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In the United States, the female prison and jail population has surged to approximately 175,000, with a striking overrepresentation of women of color, who account for more than half of this demographic. Within Texas alone, the Texas Department of Criminal Justice reported close to 9,000 women in its custody in 2022, and annually, over 100 women are identified as pregnant at intake. Building on our current NIH study, this exploratory study highlights the healthcare challenges of incarcerated pregnant women, including the lack of adequate prenatal care, and examines the impact of structural racism on perinatal health disparities. Using arrest data and criminal case filings from a large southwestern state’s County Clerk’s office, this study examines disparity-aware metrics of structural racism in the criminal justice system. The findings underscore the urgent need for policy reforms that recognize and address the compounded effects of structural inequities on the health and rehabilitative needs of incarcerated women, aiming for a more equitable and holistic approach to their care.