Shackling and pregnancy care policies in US prisons and jails

Reproductive health care for incarcerated women in the prenatal and postpartum periods

In 1976, the Supreme Court mandated that incarcerated individuals have a constitutional right to receive medical care; however, there are no mandatory standards so access to and quality of reproductive health care for incarcerated pregnant women varies widely across facilities. Without federal or state standards, there is variability in the type of prenatal care pregnant women receive, their birthing experience, how long they are able to stay with their infant after birth, and whether they are permitted to breastfeed or express milk. In this column, I review policies related to reproductive health care in carceral settings, the gaps in data collection and research, programs to support the needs of incarcerated pregnant women, and recommendations from professional organizations on reproductive health care for incarcerated women in the prenatal and postpartum periods.

Development and psychometric evaluation of the sexual and reproductive health needs of incarcerated women scale: a methodological study

BACKGROUND

This study aimed to develop and validate a comprehensive tool designed to assess the sexual and reproductive health (SRH) needs of incarcerated women.

METHODS

A methodological study was conducted from January to March 2023 in two female prisons in Tehran and Hamedan, Iran. The participant pool consisted of women who had been incarcerated for a minimum of 6 months and were aged between 15 and 49 years. The instrument development involved two phases. Phase I involved a literature review and interviews with incarcerated women to understand their SRH needs. Phase II assessed psychometric properties to establish the scale's validity and reliability.

RESULTS

The SRH Needs of Incarcerated Women (SRH-NIW) scale was refined, comprising 37 items across six domains: pregnancy and childbirth services, parenting services, family planning and sexual health services, personal and medical care services, screening services and infection control services. Exploratory factor analysis explained 66.15% of variance. The Content Validity Ratio and Content Validity Index were 0.8 and 0.94, respectively, indicating high content validity. Average Variance Extracted values ranged from 0.592 to 0.698. The whole scale showed a Cronbach's alpha of 0.823, and the Intra-class Correlation Coefficient was 0.879.

CONCLUSION

The SRH-NIW scale is a valid and reliable tool for assessing the SRH needs of incarcerated women. It can enhance healthcare services and interventions for incarcerated women, potentially leading to policy improvements within the prison system.

How are the Dietary Needs of Pregnant Incarcerated Women Being Met? A Scoping Review and Thematic Analysis

INTRODUCTION

The number of incarcerated pregnant women is increasing globally. With many having complex health and social backgrounds, incarceration provides opportunities for health interventions, including the chance to have their nutritional needs met. Despite the additional nutritional requirements of pregnancy being well documented, how these are being met within the correctional setting is currently poorly understood.

METHODS

A scoping review of the literature was conducted to identify the literature published between January 2010 and April 2023 related to the provision of nutrition for pregnant women in the international prison systems. Sixteen papers met the criteria for inclusion in the review. The relevant key findings were charted and thematically analysed.

RESULTS

Two themes were identified: 'the inconsistent reality of food provision' and 'choice, autonomy and food'. There is a clear disparity in the way in which diet is prioritised and provided to pregnant incarcerated women across several countries.

DISCUSSION

The findings highlight the need for a consistent approach to diet on a macro, global level to ensure the health of women and their infants in context.

Use of Shackles on Incarcerated Pregnant Women

The United States has the largest population of prisoners worldwide, and profound racial and structural inequities exist within this population. Qualitative and quantitative data suggest that shackling incarcerated pregnant women occurs in the United States despite anti-shackling legislation and recommendations from professional organizations against shackling. Incarcerated women are vulnerable to adverse health outcomes when shackled during labor, birth, and the postpartum period. Because anti-shackling legislation is often nonexistent or not comprehensive, nurses play a critical patient advocacy role. The purpose of this article is to increase awareness of state anti-shackling legislation and deficiencies. We also aim to promote effective state advocacy and meaningful change in clinical practice to improve patient safety and health care quality for incarcerated pregnant women.

Identifying and Treating Incarcerated Women Experiencing Substance Use Disorders: A Review

While research on substance use disorder (SUD) treatment among justice-involved populations has grown in recent years, the majority of corrections-based SUD studies have predominantly included incarcerated men or men on community supervision. This review 1) highlights special considerations for incarcerated women that may serve as facilitating factors or barriers to SUD treatment; 2) describes selected evidence-based practices for women along the cascade of care for SUD including screening and assessment, treatment and intervention strategies, and referral to services during community re-entry; and 3) discusses conclusions and implications for SUD treatment for incarcerated women.