On World Menstrual Hygiene Day, a peep into the needs of female inmates

No one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but by its lowest ones— Nelson Mandela

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IMPRISONMENT as a form of punishment has a long history— not only the physical spaces and infrastructure of prisons, but the legal and philosophical reasons for imprisonment have also evolved with time. Today, prisons are considered centres for criminal reform in India and most of the world, rather than simply a place of punishment.

The Supreme Court has argued in favour of a "therapeutic approach … as an effective way of punishment".

Also read: Supreme Court directs Union government to formulate national guidelines on menstrual health of girls in school

According to the ruling in T.K. Gopal versus State of Karnataka, a prisoner has the right to be treated as a human being with all of the basic human rights, dignity and compassion, regardless of the crime they have committed. Although individuals experience reduction in their legal status during imprisonment, the fundamental rights guaranteed by the Constitution do not end when a person enters prison.

Plight of women in jail

Given that correctional facilities were originally constructed with male inmates in mind, additional measures are required to make sure women detainees are provided safe and secure living circumstances.

Women prisoners experience all the issues with the prison system as male prisoners, including trial delays, torture and other cruel treatment, disregard for personal hygiene and health, insufficient food and clothing, prison staff and poor communication. However, some of the issues that female convicts face are unique to them.

Due to their gender, women are a particularly vulnerable population in prisons. In detention, women are also vulnerable to sexual abuse and other forms of violence, which may be used to extort false confessions. Due to the lack of sufficient medical attention, lack of hygiene, inadequate diet and overcrowding, their physical and mental condition may worsen in prison. In addition, all women have gender-specific medical needs and require regular access to women's healthcare professionals.

Menstrual management 

In India, menstruation is stigmatised, especially in casual situations. However, the issue becomes considerably more challenging to regulate in prisons. It is crucial to comprehend the demographics of our prisons to offer you a better understanding of why good menstrual hygiene management is required in prisons.

The majority of women who are imprisoned in India (81.8 percent) are between the ages of 18 and 50. This means that the menstrual hygiene needs of four out of every five women prisoners need to be addressed. This entails giving them sanitary products as and when they need them.

Women in certain prisons had to choose between purchasing sanitary products from the prison canteen or using worn-out clothing and rags, which pose a serious threat to their health and menstrual hygiene. Sometimes they ask their families for sanitary pads during mulaqaat (meeting) but when the father or brother visits, they become hesitant to inquire. This demonstrates ingrained societal taboos that prevent women from accessing hygienic menstrual management products.

According to the Ministry of Women and Child Development's Women in Prisons, India report, females reportedly pay for their sanitary products. In other instances, each woman is provided with a certain number of napkins to use. This implies that women must make do with the limited supplies, regardless of their menstrual demands. Women in prison are forced to use filthy items like cloth, ash, fragments of old mattresses, and newspapers because enough napkins are not provided.

Also read: From punishment to rehabilitation: The need for prison reforms

A detainee at the Mysuru Central Prison described how she was compelled to gather her sanitary pads and place them in plastic bags before throwing them in the trash. The act itself is unsanitary for everyone involved and breaks various health regulations for safe disposal. Another person described being made to create their pads out of old garments.

Mothers behind the bars

"I was bleeding so badly, and they only gave me one pad. They only gave me one pad the whole time, and my pants, I had blood everywhere… It took them hours before they called an ambulance and took me to the hospital, and then they found out I had miscarried," said a pregnant prisoner.

Childbirth is unquestionably a mother's most beloved and precious memory, yet the experience can also be terrible. Women of reproductive age may become pregnant and give birth in a male-dominated penal setting. Pregnancy, delivery, nursing and parenting all necessitate unique attention. Caring for pregnant jailed women is a special challenge.

Among incarcerated women, pregnancies are often unplanned and aggravated by factors such as a lack of maternity care, maternal trauma, poor nourishment, substance abuse, psychological problems, prolonged medical issues, low socio-economic status and minimal social support.

In prisons, the significance of perinatal mental health must be emphasised. A startlingly high rate of depression (70–80 percent) and anxiety-related disorders (40–70 percent) has been observed, especially in the third trimester of pregnancy. These may be exacerbated by the psychosocial obstacles and peak levels of stress found in jails.

According to studies, 60–90 percent of pregnant inmates use drugs, and 30–40 percent use illegal drugs. It is interesting to note that the majority of women are arrested for minor offences and that 25–50 percent of women are incarcerated for drug-related offences (such as possession and trafficking).

Also read: Growing need for policy safeguards to address women's menstrual concerns

Congestion, confined spaces, poor diet, a lack of maternity services, lack of female facilities and published standard guidelines (such as routine pregnancy tests for incoming women prisoners of childbearing age), postponement of transportation to medical facilities, and shortage of support, all contribute to making the care of pregnant women in prisons more difficult. Imprisonment has many negative effects, including impeding mobility, postponing treatment (especially in obstetric emergencies), raising the risk of blood clots, disrupting mother–infant adhesion and causing severe discomfort.

Lockdown in lockup

The COVID pandemic had a profound impact on prisons, where overcrowding posed a significant risk to inmates. The National Crime Records Bureau has reported that in 2020, over 16 lakh individuals were held in Indian prisons, with an occupancy rate of 118 percent of their capacity. Overcrowding in prisons continues to be a major concern in the country.

Female prisoners were particularly vulnerable, with the suspension of family visits and the closure of educational and workshop programmes further exacerbating the situation. In some cases, multiple women and children were sharing a single sleeping mat, with children found sleeping on the ground, leading to increased incidences of cold and cough. In Maharashtra, 26 children of less than six years of age were lodged with their mothers in district women's prison in Mumbai, with 20 women and five children testing positive for COVID.

Post-COVID developments

There have been positive developments in response to these challenges. The government established a dedicated helpline to address mental health concerns and conducted training programmes on physical and mental health to equip staff to handle burnout and anxiety. The courts also played a significant role, providing free legal aid to undertrials, especially women prisoners, to help reduce overcrowding and offer protection from COVID.

The Patna High Court directed the appointment of psychiatrist, physiotherapist and other medical professionals in various jails in Bihar to prevent and control the pandemic among female prison inmates.

Based on the Prison Statistics India, 2021 report, female inmates are offered vocational courses such as beauty parlour courses, cutting and tailoring, cooking and embroidery to help them earn a livelihood after their release and overcome social stigma.

In Delhi, a sanitary pad factory run by Central Jail, 06, Tihar and non-governmental organisation (NGO) Pahal, collaboratively trains inmates to make sanitary pads and provides employment opportunities. Additionally, the factory takes care of the in-house needs of pregnant women prisoners by providing gynaecological examinations, pre-natal and post-natal care, and granting emergency leave for delivery outside of the prison. Female inmates in Delhi earned over ₹79 lakh in 2022. In Tamil Nadu, female prisoners are provided with free sanitary napkins.

Model Prisons Act, 2023

The government has completed the development of a detailed Model Prisons Act, 2023 to replace the outdated Prisons Act, 1894, which primarily concentrated on incarcerating offenders and maintaining control and order in prisons. The new legislation regards prisons as institutions for reform and rehabilitation, with an emphasis on rehabilitating inmates into productive and law-abiding citizens of society.

The new Model Prisons Act comprises several notable characteristics, such as the assessment of security risks and separation of prisoners, customised planning of sentences, the resolution of complaints, the formation of a board for prison development, and special attention towards the physical and mental welfare of inmates.

Recommendations for women inmates

It is evident that incarcerated women require specialised interventions to reduce maternal stress and stigma to maintain positive mother–child interactions. Regular communication with family members and access to legal aid should be simplified. It would be crucial to screen for and treat mental health and substance addiction disorders in pregnant and postpartum women. Additionally, we must ensure that they receive appropriate maternity care while incarcerated and during childbirth.

It is possible to learn from the experiences of other countries. Two such initiatives are Motherhood Beyond Bars in Georgia and Women and Infants at Risk in Michigan, US. Reportedly, the Doula birth support programmes for incarcerated pregnant women have resulted in positive outcomes, both in terms of delivery outcomes and satisfaction.

Also read: Menstrual leave and the right to live with dignity: Why was the Menstruation Benefit Bill, 2017 withdrawn from the Arunachal Pradesh assembly's 2022 Budget session

Recidivism can be reduced and women's successful reintegration into society after release aided by intensive aftercare programmes. Housing, employment, marriage, child custody and protection from local police harassment are all areas where help could be provided.

To guarantee that prisoners' rights are respected and the voices of prisoners are heard without prejudice, every prison should have a robust grievance redress mechanism. Prisoners should be able to express their concerns through both internal and external channels.

Free sterile sanitary products should be provided to female prisoners according to their needs, with no limit on quantity. Instructions could be given to female inmates to produce inexpensive sanitary napkins for use inside and sale outside of prisons.

Each convict must be treated with the same dignity and respect as any other human being, including with respect to basic rights to self-determination and uniqueness. The requirements of female captives are frequently disregarded.

While the judiciary and government have taken significant steps towards improving the conditions of jails in India, there is still much ground to cover.

Most of the better facilities are currently available only in select correctional prisons, and it is crucial that all inmates are able to access these benefits and opportunities. Despite various laws, execution is not done correctly. Inmates face a variety of difficulties, ranging from dealing with menstruation to giving birth to a child.

Rules, particularly those focusing on female convicts, are desperately needed, as is their execution. Everything should be closely monitored by committees. The chronic and systemic injustice experienced by these vulnerable women may be merely the tip of the iceberg, jeopardising the prison's capacity to achieve its stated rehabilitative and restorative goals.