Highly Effective Birth Control Use Before and After Women's Incarceration

Abstract

Background: We examined factors associated with women's use of highly effective birth control before and after incarceration, since women with ongoing criminal justice involvement bear a disproportionate burden of sexual and reproductive health problems, including high rates of unintended pregnancy and inconsistent contraceptive use. Methods: Using a longitudinal study design, we conducted surveys with 102 women in an urban midwestern jail and then followed up with 66 of them 6 months after incarceration. We used stepwise logistic regression to assess individual, interpersonal, resource-based, organizational, and environmental factors associated with utilizing highly effective birth control. Results: Forty-two percent of women reported utilizing highly effective birth control (e.g., sterilization or other highly effective reversible methods) prior to incarceration, and 54% reported using these methods after release from jail ( p < 0.001). Ninety percent of women reported not wanting to get pregnant. Consistent use of birth control ( p = 0.001) and alcohol problems ( p = 0.027) were associated with utilization of highly effective birth control prior to incarceration. Previous pregnancies ( p = 0.012) were the only factor associated with utilization of highly effective birth control after release from jail. Conclusions: Clinicians and public health practitioners can use findings from this study to develop clinical and intervention efforts aimed at improving unintended-pregnancy prevention among incarcerated women both during their confinement and during the tumultuous period after their release from jail.

Navigating Social Networks, Resources, and Neighborhoods: Facilitators of Sexual and Reproductive Health Care Use among Women Released From Jail

“…The parent study has been described in detail elsewhere (Ramaswamy et al, 2015a, 2015b). The present qualitative study was a follow-up study that allowed for further probing into the barriers and facilitators of SRH service use after women’s release from jail.…”

“…Fifty percent of women in the criminal justice system in the U.S. have had a sexually transmitted infection (STI) in their lifetime (Oswalt et al, 2010). Over 80% have reported prior unintended pregnancies; 85% have reported inconsistent contraceptive use, and 80% have reported inconsistent condom use before and after incarceration (Clarke et al, 2006; Oswalt et al, 2010; Ramaswamy, Chen, Cropsey, Clarke, & Kelly, 2015a). …”

“…Our previous studies have shown that health is not a high priority for women upon release from jail, and sexual health is far down the list (Ramaswamy et al, 2015b). In addition, we know that use of condoms and effective birth control is generally low after release from jail, despite women’s intentions to have sex (Ramaswamy et al, 2015a). With respect to the everyday lives of women, we do not know what barriers they face to SRH care after jail.…”

Education level as a predictor of condom use in jail‐incarcerated women, with fundamental cause analysis

“…We present a secondary analysis of data from a parent survey the purpose of which was to learn more about the barriers to sexual health that women experience before and after a jail incarceration. Previously published results from the parent study reported change in women’s highly effective contraception use (i.e., sterilization, long‐acting reversible contraception) before and after an incarceration and implications for unplanned pregnancy (Ramaswamy et al, ). In the present analysis, we asked, “What social factors are associated with women’s use and nonuse of condoms prior to an incarceration.” Fundamental cause theory was used to explain our findings and to frame next steps for public health nurses and other providers.…”

“…There has little research to assess sexual health risk in this population specific to the use or nonuse of condoms, though there are a number of studies that include condom use in their measures (Clarke et al, 2006;Larochelle et al, 2012;Ramaswamy, Chen, Cropsey, Clarke, & Kelly, 2015;Schonberg, Bennett, Sufrin, Karasz, & Gold, 2015;Swan & O'Connell, 2012). But research in general with women who are incarcerated or have a history of justice involvement remains comparatively sparse offering no consensus about with whom, why, or when women with a history of incarceration use condoms and, consequently, no clear direction as to how to bring about higher rates of use.…”