Carolyn Sufrin MD, PhD, discusses recent research on pregnancy frequencies and outcomes among women in US state and federal prisons. This new data is leading policy changes to address the health and well-being of incarcerated women who are pregnant, and the children born to them.
Learn more Hello, My name is Carolyn suffering. I'm an assistant professor in the Department of gynecology and obstetrics at Johns Hopkins School of Medicine and in the Department of Health Behavior in Society at Johns Hopkins Bloomberg School of Public Health. I'm an o b g Y n and I'm also a medical anthropologist. And in those two roles, I have conducted research and provided clinical care and conducted various advocacy initiatives related to reproductive health care among incarcerated women. On any given day, there are more than 226,000 women behind bars in the United States. The majority of these women are young women of childbearing age. Two thirds of them are already mothers and the primary caregivers to young Children before they become incarcerated. And so understanding the reproductive health and often pregnancy related experiences of women behind bars is absolutely essential for their health and well being and that of their family. We know that most of these women have lives that are characteristic by by numerous forms of social and structural determinants of health that adversely affect their reproductive health experiences before they become incarcerated and while they're incarcerated in our country in the last four decades, we've seen an explosion of the number of people behind bars. And while in the last few years that population has finally started to decrease a little bit, that is not the case for women. And the numbers of women behind bars in the U. S continues to rise even as it falls for men. So what about their reproductive health care? Well, this is an area that I've been conducting research in for over a decade. Um, and what we found is that there is tremendous variability in the kind of health care that they receive. Um, there are some prisons and jails that provide quality, comprehensive pregnancy care, access to contraception and abortion when it's indicated, um and other women's health services. But there are many others that provide substandard or absent care. Some of the research that my team at Johns Hopkins has conducted relates to the frequency of pregnancy and what happens with regards to pregnancy care behind bars, as well as access to contraception and abortion. My research team, which is called advocacy and research on reproductive wellness among incarcerated people or our whip, has conducted several studies recently that I'd like to highlight for you. One of them is the pregnancy in Prison Statistics Project or pips. Hips was the first ever national data collection to collect information on the number of pregnant people behind bars. And what happens to those pregnancies? We had 22 state prison systems, all federal prisons and six jails, including the five largest jails that reported to our study data based on a monthly basis for one year on various pregnancy related outcomes. And what we found in this study is that if we extrapolated some of these data to national estimates, we could estimate that there are approximately 58,000 admissions of pregnant people to prisons and jails in the U. S. Every year, 58,000. That is a lot of times that pregnant people entering prisons and jails are going to need pregnancy related health care. In our study, there were nearly 1000 births that happened just in the sites that were in our study. We also found that there were about 6% of the pregnancies ended in miscarriage. There were very few abortions that occurred and there were no maternal deaths. Um, there were three neonatal deaths that occurred. It's essential to understand what's happening for reproductive health care and pregnancy behind bars as part of a larger equity agenda, especially when it comes to maternal health. Because we know that our system of mass incarceration is rife with inequities. It is characterized by institutionalized racism that reflects centuries of structural racism within our country. And we can see that manifested in the fact that black women are two times more likely to be incarcerated than white women. Um, despite having equal rates of of drug related crimes, which are some of the more common things that women are arrested for. And so my and my research team's commitment to doing research on incarcerated women is part of a larger commitment to equity for this population. Another study that we're conducting now has to do with the treatment of opioid use disorder among pregnant women in jails. Um, and we conducted the largest survey ever done of this nation's jails, Um and, uh, in terms of assessing their, um, their current practices around treatment of opioid use disorder and availability of methadone and buprenorphine for pregnant women. Although we focused on treatment of pregnant women with opioid use, disorder. As I mentioned, this is the largest health services, um survey ever conducted among jails in the US We will be excited to share our results once we've finished data analysis. We hope that the results that we provide through research improve health care conditions for women behind bars. And that includes contributing data to broader efforts that inform criminal legal system reform, including ways to think about alternatives to incarceration for women in the United States. Thank you very much.