A little over a year ago, Alicia Gonzales-Lamonda was arrested for shoplifting and other charges. She entered a guilty plea and was sentenced to a year on electronic monitoring. As it turns out, that may have been the least of her worries.

On Feb. 20 of this year, Gonzales-Lamonda, 34, allegedly violated the conditions of her sentence. At the time, she was a little over three months pregnant, under the influence of opiates and experiencing signs of pregnancy complications, including spotting. That night, police picked her up and took her to Santa Fe County Adult Detention Facility.

Following protocol for the detention facility, staff refused to book Gonzales-Lamonda, even though Christus St. Vincent Regional Medical Center had cleared her for incarceration. SFCADF doesn't always agree with the hospital's clearances, and Santa Fe County faced potential liability if Gonzales-Lamonda or her baby were hurt.

But Gonzales-Lamonda was booked anyway, at 9:02 pm, according to the detention facility's website. According to Annabelle Romero, who at the time served as SFCADF's director, Santa Fe County Public Safety Director Pablo Sedillo ordered staff to book Gonzales-Lamonda. When Romero found out what had happened, she had Gonzales-Lamonda transported immediately to University of New Mexico Hospital in Albuquerque—the closest facility with the ability to handle such a delicate health situation.

Susan Cave, a psychiatrist who works with three state district court systems, tells SFR that Romero discussed the case at a meeting the following day. The day after that, Romero was fired.

Gonzales-Lamonda spoke to SFR on March 13 from SFCADF, where she was taken after being stabilized at UNM Hospital. She says that, when she was discharged, hospital staff told her to return if she had any significant spotting or other complications. Gonzales-Lamonda says that, even though she subsequently began bleeding heavily and feared she was having a miscarriage, SFCADF staffers have not followed UNM's directive.

"I could lose my baby in here, and nobody's gonna care," Gonzales-Lamonda says.

Neither Sedillo, County Manager Katherine Miller nor Christus St. Vincent spokesman Arturo Delgado returned SFR's calls seeking comment, but experts familiar with corrections system health care issues say Gonzales-Lamonda's case raises several concerns.

Barbara McGuire, an internal medicine specialist who was the statewide medical director for Addus, a private company that held a contract to provide care at some state corrections facilities from 2002-2004, says Gonzales-Lamonda's concerns are valid. Pregnant women withdrawing from opiates are as much as six times more likely to miscarry. Even without drug withdrawal, a pregnant woman with symptoms of complications should be transported to a facility with the capability to evaluate and treat her, McGuire says.

Steve Spencer, who was the medical director of the New Mexico Department of Corrections for eight years and is now a Santa Fe-based consultant on jail and health care, says it's a "standard of correctional healthcare" that a person in Gonzales-Lamonda's situation should be evaluated at a medical facility capable of addressing the issue. He refers SFR to official jail health services standards created by the National Commission on Correctional Health Care, which state that "severe withdrawal symptoms must never be managed outside of a hospital" and that "pregnant inmates receive…specialized obstetrical services when indicated."

If Gonzales-Lamonda's statements are true, Santa Fe County could end up in legal hot water, McGuire says.

"If the medical record at the university demonstrates that she was told [to return if she suffered any additional symptoms], and they are not following physicians' orders, [then] that is a violation of federal statute…" McGuire says. "I've testified in a number of cases like this in other states, and failure to comply with standard of care is a losing proposition."

To some, Gonzales-Lamonda's predicament signals a return to conditions at the jail before Romero took over in 2005. Romero helped oversee the facility's compliance with a US Department of Justice order requiring that SFCADF meet basic standards in the wake of a slew of class action lawsuits during its period of private management. Michael Gzaskow, who was the facility's medical director until December 2010, says Romero did so well that the DOJ joked about wanting to send her to other troubled jails to straighten them out.

"I thought she was excellent, and I was very surprised and shocked when the county did what they did," Gzaskow says.

Spencer also lauds Romero's administration of the facility.

"The health care in the jail—and the jail itself—was running more smoothly than it had been in a long time," Spencer says. "Since Annabelle was in charge of county corrections, it improved enormously."

But Romero is gone now, and Gonzales-Lamonda is out of options. Because her charge involves escape from a community corrections program, she is being held without bond.

"It is expensive when you have a corrections officer accompany somebody to the emergency room," McGuire says. "But it's a lot safer for the patient and a whole lot less expensive than a possible lawsuit."