Filed
6:30 p.m. EDT

10.27.2025

A Marshall Project – Cleveland and News 5 investigation helped spark a bipartisan bill to track pregnancy outcomes in Ohio jails and prisons.

A bipartisan group of lawmakers have introduced legislation requiring all Ohio jails and prisons to report the outcomes of every pregnancy that ends behind bars.

The proposal comes following a Marshall Project – Cleveland and News 5 investigation that detailed how a Cleveland woman’s pregnancy ended after her repeated cries for help went unanswered for hours in the troubled Cuyahoga County jail in 2024.

That pregnancy loss and the outcomes of other pregnant women in jail aren’t tracked by Ohio. Currently, the state only requires county jails to report in-custody deaths.

But advocates and medical doctors have called the lack of reporting for failed pregnancies a blind spot for women’s health care behind bars.

If passed, House Bill 542 would require all county and city jails and state prisons to report the outcomes of pregnancies annually to the Ohio Department of Rehabilitation and Correction. The measure does not track pregnancies once a woman is released from custody.

The primary sponsors of the proposal, state Reps. Terrence Upchurch, a Democrat from Cleveland, and Josh Williams, a Republican from the Toledo area, introduced the measure Oct. 22. One other Republican and four Democrats signed on as co-sponsors.

“This is an opportunity to demonstrate that we are a pro-life state by protecting pregnant women and promoting healthy, pregnant outcomes,” Upchurch told The Marshall Project – Cleveland.

Critics say the lack of reporting requirements in jails makes it impossible to know whether any of the country’s more than 3,000 jails are failing pregnant women. A Cuyahoga County spokesperson declined to comment.

State Rep. Crystal Lett (D-Columbus), one of the co-sponsors and a mother of three, said the legislation is needed to help improve mortality rates.

“It’s deeply important that we protect all moms and to make sure that we’re providing prenatal care, regardless of incarceration,” she said.

In May, the news outlets detailed how Linda Acoff, nearly five months pregnant, screamed in pain for hours inside her cell at the Cuyahoga County jail. A nurse, who was later fired, offered only extra sanitary napkins and a dose of Tylenol.

Acoff’s condition worsened before her cellmate alerted a jailer, and she was taken by stretcher from the jail’s pregnancy pod. Left behind were the remains of Acoff’s fetus, a girl lost at 17 weeks, according to the Cuyahoga County medical examiner.

It was later determined that Acoff lost her pregnancy due to a common, but untreated, infection.

Acoff could not be reached for comment on the proposal.

Dr. Carolyn Sufrin, director of the Advocacy and Research on Reproductive Wellness of Incarcerated People program, is concerned that the proposal is too limited by the data being collected.

She said the measure, as currently written, fails to define terms and types of outcomes to be reported such as live births, still births, miscarriages and spontaneous abortion.

“I worry facility leaders would interpret it in their own way and not report full, standard pregnancy outcomes,” Sufrin wrote in a statement.

But Dr. Michael Baldonieri, an assistant professor of reproductive biology at the Case Western Reserve University School of Medicine, said the bill is a great start to wider reforms for vulnerable patients in jails.

“Historically, incarcerated individuals have suffered at the hands of medical inequity, and making these outcome data available for analysis is the first step towards taking concrete actions to improve pregnancy outcomes,” Baldonieri said in a statement.

Baldonieri is also a member of the Ohio Pregnancy-Associated Mortality Review Committee, which was created in 2010 to develop interventions to reduce maternal mortality, particularly for pregnancy-related deaths.

Upchurch said he expected some changes to the proposal as legislators hear testimony from stakeholders and medical providers.

“We are open-minded and will have the discussions to make a good bill and even better bill for the state of Ohio,” Upchurch said.