Carceral Care: Examining the Quality of Health Care for Pregnant Women in Jails in North Carolina

Abstract

Most women who are incarcerated are of childbearing age and some individuals experience pregnancy while incarcerated. However, research on pregnancy in correctional facilities is limited to within prisons, even though healthcare provision in jails is more variable and inconsistent. This study aims to address the gap in the literature about the quality of health care for pregnant women in jails, rather than prisons, in North Carolina. This purpose of this study is to understand the provision of pregnancy-related health care in jail facilities, and to what extent jails meet the recommended standards of care established by public health agencies. To collect data, surveys were administered among administrators and health care providers from 45 jail facilities across North Carolina and 6 semi-structured interviews were conducted. The results indicate a high level of variability in the provision of pregnancy care across detention facilities in North Carolina. Moreover, jails could improve quality of care in the following categories: pregnancy testing, counseling and contraception, postpartum care, HIV screenings, and substance use treatment. Findings suggest that NC jails do not follow the standards of care set by public health agencies in all areas of pregnancy care except prenatal care. Therefore, policymakers should seek to standardize jail health policies according to the benchmark standards of care offered by the American Public Health Association, American College of Obstetricians and Gynecologists, and National Commission on Correctional Health Care, to improve reproductive health care for pregnant, justice-involved individuals.