Pregnant in jail: what it's like, what it costs

In just under 25 years, the number of female inmates in Knox County has grown from 20 to almost 300.

The increasing numbers mean the Knox County Sheriff's Office faces an issue that was rather rare in the 1980s -- pregnancy in custody.

Every woman brought under Knox County Sheriff's Office custody eventually sits in one of the Detention Facility medical exam rooms.

"We're required by state statute, that any inmate that comes in our facility, whether it be female or male, that they have a physical within a 14-day window," said Rodney Bivens, Chief of Corrections for the Knox County Sheriff's Office.

Part of that physical includes a pregnancy test.

"When we do that, a lot of times, we're the ones who tell them they're pregnant. They don't know until they get here," Chief Bivens said.

"We get them from where they don't know about it on up to eight months pregnant or even further," said Dorothy Pinkston, Chief Administrator for Medical Services at the Knox County Sheriff's Office.

Once the pregnancy tests come back positive, the special care begins.

"Our concern becomes that fetus. Our goal is protecting that child," said Sara Edmonds, Director of Nursing for the Knox County Sheriff's Office Detention Facility.

"We put them on a pregnancy diet, give them pre-natal vitamins, and get them an appointment with the high-risk clinic," Pinkston said.

However, the challenges also begin with a positive test.

"Most of our female population has never had any pre-natal care before coming to our facility," Bivens said.

Histories of drug abuse, mental health issues, and high-risk behavior follow many of the women from their lives outside to their lives behind bars.

"A lot of times, they're not forthcoming with information that leads us to deal with whatever situations are going on with them," Edmonds said.

With those challenges, come the costs.

An average inmate costs the Knox County Sheriff's Office about $1,950 a month.

For a pregnant inmate, that number can rise from just a couple hundred dollars, to about $2,050 a month--to an extra thousand, adding up to approximately $3,000 a month.

Those price tags are just for a special diet, pre-natal vitamins, and inside medical care.

Other services come out of indigent care budgets, paid for by the Knox County Health Department's budget.

Those services include appointments at an area high-risk clinic for OB/GYN care, which can range from $100 to $600 per visit.

The women may also require trips to the emergency room, which averages about $155 to $233 a visit.

Indigent care pays for about 22 percent, while the hospital pays for the rest.

When the women are less than five months pregnant, they're housed at the jail in downtown Knoxville. Any female who is five months or more into her pregnancy is housed at the detention facility in East Knox County. Once the inmate is three to four weeks away from her due date, she is transferred to the detention facility's infirmary. Each move may require more expensive care and more medical attention.

The idea is to give the women the same quality care as the tax-payers footing the bill.

"Like care they'd be getting on the outside," Pinkston said.

"I'm not the judge and jury. I don't judge these people for what they've done. Medical care and the liason is why I'm here," Edmonds said.

The goal of such medical care extends beyond the women's incarceration, to the life of the baby they brought in with them.

"For a future for them," Chief Bivens said. "Otherwise, these unborn children wouldn't have what chance they do have. My hope would be that when [the inmates] leave this facility, they're a better person, a more productive person."

"You hope that in all aspects of what we do here, that somewhere, you do strike a chord," Edmonds said. "At some point you hope that wake-up call hits. If it's two out of ten, that's better than none."

Any baby that is born in custody goes to a state-approved family member or foster care.

Since January of this year, approximately 50 pregnant inmates have spent time in Knox County correctional facilities.

On average, about five to six percent of the female inmate population in Knox County is pregnant.