When a female deputy at Kentucky’s Franklin County Regional Jail first encountered Kelsey Love in her cell early May 16, 2017, the incident report she wrote after was sparse.

She noted that Love, who was eight months pregnant at the time, was suffering from back and leg pain.

But Love was actually experiencing labor pains. Her attorney, Aaron J. Bentley, argues that was clear to the officer, who was wearing a body camera that recorded the entire conversation.

Responding to screams from Love’s cell shortly after 5 a.m., the officer found Love on the floor, naked and clutching her swollen belly. Love told her the baby was coming and asked to be taken to a doctor.

“Something’s wrong with him, I need to go. He’s coming out,” Love told the officer, according to a transcript of the footage. “Why won’t you help me?”

The officer responded by asking if Love had given birth before and whether she was having contractions. Love answered yes to both questions. The transcript references the presence of another officer as well.

When the officer reached out to the jail’s on-call nurse, according to Bentley, she relayed Love’s complaint about back and leg pain, along with questions of whether Love was intoxicated or going through withdrawal. She did not mention contractions or labor pain.

Nearly three hours passed before a nurse opened the door to Love’s cell, Bentley said, citing the jail’s records and Love’s recollection. She encountered a floor covered with blood and Love, huddled inside a ripped mattress with her newborn son. Love had chewed off the umbilical cord.

On Feb. 17, a federal judge ordered the Franklin County Regional Jail to pay Love $200,000 for the incident, but neither the jail nor its employees were required to admit responsibility for what happened to Love. The county insists there was no evidence to suggest Love was in labor, according to the Associated Press.

“The defendants always have and will continue to strive to provide the best care to all people at the Franklin County Regional Jail,” said Paul Harnice, the attorney who represented the county jail, in an email.

Bentley, a civil rights lawyer who filed the lawsuit on Love’s behalf in 2018, said much of Love’s experience is common for pregnant women incarcerated in Kentucky.

“Not getting proper medical care rings true [for] every jail medical case that I’ve worked on,” he said. “It’s all about a refusal to give credence to these folks … to accept them as humans and treat them as humans.”

At the time of Love’s detention, the female prison population in the state was spiking, particularly compared to male inmates, wrote Kentucky state Sen. Julie Raque Adams (R) in a 2018 op-ed for the Courier Journal. The number of men incarcerated grew by 5 percent between 2017 and 2018; for women, the rate of increase was 14 percent.

“One in four women entering our justice system are either pregnant, or mothers to children under the age of 1,” Adams wrote, noting that a third of incarcerated mothers were serving time for drug-related offenses.

Police arrested Love in Frankfort, a city about an hour east of Louisville, after they found her driving her mother’s Cadillac Escalade, which had been reported stolen, reports the Lexington Herald-Leader. She disclosed to police that she had been using methamphetamine and opioids. Because she couldn’t afford bail, Love was in jail for two days before she went into labor, said Bentley.

According to Bentley, the county said it fulfilled its obligations when the officer reported Love’s symptoms to the nurse on staff, even if her description was incomplete.

This highlights a broader issue affecting many who pass through U.S. jails and prisons: Staff without proper medical training or knowledge act as gatekeepers for people who need all kinds of treatment, including pregnancy care.

Because of this, there is “tremendous variability” in the care that pregnant people receive when they are arrested for or convicted of a crime, said Carolyn Sufrin, an assistant professor of gynecology and obstetrics at the Johns Hopkins School of Medicine who has done extensive research on pregnancy in prison populations.

“There are no mandatory standards that jails and prisons must follow when it comes to any health care event, including pregnancy care,” said Sufrin, adding that there are no oversight boards to determine whether corrections facilities are acting appropriately. According to statistics from the American College of Obstetrics and Gynecology, 6 to 10 percent of incarcerated women are pregnant, with the highest rates in local jails.

Because of this, there is a wide spectrum of care that a pregnant person in jail or prison can experience, from a deputy who will call a nurse “if a pregnant woman does anything so much as hiccup or cough,” to officers who will ignore symptoms that require urgent care, like vaginal bleeding.

Bentley noted that when he deposed the jail staff for Love’s civil suit, they couldn’t accurately name symptoms of labor.

The nearest hospital was an eight-minute drive away from the jail, but Love was not taken there until after she had given birth, when she had lost nearly a third of a gallon of blood, according to Bentley.

Even hospital care doesn’t guarantee that pregnant people will be treated well, both Bentley and Sufrin noted. Had Love given birth in a hospital, she would have “one hundred percent been shackled,” Bentley said. Her delivery predated the 2018 passage of Kentucky’s “dignity bill,” which banned the shackling of pregnant incarcerated people while they give birth.

Bentley and Sufrin said there is a cultural impulse to punish those with substance abuse issues or downplay their pain, even if they are in medical need.

“They need medical help. Medical and mental health care,” Sufrin said. “Judging them harshly, holding [their condition] against them and alienating them from seeking care … is really detrimental to their well-being, and the well-being of the children they may give birth to.”

With the proper care, pregnant people with substance abuse disorder are more likely to engage in treatment and more likely to enter recovery, she added.

Love is now sober and doing well, Bentley said. She can visit her son, who is in good health and being cared for by her father and stepmother. She is working toward gaining custody.

It is unclear to him if the jail has made changes to ensure that what happened to Love doesn’t happen to someone else. Harnice, the county jail’s attorney, did not respond to questions about whether there have been any changes to policies since 2017.

Bentley said he continues to see the same issues play out in his other cases.

“All the problems that led up to why this happened are all systemic problems to Kentucky jails, and probably jails across the country.”

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