Family planning services for incarcerated women: models for filling an unmet need

• Published date: 13 March 2017
• Pages: 10-18
• Date: 13 March 2017
• DOI: https://doi.org/10.1108/IJPH-07-2016-0025
• Author: Carolyn Sufrin,Sara Baird,Jennifer Clarke,Elizabeth Feldman
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Family planning services for incarcerated

women: models for filling an unmet need

Carolyn Sufrin, Sara Baird, Jennifer Clarke and Elizabeth Feldman

Abstract

Purpose –Incarcerated women around the globe are predominantly of reproductive age. Most of these

women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release.

Yet few of these women are on a regular method of contraception. Providing contraceptive services for

women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy

briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy

implications for expanding services. The paper aims to discuss these issues.

Design/methodology/approach –The authors describe four model programs in the USA with established

contraceptive services on site, highlighting practical steps other facilities can implement.

Findings –Correctional facilities health administrators, providers, advocates, and legislators should advance

policies which should counsel women on family planning and should make a range of contraceptive methods

available before release, while remaining sensitive to the potential pressure thesewomen may feel to use birth

control in this unique environment.

Practical implications –Family planning services for incarcerated women benefits individuals, facilities, and

the community.

Social implications –Policies which enable correctional facilities to provide comprehensive family planning

to incarcerated women –including reproductive life goals counseling and contraceptive method provision –

promote equity in access to critical reproductive health servicesand also provide broad scale population level

benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of

women who often have limited access to such services.

Originality/value –This policy briefing highlights an area of health care in prisons and jails which gets little

attention in research and in policy circles: family planning services for incarcerated women. In addition to

reviewing the importance of such services for this population, the authors also highlightmodel family planning

programs in correctional facilities. These provide actionable insights for other administrators and providers.

Keywords Women prisoners, Correctional health care, Contraception, Family planning,

Long-acting reversible contraception, Reproductive health

Paper type Research paper

Introduction

Worldwide, over 700,000 women and girls are behind bars (Walmsley, 2015). The majority of these

women are between the ages of 18 and 44 (Carson, 2014), and therefore of reproductive age. In the

USA, which houses 30 percent of the world’s imprisoned women (Walmsley, 2015), two-thirds of

incarcerated women are mothers (Glaze and Maruschak, 2010), with a similar trend worldwide

(Glaze and Maruschak, 2010; World Health Organization, 2009). Research from US prisons and jails

has documented that incarcerated women are at high risk of unintended pregnancy before and afte r

incarceration: up to 84 percent have experienced a prior unintended pregnancy; 29 percent entering

jails have had unprotected sex within five days of arrest; 77-84 percent planned to be sexually active

within six months of release; 72 percent were not using a regular method of contraception before

incarceration; and only 9-22 percent had a positive pregnancy attitude (Clarke, Hebert, Rosengard,

Rose, DaSilva, and Stein, 2006; Clarke, Rosengard, Rose, Hebert, Phipps, and Stein, 2006;

Larochelle et al., 2012; Oswalt et al., 2010; Sufrin et al., 2010). While women’s pregnancy desires

fluctuate depending on life circumstances, 62 percent of jailed women in one studysaid they did not

Received 14 July 2016

Revised 8 December 2016

Accepted 13 December 2016

Carolyn Sufrin is an Assistant

Professor at the Department of

Gynecology and Obstetrics,

Johns Hopkins University

School of Medicine, Baltimore,

Maryland, USA.

Sara Baird is a Family Physician

at New York City Health and

Hospitals, Correctional Health

Services, New York City,

New York, USA.

Jennifer Clarke is a Medical

Director at Rhode Island

Department of Corrections,

Cranston, Rhode Island, USA.

Elizabeth Feldman is a Family

Physician and Divisional Chair

for Clinical Operations at the

Department of Correctional

Health, Cermak Health

Services of Cook County

Health and Hospitals System,

Chicago, Illinois, USA.

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VOL. 13 NO. 1 2017, pp. 10-18, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-07-2016-0025