It's not just the water. Last week a federal judge ruled that Arpaio's current jail conditions violate the U.S. Constitution, specifically when it comes to healthcare, overcrowding, and access to medication. U.S. District Court Judge Neil Wake issued a list of 15 changes — including diet, medical care, and medication — that Arpaio must make by December.

A month before that ruling, the jails also lost their national health accreditation, which is required by state law.

Arpaio does not deny that his jails are tough. He's actually built his career on claims that he doesn't coddle criminals.

Ambrett Spencer with her baby, Ambria
Ambrett Spencer with her baby, Ambria

Into the fray of Arpaio's "tough" jails come about 1,500 pregnant inmates each year. Some of them say their care hardly differs from what's given the other inmates. That is ironic, since Joe Arpaio claims to care about the unborn in his jails. In 2005, he refused to allow inmate abortions. Arpaio fought that battle all the way to the U.S. Supreme Court, where he lost.

A person like Ambrett Spencer — who admits she drove drunk more than once — deserves to be punished. But jail does not have to be a potentially unsafe place for an unborn child. Unlike Maricopa County, many other correctional facilities in the U.S. offer programs to care for pregnant women.

Dr. Mary Byrne, professor of clinical healthcare for the underserved at Columbia University, has studied prenatal care in jails and prisons for years. She points to the state of New York as a model. There, all pregnant inmates are sent to a maximum-security prison where they take birthing and parenting classes. It's worked so well that six other states have adopted similar programs.

In 2005, the San Bernardino County Sheriff's Department in California started its own program — after jail nurses and doctors realized that many pregnant inmates were getting depressed.

"Nurses and social workers at the jail and at the hospital noticed that inmates giving birth were usually scared, alone, unsure of their baby's fate and often ill-equipped to deal with the situations and decisions confronting them after giving birth," nursing director Debby Lucas wrote in a review of the program.

As a result, the San Bernardino jail started Lamaze childbirth classes, as well as parenting classes for pregnant inmates.

The Monroe County Jail in New York offers prenatal care as part of its rehabilitation for pregnant inmates. Mothers-to-be can also get tutoring about rape crisis, family planning, smoking cessation, and community resources.

In Seattle, the King County Jail brings in social workers and nurses every Wednesday to train pregnant inmates in prenatal care, examine their health, and answer questions. Some social workers even keep in touch with pregnant inmates after their release.

In Arpaio's jail, pregnant inmates say the only prenatal care they get is a bottom bunk, an extra blanket, a "snack" (which is sometimes inedible, they say), and prenatal vitamins — if the vitamins come that day.

In September, New Times asked to talk to the jail's healthcare director about prenatal care. Correctional Health Services has not yet scheduled an interview with its director, Betty Adams.

Former inmates have been far more willing to speak.

Michelle McCollum was in the first trimester of her pregnancy when she awaited trial in 2005 for possession of marijuana. She later pleaded guilty and was sentenced to probation.

McCollum blames unchecked violence and delayed medical care for the loss of her pregnancy. On August 21, 2005, she was attacked by two other inmates, she says in an affidavit filed in the lawsuit that recently found jail conditions unconstitutional.

Two inmates punched McCollum in the stomach repeatedly. After the attack, she and another inmate cried to guards for help. But McCollum writes that detention officers refused to bring her to the infirmary — even after she told them she was pregnant and injured.

Three days after the attack, McCollum's bleeding wouldn't stop. She was finally taken to the Maricopa County Hospital. There, doctors said she had miscarried and ordered that she return to the hospital for a checkup.

Despite her reminders, jail personnel did not take McCollum back to the hospital. On September 17, she began bleeding again. The bleeding wouldn't stop.

An ambulance finally rushed McCollum back to the hospital — where doctors gave her a blood transfusion because she had lost so much blood. Then they performed a procedure called a D&C, which removed the remains of the pregnancy.

Lilly Lee recently got out of the Estrella Jail. Upon her release, she called New Times to spread the word about pregnant inmates.

"The detention officers knew these women were undergoing miscarriages, and we were telling them," she says. "They just wouldn't do anything. There were a lot of things going on in there that I don't think a lot of people know."

Michael Bergman, an executive chef, agrees. His fiancée, Reyna Dziovecki, was in the jail for only two days, but it was enough to make him fear for the life of their baby. The charges against Dziovecki have since been dropped.

"She was eight months pregnant. She literally didn't eat anything from 5 p.m. one night to 6:45 a.m. two days later," he says. Bergman says he spent that time running from one downtown building to another, trying to bond his fiancée out. He finally did.

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