Improving Maternal Care for Incarcerated Pregnant Women


Incarceration rates for women in the United States are historically high — with the population of incarcerated women almost eight times higher today than in 1980, according to The Sentencing Project. And up to 5% of women are pregnant upon incarceration.

A new study with Hunter College Associate Professor Lorie Goshin as principal investigtor and co-authored by The Graduate Center Ph.D. student Gina Sissoko (also of John Jay College) looks deeply at the attitudes of nurses who work with pregnant incarcerated women, and the effects of stigma on the maternal care provided to these patients. The study is published in the American Journal of Public Health.

“Women who are incarcerated during pregnancy have higher risks for adverse pregnancy outcomes,” according to the study. “Reducing the adverse impact of incarceration on maternal health outcomes requires the elucidation of the mechanisms through which incarceration creates or exacerbates maternal health disparities.”

Pregnant women are largely unable to adequately care for themselves and their pregnancies while incarcerated. Thus, the attitudes of health care providers and custody staff have a significant impact on the women’s maternal outcomes.

The research focused, in part, on shackling and the maternal care standards set by the Association of Women’s Health, Obstetric, and Neonatal Nurses for incarcerated women. “Shackling” is when custody officers use nonmedical restraints on incarcerated pregnant women while transporting them to local hospitals to give birth.

The study surveyed 923 nurses and found that less than one in five respondents knew about AWHONN’s standards and less than 10% knew whether their states had shackling laws.

“Nurses caring for incarcerated people in carceral and community settings also report a lack of full professional autonomy because of tension with custody officers,” according to the study.

The authors highlighted the importance of addressing institutional norms, attitudes, and nurses’ perceived ability to care for incarcerated women. They also recommended multi-level stigma reduction interventions.

“These include teaching providers about mass incarceration and incarceration-related stigma, as well as creating opportunities for them to build skills related to caring for incarcerated women and communicating effectively with custody officers,” according to the study.

This research was funded by the March of Dimes and the Association of Women’s Health, Obstetric, and Neonatal Nurses.