Evaluation of birth companions perinatal and peer support provision in two prison settings in England: a mixed-methods study

Complexities of midwifery care delivered to perinatal women in prison: A qualitative study

PURPOSE

To provide insight into the challenges faced by imprisoned perinatal women in accessing appropriate information, support, and care and the importance of the midwife's role in this context.

METHOD

This paper draws on two studies conducted in one United Kingdom (UK) women's prison over two separate time points (2019, 2021). In both qualitative evaluative studies that were descriptive in nature, semi-structured interviews were conducted with perinatal women and professionals involved in their care.

PARTICIPANTS

17 women participated across the two qualitative studies, six were pregnant, nine were on the Mother and Baby Unit (MBU) and two had given birth in the last 12 months but were not on the MBU. 12 professionals participated across the two studies.

RESULTS

The studies highlight the specific challenges that perinatal women in prison face compared to their community counterparts in being able to access reliable information on pregnancy, birth, and parenting; having access to appropriate and reliable peer support and mental health support not only in terms of provision but also in terms of accessibility; and in being able to advocate for themselves or having people that can advocate for them.

CONCLUSION

These challenges arguably heighten the importance of, as well as the pressure on the midwife in this context. The authors therefore highlight the need for consideration of three factors for midwifery in this context: (1) Resourcing (2) Information provision to, and information sharing between, midwives to increase awareness of challenges faced by this cohort, and (3) Strengthening the midwife's position to support and advocate for women's perinatal mental health in prison.

Navigating pregnancy and early motherhood in prison: a thematic analysis of mothers' experiences

BACKGROUND

Maternal imprisonment negatively impacts mothers and their children and is likely to have lifelong and intergenerational sequelae. In many jurisdictions nationally and internationally, young children (usually those less than 5 years) can reside with their mothers in prison. However, there is considerable debate regarding the impact of prison environments on incarcerated mothers and their children who are born, and/or raised in prison. Research to date on the pregnancy and mothering experiences of imprisoned mothers and their preferences for care arrangements for their babies and young children is limited.

METHODS

This study was part of the Transforming Corrections to Transform Lives project, in which workshops were conducted with imprisoned mothers to understand their needs while in custody and post-release, and the kind of supports and system changes that are required to meet those needs. Incarcerated mothers (n = 75) participated in seven workshops conducted across four Queensland prisons. Themes were generated through reflexive thematic analysis.

RESULTS

Three themes characterised mothers' experiences of being pregnant and undertaking a mothering role of a young child while in prison. First, for most mothers, imprisonment adds vulnerability and isolation during pregnancy and childbirth. Second, although mothers felt that residing together with their children in prison motivated them to change for a better future, they were concerned about the potential negative impact of the prison environment on the child's development. Lastly, most mothers voiced losing autonomy and agency to practice motherhood independently within custodial settings. Mothers expressed a need for the correctional system to be adapted, so it is better equipped to address the unique and additional needs of mothers with young children.

CONCLUSION

Mothers' experiences indicated that the correctional system and policies, which were predominantly designed for men, do not adequately address the varied and complex needs of pregnant women, mothers, and their young children. Imprisonment of pregnant women and mothers with young children should be the last resort, and they should be provided with holistic, individually tailored support, most preferably in community settings, to address their multiple intersecting needs.