial, but they carry serious financial, personal, and social costs, especially for the accused but also for broader society, which finances the processing of these court cases and all of the unnecessary incarceration that comes with them. Pretrial detention actually makes people charged with misdemeanors more likely to plead guilty, to be sentenced to incarceration, and to receive longer jail sentences. Rather than investing in community-driven safety initiatives, cities and counties are still pouring vast amounts of public resources into the processing and punishment of these minor offenses.

Many people are jailed for “technical violations” of community supervision, not new criminal charges

Probation and parole are often seen as a “lenient” punishment or as an ideal “alternative” to incarceration. But while remaining in the community is generally preferable to being locked up, the conditions⁸ imposed on those under supervision are often so restrictive that they set people up to fail.⁹ “Technical violations” are behaviors that break these probation or parole rules, such as missing curfew, failing a drug test, or missing a check-in meeting; they are not behaviors that would count as “crimes” for someone not under community supervision. However, when people who are under community supervision are charged with a new crime, that also constitutes a violation of their probation or parole, and typically must be reported. Individuals can often be kept in jail without bail for either type of violation on a probation or parole detainer.

In 2023, there were about 7.6 million jail bookings, and the new Jail Data Initiative data indicate that almost 926,000 of those bookings (12% or 1 in 8) involved an alleged probation or parole violation. Almost a half million (484,000) people jailed in 2023 were jailed only for technical violations of community supervision and faced no additional criminal charges.¹⁰ We did not find much variation between men and women related to bookings for violations; 11% of women and 13% of men were booked into jail with probation or parole violations and about 7% of both women and men booked into jail were jailed for only technical violations.

Looking at a single-day snapshot, we see that about 19% of people in jail on a single day in June 2024 had probation or parole violations. This is comparable to what the Bureau of Justice Statistics found in 2023.¹¹¹² Our single-day snapshot also showed that women were more likely to be stuck in jail for a technical violation: 9% of women in jail had been admitted with only a charge of a violation, compared to 6% of men. To square this with the findings of only minimal sex differences in the year-long booking data, recall that “length of stay” impacts who is likely to be sitting in jail on a given day. Since women held on unaffordable bail typically have very low incomes, it’s plausible that women spend more time in jail for violations because they are less able to afford the bail money, when they are eligible for bail at all.

The first detailed national jail offense data published in two decades

Given that the most recent jail offense data is over 20 years old,¹³ the Jail Data Initiative dataset offers a rare opportunity to analyze the charges that people are booked under today. Our partners at JDI standardized the listed charges into both broad offense types (violent, property, public order, drug, DUI offense, and criminal traffic) and more specific charge types like aggravated assault, burglary, liquor law violations, drug possession, driving while intoxicated, and minor traffic offenses.¹⁴ Additionally, unlike the Bureau of Justice Statistics 2002 data, the JDI dataset allows us to look at all the charges individuals are booked under, in addition to the “top” – or most serious – charge for each person.

People frequently face multiple charges when they are booked into jail

People booked into jail often face more than just one criminal charge: in our sample, there were an average of four separate charges per person.¹⁵ When we look at all charges for each booking rather than “top” (most serious) charges, we find that the most frequently-used charges are often not the same as the most common top charges. People in jail often face “stacked” charges, where additional charges are added on to the most severe charge. Nine of the top 10 most common charges are relatively low-level offenses that don’t involve physical violence, including failure to appear in court, forgery or fraud, contempt of court, and drug offenses (the only serious violent offense in the top 10 most common charges is aggravated assault).¹⁶

In addition, some charges are more likely to be levied “in bulk” (e.g., people will often be detained on many counts of forgery/fraud) and this may also explain why we see charges like forgery/fraud in the top 10 most common charges. Regardless of the severity of the charges, people facing more charges face higher bail amounts, are more likely to be jailed for longer periods of time, and are more likely to be convicted.

Offense data by most serious charge per person: Most people are jailed for non-violent offenses

Looking at just the “top,” or most serious, charge facing each person in jail on a given day in 2024, we find that almost two-thirds (about 415,000) are facing a top charge that is not considered a violent offense.¹⁷ About 23% of people are jailed for a most serious charge that is a public order offense, 21% for a property offense, 14% for a drug offense, and 4% for a driving under the influence (DUI) or criminal traffic offense.

The number of people in jail for charges that reflect little-to-no risk to public safety is alarming: 8% of people were in jail with a top charge of a supervision violation, 7% for drug possession, 5% for offenses against courts, legislatures, and commissions,¹⁸ and 3% for contempt of court¹⁹ – these four kinds of charges alone account for almost a quarter of the total jail population. Probation and parole violations are the second-most common top charge, following aggravated assault. We’ve long argued that noncriminal behaviors (like missed check-ins or nonpayment of fees) should not lead to incarceration — this strips people on community supervision of any progress they’ve made, further destabilizes them and their families, and is a thoughtless waste of public funds. Each state approaches supervision violations differently, but some rely on incarceration as a response more than others. For example, 2019 data from the Bureau of Justice Statistics show:

• Tennessee’s jails hold 9,280 people for an alleged violation of supervision, accounting for 30% of the total jail population;
• In both Georgia and West Virginia, over 15,000 people — 28% of the jail population — are behind bars for supervision violations;
• An alarming 39% of the jail population in Ohio is composed of people accused of violating the rules of their supervision.

Probation and parole officials can use more effective alternative sanctions and approaches, such as incentive-based systems, but clearly too many continue to default to a “lock ‘em up” response.

Three in four women in jail are facing non-violent charges

More than 90,000 women are locked up in local jails on any given day in the U.S., representing about one-seventh of the entire jail population (14%). The new data from the Jail Data Initiative reveal that three-quarters (75%) of these women have non-violent top charges: 28% public order, 25% violent, 25% property, 19% drug, 2% DUI, and 2% criminal traffic. Further, a smaller share of jailed women (25%) than jailed men (38%) are facing a top charge that is considered violent. Compared to the 2002 Bureau of Justice Statistics data, public order and violent charges account for a larger portion of the top charges women face in 2024, while a smaller portion of women in jail are facing drug charges (-10 percentage points) and property charges (-7 percentage points).²⁰

Over a three-year period from 2020-2023, the number of women jailed at midyear increased 36%, compared to 19% for men. Women are disproportionately locked up in local jails, because they are less likely to be able to afford money bail required for pretrial release, and if convicted, they are more likely to serve a shorter sentence for a property or drug offense in jail than go to prison. While there, women in jail experience bleak conditions like expensive phone calls, a lack of programming and education opportunities, and poor quality healthcare.

In addition, the jailing of women has a devastating “ripple effect” on families and communities: at least 80% of women booked into jail are mothers, including over 55,000 women who are pregnant when they are admitted.²¹ Beyond having to leave their children in someone else’s care, these women are impacted by the brutal side effects of going to jail: aggravation of mental health problems, a greater risk of suicide, and a much higher likelihood of ending up unhoused or deprived of essential support and benefits.

Regional variations in criminal charge distributions reflect differing priorities across states

Breaking down the data by region (i.e., Northeast, Midwest, South, and West) allows us to assess how different parts of the country use jails.²² For example, previous research shows that jails in the Midwest and West have the highest percentages of people detained pretrial, while jails in the South have the highest percentages of people being held in jails for state, federal, and tribal authorities (20%).²³

We find that regionally, jurisdictions respond to certain types of offenses differently. For example, only 8% of people in jails in the Northeast are held for a top charge related to drugs, but in the South, 16% of people are held for drug charges, suggesting that a significant regional difference in the criminalization of drug use influences who is locked up. In addition, the Northeast is the only region to have weapons offenses and rape among the most common top charges, while the West is the only region with DUIs among the most common top charges. It’s important to note that these variations don’t necessarily reflect differences in actual crime rates across regions, but rather the kinds of charges law enforcement and courts in those areas deem appropriate for jail detention.²⁴

Drug possession is among the top 10 most common top charges for all regions except the Northeast.²⁵ It’s worth noting that drug and drug paraphernalia²⁶ possession offenses have been reduced to misdemeanors only – or decriminalized in part or in full – in a larger portion of Northeastern states than in any other region. Half of the Northeastern states have decriminalized drug paraphernalia, and in the remaining half of Northeastern states, possession of drug paraphernalia is limited to a misdemeanor. Only three Northeastern states (33%) classify drug possession as a felony offense, while other regions more commonly classify drug possession as a felony offense (83% of states in the Midwest, 69% in the South, and 46% in the West).

Laws and policies are largely set at the state level, so further investigation of state-level differences in charge distributions would help policymakers understand how their decisions impact jail populations, in places where the data are available. (In the sample used in this analysis, state-level comparisons were not possible.)

Smaller jails disproportionately incarcerate people for low-level offenses

Differences between jails in larger and smaller counties have grown more pronounced in recent years: as jail incarceration in large, urban counties has decreased in a number of jurisdictions, jail incarceration has exploded in smaller jurisdictions – including rural counties and those with small towns and cities.²⁷ While the Jail Data Initiative data are not broken down by rural vs. urban areas, we used jail size as a proxy measure to explore the differences in the charges smaller vs. larger jurisdictions are using their jails for.

We find that smaller jails – typically in jurisdictions with smaller overall populations – tend to have a larger portion of people incarcerated for public order and drug offenses, while larger jails hold people primarily for violent offenses. While we can’t identify the causes behind these differences from this dataset, this difference is likely explained – in part – by higher rates of violent crime in metropolitan areas.²⁸ Jails in these more populous jurisdictions are more likely to use their available beds for these more serious offenses, while smaller jurisdictions may have more space available to fill with people accused of low-level offenses. For example, charges of rape and armed robbery only appear in the ten most common top charges in jails holding 1,000 or more people (the largest jails). In the smallest jails that hold 250 people or less, 9% of people jailed are held for supervision violations, compared to 5% in jails holding 1,000 or more. Similarly, 8% of people in those smaller jails are held for “offenses against the court,” compared to 3% in the largest jails.

Conclusion

The importance of local jails to the full picture of mass incarceration cannot be overstated. Jails hold one-third of all people locked up in the U.S., most of them not convicted of the charges they are facing and detained because they cannot afford bail. Pretrial detention is the primary driver of jail population growth: over the last twenty years, the number of unconvicted people in jail increased by 34%.²⁹ Our findings come amidst a trend of small, less-populous counties (along with some larger urban counties) continuing to build new and bigger jails. This analysis shows that these costly projects, far from being a public safety necessity, are likely to exacerbate the jailing of poor people for minor offenses—while taking away resources from investments that make communities safer, such as affordable housing and healthcare.

Our analysis highlighting trends in jail detention across the country would not be possible without the data collected by the Jail Data Initiative. JDI offers one of the only alternative sources of information about why hundreds of thousands of people are behind bars, given that the Bureau of Justice Statistics has not released updated offense information for jail populations nationwide in over twenty years. This invaluable data source enables even more comprehensive analysis by capturing and standardizing individual-level booking data from hundreds of jurisdictions, offering a unique view of the flow of people through local jails over time, in addition to a detailed, updated “snapshot” view.