You're Pregnant

During the medical clearance for a female arrestee, we ask if they’ve had unprotected sex in the last three days. Because we don’t ask men this, it can come across as personal and rude, but we ask because we offer plan B if they want it. I start off the question with this reasoning to avoid dirty looks.

A female has to be ovulating to become pregnant, so there is only about a week out of every month that this can occur. While fertilization can happen quickly, it often takes days while the sperm are alive waiting for ovulation. Plan B delays ovulation and prevents pregnancy even after sex has occurred. It’s almost 90% effective when taken within 72 hours, so we offer it. While it doesn’t harm a pregnancy if fertilization has already occurred, we still do a pregnancy test beforehand, because if they are already pregnant, there is no point. 

I’m assessing a female who is here for domestic violence. Her boyfriend was arrested as well. They are in their early 20’s, and it is both their first arrest. She is tearful and the arresting officer is shrugging and kind of rolling his eyes. It turns out this was a largely verbal fight, the neighbors called the cops, the boyfriend pushed her and she threw his phone at him. Apparently, contact and the desire of the other to press charges is all that is required for an arrest. They were both angry and said they wanted to press charges, so they were both arrested. No drugs or alcohol, just a couple of 20-year-olds living in an apartment, trying to figure it out.

She says, yes, she would like plan B, but is too distraught to pee in a cup. I let her know we need the pee to give her the pill so time is of the essence. She said it’s fine, she’s probably not pregnant, she just doesn’t want to right now. 

Plan B aside, all females are asked by medical to pee in a cup when they are arrested. Our job is to keep people safe while locked in a cell, and the protocol changes if they are pregnant: they get vitamins and extra milk. Most females refuse in booking. I don’t think they are against it so much as they just want to say no to something. When you are arrested almost all of your power is taken away. You don’t get a lot of say in what happens next, and much of it is humiliating, like stripping down and having someone look at your butthole while you cough. I would probably say no to peeing in a cup too.

Every booking nurse I’ve worked with asks this question, almost always gets a, “no,” says, “ok,” and moves on. I always take a beat here though, pause, and take a deep breath. I look up from the computer where I’m charting on and look at them. “You absolutely do not have to,” I say, “But they will keep asking you everyday, so if you do it now it will be quick no, or we give you vitamins and milk and an appointment with a doctor if it’s a yes.” Maybe 25% of the time they’ll agree to pee after an explanation.

This time, it’s a hard no. I medically clear her for jail and create a task for the next morning to collect urine for a pregnancy test.

The next morning, I’m working in the unit and see her again to ask for urine. She says no, she doesn’t need to pee. I say, “Even if you just peed, all we need is like three drops and then we can leave you alone.” She takes more convincing and then pees for me while I wait. 

I test it while standing outside her cell. She is pregnant. I tell her and her face goes white.

“What?” she asks, trying to process.

“It’s positive,” I say, “Do you want to see it?” I ask and gently hold it out for her to see. Her whole body starts shaking. 

The nurse I’m working with says, “OK! Moving on.” 

I wait at her cell, “Do you want to talk to mental health?” I ask, “I can schedule an appointment.”

“Umm, OK,” she says, “Can I talk to my boyfriend?” she asks. I look at the other nurse. I usually work booking and don’t know the rules here.

“Definitely not,” she says, “They’re both in custody.”

I want her to have her mom, or her sister, if she even has a sister. I want her to have access to the internet so she can research all the questions that must be spinning in her head. I want her boyfriend to know. I want her to not be going through this alone.

The nurse looks at me and says, “We have pregnancy education print outs at the nurses station, I’ll show you.” 

I tell this shaking young woman I’ll schedule her an appointment with mental health, the doctor, and she’ll be provided printed education. She nods.

Three other females I pregnancy test that morning, all of whom required convincing to let me test their pee, are pregnant. None had any inkling they were actually pregnant. Two seemed wholly unaffected by the news.

As a human being, I don’t believe it’s possible to be unaffected by this news and I wonder what has been a part of these women’s life experience so far that would elicit this response. 

I quickly decide this wondering is not a good use of my thoughts, and like my coworker suggested, I move on.

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Review

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This piece is devastating in its quiet observations, and precise in how it conveys the human cost of systemic indifference. A central theme is bodily autonomy in a system designed to ignore it. Even when services are offered (like Plan B or mental health referrals), they are constrained by bureaucracy, coercion, and powerlessness.

Another significant theme is the invisibility of crisis. Multiple women discover they are pregnant during jail intake, yet the institutional response is muted, procedural, and transactional. The narrator’s discomfort lies not only in what happens, but in what doesn’t happen, the absence of care, of community, of pause.

The contrast between life-altering news and mundane administrative response (“OK! Moving on.”) is haunting. This is a story about how systems normalize trauma, and how even the most well-meaning people inside them are forced to move on.

The tone is measured, reflective, and emotionally restrained, which enhances its impact. The narrator presents medical facts and institutional protocol with clinical precision, which serves as a counterpoint to their understated emotional response to the events unfolding. This emotional restraint makes the rare glimpses of the narrator’s internal landscape more powerful:“I want her to have her mom, or her sister, if she even has a sister…” That sentence carries enormous emotional weight precisely because it slips through the professional veneer, a sudden, almost involuntary yearning for the arrestee to receive the support that the system cannot and will not provide.

The final line, "I quickly decide this wondering is not a good use of my thoughts, and, like my coworker suggested, I move on." is heartbreaking in its surrender. It’s not cynical. It’s survival.

The structure follows a narrative arc that feels both linear and recursive, echoing the repetitive nature of the work: question, refusal, explanation, test, result, repeat. This loop reinforces the larger existential point, that deep, irreversible events are unfolding in a context designed to process, not witness.

The piece also successfully weaves together macro-level medical context (Plan B, ovulation windows, pregnancy protocols) with micro-level human drama (the individual women’s responses). This dual perspective allows the reader to grasp both the science and the stakes, without ever losing narrative momentum.

This piece delivers exceptional insight into the gendered, bureaucratic, and emotional dimensions of incarceration and healthcare. The narrator explains why only women are asked about unprotected sex, due to pregnancy risk and the provision of Plan B, but in doing so also highlights the unequal attention given to the consequences of sexual behavior. The system reflects biology, but it also reinforces the idea that women must bear the physical, emotional, and procedural consequences.

Even medically necessary services like pregnancy testing are experienced as coercive, not because of what’s offered, but because everything in jail strips people of choice. The narrator notes that many women refuse just because saying no is the only control they have left, a poignant reflection on institutional power and psychological resistance.

The narrator is struck by how unaffected some women seem upon learning they are pregnant, and rather than judging, they wonder: what kind of history prepares someone to meet that news with a shrug? How shocking it is that some women are “unaffected” by their pregnancy result becomes a reflection with painful clarity that this emotional flattening is likely learned, practiced, and necessary for their survival. This observation is both an indictment of the systems that raised, hurt, and failed these women, and a sobering reminder of the emotional economy of trauma. 

The piece quietly but clearly captures the moral injury of working inside a system that fails people. The narrator’s small acts of compassion like explaining the reasoning behind questions, offering mental health referrals, and giving space, are powerful, but ultimately, they are operating within limits. That internal conflict, the tension between care and compliance, is the beating heart of this essay.

This piece is deeply affecting, beautifully written, and morally intelligent. It never preaches, but it shows what happens when personal crisis meets impersonal systems.