Depressive Symptoms among Pregnant and Postpartum Women in Prison

Mariann A. Howland, Bethany Kotlar, Laurel Davis, Rebecca J. Shlafer

Research output: Contribution to journalArticlepeer-review


Introduction: Women in prison experience high rates of mental and physical health problems, and pregnant and postpartum women in prison may be particularly vulnerable. Very few studies have examined depressive symptoms among women who are pregnant and give birth in prison. We assessed depressive symptoms longitudinally from pregnancy into the postpartum period in a sample of 58 women who gave birth in prison. We also considered whether incarceration-related factors (length of time incarcerated while pregnant, remaining length of sentence to serve after birth) were associated with depressive symptoms. Methods: Data were collected as part of an ongoing evaluation of a prison-based pregnancy and parenting support program at one women's state prison. At prenatal and postpartum visits with their doula, women completed the Patient Health Questionnaire-9 (PHQ-9), a measure of depressive symptom severity. Results: More than one-third of our sample of women who were incarcerated and gave birth in custody met criteria for moderate to severe depression on the PHQ-9 during pregnancy or the postpartum period. Women who faced longer periods of incarceration following birth and separation from their newborns reported higher levels of postpartum depressive symptoms. Discussion: Findings have implications for practice and policy aimed at supporting the mental health needs of women who are pregnant in prison, particularly those women who give birth in custody and are separated from their newborns.

Original languageEnglish (US)
Pages (from-to)494-502
Number of pages9
JournalJournal of Midwifery and Women's Health
Issue number4
StatePublished - Jul 1 2021

Bibliographical note

Funding Information:
This research was supported with funding from the University of Minnesota Medical School Program in Health Disparities Research (R.J.S.), the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114 (R.J.S.), and a National Science Foundation Graduate Research Fellowship (MAH). The content is solely the responsibility of the authors and does not represent the official views of these funding agencies. The authors wish to thank the women who participated in the study, the doulas and program staff for their efforts facilitating data collection, and the numerous students (especially Maggie Hall and Elizabeth Shaver) who assisted with data entry and management.

Publisher Copyright:
© 2021 by the American College of Nurse-Midwives


  • depression
  • doulas
  • incarceration
  • postpartum
  • pregnancy
  • prison

PubMed: MeSH publication types

  • Journal Article


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