respectful care, the right to refuse treatment, and the right to complete information regarding a diagnosis; the Professional Code of Ethics outlines the standards that staff must follow, including having a respect for human dignity, and a professional relationship with the patient. The DOCCS does not monitor how well facilities actually adhere to these standards, and there are no consequences for those who do not. Also, many women are not informed of their patient's rights, so are unaware when standards have been breached. The DOCCS has no written policies on pregnancy tests, pregnancy options counseling, abortion, ectopic pregnancy, miscarriage, stillbirth, nutrition for pregnant and nursing women, or hysterectomies, and has incomplete policies regarding menopause, vitamins, health care for pregnant women, women in labor, or women who have recently given birth. The DOCCS policies stray from community standards in the areas of the starting age for yearly GYN check-ups, the frequency of breast exams and Pap smears, follow-up for abnormal Pap smears, frequency of prenatal visits and ultrasounds, and the time frame for postpartum check-ups for women who have a Caesarean section. The Federal Bureau of Prisons' policy is to provide each inmate with a complete medical exam (which includes gynecological and obstetrical history) within 30 days of admission. The BOP currently adheres to the standards for yearly exams put forth by the American College of Obstetrics and Gynecology. According to a 1997 survey, approximately 90 percent of the inmates in women's state prisons reported having received a gynecologic exam from their institution upon intake. Additionally, an American Correctional Association study found that most women's correctional institutions provided OB/GYN services, prenatal and postpartum care, mammography, and Pap smears upon request. Fewer provided counseling for inmates regarding their reproductive health, many correctional facilities do not provide follow-up exams, and screenings often do not continue on the recommended schedule. In a New York city juvenile detention facility, the 5,000 youth who went through the system annually were all served by a single physician. Less than one-third of the inmates received a Pap smear test, and one in five were tested for gonorrhea, chlamydia, and syphilis. Women often report long delays and wait times in signing up for appointments with a GYN doctor, and in getting treated. For example, more than half of respondents in a survey of incarcerated women in New York state prisons said that they were not able to see the