Professional Documents
Culture Documents
Assignment 3
Assignment 3
Assignment 3
1630737
University of Washington
SPH 380, AA
Among incarcerated women, 5 – 10% are pregnant,1 with 90% giving birth while in prison.2 This
subgroup is at increased risk for poor prenatal care, stress, anxiety, major depression and substance
abuse, which in turn increase the chances for preterm delivery, miscarriage, low birth weight, and other
fatal conditions to the mother and baby.1-3 The first 1000 days of an infant’s development are critical for
the child’s brain and immune system, with nutrition levels and other risk factors determining whether
they will be predisposed to various chronic, non-communicable diseases throughout their lifetime.4
These 1000 days begin with pregnancy; the treatment and well-being of an incarcerated mother is
We must start by providing proper nutrition to pregnant inmates as prenatal care in prison is
often limited or “absent”.1,2 Additionally, to counteract preexisting risk factors, correctional facilities
must have mandatory pregnancy tests, HIV and other STD tests, and substance abuse screening upon
entry to ensure all pregnant inmates are identified and preexisting risk factors for the fetus are
addressed. After these screenings, treatment and withdrawal programs must be present to remove
these risk factors to the fetus’s development, if the mother decides to carry to term. As of now only
37.7% of facilities do pregnancy tests upon entry, and 68% provide limited infectious disease screening,
however these numbers are cited as optimistic estimates.5 Forty-eight states do not offer HIV screening
for pregnant women, highlighting another significant public health issue as the rate of mother-to-child
Additionally, shackling (chaining of the waist, hands, and feet) during the third trimester of
pregnancy should be relaxed, as the mother’s balance is already altered, with restraints further
increasing her susceptibility to falling and seriously harming the baby.1 Furthermore, these restraints
prevent timely and adequate examination during labor, which can harm both the mother and baby.1
Postpartum, most mothers are only allowed 24 hours with their infant, after which the child is
given to family or put into foster care. This early separation predisposes these children to mental and
behavioral ailments such as low self-esteem and poor coping mechanisms.7 However, if placed in foster
care for a prolonged period, the rate of depression increases by a factor of seven, behavioral problems
by a factor of six, and anxiety by a factor of five.8 With most women spending more than 18 months in
prison, if their child enters the foster care system their parental rights will be petitioned for termination
and the child may remain in the system for a prolonged period, further impacting their mental well-
being.9
breastmilk. Breastmilk reduces the risk for contraction of infectious disease and later development of
chronic diseases as well as establishes an emotional connection between the mother and baby.10 This
emotional connection reduces postpartum depression among mothers as well as creates a viable
mother-child relationship which can be used to help prevent the termination of their parental rights
and, in turn, the mental distress of their children.9 For new mothers, their infants must be allowed and
brought for visitation, as this is the only way to create such a relationship. As of now, 54.2% of facilities
allow contact visits and 68.2% allow breastmilk delivery, however these numbers are cited as optimistic
estimates.10
Correctional facilities can positively act upon the well-being of babies born by imprisoned
mothers. With adequate screening and treatments required, proper nutrition provided, shackling
relaxed in the third trimester, and postpartum breastfeeding and visits encouraged, the mental and
physical health of the child are drastically improved, and lifelong effects determined in the first 1000
days of life become positive. We must advocate change: call your representatives to create the
1. Dignam B, Adashi EY. Health Rights in the Balance: The Case Against Perinatal Shackling of
March 8, 2019.
Pregnant Women Incarcerated in Jail Facilities in the United States. Matern Child Health J.
2017;21(6):1260-1266.
7. Clarke JG, Simon RE. Shackling and Separation: Motherhood in Prison. Vol 15.; 2013. Accessed
March 6, 2019.
8. Turney K, Wildeman C. Mental and Physical Health of Children in Foster Care. Pediatrics.
9. Genty PM. Permanency Planning in the Context of Parental Incarceration: Legal Issues and
10. Shlafer RJ, Davis L, Hindt LA, Goshin LS, Gerrity E. Intention and Initiation of Breastfeeding Among
Women Who Are Incarcerated. Nurs Womens Health. 2018;22(1). Accessed March 10, 2019.