Sufrin Speaks on Reproductive Health Care for Incarcerated Women
The Office of Research on Women’s Health recently hosted a webinar on “Reproductive Health Care for Incarcerated Women: Strategies for Promoting Justice Through Research Within an Overlooked Population” as part of its Understudied, Underrepresented, and Underreported (U3) Women Lecture Series. Presenting was Dr. Carolyn Sufrin, a medical anthropologist and obstetrician-gynecologist specializing in family planning, from Johns Hopkins University.
Sufrin posited that incarceration is a social and structural determinant of health and that mass incarceration in the United States constitutes a public health epidemic. She noted that the U.S. population of 225,000 incarcerated women has a distinct set of health issues that includes higher rates of sexually transmitted infections, mental illness, trauma and substance use problems than the populations of nonincarcerated women and incarcerated men.
The health of incarcerated women has received limited attention in part due to systemic sexism and the pervading assumption “that males are the default prisoners,” said Sufrin. She said U.S. prisons and jails inconsistently provide family planning services such as contraception, emergency contraception and abortions; menstrual hygiene products; and sex-specific health care.
Sufrin further highlighted that systemic racism also contributes to health care disparities among incarcerated populations, with black men and women representing 14 percent of the general population but 44 percent of the incarcerated population.
Currently, there are no mandatory standards of care for pregnant women in U.S. prisons and jails, and many incarcerated women receive inadequate obstetric care. These facts prompted Sufrin to study pregnancy outcomes in U.S. prisons through funding she received from NIH’s Building Interdisciplinary Research Careers in Women’s Health Program.
Her original research began as the Pregnancy in Prison Statistics (PIPS) project, an epidemiological study collecting pregnancy outcome data from women incarcerated in participating prisons and jails. The study found that, among the population studied (about 57 percent of U.S. women incarcerated in 2016-2017), 1,396 were pregnant at intake. These pregnancies resulted in 753 live births, 46 miscarriages, 11 abortions, 4 stillbirths, 3 newborn deaths, 2 ectopic pregnancies and no maternal deaths. Pre-term birth rates of incarcerated mothers (6 percent) were lower than those of the overall national rate (about 10 percent) and rates of cesarean delivery were about 30 percent in prisons and jails, which is close to the national average.
The PIPS project has evolved into the Advocacy and Research on Reproductive Wellness of Incarcerated People research group. The project has expanded to “research projects looking at how to provide medication-assisted treatment to women with opioid use disorder in jails and other ongoing reproductive health studies on pregnancy decision-making and birth control access in places of confinement.”
Sufrin reported that the data on the pregnancy outcomes of incarcerated women had a high degree of variability from state to state and encouraged researchers studying PIPS data to disaggregate them accordingly. She also described many of the logistical, ethical and safety issues researchers should consider when conducting research on incarcerated populations.
Sufrin also discussed her book Jailcare: Finding the Safety Net for Women Behind Bars, which looks at mass incarceration and its intersections with reproductive politics, especially examining the contradictions of providing care in a space of punishment.
A video of Sufrin’s webinar is available at https://www.youtube.com/watch?v=VKwjFjFfwD0&feature=youtu.be.