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Zielinski MJ, Smith MS, Stahman A. Custodial and perinatal care patterns of women who received prenatal care while incarcerated in the Arkansas state prison system, 2014-2019. HEALTH & JUSTICE 2024; 12:16. [PMID: 38613729 PMCID: PMC11015593 DOI: 10.1186/s40352-024-00268-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The extraordinary growth in women's incarceration over the past several decades has resulted in calls for expansion of research into their unique needs and experiences, including those related to pregnancy and perinatal care. However, while research into the health outcomes of women who are incarcerated while pregnant has grown, research on women's custodial and perinatal care patterns has remained nearly non-existent. Here, we sought to describe (1) the characteristics of the population of women who came to be incarcerated in a state prison system during pregnancy and (2) the characteristics of women's custodial and perinatal care patterns during and after incarceration. METHODS We conducted a retrospective chart review of the population of women who received perinatal care while incarcerated in the Arkansas state prison system over a 5-year period from June 2014 to May 2019. Electronic medical records and state prison records were merged to form our study population. Data were from 212 women (Mage = 28.4 years; 75.0% non-Latina White) with a singleton pregnancy who received at least one obstetric care visit while incarcerated. RESULTS Drug-related convictions were the most common crimes leading to women's incarceration while pregnant, and violent crime convictions were rare. Nearly half (43.4%) of women who gave birth in custody did so within 90 days of admission and the great majority (80.4%) released within 1-year of giving birth, including 13.3% who released within 30 days. DISCUSSION The frequency with which women who became incarcerated while pregnant released from prison either prior to or shortly after giving birth was a striking, novel finding of this study given the implications for perinatal care disruption among a high-risk population and the harms of forced separation from infants within hours of birth. CONCLUSIONS Diversionary programs for pregnant women convicted of crimes, particularly in states without current access, are urgently needed and should be a priority for future policy work.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA.
| | - Mollee Steely Smith
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | - Alleigh Stahman
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
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Capper TS, Baldwin A, Abbott L, Briley A, Shlafer R. How are the Dietary Needs of Pregnant Incarcerated Women Being Met? A Scoping Review and Thematic Analysis. Matern Child Health J 2024; 28:253-266. [PMID: 38341837 PMCID: PMC10901961 DOI: 10.1007/s10995-023-03884-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 02/13/2024]
Abstract
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.
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Affiliation(s)
- Tanya S Capper
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, Level 20, 160 Ann Street, Brisbane, QLD, 4000, Australia.
| | - Adele Baldwin
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 538 Flinders Street, Townsville, QLD, 4810, Australia
| | - Laura Abbott
- Department of Allied Health and Midwifery, University of Hertfordshire, College Lane Campus, Room F305, The Wright Building, Hatfield, Hertfordshire, AL10 9AB, UK
| | - Annette Briley
- College of Nursing & Health Sciences, Sturt Road, Bedford Park, SA, 5042, Australia
| | - Rebecca Shlafer
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Deleware St. SE, Minneapolis, MN, 55414, USA
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Howland MA, Kotlar B, Davis L, Shlafer RJ. Depressive Symptoms among Pregnant and Postpartum Women in Prison. J Midwifery Womens Health 2021; 66:494-502. [PMID: 34260138 DOI: 10.1111/jmwh.13239] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/04/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Women in prison experience high rates of mental and physical health problems, and pregnant and postpartum women in prison may be particularly vulnerable. Very few studies have examined depressive symptoms among women who are pregnant and give birth in prison. We assessed depressive symptoms longitudinally from pregnancy into the postpartum period in a sample of 58 women who gave birth in prison. We also considered whether incarceration-related factors (length of time incarcerated while pregnant, remaining length of sentence to serve after birth) were associated with depressive symptoms. METHODS Data were collected as part of an ongoing evaluation of a prison-based pregnancy and parenting support program at one women's state prison. At prenatal and postpartum visits with their doula, women completed the Patient Health Questionnaire-9 (PHQ-9), a measure of depressive symptom severity. RESULTS More than one-third of our sample of women who were incarcerated and gave birth in custody met criteria for moderate to severe depression on the PHQ-9 during pregnancy or the postpartum period. Women who faced longer periods of incarceration following birth and separation from their newborns reported higher levels of postpartum depressive symptoms. DISCUSSION Findings have implications for practice and policy aimed at supporting the mental health needs of women who are pregnant in prison, particularly those women who give birth in custody and are separated from their newborns.
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Affiliation(s)
- Mariann A Howland
- Institute of Child Development, University of Minnesota -Twin Cities, Minneapolis, Minnesota
| | - Bethany Kotlar
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Laurel Davis
- Department of Pediatrics, University of Minnesota - Twin Cities, Minneapolis, Minnesota
| | - Rebecca J Shlafer
- Department of Pediatrics, University of Minnesota - Twin Cities, Minneapolis, Minnesota
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McCormick R, Painter L. Seeing Past the Sentence: Caring for Pregnant Women Who Are Incarcerated. J Christ Nurs 2021; 38:166-173. [PMID: 34085654 DOI: 10.1097/cnj.0000000000000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The number of women who are incarcerated in the United States has grown significantly since 1980. Caring for pregnant women who are in the correctional system requires special knowledge and the skills of advocacy and compassion. The purpose of this article is to discuss strategies to provide compassionate, sensitive, and trauma-informed care that demonstrates the love of Christ to incarcerated pregnant women.
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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] [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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Grassley JS, Ward M, Tivis R. Development and Psychometric Testing of the Nurses' Confidence Scale: Unique Families. J Obstet Gynecol Neonatal Nurs 2019; 49:101-112. [PMID: 31758912 DOI: 10.1016/j.jogn.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To develop and evaluate an instrument designed to measure the confidence of nurses in their ability to provide neutral, compassionate care to unique families in perinatal settings: the Nurses' Confidence Scale: Unique Families. DESIGN Prospective instrument development and psychometric study. SETTING Health system in the U.S. Mountain West region. PARTICIPANTS Convenience sample of 62 perinatal/neonatal nurses. METHODS We developed a two-part scale to measure the confidence of nurses in their ability to care for complex/nontraditional families, termed unique families. Part A was focused on nursing care behaviors for any unique family; Part B was focused on providing care to seven specific unique family populations. Five experts in perinatal nursing or adoption evaluated the scale's content validity. To test the psychometric properties of the scale, we used item analysis, reliability analysis, and exploratory factor analysis. RESULTS The content validity index was 0.82. The Cronbach's alpha coefficient estimate of internal consistency for Part A was .92. Principal component analysis resulted in two factors that explained 64% of the total variance: skills and resources (Cronbach's alpha coefficient = .89) and awareness and sensitivity (Cronbach's alpha coefficient = .87). Part B had a Cronbach's alpha coefficient of .90. Parts A and B showed a strong positive relationship with one another (r = .77). The general self-efficacy measure was strongly and positively correlated with Part A (r = .81) and moderately and positively correlated with Part B (r = .48). CONCLUSION The Nurses' Confidence Scale: Unique Families is a new tool with which to measure the confidence of perinatal/neonatal nurses in providing sensitive, specific care to complex/nontraditional families. Results of our psychometric evaluation supported initial acceptable reliability and validity of the scale.
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Grassley JS, Ward M, Shelton K. Partnership Between a Health System and a Correctional Center to Normalize Birth for Incarcerated Women. Nurs Womens Health 2019; 23:433-439. [PMID: 31449786 DOI: 10.1016/j.nwh.2019.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/02/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
Women of childbearing age make up a growing segment of the prison population; many are pregnant while incarcerated. The care this population has received during pregnancy often has been characterized by inattention to nutritional needs, failure to provide for safe sleeping in lower bunks, and lack of childbirth education. These women may be unprepared for childbirth and the early postpartum period. To improve care for these women, staff from a health system and a correctional center collaborated to develop an infrastructure that offered supportive care to incarcerated childbearing women in their community. Organizational policies and processes were aligned to promote a normal birth and early postpartum experience for incarcerated women and provide them with opportunities to bond with their newborns. Family-centered care offers incarcerated women the opportunity to be mothers rather than simply prisoners giving birth.
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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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Baldwin A, Sobolewska A, Capper T. Pregnant in prison: An integrative literature review. Women Birth 2018; 33:41-50. [PMID: 30559007 DOI: 10.1016/j.wombi.2018.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/29/2018] [Accepted: 12/03/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pregnant women in prisons are recognised as a marginalised group. However, there is a limited understanding of the women's unique maternity needs and how correctional institutions and maternity service providers respond to these needs. AIM The aims of the review are threefold. METHOD An integrative literature review was undertaken. A comprehensive search strategy using seven electronic databases resulted in the retrieval of 363 articles. Of them, 32 peer-reviewed studies met the final selection criteria and were included in this review which utilised the Critical Appraisal Skills Program tools and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. Thematic analysis identified universal themes. FINDINGS Three dominant themes emerged related to the experience of pregnant women in prison: (1) risks and vulnerability factors; (2) prison enablers and supports; and (3) prison barriers. Extant research on risks and vulnerability factors is disproportionate to research examining how prisons can enable or obstruct responding to the women's perinatal needs. Limited research on the midwifery support available to the women in prison is available. Significantly, only two out of 32 reviewed papers include research directly conducted with the pregnant women in prison. CONCLUSION Pregnant women in prisons have complex needs. More research is required to understand how prisons can enhance the pregnancy experience by engaging pregnant women in prisons as research participants.
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Affiliation(s)
- Adele Baldwin
- School of Nursing, Midwifery and Social Sciences, CQUniversity, 6 Finsbury Place, Townsville, Queensland, 4810, Australia.
| | - Agnieszka Sobolewska
- School of Nursing, Midwifery and Social Sciences, CQUniversity, 160 Ann St, Brisbane City, QLD, 4000, Australia
| | - Tanya Capper
- School of Nursing, Midwifery and Social Sciences, CQUniversity, 160 Ann St, Brisbane City, QLD, 4000, Australia
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Santos RMAD, Linhares FMP, Morais SCRV, Guedes TG, Guimarães ML. Nursing Diagnoses of incarcerated mothers. Rev Esc Enferm USP 2018; 52:e03338. [PMID: 29947707 DOI: 10.1590/s1980-220x2017024503338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 01/29/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the Nursing Diagnoses of incarcerated nursing mothers by the NANDA-I Taxonomy II. METHOD Descriptive/exploratory study developed in the Women's Penal Colony, Recife, PE. RESULTS The sample consisted of 18 women who were breastfeeding during the study period. A total of 17 diagnoses were listed, whose accuracy was classified as moderate and high by the Nursing Diagnoses Accuracy Scale (EADE, version 2). Five of these diagnoses were selected for discussion, regarding frequency, magnitude, and impact on the health and well-being of nursing mothers participating in the study. CONCLUSION The Nursing Diagnoses identified in this study are not exclusive to nursing mothers who are incarcerated. Some factors relevant to the prison environment may aggravate their problems, which reveal situations of health vulnerability and rights violation. These situations require changes that may respond to the health needs of this target population.
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Affiliation(s)
| | | | | | - Tatiane Gomes Guedes
- Universidade Federal de Pernambuco, Departamento de Enfermagem, Recife, PE, Brasil
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Baldwin A, Capper T, Rogers L, Wood E. From the Ground Up: Improving Pregnancy and Birth Experiences Through the Provision of Extraordinary Learning Opportunities in Australia. JOURNAL OF FORENSIC NURSING 2018; 14:80-87. [PMID: 29698361 DOI: 10.1097/jfn.0000000000000200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A collaborative project formally titled "Working together to improve pregnancy and birth experiences for women and provide extraordinary learning opportunities for midwifery students" was launched in April 2017, after several years of consultation and planning. The opportunity to adopt an integrated response to the needs of incarcerated pregnant women and the learning needs of midwifery students was identified and supported by the university offering a graduate-entry midwifery program, a women's correctional center, and a health service in a regional area of Australia. Incarcerated women who are pregnant require pregnancy, birth, and postnatal support distinct from their clinical care, while at the same time, midwifery students need to recruit pregnant women for continuity-of-care experiences. This article presents an overview of the implementation of the pilot project. It also discusses the project team and the challenges and successes of and unanticipated opportunities for practice modification and change.
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Affiliation(s)
- Adele Baldwin
- Author Affiliations: School of Nursing, Midwifery and Social Sciences, Central Queensland University
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Sexual and Reproductive Health Care For Incarcerated Women. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2016; 48:107. [PMID: 27303870 DOI: 10.1363/48e8916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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