Systematic mixed-methods review of interventions, outcomes and experiences for imprisoned pregnant women

Abstract

Aims.
To review published studies reporting maternity experiences and outcomes for pregnant incarcerated women and their babies.

Background.
Numbers of women in prison have increased in many countries. Imprisoned women who are pregnant are particularly vulnerable and marginalised. Little is known about their maternity care experiences, or outcomes.

Design.
Systematic mixed-methods review using a segregated approach.

Data sources.
The Cochrane Library, CINAHL, EMBASE, MEDLINE Psych INFO and PubMed were searched using the terms ‘mother’ and ‘prison’, (January 1995–July 2012). From July 2012–May 2014 possible new studies were identified through scrutiny of 50 relevant journal contents pages via Zetoc.

Results.
Seven studies met the review criteria and quality standards, all from the USA or UK. Four of the studies were quantitative; two were qualitative; and one used mixed methods. None reported the outcomes of an intervention. Examination of the quantitative data identified a complex picture of potential harms and benefits for babies born in prison. Qualitative data revealed the unique needs of childbearing women in prison, as they continuously negotiate being an inmate, becoming a mother, complex social histories and the threat of losing their baby, all coalescing with opportunities for transformation offered by pregnancy.

Conclusions.
There is very limited published data on the experiences and outcomes of childbearing women in prison. There appear to be no good quality intervention studies examining the effectiveness of interventions to improve wellbeing in the short or longer term for these women and their babies.