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Crawford AD, Testa A, Darilek U, Howe R, McGrath JM, Shlafer R. Perinatal Health Outcomes Among Women on Community Supervision: A Scoping Review. JOURNAL OF CORRECTIONAL HEALTH CARE 2024. [PMID: 38985685 DOI: 10.1089/jchc.23.09.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
The purpose of this scoping review is to review the extant literature regarding perinatal health outcomes for women on community supervision in the United States. PubMed, CINAHL, Scopus, PsycINFO, and Public Health were searched for peer-reviewed articles published in the United States from January 1, 1970, to March 7, 2023. After removal of duplicates and review of 1,412 article titles and abstracts, 19 articles were retrieved for full-text review; this yielded 4 studies for inclusion. Studies range in size from 10 to 292 participants (N = 405) and only two reported geographic locations. Three studies comprised probation or parole and two studies included court-mandated treatment for substance use. All studies examined outcomes during the postpartum period, such as mood disorder or substance use severity. No studies evaluated the health of women during pregnancy and/or childbirth. To enhance health equity and reduce maternal morbidity and mortality among women on community supervision, more inclusive research that examines health outcomes during the perinatal period is needed. Furthermore, there must be interventions that address the social determinants of health, racial and systemic discrimination, socioeconomic barriers, and violence that are often experienced among women with criminal justice system involvement.
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Affiliation(s)
- Allison D Crawford
- School of Nursing, University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Alexander Testa
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - Umber Darilek
- Department of Pediatrics, School of Medicine, University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Rebecca Howe
- Briscoe Library, School of Health Professions, University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Jacqueline M McGrath
- School of Nursing, University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Rebecca Shlafer
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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Hairston E, Jones HE, Johnson E, Alexander J, Andringa KR, O'Grady KE, Knittel AK. Jenna's Project: Preventing Overdose and Improving Recovery Outcomes for Women Leaving Incarcerated Settings during Pregnancy and Postpartum Periods. J Addict Med 2024:01271255-990000000-00342. [PMID: 38958275 DOI: 10.1097/adm.0000000000001341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
OBJECTIVES For people with opioid use disorder (OUD), transitioning from pregnancy to postpartum and from incarceration to the community is a time of increased risk for opioid overdose. This prospective project evaluated the extent of Jenna's Project's success in preventing overdoses and improving recovery outcomes by coordinating postrelease care in incarcerated OUD perinatal patients. METHODS Participants (N = 132) were pregnant or postpartum (1 year postdelivery) with OUD during incarceration and self-referred for postrelease services. From March 2020 to October 2021, participants could receive up to 6 months of postincarceration care coordination services (eg, regular communication, transportation, emergency housing, SUD treatment), medication to treat OUD (MOUD) and other treatment services. Outcomes included verified overdose (fatal), self-reported nonfatal overdose, reincarceration, active Medicaid, receipt of MOUD, presence of children living with participants, open Child Protective Services cases, and number of referrals for services. RESULTS There were 0 nonfatal and 0 fatal overdoses at both 1 and 6 months postrelease, and 3 of 132 (2%) returned to incarceration. Significantly fewer participants had Medicaid at release (36%) and at 6 months postrelease (60%) than before incarceration (87%) (P < 0.001 for all 3 pairwise comparisons). At 6 months postrelease, significantly more participants reported MOUD receipt (51%) compared with before incarceration (39%) (P < 0.001). There was no significant change in the number of open Child Protective Services cases. Referrals for childcare or parenting services were the most common referrals provided. CONCLUSION Immediate postrelease care coordination for pregnant and postpartum women with OUD was feasible and effective in preventing overdose, reincarceration, and promoting recovery outcomes.
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Affiliation(s)
- Essence Hairston
- From the Horizons Division and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC (EH, HEJ, EJ, KRA, AKK); Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD (HEJ); North Carolina Department of Public Safety, Raleigh, NC (JA); Department of Psychology, University of Maryland, College Park, College Park, MD (KEO'G); and Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (AKK)
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Steely Smith MK, Hinton-Froese KE, Scarbrough Kamath B, Virmani M, Walters A, Zielinski MJ. Characteristics and Outcomes of Women and Infants Who Received Prenatal Care While Incarcerated in Arkansas State Prison System, 2014-2019. Matern Child Health J 2024; 28:935-948. [PMID: 38177975 DOI: 10.1007/s10995-023-03875-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Prisons face challenges in meeting the unique health care needs of women, especially those who are pregnant. This retrospective chart review sought to describe the maternal and infant health outcomes of incarcerated women who received prenatal care while in an Arkansas prison. METHODS Using a hospital-based electronic medical records (EMR) system, we examined the maternal health history and current pregnancy characteristics of 219 pregnant women who received prenatal care while incarcerated from June 2014 to May 2019. We also examined labor and delivery characteristics and postpartum and infant birth outcomes for the 146 women from this cohort who delivered a living child while still incarcerated. RESULTS Most records indicated complex health histories with several chronic illnesses, mental health diagnoses, history of substance use, and lifetime medical complications. Despite comorbid illness, substance use disorder (SUD), trauma-history, and post-traumatic stress disorder (PTSD) prevalence was lower than expected. Previous and current obstetrical complications were common. Although the Neonatal Intensive Care Unit (NICU) admission rate (41%) was high, few infants required extensive treatment intervention. Postpartum complications were rare; however, a small portion of women who gave birth in custody experienced severe complications and were re-admitted to the hospital post-discharge. CONCLUSIONS Incarcerated pregnant women and their infants are a marginalized population in great need of health care advocacy. To optimize maternal-infant outcomes, carceral agencies must recognize the health needs of incarcerated pregnant women and provide appropriate prenatal care. Expansion of carceral perinatal care to include screening for SUD and psychiatric symptoms (e.g., PTSD) and referral to appropriate care is highly encouraged. Policies related to NICU admission for non-medical reasons should be further examined.
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Affiliation(s)
- Mollee K Steely Smith
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | | | - Brooke Scarbrough Kamath
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | - Misty Virmani
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | - Ashton Walters
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | - Melissa J Zielinski
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA.
- University of Arkansas, Fayetteville, USA.
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Hawkins SS. Reproductive health care for incarcerated women in the prenatal and postpartum periods. J Obstet Gynecol Neonatal Nurs 2024; 53:220-233. [PMID: 38588824 DOI: 10.1016/j.jogn.2024.03.006] [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: 04/10/2024] Open
Abstract
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.
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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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Chawla A, Bansal NL, Liu C, Olagunju AT. Postpartum Depression in Correctional Populations. JOURNAL OF CORRECTIONAL HEALTH CARE 2024; 30:65-70. [PMID: 38466964 DOI: 10.1089/jchc.23.08.0071] [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] [Indexed: 03/13/2024]
Abstract
This viewpoint was developed to revisit the burden and risks associated with postpartum depression (PPD) among incarcerated women based on a thematic review of the literature. Around one third of incarcerated pregnant women have symptoms of moderate to severe depression perinatally. In particular, PPD negatively impacts the well-being of parents and their children. Mitigating the consequences of PPD through screening, promotion of protective factors, and early identification coupled with treatment may have a substantial impact on the overall well-being of the affected children and postpartum individuals. Important risk factors for PPD in correctional populations include previous mental illness diagnosis, a lack of social support, poor pre- and perinatal care, inability to breastfeed, a lack of skin-to-skin contact, and partner violence. We recommend that correctional facilities promote the development of on-site mother-baby units and streamline the visitation process for newborns to visit parents. Improved access to pre- and postnatal care, education, and doula support is highly recommended, as well as consideration of community-based alternatives to incarceration, particularly in correctional settings with underserved mental health care needs. Future studies are needed to estimate the burden of PPD in correctional settings, identify system-related risk factors, and implement evidence-based guidelines for PPD and associated psychosocial sequelae.
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Affiliation(s)
- Aikansha Chawla
- Undergraduate Medical Education Program, DeGroote School of Medicine, McMaster University, Hamilton, Canada
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Nandini L Bansal
- Undergraduate Medical Education Program, DeGroote School of Medicine, McMaster University, Hamilton, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Celina Liu
- Undergraduate Medical Education Program, DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Andrew T Olagunju
- Undergraduate Medical Education Program, DeGroote School of Medicine, McMaster University, Hamilton, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Canada
- Department of Psychiatry and Behavioral Neurosciences, Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
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Crawford AD, McGlothen-Bell K, Testa A, McGrath JM, Cleveland L. Exploration of the effects of incarceration on the health of Latina women and their children using the life course theory. Public Health Nurs 2024; 41:264-273. [PMID: 38129292 PMCID: PMC11293011 DOI: 10.1111/phn.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/19/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Use the Life Course Theory (LCT) to explore the effects of involvement with the justice system on the health of Latina women and their children. DESIGN A supplementary analysis was conducted using data collected from the original study to answer a new research question. SETTING South Central Texas. PARTICIPANTS A primary qualitative data set from 12 Latina women involved with the justice system. METHODS We applied LCT principles and used thematic content analysis as such we employed categoric distinction: lifespan development, time and place in individuals' lives, the timing of lives, human agency, and linked lives to analyze participants' narratives. RESULTS Five themes emerged that aligned with LCT principles: (1) It feels like I'm living in my own prison; (2) What do I have to live for now; (3) It is like double punishment; (4) They made my choices; and (5) People didn't really understand. Participants felt helpless with few options to overcome their prior adversities, which affected their ability to make positive future choices. CONCLUSIONS Findings highlight the potential, long-term, negative health consequences that may result from incarceration. Considering that justice system involvement can lead to more profound maternal and child health disparities, our findings suggest that greater advocacy from the nursing profession would increase accessibility to equitable and respectful maternity and women's health care services. Key points Involvement with the justice system can result in negative health consequences for women and their children. Maternal and child health disparities are often more profound after involvement with the justice system. Greater advocacy is needed from the nursing profession to ensure access to equitable and respectful maternity and women's health care services.
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Affiliation(s)
- Allison D. Crawford
- School of Nursing, The University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Kelly McGlothen-Bell
- School of Nursing, The University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Alexander Testa
- School of Public Health, The University of Texas Health Science Center at Houston, San Antonio, Texas, USA
| | - Jacqueline M. McGrath
- School of Nursing, The University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Lisa Cleveland
- School of Nursing, The University of Texas Health at San Antonio, San Antonio, Texas, USA
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Bell SO, Dozier JL, Casubhoy I, Sufrin C. Impact of new abortion restrictions on people in prison: Estimated number of incarcerated people without abortion access and distance to abortion providers. Contraception 2024; 129:110278. [PMID: 37673362 DOI: 10.1016/j.contraception.2023.110278] [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] [Received: 06/07/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES This study aimed to estimate the annual number of incarcerated pregnant people in state and federal prisons needing an abortion. STUDY DESIGN We used 2021 Bureau of Justice Statistics data and prior studies' findings to estimate the number of pregnant incarcerated people, then calculated state-specific abortion ratios to determine the number potentially needing an abortion. RESULTS Of 638 pregnant people incarcerated in prisons annually, 110 would be expected to need an abortion, including 55 in states where abortion is currently banned or restricted. CONCLUSIONS Under Dobbs, many incarcerated pregnant people will be forced to continue unwanted pregnancies to term.
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Affiliation(s)
- Suzanne O Bell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Jessica L Dozier
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Imaima Casubhoy
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Carolyn Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Hendricks CA, Rajagopal KM, Sufrin CB, Kramer C, Jiménez MC. Mental health, chronic and infectious conditions among pregnant persons in US state prisons and local jails 2016-2017. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241228748. [PMID: 38468474 PMCID: PMC10929028 DOI: 10.1177/17455057241228748] [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: 06/20/2023] [Revised: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Pregnant individuals in incarcerated settings have unique healthcare needs. Rates of mental health, infectious diseases, and chronic disease are higher among nonpregnant incarcerated women compared with those who are not, but the prevalence of these conditions among pregnant people in custody has not been documented. OBJECTIVES The objective of this study is to describe the prevalence of metabolic, infectious, and mental health conditions in pregnant people to identify the medical needs of high-risk pregnancies in US state prisons and local jails. STUDY DESIGN This was a prospective epidemiologic surveillance of a convenience sample of state prisons (n = 20) and local jails (n = 3). METHODS We used purposive and snowball sampling to recruit a national sample of prisons and jails of a range of sizes and geographies. Reporters submitted to our study database monthly data on selected pregnancy comorbidities for 6 months between 2016 and 2017. Screening, diagnosis, and tracking of these conditions are derived from each facility's medical record and health care delivery systems. RESULTS Of the 445 newly admitted pregnant people in prisons and 243 in jails, the most prevalent conditions were mental health conditions and hepatitis C. Specifically, 34.1% (n = 152) in prison and 23.5% (n = 57) in jail had a substance use disorder, and 27.4% (n = 122) of those in prison and 17.7% (n = 43) in jail had a psychiatric diagnosis. Finally, 20.2% (n = 91) in prison and 6.6% (n = 16) in jail had hepatitis C. CONCLUSIONS This study demonstrates that chronic medical and mental health conditions are prevalent among pregnant people in US prisons and jails. However, significant variability in the reported number of cases of these conditions from state to state and between facility types implies a lack of or inadequate screening practices. These data indicate the need for comprehensive screening and appropriate care for the complex needs of pregnant incarcerated people.
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Affiliation(s)
- Caitlin A Hendricks
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Karissa M Rajagopal
- College of Osteopathic Medicine, University of New England, Biddeford, ME, USA
- Department of Obstetrics and Gynecology, Cooper Medical School of Rowan University, Cooper University Hospital, Camden, NJ, USA
| | - Carolyn B Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Camille Kramer
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Monik C Jiménez
- Division of Women’s Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Brawley V, Kurnat-Thoma E. Use of Shackles on Incarcerated Pregnant Women. J Obstet Gynecol Neonatal Nurs 2024; 53:79-91. [PMID: 37858602 DOI: 10.1016/j.jogn.2023.09.005] [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] [Received: 01/23/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023] Open
Abstract
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.
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Usigbe J, Macey E, Klemme P, Williams M, Turman JE. Applying a Maternal Standards of Care Audit Tool and Quality Improvement Process to Improve Healthcare for Pregnant Women in Prison. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231206518. [PMID: 37902383 DOI: 10.1177/0306624x231206518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Women are the fastest growing prison population, but little is known about the quality of maternal care for pregnant women in prison. In partnership with the Indiana Department of Correction (IDOC) Transitional Healthcare Team (THT), we developed a maternal standard of care (MSOC) audit tool to identify existing strengths and weaknesses and recommend evidence-based strategies for improvement. After creating the MSOC audit tool, we used it to audit 52 charts and conducted interviews of IDOC staff regarding maternal health care processes. Identified strengths include prenatal care, screening/treatment for sexually transmitted diseases and substance use disorders, contraception use, and health education. Mental and nutritional health care are areas of weakness. Staff motivation and community partnerships facilitate positive change, but a "punitive" culture, lack of resources, and communication challenges are barriers to change. Developing accountability tools and processes to promote maternal standards of care holds the potential to increase the health and wellbeing of mothers and their babies and improve re-integration into society.
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Routh D, Simmons R, Sanders J, Gero A, Tanner HA, Turok DK. Building an implementation framework to address unmet contraceptive care needs in a carceral setting: a systematic review. HEALTH & JUSTICE 2023; 11:43. [PMID: 37861888 PMCID: PMC10588068 DOI: 10.1186/s40352-023-00243-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The provision of contraceptive care for incarcerated individuals has been largely inconsistent and has contributed to, at best, inadequate care, and at worst reproductive abuses, violence, and coercion. While previous research has identified strategies to remedy known issues, to date, very few recommendations have been implemented across the carceral system. To address this, we conducted a systematic review of policy and practice recommendations to improve contraceptive care to reproductive-aged, incarcerated individuals in the United States. METHODS We conducted this systematic review utilizing the Joanna Briggs Institute methodology and framed it within the National Implementation Research Network's (NIRN) Exploration stage. We searched PubMed, PSYCInfo, SCOPUS, ProQuest, Web of Science, MedLine, Social Science Citation Index and reference sections of included materials. Basic study information, explicitly stated policy and practice recommendations, and discussions and conclusions that subtly provide recommendations were extracted in full text. We utilized a thematic analysis approach to analyze the extracted text. RESULTS A total of 45 materials met the inclusion criteria. Seven overarching themes were identified: 1) policy changes needed to implement care; 2) need for contraceptive care in carceral systems; 3) justice agency barriers regarding contraceptive care provision; 4) policy barriers to contraceptive access; 5) funding strategies to improve care; 6) patient preferences for contraceptive care delivery; and 7) healthcare provider knowledge regarding contraceptive care. The seven themes identified shed light on the need for, gaps, barriers, and facilitators of current contraceptive care provision to incarcerated individuals. CONCLUSION This systematic review accomplished two goals of NIRN's Exploration stage. First, the compiled evidence identified a clear need for change regarding policies and practices pertaining to contraceptive care provision to incarcerated individuals in the United States. Second, our findings identified several evidence-based solutions supported both by research and professional healthcare organizations to address the identified need for change. This study provides an initial blueprint for correctional agencies to implement the necessary changes for improving contraceptive care provision to incarcerated populations. The correctional system is in a unique position to deliver much-needed care, which would result in many potential benefits to the individuals, correctional system, and community at large.
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Affiliation(s)
- Douglas Routh
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA.
| | - Rebecca Simmons
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - Jessica Sanders
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - Alexandra Gero
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - Hannah Aanderud Tanner
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - David K Turok
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
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Steely Smith MK, Zielinski MJ, Sufrin C, Kramer CT, Benning SJ, Laine R, Shlafer RJ. State Laws on Substance Use Treatment for Incarcerated Pregnant and Postpartum People. Subst Abuse 2023; 17:11782218231195556. [PMID: 37746631 PMCID: PMC10517601 DOI: 10.1177/11782218231195556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/27/2023] [Indexed: 09/26/2023]
Abstract
Background Incarcerated perinatal populations report high rates of substance use in the United States (US). Despite this, substance use disorder (SUD) treatment is not routinely available in carceral settings and state policies related to the provision of substance use screening and treatment are unknown. Methods We conducted a systematic search in WestLaw through the end of the 2020 legislative session combining the terms "pregnant" and "postpartum" with terms for incarceration and related terms. The search returned 453 statutes from 43 states. A deductive codebook of various maternal health topics was developed. Legislative texts related to SUD screening and treatment were extracted for textual analysis. Results Of the 43 states identified as having at least 1 state statute pertaining to pregnant or postpartum incarcerated people, 7 states had statutes relevant to SUD screening and treatment. Statutes related to substance use screening, education, treatment and diversion programs, program eligibility, aftercare and release planning, and funding appropriations. Conclusions The majority of states across the U.S. lack legislation that address SUD screening and treatment among incarcerated perinatal populations. Given the known limited access to SUD treatment for perinatal populations in custody, increasing legislative statutes could increase access to essential care.
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Affiliation(s)
- Mollee K Steely Smith
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Psychiatry and Behavioral Sciences, University of Arkansas at Fayetteville, Fayetteville, AR, USA
| | - Carolyn Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Camille T Kramer
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sara J Benning
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rosemary Laine
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca J Shlafer
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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14
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Crawford AD, Ricks TN, Polinard E, Abbyad CW. What is Known About Reproductive Autonomy Among Justice-Involved Black Women?: A Scoping Review. J Transcult Nurs 2023; 34:375-388. [PMID: 37431805 DOI: 10.1177/10436596231183180] [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] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVE There are approximately 231,000 women detained daily within the nation's jail and prison systems with women of color making up nearly half of those experiencing incarceration. The purpose of this scoping review was to synthesize the literature on the reproductive autonomy of Black women influenced by incarceration, using the three tenets of reproductive justice. METHODS We searched PubMed, CINAHL, SocINDEX, and PsycINFO for research related to reproductive justice written in English and published in the United States from 1980 to 2022. A review of 440 article titles and abstracts yielded 32 articles for full-text review; nine articles met inclusion. RESULTS Eight addressed Tenet 1; five mentioned Tenet 2; none addressed Tenet 3. Recognition of the influence of incarceration on the reproductive autonomy of Black women is limited. CONCLUSION The findings from this review suggest a need to address (a) reproductive choice, (b) support goals, and (c) support of justice-involved Black women.
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15
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Sufrin CB, Devon-Williamston A, Beal L, Hayes CM, Kramer C. "I mean, I didn't really have a choice of anything:" How incarceration influences abortion decision-making and precludes access in the United States. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2023; 55:165-177. [PMID: 37394626 DOI: 10.1363/psrh.12235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To understand how the punitive, rights-limiting, and racially stratified environment of incarceration in the United States (US) shapes the abortion desires, access, and pregnancy experiences of pregnant women, transgender men, and gender non-binary individuals. METHODS From May 2018-November 2020, we conducted semi-structured, qualitative interviews with pregnant women in prisons and jails in an abortion supportive and an abortion restrictive state. Interviews explored whether participants considered abortion for this pregnancy; attempted to obtain an abortion in custody; whether and how incarceration affected their thoughts about pregnancy, birth, parenting, and abortion; and options counseling and prenatal care experiences, or lack thereof, in custody. RESULTS The conditions of incarceration deeply shaped our 39 participants' abortion and pregnancy decisions, with some experiencing pregnancy continuation as punishment. Four themes emerged: (1) medical providers' overt obstruction of desired abortions; (2) participants assuming that incarcerated women had no right to abortion; (3) carceral bureaucracy constraining abortion access; and (4) carceral conditions made women wish they had aborted. Themes were similar in supportive and restrictive states. CONCLUSIONS Incarceration shaped participants' thoughts about pregnancy and their abilities to access abortion, consider whether abortion was an attainable option, and make pregnancy-related decisions. These subtle carceral control aspects presented more frequent barriers to abortion than overt logistical ones. The carceral environment played a more significant role than the state's overall abortion climate in shaping abortion experiences. Incarceration constrains and devalues reproductive wellbeing in punitive ways that are a microcosm of broader forces of reproductive control in US society.
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Affiliation(s)
- Carolyn B Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Crystal M Hayes
- Department of Maternal and Child Health Center of Excellence, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Camille Kramer
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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16
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Knittel AK, Swartzwelder RA, Zarnick S, Tsujimoto TM, Horne T, Lin FC, Edwards J, Amos E, Alexander J, Thorp J, Jones HE. Neonatal Outcomes after Medications for Opioid Use Disorder during Pregnancy in a State Women's Prison Facility, 2016-2019. J Addict Med 2023; 17:587-591. [PMID: 37788614 PMCID: PMC10593980 DOI: 10.1097/adm.0000000000001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Although medications for opioid use disorder improve both maternal and neonatal outcomes, little is known about opioid-exposed infants born during episodes of incarceration. The study sought to examine birth outcomes for infants born with opioid exposure during perinatal incarceration. METHODS Participants were identified from clinic rosters in a Southeastern women's prison (2016-2019). Included infants born to pregnant people with opioid use disorder incarcerated in the study facility at the time of delivery. We abstracted hospital length of stay, neonatal opioid withdrawal syndrome (NOWS) severity, and discharge plan from hospital records and report descriptive statistics, analysis of variance F tests, and chi-square tests to compare outcomes by opioid exposure type. RESULTS There were 125 infants born after exposure to methadone (n = 34), buprenorphine (n = 15), oxycodone (n = 22), or no opioid medication (n = 54) during prenatal incarceration. Most infants exposed to methadone or buprenorphine had difficulty with eating, sleeping, or consoling (97% and 80%), and 59% and 47% were treated with medication for NOWS, respectively. The majority with prenatal opioid exposure required intervention for NOWS symptoms after their birthing parent was discharged to the prison. The average hospital length of stay was different for infants with no opioid, methadone, buprenorphine, and oxycodone exposure during incarceration (4, 15, 12, and 9 days, respectively, P < 0.001). CONCLUSIONS Neonatal hospitalization experiences of infants with perinatal opioid exposures during maternal incarceration mirror those of similarly exposed infants born outside the context of incarceration, except for hospital length of stay. Consideration of avoiding separation of the parent-infant dyad may be needed to improve outcomes for these infants.
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Affiliation(s)
- Andrea K Knittel
- Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Rita A Swartzwelder
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Samantha Zarnick
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Tamy Moraes Tsujimoto
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Timeli Horne
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Feng Chang Lin
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Elton Amos
- North Carolina Department of Public Safety, Raleigh, NC
| | | | - John Thorp
- Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Hendree E Jones
- UNC Horizons, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
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17
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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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18
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Rajagopal K, Landis-Lewis D, Haven K, Sufrin C. Reproductive Health Care for Incarcerated People: Advancing Health Equity in Unequitable Settings. Clin Obstet Gynecol 2023; 66:73-85. [PMID: 36044632 PMCID: PMC9851923 DOI: 10.1097/grf.0000000000000746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
There are over 150,000 incarcerated females in the United States. Structural inequities, including racism, adversely affect the reproductive health outcomes, autonomy, and access to care that people in custody face. This article reviews the status of reproductive health and health care among incarcerated women and describes ways that community OB/GYNs can address health inequities by providing comprehensive, compassionate care to incarcerated people, especially when they come to community settings for care while they are in custody. To address reproductive health disparities and inequities that adversely affect incarcerated individuals, community providers can implement these recommendations and also engage in advocacy.
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Affiliation(s)
- Karissa Rajagopal
- University of New England College of Osteopathic Medicine, Biddeford, Maine
| | | | | | - Carolyn Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland
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19
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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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20
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Kramer C, Thomas K, Patil A, Hayes CM, Sufrin CB. Shackling and pregnancy care policies in US prisons and jails. Matern Child Health J 2023; 27:186-196. [PMID: 36372806 PMCID: PMC9660187 DOI: 10.1007/s10995-022-03526-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The number of incarcerated women in the United States has risen exponentially. Many are of childbearing age with 3-4% being pregnant at intake. Despite the need for comprehensive pregnancy-related health care in prisons and jails, there is no oversight that requires adherence to the established standards. The objective of this study was to assess prison and jail pregnancy policies and practices with an emphasis on restraint use and compliance with anti-shackling legislation. METHODS We conducted a survey of 22 state prisons and six jails, including the five largest jails, from 2016-2017 regarding pregnancy policies and practices including restraint use, prenatal care, delivery and birth, and other pregnancy accommodations. We compared reported restraint policies to state legislation at the time of the survey. RESULTS Data indicate that pregnancy policies and services in prisons and jails vary and compliance inconsistencies with anti-shackling legislation exist. A third of the prisons and half of the jails did not have accredited health care services. All study facilities provided prenatal vitamins and most provided supplemental snacks. Most facilities stationed an officer inside the hospital room during labor and delivery, but nearly one-third of facilities did not require a female-identifying officer. CONCLUSIONS FOR PRACTICE Limited oversight and standardization of carceral health care and accommodations for pregnant people lead to variability in prisons and jails. Prisons and jails should adopt and implement standards of care guidelines to ensure the safety and well-being of pregnant people who have unique healthcare needs. Incarcerated pregnant people should be viewed as expectant parents in need of comprehensive health care, rather than as criminals who forfeited their right to a safe, respectful, and humane childbirth.
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Affiliation(s)
- Camille Kramer
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave., A101, 21224 Baltimore, MD USA
| | - Karenna Thomas
- School of Public Health, Yale University, 60 College St, 06510 New Haven, CT USA
| | - Ankita Patil
- Department of Psychology, The College of New Jersey, 2000 Pennington Rd. Ewing Township, 08618 Ewing, NJ USA
| | - Crystal M. Hayes
- Center of Excellence, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Carolyn B. Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Ave., A101, 21224 Baltimore, MD USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, 21205 Baltimore, MD USA
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21
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Lipnicky A, Stites S, Sufrin C, Bello JK, Shlafer R, Kelly PJ, Ramaswamy M. Jail Provision of Pregnancy and Sexual Health Services in Four Midwestern States. Womens Health Issues 2023; 33:97-104. [PMID: 36096980 DOI: 10.1016/j.whi.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/10/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Women incarcerated in local jails have pregnancy and sexual health needs, yet little information is available about what services are provided and how jail administrators prioritize this care. Our objective was to document jails' provision of pregnancy and sexual health services in four states in the Midwest. METHODS We invited all jail administrators (N = 347) in Kansas, Missouri, Iowa, and Nebraska to participate in a web-based survey conducted from November 2017 to October 2018. We asked administrators which pregnancy and sexual health services they offered and to rate the importance of offering services. Results were analyzed using descriptive statistics and logistic regression. RESULTS The survey response rate was 55% (192/347). Jails most often provided pregnancy testing (n = 116 [60%]) and distribution of prenatal vitamins (n = 85 [44%]). Sexually transmitted infection treatment was offered at 23% of jails (n = 45). Larger, accredited jails located in urban areas and with high numbers of clinical providers on staff were more likely to provide sexual health services. Jails with privately contracted health care were more likely to provide pregnancy services compared with other entities providing medical care. The most prioritized sexual health service was sexually transmitted infection testing, with 39% of administrators believing it was important. Only 6% of administrators responded that contraception was important. CONCLUSIONS Local jails in the Midwest do not meet the basic reproductive and sexual health needs of women. Provision of these services is not a priority for jail administrators. Appropriate partnerships could engage administrators and increase the availability of services to meet the needs of women in jail.
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Affiliation(s)
- Ashlyn Lipnicky
- University of Kansas School of Medicine, Kansas City, Kansas
| | - Sierra Stites
- University of Kansas School of Medicine, Kansas City, Kansas
| | | | | | - Rebecca Shlafer
- University of Minnesota Medical School, Minneapolis, Minnesota
| | | | - Megha Ramaswamy
- University of Kansas School of Medicine, Kansas City, Kansas
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22
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da Silva AZ, Kendall C, Mota RMS, Machado ALG, Pires Neto RDJ, Maia Macena RH, Regina Franco Sansigolo Kerr L. Hypertension among women experiencing incarceration: A comparison with the general female population. Glob Public Health 2022; 17:3548-3556. [PMID: 36127869 DOI: 10.1080/17441692.2022.2124301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To compare the prevalence and characteristics of hypertension in women experiencing incarceration (WEI) to the general population in Brazil: (1) a prison survey conducted from January 2014 to December 2015 in 15 states, with 1,327 WEI; and (2) a household survey in the 26 states and the Federal District of Brazil administered to women in the general population (WGP). Data analysis used SPSS® version 20.0. The point estimates and the prevalence ratio with their respective confidence intervals were calculated using Poisson regression. Ages in the two populations differed, 27.9% of WGP were over 50, while 7.3% of WEI were. The overall prevalence of arterial hypertension was 31.3% (95% CI: 28.6-34.0) in the WEI and 38.9% (95% CI: 37.8-39.9) for WGP. For individuals under 30, hypertension was found in 22.4% of WEI and 13.4% of WGP. WEI have a higher prevalence of hypertension at an earlier age than the GP. Less education, obesity, using illegal drugs, previous pregnancy, and not using contraceptives were more frequent in this group, revealing the need to implement policies aimed at treating both their hypertension and other health issues in prison.
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Affiliation(s)
- Ana Zaira da Silva
- Department of Community Health, School of Medicine, Federal University of Ceará, Ceará, Brazil
| | - Carl Kendall
- Department of Community Health, School of Medicine, Federal University of Ceará, Ceará, Brazil.,Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Rosa Maria Salani Mota
- Department of Community Health, School of Medicine, Federal University of Ceará, Ceará, Brazil
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Hessami K, Hutchinson-Colas JA, Chervenak FA, Shamshirsaz AA, Zargarzadeh N, Norooznezhad AH, Grünebaum A, Bachmann GA. Prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States: a systematic review and meta-analysis. J Perinat Med 2022:jpm-2022-0412. [PMID: 36394545 DOI: 10.1515/jpm-2022-0412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022]
Abstract
This systematic review and meta-analysis assessed the risk of inadequate prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States. PubMed/MedLine, Embase, ClinicalTrials.gov and Web of Science were searched from inception up to March 30th, 2022. Studies were included if they reported the risk of inadequate prenatal care and/or pregnancy outcomes among incarcerated pregnant individuals in the United States jails or prisons. Adequacy of prenatal care was quantified by Kessner index. The random-effects model was used to pool the mean differences or odds ratios (OR) and the corresponding 95% confidence intervals (CIs) using RevMan software. Nine studies were included in the final review. A total of 11,534 pregnant individuals, of whom 2,544 were incarcerated while pregnant, and 8,990 who were matched non-incarcerated pregnant individuals serving as control group, were utilized. Compared to non-incarcerated pregnancies, incarcerated pregnant individuals were at higher risk of inadequate prenatal care (OR 2.99 [95% CI: 1.60, 5.61], p<0.001) and were more likely to have newborns with low birthweight (OR 1.66 [95% CI: 1.19, 2.32], p=0.003). There was no significant difference between incarcerated and matched control pregnancies in the rates of preterm birth and stillbirth. The findings of the current systematic review and meta-analysis suggest that incarcerated pregnant individuals have an increased risk of inadequate prenatal care. Considering the limited number of current studies, further research is indicated to both assess whether the risk of inadequate prenatal care has negative impact on prenatal outcomes for this population and to determine the steps that can be taken to enhance prenatal care for all pregnant individuals incarcerated in the United States prisons.
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Affiliation(s)
- Kamran Hessami
- Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Juana A Hutchinson-Colas
- Department of Obstetrics and Gynecology, Women's Health Institute, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Frank A Chervenak
- Departments of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA
| | - Alireza A Shamshirsaz
- Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nikan Zargarzadeh
- Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amos Grünebaum
- Departments of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA
| | - Gloria A Bachmann
- Department of Obstetrics and Gynecology, Women's Health Institute, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Wouk K, Piggott J, Towner Wright S, Palmquist AE, Knittel A. Lactation Support for People Who Are Incarcerated: A Systematic Review. Breastfeed Med 2022; 17:891-925. [PMID: 36301257 PMCID: PMC9700340 DOI: 10.1089/bfm.2022.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Lactation support, defined here as the access to educational resources, supplies, mental health and psychosocial support, skilled lactation counseling, and peer support, has been identified as critical to optimal health outcomes for birthing parents and infants. People who give birth while incarcerated are likely to receive suboptimal lactation support. The purpose of this review is to explore the literature on lactation support for incarcerated people to identify existing programs and policies, gaps in lactation support and ways to address the gaps, and incarcerated people's perspectives on breastfeeding and lactation support. Methods: We conducted a systematic review of the peer-reviewed literature to identify studies that addressed two main concepts: (1) breastfeeding and (2) incarcerated populations in the United States. Results: After meeting the eligibility criteria, 29 studies were included in the qualitative synthesis of the findings. Studies highlight the importance of supporting birthing people who want to provide milk to their infants in a way that is desired, psychologically safe, and structurally supported. Programs are needed to delay or prevent parent-infant separation after birth, provide education around breastfeeding misconceptions, and link to resources and ongoing support for both breastfeeding and milk expression. Implementation of breastfeeding programs may be most effectively undertaken with clear policies and dedicated leadership either internally or through community or health care partnerships. Discussion: This review highlights the policies and practices that hinder adequate lactation support for birthing parent-infant dyads who are incarcerated and describes feasible policies, education, and clinical support that can be used to improve care.
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Affiliation(s)
- Kathryn Wouk
- Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jaslyn Piggott
- Department of Obstetrics and Gynecology, George Washington University, Washington, District of Columbia, USA
| | - Sarah Towner Wright
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Aunchalee E.L. Palmquist
- Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Andrea Knittel
- Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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25
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Eidelman AI. Breastfeeding While Being Incarcerated. Breastfeed Med 2022; 17:871. [PMID: 36318803 DOI: 10.1089/bfm.2022.29227.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Arthur I Eidelman
- -Arthur I. Eidelman, MD, FABM, FAAP, Editor-in-Chief, Breastfeeding Medicine
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26
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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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27
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Paynter MJ, Norman WV. The Intersection of Abortion and Criminalization: Abortion Access for People in Prisons. Semin Reprod Med 2022; 40:264-267. [PMID: 36535662 DOI: 10.1055/s-0042-1758481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Most incarcerated women are of reproductive age, and more than a third of women will have an abortion during their reproductive years. Although women are the fastest growing population in Canadian prisons, no one has studied the effect of their incarceration on access to abortion services. Studies outside of Canada indicate rates of abortion are higher among people experiencing incarceration than in the general population, and that abortion access is often problematic. Although international standards for abortion care among incarcerated populations exist, there conversely appear to be no Canadian guidelines or procedures to facilitate unintended pregnancy prevention or management. Barriers to abortion care inequitably restrict people with unintended pregnancy from attaining education and employment opportunities, cause entrenchment in violent relationships, and prevent people from choosing to parent when they are ready and able. Understanding and facilitating equitable access to abortion care for incarcerated people is critical to address structural, gender-, and race-based reproductive health inequities, and to promote reproductive justice. There is an urgent need for research in this area to direct best practices in clinical care and support policies capable to ensure equal access to abortion care for incarcerated people.
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Affiliation(s)
- Martha J Paynter
- Faculty of Nursing, University of New Brunswick, Fredericton, Canada
| | - Wendy V Norman
- Department of Family Practice, University of British Columbia, Vancouver, Canada.,Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Longhi MTDM, Silva RUDO, Gasque KCDS, de Lima DC, de Oliveira JM, Caldeira FID. Impact of oral comorbidities on incarcerated women: an integrative review. REVISTA ESPANOLA DE SANIDAD PENITENCIARIA 2022; 24:94-100. [PMID: 36533787 PMCID: PMC9768559 DOI: 10.18176/resp.00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/26/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Oral health care directly impacts the well-being of incarcerated women. It is related to the quality of life, social and economic discrepancies and lack of access to programs that offer free dental services and health promotion for this population. OBJECTIVES This work aimed to understand oral health challenges faced by women incarcerated in Brazil and worldwide. MATERIAL AND METHOD The following databases were selected: EMBASE, (Virtual Health Library=LILACS+BDENF), Scielo, Scopus, Cochrane-Library and the PubMed search engine. These databases were searched until the closing date of October 2021 with no time limit for the searches. The key words used in the searches were "incarceration", "prison", "woman", and "oral health". RESULTS Caries, periodontal disease, tooth pain, and the use of dental prostheses were the most prevalent oral health conditions amongst incarcerated women in Brazil and worldwide. Regarding the level of scientific evidence, the included articles fit level III, according to Melnyk and Fineout. DISCUSSION Bearing in mind the limitations of the study, oral diseases in the global context showed that the quality of life related to oral and systemic health of women during and after incarceration was negatively affected. It is also essential for further clinical and follow-up studies to be carried out on incarcerated women that address their actual oral health needs.
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Affiliation(s)
- Maria Tereza de Moraes Longhi
- School of Dentistry, Alfenas Federal University (Unifal-MG). Alfenas, Minas Gerais, Brazil.Universidade Federal de AlfenasSchool of DentistryAlfenas Federal UniversityAlfenasMinas GeraisBrazil
| | - Rafaella Ugrin de Oliveira Silva
- School of Dentistry, Alfenas Federal University (Unifal-MG). Alfenas, Minas Gerais, Brazil.Universidade Federal de AlfenasSchool of DentistryAlfenas Federal UniversityAlfenasMinas GeraisBrazil
| | - Kellen Cristina da Silva Gasque
- Regional Board of Brasília, Oswaldo Cruz Foundation (Fiocruz-DF). Brasília, Distrito Federal, Brazil.Fundação Oswaldo CruzRegional Board of BrasíliaOswaldo Cruz FoundationBrasíliaDistrito FederalBrazil
| | - Daniela Coelho de Lima
- School of Dentistry, Alfenas Federal University (Unifal-MG). Alfenas, Minas Gerais, Brazil.Universidade Federal de AlfenasSchool of DentistryAlfenas Federal UniversityAlfenasMinas GeraisBrazil
| | - Josué Miguel de Oliveira
- Department of Dentistry, Health Sciences School, University of Brasília. Brasília, Distrito Federal, Brazil.Universidade de BrasíliaDepartment of DentistryHealth Sciences SchoolUniversity of BrasíliaBrasíliaDistrito FederalBrazil
| | - François Isnaldo Dias Caldeira
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry. School of Dentistry at Araraquara (FOAr/UNESP). Araraquara, São Paulo, Brazil.Universidade Estadual PaulistaDepartment of Morphology, Genetics, Orthodontics and Pediatric DentistrySchool of Dentistry at AraraquaraUNESP -São Paulo State UniversityAraraquaraSão PauloBrazil
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King Z, Lyerly AD, Knittel AK. Safekeeping of Pregnant People Experiencing Incarceration. WOMEN & CRIMINAL JUSTICE 2022; 33:363-377. [PMID: 37789904 PMCID: PMC10545335 DOI: 10.1080/08974454.2022.2104986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Safekeeping involves transferring individuals from jails to prisons without the presence of a conviction. In North Carolina, safekeeping is used for pregnant people with the aim of providing better prenatal care. We interviewed 14 stakeholders in the safekeeping process including sheriffs, clinicians, advocates, and lawyers. Three key themes emerged: jails' inability to provide care for pregnant individuals; safekeeping as an additional punishment to incarceration; and differing attitudes on the necessity of safekeeping. Participants perceived that while there may be some benefits of safekeeping such as enhanced prenatal care, safekeeping can also lead to worsened conditions for pregnant people experiencing incarceration.
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Affiliation(s)
- Zoe King
- Duke University, Trinity College of Arts & Sciences; 117 Physics Building; 120 Science Dr.; Durham, NC 27708; United States
| | - Anne D. Lyerly
- University of North Carolina at Chapel Hill School of Medicine, Department of Social Medicine, 333 South Columbia St, 333 MacNider Hall, CB# 7240, Chapel Hill, NC 27599; United States
| | - Andrea K. Knittel
- University of North Carolina at Chapel Hill Department of Obstetrics and Gynecology; 3027 Old Clinic Building, CB#7570, Chapel Hill, NC 27599
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Abou-Jaoude MM, Crawford J, Kryscio RJ, Moore DB. Accuracy of Ophthalmology Clinic Follow-Up in the Incarcerated Patient Population. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2022. [DOI: 10.1055/s-0042-1758562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Purpose Incarcerated patients represent a uniquely vulnerable population in the outpatient ophthalmology setting, and the reliability of follow-up in this group is undetermined.
Methods This was a retrospective, observational chart review of consecutive incarcerated patients evaluated at the ophthalmology clinic of a single academic medical center between July 2012 and September 2016. For each encounter the following were recorded: patient age, gender, incarcerated status at the time of encounter (a subset of patients had encounters before/after incarceration), interventions performed, follow-up interval requested, urgency of follow-up, and actual time to subsequent follow-up. Primary outcome measures were no-show rate and timeliness, which was defined as follow-up within 1.5× the requested period.
Results There were 489 patients included during the study period, representing a total of 2,014 clinical encounters. Of the 489 patients, 189 (38.7%) were seen once. Of the remaining 300 patients with more than one encounter, 184 (61.3%) ultimately did not return and only 24 (8%) were always on time for every encounter. Of 1,747 encounters with specific follow-up requested, 1,072 were considered timely (61.3%). Factors significantly associated with subsequent loss to follow-up include whether a procedure was performed (p < 0.0001), urgency of follow-up (p < 0.0001), incarcerated status (p = 0.0408), and whether follow-up was requested (p < 0.0001).
Conclusion Almost two-thirds of incarcerated patients in our population requiring repeat examination were lost to follow-up, particularly those who underwent an intervention or required more urgent follow-up. Patients entering and exiting the penal system were less likely to follow-up while incarcerated. Further work is needed to understand how these gaps compare to those in the general population and to identify means of improving these outcomes.
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Affiliation(s)
- Michelle M. Abou-Jaoude
- Department of Ophthalmology and Visual Sciences, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Jessica Crawford
- Department of Ophthalmology and Visual Sciences, University of Kentucky College of Medicine, Lexington, Kentucky
| | | | - Daniel B. Moore
- Department of Ophthalmology and Visual Sciences, University of Kentucky College of Medicine, Lexington, Kentucky
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Nguyen M, Mead J, St Ivany A. An Injustice to the Justice-Involved: A Brief Report on the Impact of Traumatic Brain Injury on Incarcerated Mothers. JOURNAL OF FORENSIC NURSING 2022; 18:E18-E25. [PMID: 35696416 DOI: 10.1097/jfn.0000000000000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Traumatic brain injury (TBI) is one of the leading causes of death and long-term disability among young adults worldwide and in the United States. TBIs are often associated with a high prevalence of morbidity, mortality, and other behavioral and cognitive problems. Several studies have shown that women living with TBIs have significantly higher odds of committing criminal acts, yet the impact of TBI on incarcerated women remains an underresearched area. By contrast, the effect of TBI on men is more prevalent in current literature, particularly relating to sports-related injuries. Given that an estimate of 80% of incarcerated women are mothers, we conducted a literature review in two phases focused on TBI in incarcerated mothers. The initial search of TBI in incarcerated mothers returned no results, so we proceeded in two phases. Phase 1 searched maternal outcomes of TBI, using the terms "maternal health" and "traumatic brain injury," whereas Phase 2 searched "traumatic brain injury" and "incarcerated women." Because so little information is available regarding TBI in incarcerated mothers, we used what we could find in these two phases to highlight the scarcity of knowledge about this population. This brief report addresses the knowledge gap that exists for incarcerated mothers living with TBI to encourage regular TBI screening to raise awareness and advocate for accommodated care. Correctional forensic nurses are perfectly placed to do TBI screening and to provide continuous rehabilitation after release to prevent reoffending.
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Affiliation(s)
- Monica Nguyen
- Author Affiliations: The Dartmouth Institute of Health Policy and Clinical Practice
| | | | - Amanda St Ivany
- Author Affiliations: The Dartmouth Institute of Health Policy and Clinical Practice
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Lived experiences of pregnancy and prison through a reproductive justice lens: A qualitative meta-synthesis. Soc Sci Med 2022; 307:115179. [DOI: 10.1016/j.socscimed.2022.115179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 11/18/2022]
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Kramer C, Williamston AD, Shlafer RJ, Sufrin CB. COVID-19's Effect on Pregnancy Care for Incarcerated People. Health Equity 2022; 6:406-411. [PMID: 35801144 PMCID: PMC9257549 DOI: 10.1089/heq.2022.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objective/background: Prisons and jails are high risk environments for COVID-19. Little is known about COVID-19's impact on pregnancy care for the tens of thousands of pregnant people who pass through these institutions each year. This study aimed to describe how COVID-19 has influenced prisons' and jails' pregnancy care services. Methods: We conducted a cross-sectional survey of a convenience sample of U.S. prisons and jails and report descriptive statistics. Results: We received 17 responses. Sites reported changes in prenatal care delivery, support programming, housing, and visitation. Most sites implemented changes in housing arrangements to quarantine individuals at-risk for COVID-19. Many sites increased their use of virtual technology to supplement for suspended in-person appointments, programming, and visitation. Conclusions: The impact of COVID-19 on pregnancy care delivery and support services for incarcerated pregnant people is variable. As the pandemic continues, research and policy should ensure that incarcerated pregnant people have access to full scope pregnancy care.
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Affiliation(s)
- Camille Kramer
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ashley-Devon Williamston
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rebecca J. Shlafer
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Carolyn B. Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Incarceration exposure and prescription opioid use during pregnancy. Drug Alcohol Depend 2022; 235:109434. [PMID: 35405460 DOI: 10.1016/j.drugalcdep.2022.109434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Prior research demonstrates a high prevalence of substance use, including opioid use, among those who have had personal or vicarious contact with the correctional system. Relatedly, alongside patterns of rising opioid use in general, opioid use during pregnancy is becoming a growing public health concern. Still, risk factors for prescription opioid use during pregnancy remain understudied. This study is the first to assess the connection between a women's personal or vicarious exposure to incarceration in the 12 months prior to birth and patterns of prenatal opioid use. METHODS Data are from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2019 (N = 17,551 mothers). Logistic and multinomial logistic regression are used to assess the association between incarceration exposure and patterns of opioid use during pregnancy. RESULTS Incarceration-exposed women were more likely to use all eight types of prescription opioids assessed in this study (Hydrocodone, Codeine, Oxycodone, Tramadol, Hydromorphone/Meperidine, Oxymorphone, Morphine, and Fentanyl). After adjustment for control variables, incarceration-exposed women were significantly more likely to report any prescription opioid use during pregnancy (OR = 1.745, 95% CI = 1.194, 2.554). Furthermore, relative to no opioid use, incarceration exposure was also associated with illicit prescription opioid use (RRR = 2.979, 1.533, 5.791). CONCLUSIONS Incarceration exposure in the year prior to birth is associated with higher odds of prescription opioid use. These findings add to the burgeoning literature that details a women's exposure to incarceration is a risk marker for substance use and engagement in health risk behaviors that can jeopardize maternal and infant wellbeing.
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Testa A, Fahmy C, Jackson DB, Ganson KT, Nagata JM. Incarceration exposure during pregnancy and maternal disability: findings from the Pregnancy Risk Assessment Monitoring System. BMC Public Health 2022; 22:744. [PMID: 35418044 PMCID: PMC9009053 DOI: 10.1186/s12889-022-13143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/31/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Extant research reveals that currently and formerly incarcerated individuals exhibit higher rates of disability. Moreover, recent research highlights that women exposed to incarceration during pregnancy -either personally or vicariously through a partner- face poorer health. However, prior research has not detailed the connection between incarceration exposure and risk for maternal disability. METHODS The aim of this study is to evaluate the association between a women's exposure to incarceration during pregnancy and disability including difficulty with: communication, hearing, remembering, seeing, self-care, or walking. Data are from Pregnancy Risk Assessment Monitoring System (PRAMS), 2019 (N = 12,712). Logistic and negative binomial regression were used to assess the relationship between incarceration exposure and maternal disability. RESULTS Among the sample of women who delivered a recent live birth, approximately 3.3% of the sample indicated they were personally or vicariously exposed to incarceration in the 12 months before birth. Compared to those who did not have incarceration exposure, women with incarceration exposure have elevated odds of several disabilities, including difficulty remembering (Adjusted Odds Ratio [AOR] = 1.971; 95% Confidence Interval [CI] = 1.429, 2.718), difficulty seeing (AOR = 1.642, 95% CI = 1.179, 2.288), difficulty walking (AOR = 1.896, 95% CI = 1.413, 2.544), and a greater number of cumulative disabilities (Incidence Risk Ratio [IRR] = 1.483; 95% CI = 1.271, 1.731). CONCLUSIONS Women personally or vicariously exposed to incarceration during pregnancy endure greater odds of having a disability. Considering both incarceration and disability are important public health issues with implications for maternal and child well-being, these findings highlight the need for further research that can better understand the connection between incarceration and disability.
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Affiliation(s)
- Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, US
| | - Chantal Fahmy
- Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, Texas, US
| | - Dylan B Jackson
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, US
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, US.
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Ali S, Adshead G. Just Like a Woman: Gender Role Stereotypes in Forensic Psychiatry. Front Psychiatry 2022; 13:840837. [PMID: 35444574 PMCID: PMC9014176 DOI: 10.3389/fpsyt.2022.840837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
The relationship between violence, gender and mental health is a complex one which is yet to be fully understood. Gender role stereotypes are social constructs that can powerfully influence and regulate human behaviour, including violence; and so it is likely that they also influence the nexus of violence management and mental health which is at the core of forensic psychiatry. In this article, we examine how gender role stereotypes might influence the practice of forensic psychiatry: specifically, in relation to women as violent offenders, as patients in secure psychiatric care and as clinicians working in forensic settings. We identify areas of development in women's forensic mental health services, and examine whether patriarchal influences and gender role stereotypes may have inadvertently impacted upon these changes. We also consider whether these changes may maintain pre-existing barriers to treatment for both men and women.
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Affiliation(s)
- Saima Ali
- West London NHS Trust, Southall, United Kingdom
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Abstract
OBJECTIVES The purpose of this commentary is to provide an overview of the current landscape for childbearing families and pregnancy-capable people and a call to action toward the courage to align health and human services that support improved health outcomes. The commentary is broken into 3 parts. RESEARCH The framework of retrofit, reform, and reimagine is developed to provide a conceptual framework that supports a shared language. METHODS The current landscape is juxtaposed on the framework of retrofit, reform, and reimagine to connect the dots for health equity. CONCLUSIONS The commentary ends with a call to action that demonstrates a bold roadmap for birth workers, clinicians, nurses, doulas, physicians, and other clinical health services providers to coconstruct paths to human services that should resolve health inequities.
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Affiliation(s)
- Monica R McLemore
- Family Health Care Nursing Department, University of California, San Francisco
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38
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Gordon MR, Coverdale J, Chervenak FA, McCullough LB. Undue burdens created by the Texas Abortion Law for vulnerable pregnant women. Am J Obstet Gynecol 2022; 226:529-534. [PMID: 34954218 DOI: 10.1016/j.ajog.2021.12.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022]
Abstract
The new Texas abortion law requires the physician to determine whether a fetal heartbeat is present and prohibits abortion after a heartbeat has been documented. An exception is allowed when a "medical emergency necessitated the abortion." These and other provisions of the statute are to be enforced through "civil actions" brought by private citizens. This article identifies 3 populations of vulnerable women who will experience undue burdens created by the Texas abortion law. We begin with an account of the concept of undue burden in the jurisprudence of abortion, as expressed in the 1992 US Supreme Court case, Planned Parenthood v. Casey of Southeastern Pennsylvania. We then provide an evidence-based account of the predictable, undue burdens for 3 populations of vulnerable women: pregnant women with decreased freedom of movement; pregnant minors; and pregnant women with major mental disorders and cognitive disabilities. The Texas law creates an undue burden on these 3 populations of vulnerable women by reducing or even eliminating access to abortion services outside of Texas. The Texas law also creates an undue burden by preventably increasing the risks of morbidity, including loss of fertility, and mortality for these 3 populations of vulnerable women. For these women, it is indisputable that the Texas law will create undue burdens and is therefore not compatible with the jurisprudence of abortion as set forth in Planned Parenthood v. Casey because a "significant number of women will likely be prevented from obtaining an abortion." Federal courts should therefore strike down this law.
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Medications for opioid use disorder during pregnancy: Access and continuity in a state women's prison facility, 2016-2019. Drug Alcohol Depend 2022; 232:109308. [PMID: 35074696 PMCID: PMC8946772 DOI: 10.1016/j.drugalcdep.2022.109308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although medications to treat opioid use disorder (MOUD) are the standard of care during pregnancy, there are many potential gaps in the cascade of care for pregnant people experiencing incarceration. METHODS We conducted a retrospective cohort study of pregnant people with opioid use disorder incarcerated in a Southeastern women's prison from 2016 to 2019. The primary outcomes were access to MOUD during incarceration and continuity in the community. We used descriptive statistics to summarize aspects of our sample and logistic regression to identify predictors of MOUD receipt during incarceration. RESULTS Of the 279 pregnant people with OUD included in the analysis, only 40.1% (n = 112) received MOUD during incarceration, including 67 (59.8%) who received methadone and 45 (40.1%) who received buprenorphine. Less than one-third of the participants were referred to a community MOUD provider (n = 83, 30%) on return to the community. Significant predictors of MOUD receipt included medium/close custody level during incarceration, incarceration during the latter portion of the study period, pre-incarceration heroin use, and receipt of pre-incarceration MOUD. CONCLUSIONS Although prisons can serve as an important site of retention in MOUD for some pregnant people, there were substantial gaps in initiation of MOUD and retention in MOUD among pregnant people with OUD imprisoned in the Southeast during the study period.
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Norris WK, Allison MK, Fradley MF, Zielinski MJ. 'You're setting a lot of people up for failure': what formerly incarcerated women would tell healthcare decision makers. HEALTH & JUSTICE 2022; 10:4. [PMID: 35103865 PMCID: PMC8808972 DOI: 10.1186/s40352-022-00166-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/30/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Incarcerated women have a higher prevalence of health problems than the general population; however, little is known about their perspectives on the healthcare they receive. Here, we conducted semi-structured interviews with women who had been incarcerated (n = 63) which asked what they would tell healthcare decision-makers about their experiences of healthcare in prisons and the community post-incarceration if provided the opportunity. All participants had a history of sexual violence victimization and had at least one period of incarceration in a community corrections center in Arkansas due to the goals of the larger study from which data were drawn. RESULTS Four themes arose when participants were asked what they would tell people who make decisions about community healthcare: 1) the healthcare system is not working (52%; n = 33), 2) have compassion for us (27%; n = 17), 3) recognize that we have specific and unique needs (17%; n = 11), and 4) the transition from incarceration is challenging and requires more support (22%; n = 14). Three themes arose when we asked participants what they would tell people who make decisions about healthcare in prisons: 1) we had experiences of poor physical healthcare in prison (44%; n = 28), 2) more specialty care is needed in prison (49%; n = 31), and 3) healthcare providers treat women in prison poorly (37%; n = 23). CONCLUSIONS Our findings underscore the need for systemic changes including greater oversight of prison-based healthcare services, enhanced access to medical subspecialties in prisons, and healthcare provider training on the unique needs of incarcerated and previously incarcerated women. Polices that expand healthcare access are also likely to benefit formerly incarcerated women given the challenges they experience seeking community-based care.
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Affiliation(s)
- Whitney K Norris
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Marley F Fradley
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- University of Arkansas for Medical Sciences, Little Rock, AR, USA.
- University of Arkansas, Fayetteville, AR, USA.
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Drago MJ, Shabanova V, Hochreiter D, Grossman M, Mercurio M. Does Maternal Incarceration Impact Infants with Neonatal Abstinence Syndrome? Matern Child Health J 2022; 26:1095-1103. [PMID: 35088297 DOI: 10.1007/s10995-021-03356-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Opioid exposed infants born to incarcerated women represent a vulnerable and understudied subset of infants with neonatal abstinence syndrome (NAS). The impact of maternal incarceration on length of stay (LOS) for infants with NAS is unknown. We hypothesized that infants with NAS born to incarcerated women have longer hospitalizations compared to infants with NAS born to non-incarcerated women. METHODS This is a retrospective cohort study of infants with NAS born between 2011 and 2018 at the primary delivery site for Connecticut's only women's prison. Opioid exposed infants were assessed by Finnegan Scores for withdrawal and received morphine as a first line agent and phenobarbital as a second line agent. LOS was compared using Poisson regression. RESULTS Of 206 infants identified, 166 were included in the analysis, with 28 born to incarcerated women and 138 to non-incarcerated women. Incarcerated women were more likely to report prenatal alcohol use, 14.3% vs 2.2% p = 0.016 and benzodiazepine use 21.4% vs 7.3% p = 0.032. Infants of incarcerated women were less likely to be fed breast milk at discharge, 3.6% vs 37% p < 0.001. Adjusted mean LOS was longer among infants born to incarcerated women, 18.5 vs 16.6 days (p = 0.009). CONCLUSIONS FOR PRACTICE Infants with NAS born to incarcerated women in Connecticut had longer LOS, lower rates of being fed breast milk, and different prenatal substance exposures than infants with NAS born to non-incarcerated women. Supporting the maternal-infant dyad until infant discharge may mitigate the potential negative impact of maternal incarceration on the care of infants with NAS.
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Affiliation(s)
- Matthew J Drago
- Department of Pediatrics, Section of Neonatology, Yale School of Medicine, New Haven, CT, USA. .,Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, 1176 Fifth Avenue, 3rd Floor, New York, NY, 10029, USA.
| | - Veronika Shabanova
- Department of Pediatrics, Section of General Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Daniela Hochreiter
- Department of Pediatrics, Section of Hospitalist Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Matthew Grossman
- Department of Pediatrics, Section of Hospitalist Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Mark Mercurio
- Department of Pediatrics, Section of Neonatology, Yale School of Medicine, New Haven, CT, USA
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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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Hutchinson-Colas J, AlShowaikh K. Pregnant Behind Bars. Am J Public Health 2022; 112:14-16. [PMID: 34936394 PMCID: PMC8713614 DOI: 10.2105/ajph.2021.306580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Juana Hutchinson-Colas
- Juana Hutchinson-Colas and Khadija AlShowaikh are with the Women's Health Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Khadija AlShowaikh
- Juana Hutchinson-Colas and Khadija AlShowaikh are with the Women's Health Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
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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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Mehta LS, Sharma G, Creanga AA, Hameed AB, Hollier LM, Johnson JC, Leffert L, McCullough LD, Mujahid MS, Watson K, White CJ. Call to Action: Maternal Health and Saving Mothers: A Policy Statement From the American Heart Association. Circulation 2021; 144:e251-e269. [PMID: 34493059 DOI: 10.1161/cir.0000000000001000] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The United States has the highest maternal mortality rates among developed countries, and cardiovascular disease is the leading cause. Therefore, the American Heart Association has a unique role in advocating for efforts to improve maternal health and to enhance access to and delivery of care before, during, and after pregnancy. Several initiatives have shaped the time course of major milestones in advancing maternal and reproductive health equity in the United States. There have been significant strides in improving the timeliness of data reporting in maternal mortality surveillance and epidemiological programs in maternal and child health, yet more policy reforms are necessary. To make a sustainable and systemic impact on maternal health, further efforts are necessary at the societal, institutional, stakeholder, and regulatory levels to address the racial and ethnic disparities in maternal health, to effectively reduce inequities in care, and to mitigate maternal morbidity and mortality. In alignment with American Heart Association's mission "to be a relentless force for longer, healthier lives," this policy statement outlines the inequities that influence disparities in maternal outcomes and current policy approaches to improving maternal health and suggests additional potentially impactful actions to improve maternal outcomes and ultimately save mothers' lives.
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The Process of Becoming a Mother in French Prison Nurseries: A Qualitative Study. Matern Child Health J 2021; 26:367-380. [PMID: 34618310 DOI: 10.1007/s10995-021-03254-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Many variables can influence the process of motherhood, including environmental precarity and personal adversity. One about which little is known is the impact of incarceration on women during or after pregnancy. In France, pregnant women or those with children up to 18 months old can be incarcerated with their child in specific units called nurseries. We sought to explore incarcerated women's experience of motherhood in prison environments and its potential consequences on the construction of their identity as mothers. METHOD We conducted semi-structured interviews to collect the experience of the process of motherhood among 25 mothers and 5 pregnant women in 13 different prison nurseries in France and used interpretative phenomenological analysis to explore the data. RESULTS Four different themes emerged: prison conflates their status as inmates and as mothers; it limits their freedom as mothers; it disrupts their family structure; and motherhood may help distinguish them from other inmates. CONCLUSION Incarceration of pregnant women or young mothers in prison nurseries might disrupt the process involved in becoming mothers, causing their identities as prisoners to englobe their identities as mothers and resulting in inappropriate parenting support by prison staff. A professional specialized in peripartum issues should help each woman disentangle her identity as inmate and mother and enable her placement at the facility best adapted to her individual needs as a mother. In any case, if prison must continue to be possible, it must always be a last alternative for women with young children.
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Sufrin CB, Knittel A. Health care and social justice implications of incarceration for pregnant people who use drugs. Int Rev Psychiatry 2021; 33:557-571. [PMID: 34098837 PMCID: PMC9251864 DOI: 10.1080/09540261.2021.1887097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The experiences of and care for pregnant, incarcerated people with substance use disorders represent a convergence of numerous clinical, historical, racialized, legal, and gendered factors. Understanding how these forces shape how they became enmeshed in the criminal legal system as well as the context of the care they do or do not receive while in custody is essential for promoting equitable maternal health care. In this review, we describe the prevalence of SUD among pregnant people behind bars, the health care landscape of incarceration, access to treatment for opioid use disorder for incarcerated pregnant and postpartum people, and nuances of providing such treatment in an inherently coercive setting. Throughout, we highlight the ways that the child welfare system and mass incarceration in the U.S. have had a unique and discriminatory impact on pregnant and parenting people, and have done so in distinctly racialized ways. Situating the clinical care of incarcerated pregnant people who use drugs in this context sheds light on fundamental social justice and health care intersections.
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Affiliation(s)
- Carolyn B. Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrea Knittel
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA
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Asiodu IV, Beal L, Sufrin C. Breastfeeding in Incarcerated Settings in the United States: A National Survey of Frequency and Policies. Breastfeed Med 2021; 16:710-716. [PMID: 33835854 PMCID: PMC8563451 DOI: 10.1089/bfm.2020.0410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: To assess the existence of prison and jail policies and practices that allow incarcerated women to breastfeed while in custody, and prevalence of women in custody who pumped human milk for their infants. Methods: We surveyed 22 state prison systems and 6 county jails from 2016 to 2017 about policies related to breastfeeding and other programs for pregnant and parenting women in custody. In addition, 11 prisons and 5 jails reported 6 months of monthly, prospective data on the number of women pumping human milk, as well as information on placement of infants born to women in custody. Results: Eleven prisons and five jails had policies that supported the practice of expressed milk, either through pumping or breastfeeding. Over 6 months at these sites that allowed lactation, there were 207 women who gave birth in the prisons and an average of 8 women/month who pumped human milk; at the jails, there were 67 women who gave birth and an average of 6 women/month who pumped human milk. Most infants born to women in custody were placed in the care of a family member. Conclusions: Breastfeeding and the provision of human milk are critical public health issues. Our data show inconsistent implementation of policies and practices supportive of breastfeeding in prisons and jails. However, there are institutions in the United States that are supportive of incarcerated women's breastfeeding and lactation needs. Further research is needed to identify the barriers and facilitators associated with implementing supportive breastfeeding policies and practices in the carceral system.
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Affiliation(s)
- Ifeyinwa V Asiodu
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Lauren Beal
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carolyn Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Suarez A. "I Wish I Could Hold Your Hand": Inconsistent Interactions Between Pregnant Women and Prison Officers. JOURNAL OF CORRECTIONAL HEALTH CARE 2021; 27:23-29. [PMID: 34232769 DOI: 10.1089/jchc.19.06.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Much of the literature on pregnant women who are incarcerated focuses on perinatal outcomes for infants, access to and quality of medical care, mental health concerns, prison nurseries, and shackling. This research adds a unique contribution by exploring women's interactions with prison officers during pregnancy, labor, and birth. Based on in-depth interviews with 18 pregnant or postpartum women incarcerated at a maximum-security state prison, the findings suggest inconsistent interactions between women and prison officers. Officers served as gatekeepers and/or advocates. Women reported dehumanizing behaviors, yet they also experienced compassion, especially in the delivery room, though limited by prison regulations. The findings have implications for training in trauma-informed care, clear expectations for prison officers, and consideration of doula programs.
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Affiliation(s)
- Alicia Suarez
- Department of Sociology and Anthropology, DePauw University, Greencastle, Indiana, USA
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