Johns Hopkins School of Medicine
Presentation Abstract
Pregnancy Care and Outcomes in Incarcerated Settings
Tens of thousands of pregnant people pass through our nation’s jails and prisons each year. The U.S. carceral system is marked by profound structural racism, underlying the racial disproportionality that Black women are incarcerated at twice the rate of White women, which comes to bear on maternal health inequities. Incarcerated women have higher rates of chronic medical conditions, histories of trauma, mental health diagnoses, and substance use disorders, suggesting higher risk of adverse outcomes for pregnant and postpartum people experiencing incarceration. While institutions of incarceration are constitutionally required to provide access to health care, there are no mandatory standards or oversight. As a result, the availability and quality of pregnancy and postpartum care in incarcerated settings is highly variable. Most institutions of incarceration have limited abilities to meet the comprehensive medical and psychosocial needs of pregnant and postpartum people. Additionally, the harsh conditions of incarceration, including nutrition, isolation from community supports, living arrangements, variable access to mental health and substance use care, and lack of autonomy negatively impact the lived experiences and health outcomes of incarcerated pregnant and postpartum people. This presentation will review data on pregnancy prevalence and outcomes in U.S. prisons and jails as well as research on institutions’ policies and practices surrounding pregnancy and postpartum care. We will discuss the challenges to collecting pregnancy and postpartum data in incarcerated settings. Research gaps that we will discuss include lack of ongoing pregnancy outcomes data collection, absence of data disaggregated by race and other demographic factors, dearth of postpartum data on people whose pregnancies end in custody, and rigorous assessment of incarceration exposure during pregnancy as a risk factor for adverse outcomes. We will conclude with suggestions for future research to address these research gaps.
About Dr. Sufrin
Dr. Carolyn Sufrin is a Medical Anthropologist and an Obstetrician-Gynecologist specializing in family planning at Johns Hopkins University, where she is an Associate Professor in the Department of Gynecology and Obstetrics and Associate Director of the Center for Medical Humanities and Social Medicine at the School of Medicine; she also holds an appointment in Health, Behavior, and Society at the Johns Hopkins Bloomberg School of Public Health. Dr. Sufrin obtained her undergraduate degree in anthropology and chemistry from Amherst College and a medical doctor degree from Johns Hopkins University. After her residency in obstetrics and gynecology at the University of Pittsburgh, she completed a fellowship in family planning at University of California, San Francisco, where she also obtained a Ph.D. in medical anthropology. She has worked extensively on reproductive health issues affecting incarcerated women, from providing clinical care in jail, to research, policy, and advocacy. Her work is situated at the intersection of reproductive justice, health care, and mass incarceration. She has authored over 75 peer-reviewed journal publications, national guidelines, and a book. Along with her research team at Advocacy and Research on Reproductive Wellness of Incarcerated People, Dr. Sufrin conducts qualitative, quantitative, and mixed methods research to understand and improve reproductive health conditions for people affected by incarceration, including prenatal care standards, access to contraception and abortion, and treatment of opioid use disorder for pregnant people in custody. Her work in this area has been funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Drug Abuse, Society of Family Planning, and the Wenner-Gren Foundation. Dr. Sufrin also serves on the board of directors of the National Commission on Correctional Health Care as the liaison for the American College of Obstetricians and Gynecologists.
Dr. Sufrin disclosed the following conflicts of interest: Book royalties from University of California Press for “Jailcare”; Advisory Board member for Urban Institute study of reproductive health care services at the San Diego jail.