Abstract:There is growing evidence to show increased mental ill health in women compulsorily separated from their babies at birth (Cantwell et al., MBRRACE‐UK, 2018:56). For imprisoned women, the risk of self‐harm and suicide may be exacerbated. This article draws on in‐depth interviews with a sample of 28 imprisoned pregnant women/new mothers, 10 prison staff and observations to discuss the experience of separation from or anticipation of separation of women from their babies. Oakley (Signs, 4:607–631, 1980) reflected… Show more
“…Intertwined with feelings of acute distress at the separation, the interview data also show how the failure to acknowledge the mothers' grief served as a further complicating factor. As several researchers have found (Abbott et al, 2021; Broadhurst & Mason, 2020; Brodzinsky & Smith, 2014; Geddes, 2021; Memarnia et al, 2015), the literature on disenfranchised grief (Corr, 1999; Doka, 1999) provides a valuable lens through which the experiences of mothers whose infants have been removed can be better understood. Disenfranchised grief can be defined as the grief experienced by those who incur a loss that is not, or cannot be, openly acknowledged, publicly mourned or socially supported.…”
Whatever the circumstances, the separation of infants from their mothers at birth is a traumatic experience for all concerned. The paper reports on a study designed to improve practice in this highly sensitive area. An analysis of data collected through semi‐structured interviews with 38 mothers who had experienced removal at birth identified four common themes: isolation and unacknowledged support needs; shame, stigma and the failure of others to acknowledge their maternal identity; acute trauma, immediate downturn and disenfranchised grief following infant removal; and strategies to mitigate their pain and grief. These last themes included the use of artefacts both as transitional objects to help mothers come to terms with the permanent loss of a baby, and as a means of keeping maternal identity alive and connecting with an infant who might eventually return home. In response to these findings, and in collaboration with a group of women with lived experience, HOPE boxes were designed to ameliorate the trauma and psychological burden borne by women in this situation. The contents of the boxes have been chosen to reflect the changing experiences of the women's journeys but also the range of possible potential outcomes. The intervention has considerable potential to minimise the trauma of this painful experience.
“…Intertwined with feelings of acute distress at the separation, the interview data also show how the failure to acknowledge the mothers' grief served as a further complicating factor. As several researchers have found (Abbott et al, 2021; Broadhurst & Mason, 2020; Brodzinsky & Smith, 2014; Geddes, 2021; Memarnia et al, 2015), the literature on disenfranchised grief (Corr, 1999; Doka, 1999) provides a valuable lens through which the experiences of mothers whose infants have been removed can be better understood. Disenfranchised grief can be defined as the grief experienced by those who incur a loss that is not, or cannot be, openly acknowledged, publicly mourned or socially supported.…”
Whatever the circumstances, the separation of infants from their mothers at birth is a traumatic experience for all concerned. The paper reports on a study designed to improve practice in this highly sensitive area. An analysis of data collected through semi‐structured interviews with 38 mothers who had experienced removal at birth identified four common themes: isolation and unacknowledged support needs; shame, stigma and the failure of others to acknowledge their maternal identity; acute trauma, immediate downturn and disenfranchised grief following infant removal; and strategies to mitigate their pain and grief. These last themes included the use of artefacts both as transitional objects to help mothers come to terms with the permanent loss of a baby, and as a means of keeping maternal identity alive and connecting with an infant who might eventually return home. In response to these findings, and in collaboration with a group of women with lived experience, HOPE boxes were designed to ameliorate the trauma and psychological burden borne by women in this situation. The contents of the boxes have been chosen to reflect the changing experiences of the women's journeys but also the range of possible potential outcomes. The intervention has considerable potential to minimise the trauma of this painful experience.
“…The objectives of this paper are to examine pregnant women prisoners' and custody staffs' experiences and perceptions of midwifery care in English prisons. Elsewhere, we have discussed the stigma faced by pregnant women in prison 13 and the experience of loss of those separated from their babies at birth. 14 In response to our research findings, we offer practice recommendations designed to improve care and outcomes for incarcerated pregnant women and their babies.…”
Section: Health Outcomes For Pregnant Prisonersmentioning
confidence: 99%
“…Those who have not been allocated a place in an MBU return to the general prison population without their babies. 13 Midwives, based in community teams, are the lead care providers for all perinatal women in the UK. Scans and specialist referrals are typically facilitated in the hospital closest to the prison, and women are usually accompanied to appointments by two prison officers.…”
Section: English Prisonsmentioning
confidence: 99%
“…Following birth, women who have been allocated a place in a prison MBU return to the MBU with their babies. Those who have not been allocated a place in an MBU return to the general prison population without their babies 13 …”
Background: In the United Kingdom (UK), all prisoners must receive healthcare equivalent to that available in the community. However, evidence suggests that equality in healthcare provision for perinatal women in UK prisons is not always achieved. The aim of this research was to examine pregnant women prisoners' and custody staffs' experiences and perceptions of midwifery care in English prisons.
Methods:A qualitative approach based on institutional ethnography was used to research women's experiences in three English prisons over a period of 10 months. In total, 28 women participated in audio-recorded, semi-structured interviews. Ten staff members were interviewed, including six prison service staff and four health care personnel. Ten months of prison fieldwork enabled observations of everyday prison life. NVivo was used for data organization with an inductive thematic analysis method.Results: Women's experiences included: disempowerment due to limited choice; fear of birthing alone; and a lack of information about rights, with a sense of not receiving entitlements. Some women reported favorably on the continuity of midwifery care provided. There was confusion around the statutory role of UK midwifery.Discussion: Experiences of perinatal prisoners contrast starkly with best midwifery practice-women are unable to choose their care provider, their birth companions, or their place of birth. In addition, a reliance upon "good behavior" in return for appropriate treatment may be detrimental to the health, safety, and well-being of the pregnant woman and her unborn baby.
Conclusion:Prison is an adverse environment for a pregnant woman. This study provides key insights into imprisoned women's experiences of midwifery care in England and shows that midwives play an essential role in ensuring that perinatal prisoners receive safe, high-quality, respectful care.
“…As already noted, research focused on pregnancy, postpartum care and MBUs dominates the literature on imprisoned women's reproductive health (Abbott, 2015(Abbott, , 2018(Abbott, , 2021Abbott et al, 2020Abbott et al, , 2021Baldwin, 2021;Birth Companions, 2016;Corston, 2007;Elton, 1988;Gardiner et al, 2016;Ginn, 2013;Gullberg, 2013;North, n.d.;Plugge et al, 2006;RCM, 2008;Sikand, 2017). Accurate numbers of pregnant women held in UK prisons are not recorded, although it is estimated that 6%-7% of the female prison population are at varying stages of pregnancy at any one time, and that around 100 babies are born in prison each year (Abbott, 2018;Birth Companions, 2016;Prison Reform Trust, 2017).…”
Despite academic, policy and charity commissioned research giving considerable attention to the health of imprisoned women, significantly less research has considered the reproductive health and rights of this group. This shortfall is noteworthy since women who are imprisoned are often in very vulnerable positions, and so their ongoing healthcare in relation to gynaecology, obstetrics and sexual health and wellbeing, as well as access to such rights, should be a priority. These issues are exacerbated for the high number of women who are repeatedly imprisoned for short sentences. Presenting findings of a rapid evidence assessment, this article highlights the lack of attention to this aspect of imprisoned women’s health and rights, using the limited information available. The article argues that suitable reproductive healthcare needs to be seen as an essential aspect of women’s rights. Furthermore, the current nature of imprisonment in England and Wales results in multiple and frequent rights violations.
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