What to expect when you’re expecting in prison?

As the prisoner health project continues, it’s become clear to Miranda Davies there are different gaps in knowledge. In this blog, she looks at what we know (or don’t know) about pregnant women in prison, and what our research will do about it.

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Published: 05/09/2018

Some facts and figures about life in prison we can be relatively sure about, such as how many people are in prison, but information about the health of prisoners is not available in the same way as it is for the general population. For instance, today there are approximately 3,800 women in prison in England, but we don’t know how many are pregnant or how many gave birth in prison in the last year.

Talking to people from organisations who work within prisons about our prisoner health project, it is clear that the lack of access to basic statistics, such as the number of pregnancies and births, makes it challenging to provide effective services and support.

In this blog I consider the implications of not knowing basic information about the health of prisoners – focusing on the health needs of women in prison who are pregnant – and outline what our research will provide in this area.

What do we know about women in prison who are pregnant?

Statistics on the number of prisoners who give birth are not collected centrally. There are estimated numbers, but what we know tends to come from local information sources, or accounts from advocacy groups about the experiences of women they work with.

As part of our research, we will be looking at prisoners’ visits to A&E, outpatients or inpatients over the last year, which will capture visits related to either pregnancy or childbirth.

As Abbi Ayers, prison and project coordinator and breastfeeding lead at Birth Companions and one of the expert panel advising our project, told me: “Without independent evidence and statistics on the number of women experiencing pregnancy and child birth in prison, all stakeholders involved in prison-based maternity services are at a disadvantage.

“Access to accurate and updated pregnancy, birth and breastfeeding rates would enable staff, health professionals and voluntary sector organisations to identify where the support, funding, training and facilities are most needed to best support pregnant women and new mothers in prison.”

Statistics can be a tool for change

Being able to reliably count the number of women in prison who are pregnant or have given birth is a vital first step in considering outcomes for pregnant women in prison.

In the general population we know how breastfeeding rates have changed over time, as well as the proportion of births ending in a C-section. Knowing this type of information is a catalyst for discussions about the care women should receive while in labour and after giving birth, and how to make sure they are supported regardless of their birth choices or whether they wish to breast or bottle feed their baby.

What will our research provide?

Our research will establish what can be learned about the health of prisoners by looking at their use of hospital services. This could provide insights in a wide variety of areas, far beyond just this key issue of pregnant women. For instance, for people with chronic conditions such as kidney disease, what might how frequently they have to attend hospital for dialysis tell us about the way care is organised and the impact it has on health?

Statistics about the different health needs of prisoners are also vital context for broader discussion about equity of care between those who are in prison and those who are not.

As Abbi added, knowing more about the specific health needs of pregnant women in prison (or in the period after birth) is vital: “Women face numerous and complex issues during the perinatal period, including poor physical and mental health, limited emotional and financial support from family members – and, in some instances, the trauma and anxiety of not knowing whether or not they will be separated from their baby after birth.”

By the end of the year, we will publish a literature review that focuses on the physical health needs of those in prison. Before then though, look out for more blogs from me on other gaps in knowledge that I’ve encountered when it comes to prisoner health, as we carry on with this vital research.

*The project is funded by The Health Foundation, an independent charity committed to bringing about better health and health care for people in the UK.

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