Academic journal article Social Work

Improving Pregnancy Outcome during Imprisonment: A Model Residential Care Program

Academic journal article Social Work

Improving Pregnancy Outcome during Imprisonment: A Model Residential Care Program

Article excerpt

The female prison population has increased dramatically in recent years. Most women prisoners are involved with drugs, and as many as 25 percent are pregnant or have delivered within the past year. Reproductive health and drug treatment services for women in prison are inadequate, if they are available at all, and although illicit drugs are readily available in prison, drug-involved pregnant women often are incarcerated to protect fetal health. Studies of pregnancy outcome among women prisoners have demonstrated high rates of perinatal mortality and morbidity. This article examines issues related to pregnancy among women prisoners and describes an innovative residential program designed for pregnant, drug-dependent women in a state adult corrections system. Social workers can play an important role in promoting policy reform and improved services for this underserved population.

Key words: incarceration; pregnancy; prenatal care; prisoners; substance abuse

The number of incarcerated women in the United States has increased substantially in recent years, and currently it is estimated that more than 87,000 women are in federal and state prisons (Beck, 2000). Women constitute the most rapidly growing population in the criminal justice system: since 1980, the female prison population has increased 573 percent compared with 294 percent for men during the same period (Beck). In part because of heavier legal sanctions for drug offenses, a significant proportion of women are incarcerated for drug or drug-related crimes. These offenses include the possession, manufacturing, and sale of drugs and income-producing crimes that are committed to support drug addiction, such as larceny, prostitution, fraud, and burglary (Barry, Ginchild, & Lee, 1995; Wellisch, Prendergast, & Anglin, 1994). Drug offenses accounted for half of the increase in the number of women incarcerated in state prisons between 1986 and 1996 (Mauer, Potler, & Wolf, 1999).

Characteristics of Women Prisoners

Incarcerated women are typically poor, uneducated, and limited in job skills; more than half are unemployed before their incarceration (Smith, 1993). Because of poverty, selective arrest and prosecution by race, and lack of access to legal and other resources, they are disproportionately women of color: 46 percent of women prisoners are African American, and 12 percent are Latina Americans (Connolly & Marshall, 1991; Neuspiel, 1996; Smith). Eighty percent of women prisoners are mothers, and 85 percent had custody of their children before incarceration (Smith). As noted, many are drug involved; a survey of arrestees conducted by the National Institute of Justice (1993) found that the majority of women interviewed tested positive for illicit drugs, regardless of the charge against them. Most have been uninsured or medically underinsured before incarceration; lack of adequate health insurance is a major reason for their inability to obtain treatment for drug dependency (Barry et al., 1995).

Most women prisoners are in the reproductive age group, and as many as 25 percent are pregnant on intake or have delivered within the past year (Wooldredge & Masters, 1993). Despite the lack of availability of adequate perinatal care for prisoners, and research showing that illicit drugs are readily available in prison, there is a trend to incarcerate drug-involved pregnant women to protect fetal health (Barry et al, 1995; Becker, 1991; Egley, Miller, Granados, & Ingram-Fogel, 1992). A study of pregnant women prisoners in the North Carolina Correctional Institution for Women found that prisoners were more likely than nonincarcerated matched controls to use illicit drugs, with 36 percent of the inmates acknowledging the use of illicit drugs while pregnant in prison, compared with 3 percent of the controls (Egley et al., 1992). Nevertheless, prosecutions of pregnant, drug-involved women for child abuse and drug transportation and trafficking have occurred in 34 states during the past decade (Chavkin, Breitbart , Elman, & Wise, 1998). …

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