During my incarceration, I initially endured the stress of not knowing where my sons were because I had not been allowed a call the first three days I was taken. My sons had to care for themselves during my absence, as I lacked any familial or other social support, and I did not see them the entirety of my incarceration.
I was also six weeks pregnant. Anytime I had to be transported, I was chained at my ankles with another chain around my waist that bound my hands in front of my belly.
While shackled, attempting to step up into a van, I fell. A couple days later I begin spotting with streaks of blood, which I reported to the medical staff.
They informed me that they had literally “no” means of caring for me and would have to get approval from the US Marshals to take me to the ER. The turnaround time for approval ended up being 4 weeks. At that point, it was no longer an “emergency,” so I was turned away from the ER — I then required a second approval for an obstetrician, which took 4 more weeks. I ended up miscarrying at approximately 20 weeks without any formal or proper prenatal care.
To add insult to injury, I was assigned to a cell on a second floor and my request to be moved fell upon deaf ears causing me to have to climb steps daily. There was a fountain that provided brown water that I protested to the warden, who agreed to provide me with ice daily which did not occur. When I was miscarrying, I lay wet in blood, in the dark, curled up in excruciating pain until an officer made rounds. And I suffered the entire miscarriage shackled to the bed — I was told that the linen that contained my unborn child had been thrown in the trash.
I had no privacy, no counseling, nor any opportunity to grieve my miscarriage.
Then I was relocated to another facility where I was placed in solitary confinement for a month. Solitary is being locked in a 6’ by 9’ room with a bed, toilet, sink, and no window for 23 hours a day. Solitary is usually a means of punishment. In my case it was to keep me separated from other inmates because I was a federal inmate.
After 6 years, I was released diagnosed with high blood pressure related to my continuous physical stress along with a high sodium diet and depression caused by emotional distress. The additional stress of having my professional license revoked, the challenges of employment, housing, lack of insurance, little to no finances, the restrictions that come with being a convicted felon, and a woman compounded my state of health.
I left whole, I returned in pieces. Incarceration is a public health issue due to the social and physical determinants of discrimination, crowded conditions, income, and gender.

Pamela with her sons
Pamela Winn organizes formerly incarcerated women and allies with Women on the Rise in Atlanta, Georgia, where she is spearheading a campaign to close the Atlanta City Detention Center and instead put resources back into the community to support health instead of punishment.
She is a national leader and advocate in anti-shackling legislation, working in collaboration with other women who have experienced shackling while pregnant and advocates motivated to pass anti-shackling laws in their states. Together, they are developing a boilerplate anti-shackling bill for use in states without this legislation as well as a bill of rights for incarcerated pregnant women to serve as guidance in detention facilities.
Pamela also recently completed a Fellowship with the JustLeadershipUSA Leading With Conviction Program.
Pamela’s story, unfortunately, is more like the rule than an exception. To give just a glimpse into the social determinants of health she’s lifted up, here are some examples of the health impacts research and policy advocacy underway: