Contraceptive needs among newly incarcerated women in a county jail in the United States

• Pages: 244-253
• DOI: https://doi.org/10.1108/IJPH-08-2017-0036
• Published date: 17 December 2018
• Date: 17 December 2018
• Author: Rachel Cannon,Jessica M. Madrigal,Elizabeth Feldman,Kelly Stempinski-Metoyer,Lillian Holloway,Ashlesha Patel
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Contraceptive needs among newly

incarcerated women in a county jail

in the United States

Rachel Cannon, Jessica M. Madrigal, Elizabeth Feldman, Kelly Stempinski-Metoyer,

Lillian Holloway and Ashlesha Patel

Abstract

Purpose –The purpose of this paper is to examine the risk of unintended pregnancy among women during

Cook County Jail intake by assessing basic contraceptive history, theneed for emergency contraception (EC)

at intake, and contraception at release.

Design/methodology/approach –This is a cross-sectional study of women 18–50 years old at Cook

County Jail in Chicago, Illinois from June 2011 through August 2012. The authors administered the survey at

the time of intake on 33 convenient evenings. Surveys consisted of multiple-choice close-ended questions

administered via interview. Topics included contraceptive use, pregnancy risk and pregnancy desire. The

authors computed frequencies to describe the distribution of question responses and used logistic

regression modeling to identify factors significantly related to the use of contraception at intake and to the

acceptance of contraception at release.

Findings –Overall, 194 women participated. Excluding women not at risk for pregnancy (4.6 percent

currently pregnant, 17.5 percent surgically sterilized/postmenopausal and 4.6 percent using long-acting

reversible contraceptives), 73.2 percent of women were at risk for pregnancy (n ¼142) and, therefore, had a

potential need for contraception. Among these women at risk for unintended pregnancy, 68 (47.9 percent)

had unprotected intercourse within five days prior to survey administration. When asked about EC, most

women (81.4 percent) would be interested if available. Additionally, 141 (72.7 percent) of women would be

interested in contraceptive supplies if provided free at release.

Originality/value –Newly incarcerated women are at high risk for unintended pregnancy. Knowledge about

EC and ability to access birth control services are both significantly limited. These conclusions support

providing an intake screening in jails to identify women at risk for unintended pregnancy.

Keywords Women’s health, Health in prison, Public health, Women prisoners, Correctional health care,

Sexual health

Paper type Research paper

Introduction

Women represent the fastest growing population in the US criminal justice system. The

female jail population in the USA increased 18.1 percent between midyear 2010 and 2014

(Minton and Zeng, 2015). Of this female population, 74 percent are between the ages of 18

and 44 (Greenfeld and Snell, 1999; Carson, 2014). Incarcerated women are medically and

otherwise marginalized; this includes reduced access and utilization of family planning

services (Covington, 2007; Ramaswamy et al., 2015). One study of US correctional health

providers indicated that only 38 percent of all correctional facilities provided birth control

services (Sufrin et al., 2009). Many US correctional facilities do not have standardized

polices regarding continuation or initiation of birth control services and face challenges such

as cost, system-related challenges to implementation, lack of national policy-level emphasis

on contraception and overall disregard for comprehensive women’s health care services

(Sufrin et al., 2017).

Received 15 August 2017

Revised 19 December 2017

2 February 2018

Accepted 15 February 2018

(The authors affiliations can be

found at the end of this article.)

PAGE244

j

INTERNATIONALJOURNAL OF PRISONER HEALTH

j

VOL. 14 NO. 4 2018, pp. 244-253, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-08-2017-0036