UPDATE, April 25, 11:01 a.m.: Maryland Gov. Larry Hogan (R) on Tuesday signed HB 797/ SB 598, mandating a sufficient supply of free menstrual hygiene products for incarcerated women. The medical policies bill has not yet been signed.

Maryland legislators have passed landmark legislation to protect the health and dignity of incarcerated women.

Maryland’s Democratic-majority General Assembly last week passed two bills with bipartisan support to ensure the prison system develops policies on medical care for pregnant inmates and detainees, and provides free feminine hygiene products to people who are incarcerated.

“We are the first in the nation to do this and it says a lot,” Diana Philip, executive director of NARAL Pro-Choice Maryland, told Rewire.News. “It is a great foundational law and a good risk-management tool for the administration. These two bills will lead the reform that so many people are looking for.”

Expected to go into effect October 1, HB 787/SB 629 requires every correctional facility in the state to have a robust policy in place for the medical care of pregnant inmates, including prenatal testing, labor and delivery, abortion care, postpartum care, access to child placement services, and counseling. Incoming women have to be provided with the policy. This is important, advocates said, because pregnant people often don’t know their rights or even expect health care in prison.

Former inmates have shared harrowing stories of never getting prenatal testing results, a total absence of pregnancy options counseling, denial of abortion care, unlawful shackling, and even forced cesarean sections, Philip said.

“Pregnant inmates are not any less deserving of proper medical care to ensure their own health and the health of their child,” said lead sponsor of the house bill Del. Kathleen Dumais (D-Montgomery County).

The companion bill, HB 797/SB 598, requires correctional facilities in Maryland to have a written policy and sufficient supply of free menstrual hygiene products as needed. It sounds like a basic necessity, but many imprisoned women go without pads or tampons. The products can be expensive or simply unavailable, advocates said.

“Menstrual hygiene products should be considered basic necessities for women,” said state Sen. Susan Lee (D-Montgomery County), who sponsored the Senate bill. “Ensuring women in prison have access to these products is simply the right thing to do.”

Even vendors realize when prisons cut shipments from 1,000 to 200 pads a month to save money, said Monica Cooper, former inmate and co-founder of the Maryland Justice Project, an advocacy group that pushes for prison reform.

These are “dignity bills” and she hopes Maryland lawmakers will inspire other state lawmakers to follow suit, Cooper told Rewire.News.

Despite a 700 percent increase in women’s incarceration since 1980, prison policies and services have not been updated to better accommodate women. “It’s almost as if incarcerated women are an afterthought,” Cooper added.

It’s “mind blowing” that these commonsense policies are not in place everywhere, especially during a woman’s most vulnerable and at-risk time of her life, said Julie Magers, leader of the Maryland Prisoners’ Rights Coalition.

“I’ve received many many complaints from women I’ve interviewed about the lack of basic hygiene and health care so to have these bills pass. It’s landmark and so incredibly needed,” she told Rewire.News.

She has heard from a woman who was put into medical isolation after she miscarried with no aftercare provided; a woman who was shackled during labor and was forced to walk in chains after giving birth; women threatened with solitary confinement for bleeding through their uniforms during menstruation when they had maybe three pads for their entire menstrual cycle, or worse, none.

Maryland already has an anti-shackling law on the books but that policy is often not enforced, advocates said.

“You’re a prisoner so it doesn’t matter. We hear that frequently. I think that’s how (women) are made to feel,” Magers said. “One of the problems women face a lot is the lack of proper care being directly related to the fact that they are prisoners. That’s not how it should be. It shouldn’t be a matter of whether they are prisoners; they are human beings.”

Formerly incarcerated women like Kimberly Haven recently amplified the subject via the #MeToo campaign by sharing how she made sanitary products using toilet paper during her 15-month stint at a Maryland prison. This led to toxic shock syndrome and eventually,  an emergency hysterectomy.

“We had no access some days to pads or tampons and some days not even to toilet paper,” said Sherell Evans, a former inmate and member of the Maryland Justice Project. “As you can imagine, in a facility that houses over 1,000 inmates, things can get pretty messy. Some people would tear up sheets to use as sanitary napkins, they were making homemade tampons out of paper and different stuff …. It was a very, very terrible situation.”

While accurate numbers of incarcerated women are hard to find, the Maryland Correctional Institution for Women in Jessup, the state’s only all-female facility, houses between 800 to 1,000 women. Advocates estimate there are more than 2,000 women detained or imprisoned statewide.

Both bills were priorities for the statewide coalition Reproductive Justice Inside, which advocated for the reforms with partner members that included doctors, midwives, lawyers, professors, and students.

“I commend our partners in the Maryland ​General ​Assembly and at Reproductive Justice Inside who worked tirelessly to pass these important measures,” said Gloria Totten, president and founder of the nonprofit Public Leadership Institute, a nonpartisan nonprofit. “I would encourage other states to follow this example and ensure that incarcerated women have access to essential health care needs such as menstrual hygiene products and information ​about​ all pregnancy outcome options including abortion.”

Republican Gov. Larry Hogan’s office did not return messages seeking comment on if he would sign the bills, but the legislation passed both chambers of the legislature with enough votes to override a potential veto.