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Article title

“We Were on Lockdown for Pretty Much My Entire Pregnancy”: A Qualitative Study of Pregnancy Care in Prisons and Jails During the COVID-19 Pandemic.

Summary

The COVID-19 pandemic disproportionately impacted incarcerated people, and pregnant and postpartum people were no exception.

Abstract

It has been demonstrated that the COVID-19 pandemic negatively impacted incarcerated people in myriad ways: through conditions of confinement resulting in increased exposure to COVID-19, restrictive prison and jail policies intended to decrease the spread of COVID-19, and more. However, there has been little attention to the impact of the COVID-19 pandemic on the care and treatment of pregnant and postpartum individuals in carceral settings, given their unique needs. We conducted interviews with 10 formerly incarcerated women who were incarcerated and were pregnant or postpartum between March 2020 and January 2022. Each transcript was coded by two independent coders. Our analysis revealed factors specific to the COVID-19 pandemic that exacerbated the harm faced by incarcerated pregnant and postpartum people, as well as factors that mitigated these negative impacts. We conclude with a series of policy and practice recommendations that carceral facilities may implement to improve the health and wellbeing of incarcerated pregnant people and their babies.

Main research questions 

1. What were the experiences of pregnant and postpartum women who were incarcerated during the COVID-19 pandemic? 
2. What unique challenges did pregnant and postpartum women who were incarcerated during the pandemic face? 
3. What factors might have mitigated these challenges?

What the research builds on

1. Studies have consistently shown that as the number of incarcerated women—and incarcerated mothers, in particular – has risen, prisons have struggled to meet the unique needs of this population. 
2. Despite a constitutional requirement for institutions of incarceration to provide healthcare, there are no mandatory standards for pregnancy-related care in prisons and jails. 
3. Existing research demonstrates that pregnant and postpartum people often face numerous barriers to their health while incarcerated, including inadequate prenatal diets, use of restraints during labor and delivery, lack of labor and delivery supports (e.g., family members, doulas), separation from newborns, inadequate supports related to lactation, and other distressing conditions.

How the research adds to the discussion?

Our results uniquely highlight factors that mitigated some of the negative and violent experiences of being pregnant and incarcerated during COVID. Mitigating factors included: 

• support they received from external pregnancy or doula organizations
• support they received from incarcerated peers
• self-advocacy to improve their living conditions or express bodily autonomy

Novel methodology

Each phase of this work was guided, in part, by a national Community Research Council (CRC) made up of nine formerly incarcerated people who gave birth or were postpartum while incarcerated.

Implications for policy

Two of seven recommendations we provide are decarcertation and continuing visitations and programming. Our findings highlight that prison and jail systems pose a risk to pregnant and postpartum people; therefore, we recommend identifying and pursuing opportunities for decarceration wherever possible to promote their health and wellbeing, through and beyond the COVID-19 pandemic. When decarceration opportunities are pursued, we recommend that they be accompanied by comprehensive, wrap-around re-entry supports (e.g., access to safe housing, healthcare, parenting skills and support). Similar to Dallaire et al. (2021) and Muñiz et al. (2024), interviewees described how the prisons or jails where they were incarcerated at various times halted visiting, suspended phone calls, and cancelled parenting programs. It is well established that visiting has positive impacts for incarcerated people, including improved maternal mental health, strengthened parent-child bonds, and reduced recidivism, suggesting that even in times of crisis like the pandemic, Departments of Corrections need to ensure access to forms of visitation and programming for incarcerated people.

Funding

National Institute of Child Health and Human Development of the National Institutes of Health, 1R01HD103634-01