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Jail questioned in mishandling of another pregnancy



Abby Chapman wonders if the baby would have had her eyes.
"The what-ifs weigh on your mind," she said. "What if I had become a mom? What would my life have been like?"
Two years ago, Chapman entered the Dubuque County Jail pregnant with her first child. When she left, she no longer had hopes of holding her newborn.
"What happened is something that will affect my life forever," she said.
The Dubuque woman said her miscarriage could have been avoided if guards had provided immediate medical attention. Jail officials call the incident a tragic coincidence.
"Unfortunately, these things happen, and sometimes they happen here," said Jail Administrator Greg Egan.
But some question if they are happening too often.


Situation 'critical'
Around 7 a.m. on May 12, a 19-year-old inmate delivered her son alone while sitting on the metal toilet in a Dubuque County Jail cell.
Terra Keil said guards ignored her pleas for help and called the nurse too late.
Jail logs dispute the fact, saying "Keil did not bang on the cell door or yell through the intercom system to state she was having any sort of pains associated with being in labor."
The incident is an isolated one, Egan said, although he deems the situation "critical."
"Obviously we do not want to have these things happen in this facility," Egan said. "If there are lessons to be learned here, we will make those changes, and there are always lessons that can be learned."
Yet county officials anticipate no protocol changes, and medical administrators say the Dubuque facility is a "model in how things should be done."


'Protocol followed'
Abby Chapman was 12 weeks pregnant when she started serving 10 days for an operating-while-intoxicated citation.
Jail records show she was admitted on Wednesday, Jan. 24, 2007. Three days later, she started bleeding.
"The stuff that came from the guards' mouths amazed me," Chapman said. "They told me it was normal."
Guards gave her feminine hygiene products and required her to show them the used products so they could monitor her.
"I've never felt like such scum in my life," Chapman said. "I just laid on my bunk and cried. I didn't know what was going on. I asked to see the nurse, but they told me she wouldn't be in until Monday."
Jail records show that on Monday, Jan 29, 2007, "blood clots were noticeable" and that the "inmate will be released (to the emergency room) due to pregnancy problem."
The problem was an incomplete miscarriage, according to medical records from Mercy Medical Center.
Jail officials say no wrongdoings occurred during Chapman's stay.
"They did follow the protocol," said Egan, who was not jail administrator at the time.
Protocol says site physicians should be called if a pregnant inmate complains of pain or severe cramping, and it also tells employees "if the (pregnant) detainee complains of bleeding, give detainee four pads and monitor for bleeding. If the detainee saturates two pads within the hour, contact the detainee's obstetrician for instructions."
Then it adds, "Four pads is a guideline. Please use common sense when assessing the detainee."


Questionable claims, limited staffing
Jail guards are not doctors, said Dr. Norman Johnson.
"The protocol is not to help guards treat anything," he said. "It's to help them organize their thoughts before calling the doctor."
Johnson is CEO of Advanced Correctional Healthcare, which provides services to the Dubuque County Jail.
"You're touching on an area of health care that nobody in the public understands," he said. "These are very dedicated professionals who work under extreme handicaps."
Lying inmates is one setback, Johnson said.
"Sometimes the truthfulness surrounding the claim is questionable. Some detainees have ulterior motives," he said. "Crying wolf happens, but there are some very real cases, so they try to treat each claim professionally."
Which leads to the next obstacle -- limited staffing.
While each guard is a trained first responder, nursing staff is only available from 7 a.m. to 7 p.m. Monday through Friday. Medical staff remains on call during the weekends.
"I don't know of any jails of this size that have 24-hour nursing staff," Johnson said. "There is just not enough tax dollars available to supply that level of health care."


Seeking change
Two years ago, Mark Schmidt began drafting legislation to outlaw shackling pregnant inmates during labor. Now the Preston, Iowa, social worker plans to expand his request to legislators.
"The instances in Dubuque show we need to change how we deal with pregnant women who happen to be in jail or in prison," he said. "That's not going to happen until people stop saying, 'Oh, that's horrible that happened to her, but what was she in for?'"

Further investigation?
After Terra Keil delivered her baby, county officials scoured records and reports.
"We discussed what went on," said Dubuque County Attorney Ralph Potter. "But as far as an investigation, there's nothing criminal."
Dubuque County Supervisor Wayne Demmer said he would follow up on the matter.
Potter said he considers the issue resolved.
Neither Keil nor Chapman have brought civil suits against the county.
Keil was transferred to the Elm Street Correctional Facility in Dubuque to serve a 90-day sentence for a probation violation. The Department of Human Services placed her son, Colton John, in foster care. Her oldest son, Caden James, was removed from her custody after she was discovered using drugs, court records show. The records also show she used marijuana days before the birth.
Yet Chapman says neither her nor Keil's records justify the treatment they received.
"We're people," she said. "Inmates are normal people with normal lives. Everybody makes mistakes, but you can't hold it against them like that and treat them like that."