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Volkov BB, Pulley C, Shlafer R. Addressing health disparities in the criminal legal system: Translational benefits, challenges, and facilitators of impactful research with incarcerated pregnant women. J Clin Transl Sci 2023; 7:e112. [PMID: 37250993 PMCID: PMC10225259 DOI: 10.1017/cts.2023.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/13/2023] [Accepted: 04/04/2023] [Indexed: 05/31/2023] Open
Abstract
This in-depth analysis illuminates a translational journey of a community-university research collaboration that examined health disparities among incarcerated pregnant women and spanned the translational spectrum, with the initial collaboration in 2011 paving the way for consequent research grants, publications, practices, programs, and legislation passed years later. The case study utilized data from interviews with research stakeholders, institutional and governmental sources, peer-reviewed publications, and news stories. Identified research and translational challenges included cultural differences between research and prison system; the prison system's lack of transparency; politics of using and translating research to policy change; and issues of capacity, power, privilege, and opportunity when doing community-engaged research/science. Among the facilitators of translation were the Clinical and Translational Science Award and institutional support; engagement of key stakeholders and influencers; authentic collaboration and team science; researchers as translation catalysts; pragmatic scientific approach; and policies and legislative activities. The research contributed to a variety of community and public health, policy/legislative, clinical/medical, and economic benefits. The case study findings enhance our understanding of translational science principles and processes leading to improved wellbeing and serve as a call for advancing the research agenda addressing health disparities related to criminal and social justice issues.
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Affiliation(s)
- Boris B. Volkov
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
- Institute for Health Informatics and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Chris Pulley
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca Shlafer
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Steely Smith MK, Wilson SH, Zielinski MJ. An integrative literature review of substance use treatment service need and provision to pregnant and postpartum populations in carceral settings. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057221147802. [PMID: 36920150 PMCID: PMC10021089 DOI: 10.1177/17455057221147802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/12/2022] [Accepted: 12/08/2022] [Indexed: 03/16/2023]
Abstract
Pregnancy is a critical time to provide access to substance use treatment; this is especially true among incarcerated populations, who are known to be at particularly high risk of poor health outcomes. In this integrated literature review, we (1) report what is known about the prevalence of substance use among incarcerated pregnant and postpartum populations; (2) describe substance use treatment programs and current care practices of pregnant and postpartum populations in carceral settings; and (3) explore recommendations and strategies for increasing access to substance use treatment for incarcerated pregnant and postpartum populations. A comprehensive search of seven electronic databases yielded in the retrieval of 139 articles that were assessed for inclusion. Of the retrieved articles, 33 articles met criteria for inclusion in this review. A review of the literature revealed that the understanding of substance use prevalence among pregnant incarcerated women is limited. We also found that treatment of substance use disorders among pregnant and postpartum populations is not routinely available, enhanced perinatal services are sorely needed, and substance use treatment programs are feasible with the help of community partnerships. More research is required to understand current substance use treatment initiatives and outcomes for pregnant women in prison. In addition, strategies for integrating evidence-based, substance use treatment in carceral settings is also needed. Future directions are discussed.
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Affiliation(s)
| | | | - Melissa J Zielinski
- University of Arkansas for Medical
Sciences, Little Rock, AR, USA
- University of Arkansas, Fayetteville,
AR, USA
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Knittel AK, Ferguson EG, Jackson JB, Adimora AA. The influence of social relationships on PrEP attitudes among women with incarceration experience in the Southeastern USA. CULTURE, HEALTH & SEXUALITY 2023; 25:110-125. [PMID: 35015606 PMCID: PMC9271531 DOI: 10.1080/13691058.2021.2023760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
Women who have experienced incarceration face a disproportionately high risk of acquiring HIV. Despite efficacy of pre-exposure prophylaxis (PrEP) for HIV, very few women with incarceration histories are using PrEP. Our objective was to learn how sexual, drug-use and social relationships shape decisions about PrEP among women who have experienced incarceration. We used an inductive approach to analyse data from four focus groups undertaken with women who had previously experienced incarceration recruited from three community-based organisations. We identified public policy (medical distrust, lack of prevention in prisons and jails, and cost and coverage of PrEP); community (incarceration stigma, gossip as prevention); social and sexual network (positive peer and parenting relationships, distrust of sexual partners, and networks as a source of risk); and individual-level (active addiction or recovery, change after incarceration, and medical concerns) factors influencing the use of PrEP. Actions and interventions to improve PrEP uptake among women who have experienced incarceration must take account of the multilevel context of HIV prevention decisions.
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Affiliation(s)
- Andrea K. Knittel
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Ella G. Ferguson
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jamie B. Jackson
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Adaora A. Adimora
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Wilson SH, Marsh LN, Zielinski M, Corbett A, Siegler A, Shlafer R. Enhanced Perinatal Programs for People in Prisons: A Summary of Six States' Programs. JOURNAL OF CRIMINAL JUSTICE 2022; 83:101965. [PMID: 37441170 PMCID: PMC10338033 DOI: 10.1016/j.jcrimjus.2022.101965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
Purpose The purpose of this study was to examine enhanced perinatal support programs for pregnant and postpartum people in six state prisons, describe the service components offered by each program, and discuss similarities and differences of services offered between programs. Methods In-depth, semi-structured interviews were conducted with each program's site lead(s) in order to collect information regarding each program's historical context, conception, and key aspects of the implementation of service components offered at each site. Results Program components fell into five broad categories: group-based education and support, one-on-one support, labor and birth support, lactation facilitation and support, and other support services. Results highlight similarities and differences within and across programs and common themes that govern program success. Conclusions This study provides an initial understanding of the variation in enhanced perinatal programming in six state prisons and offers insights for other states interested in establishing these types of programs. These programs implemented individual components piecemeal to fit site-specific context and needs, instead of adopting the entirety of another program model. Programs' success was largely dependent upon collaboration between program facilitators and partnering prison sites.
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Affiliation(s)
- Stephanie H. Wilson
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - L. Noël Marsh
- Department of Anthropology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Melissa Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Amanda Corbett
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Anne Siegler
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca Shlafer
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Gato CM, Nascimento LC, Simoneti RAADO, Massaroli A, Silva SÉDD, Araújo JS. Family implications during deprivation of liberty and Attachment Theory: a qualitative metasynthesis. Rev Bras Enferm 2022; 75Suppl 2:e20210722. [PMID: 35766711 DOI: 10.1590/0034-7167-2021-0722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/10/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to synthesize evidence from qualitative studies about the implications that the deprivation of liberty process has on incarcerated adults' family relationships. METHODS a qualitative meta-synthesis, carried out in January 2021, by searching for publications indexed in six databases. The sample consisted of 10 studies, which were analyzed by MaxQDA®, and an interpretative synthesis was performed based on Attachment Theory. RESULTS based on first-order concepts, it was possible to synthesize second- and third-order concepts and present them in two interpretive context units: Strategies for strengthening family ties; Relationships that contribute to breaking down family ties. It was evidenced that visits, phone calls and letters favor the strengthening of secure attachment. FINAL CONSIDERATIONS incarceration causes consequences in tie formation, reflecting on the attachment process between family members.
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Affiliation(s)
| | | | | | - Aline Massaroli
- Universidade Federal da Fronteira Sul. Chapecó, Santa Catarina, Brazil
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Shlafer RJ, Gerrity E, Norris C, Freeman-Cook R, B Sufrin C. Justice for Incarcerated Moms Act of 2021: Reflections and recommendations. WOMEN'S HEALTH 2022; 18:17455057221093037. [PMID: 35438013 PMCID: PMC9021469 DOI: 10.1177/17455057221093037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the last five decades, the number of women behind bars in the United States has risen exponentially. It is now estimated that there are nearly 58,000 admissions of pregnant people—disproportionately women of color—to jails and prisons each year. Recognizing the urgency and consequences of mass incarceration on pregnant people, their families, and communities, House Resolution 948: Justice for Incarcerated Moms Act of 2021 was introduced to Congress as a part of the Black Maternal Health Momnibus. The Justice for Incarcerated Moms Act aims to improve health care and promote dignity for incarcerated pregnant and parenting people through an array of policies and oversight. In this article, we review and reflect on the components of this bill within their broader public health and reproductive justice contexts. We close with recommendations for policymakers and professionals committed to promoting equity and justice for pregnant and postpartum incarcerated people.
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Affiliation(s)
| | - Erica Gerrity
- Minnesota Prison Doula Project, Ostara Initiative, Minneapolis, MN, USA
| | - Chauntel Norris
- Alabama Prison Birth Project, Ostara Initiative, Auburn, AL, USA
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Alirezaei S, Latifnejad Roudsari R. The Needs of Incarcerated Pregnant Women: A Systematic Review of Literature. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2022; 10:2-17. [PMID: 35005037 PMCID: PMC8724729 DOI: 10.30476/ijcbnm.2021.89508.1613] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/23/2021] [Accepted: 07/31/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND With increase in the number of female prisoners, it seems necessary to follow up the conditions of pregnant women in prison in order to identify their needs and provide healthcare and social services to improve their health accordingly. Therefore, a systematic review was conducted to examine the needs of incarcerated pregnant women. METHODS In this systematic review, we searched the databases including PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and the Cochran Library. All studies including cross-sectional, retrospective, and prospective cohorts as well as case series, which addressed the needs and expectations of incarcerated pregnant women, were included in this review. Two reviewers independently evaluated the retrieved articles, the discrepancies were discussed, and a consensus was achieved. RESULTS 31 eligible studies consisting of 5435 incarcerated pregnant women were included in the review. The needs of incarcerated pregnant women comprised six general categories: healthcare needs including prenatal, labor, delivery, and postpartum services; educational needs on pregnancy, childbirth, and parenting; the support needs to be provided by government agencies, social workers, and doula services; the need for psychological counseling services; nutritional needs during pregnancy; and the needs related to the substance abuse management. CONCLUSION The needs of incarcerated pregnant women included healthcare, educational, supportive, counseling, and nutritional needs as well as those related to the substance abuse management. Identifying these needs can be useful in developing accurate and appropriate policies and programs to promote the health status of this vulnerable group.
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Affiliation(s)
- Somayeh Alirezaei
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Gato CM, Nascimento LC, Simoneti RAADO, Massaroli A, Silva SÉDD, Araújo JS. Implicações familiares durante a privação de liberdade e a Teoria do Apego: uma metassíntese qualitativa. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0722pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos: sintetizar as evidências de estudos qualitativos acerca das implicações que o processo de privação de liberdade apresenta nas relações familiares de adultos apenados. Métodos: metassíntese qualitativa, realizada em janeiro de 2021, por meio da busca de publicações indexadas em seis bases de dados. A amostra foi composta por 10 estudos, que foram analisados pelo software MaxQDA®, e realizada a síntese interpretativa com base na Teoria do Apego. Resultados: com base nos conceitos de primeira ordem, foi possível sintetizar os conceitos de segunda e terceira ordem e apresentá-los em duas unidades de contexto interpretativo: Estratégias de fortalecimento de vínculos familiares; Relações que contribuem para a ruptura de vínculos familiares. Foi evidenciado que as visitas, telefonemas e cartas favorecem o fortalecimento do apego seguro. Considerações Finais: o encarceramento provoca consequências na formação de vínculos, refletindo no processo de apego entre os familiares.
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Shlafer R, Saunders JB, Boraas CM, Kozhimannil KB, Mazumder N, Freese R. Maternal and neonatal outcomes among incarcerated women who gave birth in custody. Birth 2021; 48:122-131. [PMID: 33368480 PMCID: PMC8246999 DOI: 10.1111/birt.12524] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/07/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the United States, the population of incarcerated women has increased by more than 600% since the 1980s. With this rise, correctional facilities have faced new challenges meeting the health care needs of women, especially those who are pregnant. This retrospective cohort study sought to describe five indicators of maternal and neonatal health among women who gave birth in custody, and to compare outcomes among incarcerated women who did and did not receive enhanced pregnancy support. METHODS We used deidentified electronic health records (EHRs) to examine maternal and neonatal birth outcomes (ie, mode of birth, low birthweight, preterm birth, APGAR score, NICU admission) among women who gave birth in custody. Regression models examined differences in outcomes between women who received enhanced pregnancy support-group prenatal education and one-on-one doula visits-and a historical control group of women who received standard prenatal care. RESULTS Adverse maternal and neonatal birth outcomes in this sample were rare. No differences in outcomes were found between incarcerated women who received enhanced pregnancy support and the historical control group. CONCLUSIONS Despite evidence for the benefits of enhanced pregnancy support in the general population, this study did not find differences in outcomes between incarcerated women who did and did not receive support. Integrated data from prison and hospital records are innovative, but effect measurement is limited by sample size. Future research should include primary data collection on maternal, neonatal, and dyadic outcomes longitudinally and across prisons.
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Affiliation(s)
- Rebecca Shlafer
- Division of General Pediatrics and Adolescent HealthDepartment of PediatricsUniversity of MinnesotaMinneapolisMNUSA
| | - Jennifer B. Saunders
- Division of Health Policy and ManagementSchool of Public HealthUniversity of MinnesotaMinneapolisMNUSA
| | - Christy M. Boraas
- Department of Obstetrics, Gynecology and Women’s HealthMedical SchoolUniversity of MinnesotaMinneapolisMNUSA
| | - Katy B. Kozhimannil
- Division of Health Policy and ManagementSchool of Public HealthUniversity of MinnesotaMinneapolisMNUSA
| | | | - Rebecca Freese
- Biostatistical Design and Analysis CenterClinical and Translational Science InstituteUniversity of MinnesotaMinneapolisMNUSA
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Alirezaei S, Roudsari RL. Promoting Health Care for Pregnant Women in Prison: A Review of International Guidelines. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:91-101. [PMID: 32195153 PMCID: PMC7055189 DOI: 10.4103/ijnmr.ijnmr_169_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/04/2020] [Accepted: 01/27/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are standard guidelines for the provision of health care for pregnant women in prisons. There is no single guide to meet all the specific needs of imprisoned women. In this study, the related international guidelines were reviewed to reveal the existing gaps. MATERIALS AND METHODS In this narrative review, studies published from May 2010 to January 2019 were reviewed through investigating databases including PubMed, Scopus, the Cochrane Library database as well as Science Direct Google Scholar using keywords: Guideline AND Prison AND Pregnancy AND Prenatal Care. The contents of the guidelines were subjected to analogy comparison. RESULTS 13 guidelines were included in the study. Of these, 10 guidelines were related to the organizations deployed in the USA, two guidelines to the United Nations and the World Health Organization, and one guideline to the United Kingdom. The most comprehensive care coverage of pregnant women was suggested, at the first level, by Birth Champion and in the second level by the Federal Bureau of Prisons. The care recommended in the guidelines was classified into four general categories of health care, safety and security, education and counseling, as well as miscellaneous issues. Most of the care items mentioned in the guidelines were related to the issue of safety and security of pregnant women. CONCLUSIONS There are currently gaps in the guidelines in many aspects including maternal and fetal health assessments, mental health care, and also ethical and communication issues. It is essential to upgrade the guidelines provided for imprisoned women to promote their health.
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Affiliation(s)
- Somayeh Alirezaei
- PhD Student in Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Shlafer RJ, Hardeman RR, Carlson EA. Reproductive justice for incarcerated mothers and advocacy for their infants and young children. Infant Ment Health J 2019; 40:725-741. [PMID: 31323699 PMCID: PMC6973282 DOI: 10.1002/imhj.21810] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well-being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research on the reproductive health of incarcerated women, (b) characteristics and experiences of pregnant incarcerated women, (c) outcomes of infants and young children with incarcerated parents, (d) implications of research findings for policy and practice, and (e) the need for increased research, public education, and advocacy. We strongly recommend that correctional policies and practices be updated to address the common misconceptions and biases as well as the unique vulnerabilities and health needs of incarcerated women and their young children.
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Baker B. Perinatal Outcomes of Incarcerated Pregnant Women: An Integrative Review. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:92-104. [DOI: 10.1177/1078345819832366] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Brenda Baker
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Shlafer RJ, Davis L, Hindt LA, Goshin LS, Gerrity E. Intention and Initiation of Breastfeeding Among Women Who Are Incarcerated. Nurs Womens Health 2018; 22:64-78. [PMID: 29433701 DOI: 10.1016/j.nwh.2017.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 08/22/2017] [Indexed: 06/08/2023]
Abstract
The Baby-Friendly Hospital Initiative recommends that all mothers be shown how to breastfeed, even when mothers and newborns are separated. Most incarcerated women are separated from their infants after the postpartum hospital stay, creating barriers to breastfeeding. We examined breastfeeding among a sample of women participating in a prison-based pregnancy program. Quantitative data indicated that women who discussed breastfeeding with their doulas were more likely to initiate breastfeeding. Three qualitative themes were identified: Benefits of Breastfeeding, Barriers to Breastfeeding, and Role of the Doula. We identified incongruence between the expected standard of breastfeeding support and the care incarcerated women received. Findings suggest that prison-based doula care might be an effective intervention for supporting breastfeeding among incarcerated women and highlight the importance of education for perinatal nurses about breastfeeding support of incarcerated women.
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Domingues RMSM, Leal MDC, Pereira APE, Ayres B, Sánchez AR, Larouzé B. Prevalence of syphilis and HIV infection during pregnancy in incarcerated women and the incidence of congenital syphilis in births in prison in Brazil. CAD SAUDE PUBLICA 2017; 33:e00183616. [PMID: 29166489 DOI: 10.1590/0102-311x00183616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 02/01/2017] [Indexed: 11/21/2022] Open
Abstract
This study aimed to estimate the prevalence of syphilis and HIV infection during pregnancy, the mother to child transmission of syphilis and the incidence of congenital syphilis in incarcerated women in Brazil; to compare these rates to those observed in pregnant women outside of jail; and to verify the maternal factors associated with syphilis infection during pregnancy in free and incarcerated women. We used data from two nationwide studies conducted during the period 2011-2014. The Birth in Brazil study included 23,894 free women cared for in 266 hospitals. The Maternal and Infant Health in Prisons study included 495 incarcerated pregnant women or mothers living with their children, according to a census conducted in 33 female prisons. The same case definitions and data collection methods were used in both studies. The chi-square test was used to compare the characteristics of incarcerated and free women with a significance of 0.05. For incarcerated women, the estimated prevalence of syphilis during pregnancy was 8.7% (95%CI: 5.7-13.1) and for HIV infection 3.3% (95%CI: 1.7-6.6); the estimated mother to child transmission of syphilis was 66.7% (95%CI: 44.7-83.2) and the incidence of congenital syphilis was 58.1 per 1,000 living newborns (95%CI: 40.4-82.8). Incarcerated women had a greater prevalence of syphilis and HIV infection during pregnancy, lower quality of antenatal care and higher levels of social vulnerability. Syphilis infection showed to be an indicator of social vulnerability in free women, but not in incarcerated women. Health initiatives in prison are necessary to reduce healthcare inequalities and should include adequate antenatal and birth care.
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Affiliation(s)
| | - Maria do Carmo Leal
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | - Barbara Ayres
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Alexandra Roma Sánchez
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Bernard Larouzé
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, IPLESP UMRS 1132, F75012 Paris, France
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Shlafer RJ, Hellerstedt WL, Secor-Turner M, Gerrity E, Baker R. Doulas' Perspectives about Providing Support to Incarcerated Women: A Feasibility Study. Public Health Nurs 2014; 32:316-26. [PMID: 24980835 DOI: 10.1111/phn.12137] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To document the logistical feasibility of a doula program for pregnant incarcerated women and to assess doulas' perceptions of their achievements. DESIGN AND SAMPLE Six doulas provided written case notes ("birth stories") about their experiences with 18 pregnant women in one Midwestern state prison. MEASURES The birth stories were analyzed by two coders to identify major themes related to doulas' perceptions about providing support to incarcerated women. Analyses involved coder consensus about major themes and doula affirmation of findings. RESULTS All doulas reported that they met key objectives for a successful relationship with each of their clients. Key themes were their ability to empower clients, establish a trusting relationship, normalize the delivery, and support women as they were separated from their newborns. CONCLUSIONS The intervention was logistically feasible, suggesting that doulas can adapt their practice for incarcerated women. Doulas may need specific training to prepare themselves for institutional restrictions that may conflict with the traditional roles of doula care. It may be important for doulas to understand the level of personal and professional resources they may have to expend to support incarcerated women if they are separated from their infants soon after delivery.
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Affiliation(s)
- Rebecca J Shlafer
- Division of General Pediatrics & Adolescent Health, University of Minnesota, Minneapolis, Minnesota
| | - Wendy L Hellerstedt
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Erica Gerrity
- Isis Rising - Everyday Miracles, Minneapolis, Minnesota
| | - Rae Baker
- Isis Rising - Everyday Miracles, Minneapolis, Minnesota
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