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Objective: This paper discusses incarcerated girls’ and women’s access to reproductive health care, including contraception and abortion, in our current era. Data/methods: Review of extant literature, policy, law, and legislation. Results: In many facilities, the quality of gynecological, prenatal, and obstetric care is quite low or unavailable, even in states with wide legal access; girls and women who are pregnant or have reproductive health challenges, including HIV and hepatitis C, face additional challenges. Moreover, in some facilities, gynecological care has been accompanied by sexual harassment, new forms of involuntary sterilization, and assault or used as a way of punishment. The illegalization of reproductive care and lack of adequate options especially affect trans- and nonbinary incarcerated individuals as well. Lastly, although incarcerated girls and women have the right to contraceptives or abortion (if their state laws allow for it), there are several dilemmas that arise when such rights are asserted. Conclusion: System-impacted girls and women have traditionally struggled to gain access to adequate reproductive care, made even more dire post-Roe. This presentation ends by reaffirming that reproductive care access when incarcerated is still a human right and that denial of needed reproductive services amounts to government sponsored violence.