Pregnancy in incarcerated women: need for national legislation to standardize care

Abstract

Objective This review examined prenatal care provided to incarcerated women to identify areas where improvement is needed, and examined current legislative gaps such that they can be addressed to ensure uniform templates of care be instituted at women’s prisons. Content Data were compiled from 2000-2021 citations in PubMed and Google Scholar using the keywords: prison AND prenatal care AND pregnancy. Summary and Outlook Although the right to health care of inmates is protected under the Eight Amendment to the United States Constitution, the literature suggests that prenatal care of incarcerated individuals is variable and would benefit from uniform federal standards. Inconsistency in reporting requirements has created a scarcity of data for this population, making standardization of care difficult. Although incarceration may result in improved access to care that women may not have had in their community, issues of shackling, inadequate prenatal diet, lack of access to comprehensive mental health management, and poor availability of opioid use disorder (OUD) management such as Medication Assisted Therapy (MAT) amd Opioid Treatment Programs (OTP), history of post-traumatic stress disorder (PTSD) are just a few areas that must be focused on in prenatal care. After birth, mother-baby units (MBU) to enhance maternal-fetal bonding also should be a prison standard. In addition to implementing templates of care specifically directed to this subgroup of women, standardized state and federal legislation are recommended to ensure that uniform standards of prenatal care are enforced and also to encourage the reporting of data regarding pregnancy and neonatal outcomes in correctional facilities.

How are the Dietary Needs of Pregnant Incarcerated Women Being Met? A Scoping Review and Thematic Analysis

“…Of the sixteen included papers, six were from the United States of America (USA) (Ferszt & Clarke, 2012 ; Hackett, 2017 ; Kelsey et al, 2017 ; Kotlar et al, 2015 ; Kramer et al, 2023 ; Nair et al, 2021 ), four from the United Kingdom (UK) (Abbott, 2018 ; Abbott et al, 2023 ; Albertson et al, 2012 ; Bard et al, 2016 ), three from Iran (Alirezaei & Roudsari, 2020 , 2022a , 2022b ), two from Canada (Ifeonu et al, 2022 ; Kirubarajan et al, 2022 ), and one from Australia (Baldwin et al, 2020a ). Five of the included papers were literature reviews (Alirezaei & Roudsari, 2022a ; Baldwin et al, 2020a ; Bard et al, 2016 ; Kirubarajan et al, 2022 ; Nair et al, 2021 ), one a mixed methods study (Ferszt & Clarke, 2012 ), one a quantitative study (Kelsey et al, 2017 ), five qualitative studies (Abbott, 2018 ; Abbott et al, 2023 ; Alirezaei & Roudsari, 2022b ; Hackett, 2017 ; Ifeonu et al, 2022 ), two policy analyses (Alirezaei & Roudsari, 2020 ; Kramer et al, 2023 ), one a multi-component consultation paper (Albertson et al, 2012 ), and one a report (Kotlar et al, 2015 ).…”

“…Some facilities had policies on pregnant women’s additional calorific needs (pregnancy specific diet) and the types of foods that are to be provided. These included yoghurt, cheese, vegetables, sandwiches, and peanut butter Some facilities provide additional milk and fresh fruit for pregnant women Nair et al ( 2021 ) USA To examine prenatal care provided to incarcerated women identifying areas where improvement is required. To examine current legislative gaps to ensure uniform templates of care are provided at women’s prisons Not described Literature review No federal regulations set a national standard for the nutrition of pregnant inmates.…”

Incarceration status at buprenorphine initiation and OUD treatment outcomes during pregnancy

“…Despite the recommendation that MOUD be provided to all patients with OUD regardless of incarceration status, actual 10.3389/fpsyt.2023.1157611 MOUD provision varies widely between incarceration facilities (15). Legislation is greatly needed to standardize this care (5). Interruptions in Medicaid coverage between incarceration and release likely contribute to this important public health issue (6).…”

“…SAMHSA recommends MOUD be offered to all people with OUD during incarceration ( 4 ). However, several barriers to MOUD provision during incarceration and its transitions pre/post-release exist, such as inconsistencies across states in insurance coverage (e.g., Medicaid not accessible during incarceration) and levels of access to medical specialty services across institutions (e.g., carceral systems are fiscally responsible for medical care) ( 5 , 6 ).…”

Public Health and Prisons: Priorities in the Age of Mass Incarceration

“…The Federal Bureau of Prisons ended routine shackling of pregnant people in 2009; however, this practice persists in several states ( 24 ), even though it is considered a human rights violation internationally ( 59 ). Moreover, the United States is one of only a few countries that routinely separates mothers from newborns, even though mother–baby units lower recidivism rates and promote healthy mother–child bonds and parental education ( 104 ). Ensuring that evidence-based, high-quality, dignified perinatal care is accessible to incarcerated women is critical to the promotion of maternal, child, and community health.…”