Maternal and neonatal outcomes among incarcerated women who gave birth in custody

Rebecca Shlafer, Jennifer B. Saunders, Christy M. Boraas, Katy B. Kozhimannil, Narayana Mazumder, Rebecca Freese

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In the United States, the population of incarcerated women has increased by more than 600% since the 1980s. With this rise, correctional facilities have faced new challenges meeting the health care needs of women, especially those who are pregnant. This retrospective cohort study sought to describe five indicators of maternal and neonatal health among women who gave birth in custody, and to compare outcomes among incarcerated women who did and did not receive enhanced pregnancy support. Methods: We used deidentified electronic health records (EHRs) to examine maternal and neonatal birth outcomes (ie, mode of birth, low birthweight, preterm birth, APGAR score, NICU admission) among women who gave birth in custody. Regression models examined differences in outcomes between women who received enhanced pregnancy support—group prenatal education and one-on-one doula visits—and a historical control group of women who received standard prenatal care. Results: Adverse maternal and neonatal birth outcomes in this sample were rare. No differences in outcomes were found between incarcerated women who received enhanced pregnancy support and the historical control group. Conclusions: Despite evidence for the benefits of enhanced pregnancy support in the general population, this study did not find differences in outcomes between incarcerated women who did and did not receive support. Integrated data from prison and hospital records are innovative, but effect measurement is limited by sample size. Future research should include primary data collection on maternal, neonatal, and dyadic outcomes longitudinally and across prisons.

Original languageEnglish (US)
Pages (from-to)122-131
Number of pages10
JournalBirth
Volume48
Issue number1
DOIs
StatePublished - Mar 2021

Bibliographical note

Funding Information:
This project was supported by internal funds from the Department of Pediatrics at the University of Minnesota, by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (NIH) under Award Number R03HD093961, and by NIH's National Center for Advancing Translational Sciences under Award Number UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH. The authors wish to thank Erica Gerrity, Rae Baker, and the doulas from the Minnesota Prison Doula Project. The authors also wish to thank Mr Steve Mongin and Dr John Connett for their early contributions to the statistical design and analysis.

Funding Information:
This project was supported by internal funds from the Department of Pediatrics at the University of Minnesota, by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (NIH) under Award Number R03HD093961, and by NIH's National Center for Advancing Translational Sciences under Award Number UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH. The authors wish to thank Erica Gerrity, Rae Baker, and the doulas from the Minnesota Prison Doula Project. The authors also wish to thank Mr Steve Mongin and Dr John Connett for their early contributions to the statistical design and analysis.

Publisher Copyright:
© 2020 The Authors. Birth published by Wiley Periodicals LLC

Keywords

  • birth outcomes
  • doulas
  • pregnancy
  • prison

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