ACLU Settlement Ensures Proper Medical Treatment for Pregnant Mothers in Montana Jail

Officials at a Montana jail will be required to ensure pregnant inmates at risk of opiate withdrawal receive proper medical treatment as part of the settlement of a lawsuit filed by the American Civil Liberties Union and the ACLU of Montana.

The ACLU filed a lawsuit in November 2009 after Bethany Cajune was denied medication essential for preventing the serious medical risks associated with opiate withdrawal, including miscarriage, while four months pregnant and incarcerated at the Lake County Detention Center in Polson, MT.

"Women don't give up their right to medical treatment or their right to have a healthy pregnancy when they are incarcerated," said Jennifer Giuttari, staff attorney with the ACLU of Montana. "Under this policy, pregnant women incarcerated at Lake County Detention Center cannot be denied the obstetrical care and medication they need. We are extremely hopeful that this change in practice at Lake County Detention Center means that no other pregnant women will be treated the way our client was treated."

The settlement includes a new policy establishing necessary medical care for pregnant inmates with opiate dependency. That policy requires immediate referral to an obstetrical provider for a medical evaluation and plan of care, including treatment to prevent pregnant inmates from undergoing opiate withdrawal while in prison.

It also requires the county to train its officers on implementation of the policy and to ensure all pregnant inmates are fully informed about the policy.

In March 2009, Cajune voluntarily reported to Lake County Detention Center to complete an outstanding short-term sentence for traffic violations. At that time, she was approximately four months pregnant, raising five small children at home and successfully participating in a medication-treatment program for a diagnosed addiction to opiate drugs. Despite attempts by Cajune's treating physician and drug treatment counselor to ensure that Cajune could continue receiving her medication to prevent withdrawal while in Lake County Detention Center, and repeated warnings of the serious risk abrupt withdrawal posed to her health and pregnancy, including miscarriage, the facility continued to deny Cajune her medication. It took the intervention of a public defender, and a court order, to secure Cajune's release after nine days of being denied care so that she could resume the treatment.

Lake County Detention Center's treatment of Cajune was contrary to established standards of care for pregnant women who are receiving treatment for opiate addiction. Medical experts, the federal government and the National Commission on Correctional Health Care uniformly advise that pregnant patients should not be withdrawn from opiate treatment.

"By adopting this policy, Lake County has come in line with the prevailing medical standard of providing obstetrical care and treatment to prevent withdrawal for pregnant women with opiate dependency. This is an important step in providing women who are incarcerated with the full range of care necessary for safe and healthy pregnancies," said Diana Kasdan, staff attorney with the ACLU Reproductive Freedom Project.

The case is Cajune v. Lake County. Lawyers on the case include Betsy Griffing and Giuttari of the ACLU of Montana; Kasdan and Talcott Camp of the ACLU; and pro bono counsel, Gregory S. Munro.

For more information on this case, please visit: www.aclu.org/reproductive-freedom/cajune-v-lake-county