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A Texas Jail Delayed My Prenatal Care to Keep Costs Down. Then I Had a Miscarriage.

Collin County Jail failed to send a bleeding, cramping Lauren Kent to an outside OB-GYN. In a lawsuit, she blames their “cost-containment” strategy.

An illustration in purple tones shows a portrait of a woman with blue eyes, with her hair down and wearing a tank top.

In 2019, after days of bleeding, cramping and begging to go to the offsite obstetrician, Lauren Kent had a miscarriage in Texas’ Collin County Jail. Two years later, she filed a lawsuit against the county and private medical provider, Wellpath, alleging that jail staff ignored her repeated requests due to a “cost containment program.” The program was designed to keep medical spending low by limiting access to outside appointments. Detainees at the Collin County Jail must be suffering from a “life or limb threatening illness or injury” to be transported offsite for emergency medical care, according to court documents. The case is still pending.

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Before I went to jail in 2019, I was struggling. I was homeless and dealing with my drug addiction while living in Plano, Texas. So when I got pregnant, I knew things needed to change. I wanted better for my baby.

Seventeen years prior, I had given a baby up for adoption, and I still had the agency’s card in my wallet. So I gave them a call and told them I was pregnant and stuck in a toxic environment. I asked the woman on the phone if she would help me find a family that would care for my baby and help me get out of my bad situation. She said yes.

Almost immediately, the agency put me up in a long-term hotel in Dallas, Texas. They found a family who wanted a baby. And they helped me schedule my first doctor’s appointment. For the first time in a long time, I had a plan in place. I was sober.

Over a month into my new arrangement, I went back to Plano to get my bicycle. I’d left it in front of a friend’s house. I didn’t have a car, and I thought a bike would help me get around. Even though I was only three and a half months pregnant, it was a struggle to ride the bike. So I walked it along the side of the road.

That’s when the cops stopped me. They asked for my ID. It turns out, I had a warrant out for my arrest for using a credit card that I found in a parking lot of a grocery store when I was homeless. I used it to buy groceries.

The cops took me straight to Collin County Jail in McKinney, Texas. I was just a few days shy of seeing my doctor for the first time to make sure everything was OK with my pregnancy.

At first, I didn’t have any worries about being in jail. I didn’t even cry. I’d been to Collin County Jail before, so I knew how everything worked. I thought: At least I am in a safe environment and away from the bad influences that had gotten me into trouble in the past. More than anything, I just wanted to stay sober for my baby.

I told the jail administrators who booked me in that I was pregnant. At the time, I thought I might be having twins because I was so big. They gave me a pregnancy test anyway.

A couple of days after I got to the jail, I saw a physician's assistant. She told me I would see her again in one month and that I would be going to a doctor within the week. There are no doctors onsite at the jail, so I would have to go offsite to see an obstetrician.

It was comforting knowing that I would see a doctor soon. I took them for their word and waited for the day to come.

Being pregnant in jail is not easy. There is not much comfort. The jail wouldn’t give me an extra pad for my bed. They did give me a bottom bunk and a few extra snacks between meals. But without the help and support from the adoption agency on the outside, I would have been hungry many nights.

A nurse came into our pod several times a day to give people their medicine and check people’s blood sugar after meals. On several occasions, I told a nurse that I was supposed to have a doctor’s appointment. Each time, they’d say, “OK. OK.”

Around three weeks into being in jail, I started spotting. I had nothing but time to sit in my cell worrying about what was going on. I’d go to the kiosk where we can file complaints and make medical requests to remind them that I was supposed to have a doctor’s appointment. I told them that something was wrong.

I told every guard, every member of the medical staff, every employee that I saw in that place, what was happening to me. I was spotting and I was cramping. The bleeding got worse each day.

Their response was always the same. They’d tell me I was scheduled to see the physician’s assistant again in a few days and could voice my concerns then.

At one point, the pain was unbearable. I was curled up in a little ball on my bunk, begging for help. The women in my unit brought me wet towels to cool me down and mop the sweat from my head and my neck. They held my hand. They were mean to the guards on my behalf, telling them how messed up this all was and that I needed to go to the doctor. They wrote grievances and complained on my behalf.

Finally, a nurse told me to count the number of pads I was bleeding into. He told me I needed to saturate two pads full of blood within 30 minutes for them to feel it was necessary for me to go to the hospital. I told him that most of the blood was coming out when I was going to the bathroom. I even left the blood in the toilet and asked the girls not to flush it so the nurse could see how much blood I was losing. But he wouldn’t look.

I called the adoption agency and I told an agent that I was cramping and bleeding and that no one would help me or take me to the doctor. The agent called the jail on my behalf. I learned later that the person she spoke to said, “You know how these people are,” implying that women like me like to make things up to get attention. But the agent had known me since I gave my first child up for adoption. “No, I don’t,” she replied.

After the call, I was moved to the infirmary. I was relieved. I thought I was one step closer to seeing a doctor. But the infirmary is just glorified solitary confinement. The only difference is that my cell had two large windows so the nurses could watch me. I was locked in for 23 hours a day, with one hour out to bathe or pick a book.

The nurse took my vitals once a day. But the facility used no equipment to monitor a baby — not even one of the little machines where you can hear the heartbeat. I told the nurse that I hadn’t felt my baby move in nearly 36 hours. But still, they did nothing.

When I finally saw the physician's assistant again, a day before I lost my baby, I told her everything that happened. And I asked her why I never got to see a doctor. She told me the request must have been lost in some paperwork. During her examination, she discovered that I had a bladder infection and gave me some medication.

The next day, I started going into labor in the infirmary. The nurse on call didn’t believe I was in labor. She gave me a couple of hot compresses for my pain. There was no clock, but I remember that it was nearly dinner time when the baby came out of me. When the nurse saw the baby in the toilet, she dropped to her knees and apologized.

Looking back, I think about how if they had done the bare minimum for me, they would have detected the infection earlier. They wouldn’t have had to take me anywhere. I wonder if my baby’s life would have been saved.

I was blessed to have two sons after I got out of jail. And I think about the baby I lost, who I named Dakota, all the time when I look at my boys. I wonder if Dakota would look like them even though they have different dads.

Deep in my gut, I know that this could have been prevented if someone had given me help. The guards did the only thing they could do, which is to notify the medical staff. But the medical staff were indifferent. One nurse even told me that if I kept acting the way I was acting, that I would go back to maximum security.

They threatened me with punishment. While all I did was beg for help.

In a July 6, 2023 email, a public information officer with Collin County Sheriff’s Office stated that “Collin County denies Ms. Kent’s allegations and is defending itself in the lawsuit. Also, the County has no further comment while the litigation is pending.”

Nicole Lewis Twitter Email is the engagement editor for The Marshall Project, leading the organization’s strategic efforts to deepen reporting that reaches communities most affected by the criminal legal system.