The outcomes of pregnancy among imprisoned women: a systematic review

Abstract

Objective To investigate the association between maternal imprisonment during pregnancy and perinatal outcomes. Design Systematic review and meta-analysis.Setting Prisons in developed countries.Population Imprisoned pregnant women.Methods Two reviewers extracted the data independently according to a fixed protocol. Studies were included if they were cohort or case -control studies with women identified as being imprisoned at any point during pregnancy and if they included a comparison group of women who had not been imprisoned. Case series without a comparison group of women who were not imprisoned were excluded, as were studies that did not include information on the pre-specified outcomes. Main outcome measures Perinatal or infant death, stillbirth, preterm delivery, low birthweight, fetal anomalies and use of breast milk substitutes. Results Of 28 relevant papers, 10 met the inclusion criteria, involving 1960 imprisoned pregnant women and 10,858 controls. There were significant differences in results between studies comparing imprisoned women with population controls and those making comparisons with disadvantaged control women. Imprisoned women are more likely to deliver prematurely and have a low birthweight baby than population control women. However, when compared with a similarly disadvantaged group, imprisoned woman are less likely to have a stillbirth or low birthweight baby, suggesting imprisonment may have a beneficial effect. Conclusions Particular perinatal outcomes appear to be improved in imprisoned women compared with similarly disadvantaged women. Imprisonment of the mother has a beneficial effect on the birthweight of her baby.

Incarceration, Maternal Hardship, and Perinatal Health Behaviors

“…Studies of the relatively small number of births during incarceration have yielded contradictory conclusions about whether incarceration during pregnancy improves birth outcomes (56-58). Women who are incarcerated have high rates of substance dependence, STIs, and other health problems that can complicate neonatal health (59-62).…”

The impact of imprisonment on health: what do women prisoners say?

“…Condon et al similarly reported that prisoners with the lowest standard of self-care outside prison can experience health improvement 42. Other studies have identified beneficial health outcomes of imprisonment, including during pregnancy 43444546. Indeed, commentators have long voiced their suspicions that sentencing authorities order custody in some cases “for the woman’s own good” in the absence of appropriate health and social care in the community 1647.…”

Pregnancy, prison and perinatal outcomes in New South Wales, Australia: a retrospective cohort study using linked health data

“…Findings are equivocal, but a systematic review concluded that imprisoned women were more likely to experience poorer maternity outcomes than women in the general population, yet less likely to experience poorer outcomes than other disadvantaged women [13]. Studies have suggested that imprisonment provides safety from abusive relationships, better nutrition, improved access to health care, and cessation of drug and alcohol use [8-12].…”