Paige was seated in the nurses’ station at Winnebago County Jail, feeling shocked. She had just received news that her pregnancy test was positive. Paige, who preferred not to disclose her last name, was not prepared to have a baby. She was facing drug charges in Illinois that could result in potential prison time, and she was already concerned about the well-being of her four children at home. Given her high-risk pregnancy due to previous cesarean sections and recent surgery complications with her placenta, Paige doubted the quality of medical care she would receive from the county. “My life was on the line at that moment,” she explained. She attempted to request an appointment for an abortion through the jail’s messaging system, only to receive a response that left her baffled – a sad-face emoticon. Data from researchers at Johns Hopkins School of Medicine in 2017 revealed that about 3% of women in jail in the United States were pregnant upon admission. Despite this statistic, there is a lack of information on access to abortions in jails across the country. A recent report shed light on reproductive care in Illinois jails, showing that less than one-third of the state’s jails have explicit policies on abortions. These existing policies are often ambiguous and may impose significant obstacles, such as requiring individuals to make their own arrangements or payment for the procedure while incarcerated. Similar trends were found in a review of pregnancy policies at 27 jails in 12 states and in a study conducted in Oregon. These studies indicate that even in regions where abortion is legal post the Roe v. Wade decision, incarcerated individuals’ reproductive rights are tenuous and limited. Incarcerated individuals face significant challenges in accessing abortion due to lack of clear guidelines and policies. Without written policies in place, decisions regarding reproductive care are left to the discretion of staff, potentially conflicting with the pregnant person’s wishes. The absence of written guidelines at the jail where Paige was held exemplifies this issue. Despite her attempts to secure an abortion, she did not receive the necessary care. While officials at Winnebago County Sheriff’s Office did not respond to inquiries, Paige’s mother confirmed her account of the incident. Advocates stress the importance of releasing pregnant individuals from jail whenever possible and ensuring access to reproductive care guided by clear policies. Restrictions imposed by jails, as well as state laws limiting or prohibiting abortion, disproportionately affect incarcerated individuals. Incarcerated individuals must navigate financial barriers as well, such as the requirement to pay for the procedure themselves, making access to abortion even more challenging. Despite recent efforts in some states to expand abortion access, jails often operate under their own policies, leading to a patchwork of approaches across the country. In some cases, like Yamhill County in Oregon, laws explicitly prohibit jail staff from facilitating abortions, creating additional obstacles for incarcerated individuals seeking reproductive care. The impact of such restrictions is compounded by federal policies that terminate Medicaid coverage for individuals while incarcerated, further limiting access to abortion services. The debate over reproductive rights in the criminal justice system underscores the need for clear policies and standards to ensure the health and well-being of incarcerated individuals, particularly when it comes to crucial decisions like abortion.