Reproductive healthcare in prison: A qualitative study of women’s experiences and perspectives in Ontario, Canada

Abstract

Objective To explore women’s experiences and perspectives of reproductive healthcare in prison. Methods We conducted a qualitative study using semi-structured focus groups in 2018 with women in a provincial prison in Ontario, Canada. We asked participants about their experiences and perspectives of pregnancy and contraception related to healthcare in prison. We used a combination of deductive and inductive content analysis to categorize data. A concept map was generated using a reproductive justice framework. Results The data reflected three components of a reproductive justice framework: 1) women have limited access to healthcare in prison, 2) reproductive safety and dignity influence attitudes toward pregnancy and contraception, and 3) women in prison want better reproductive healthcare. Discrimination and stigma were commonly invoked throughout women’s experiences in seeking reproductive healthcare. Conclusions Improving reproductive healthcare for women in prison is crucial to promoting reproductive justice in this population. Efforts to increase access to comprehensive, responsive, and timely reproductive healthcare should be informed by the needs and desires of women in prison and should actively seek to reduce their experience of discrimination and stigma in this context.

Abortion and contraception for incarcerated people: A scoping review

“…See Table 1 below. The settings included 35 studies set in the US [ 4 , 12 – 45 ]; three in Brazil [ 46 – 48 ], two in Canada [ 2 , 5 ], one in the US and Mexico [ 49 ]; one in French Guiana [ 50 ]; and one in Uganda [ 51 ].…”

“…In 34 studies, the population was currently incarcerated [ 2 , 4 , 5 , 12 – 31 , 33 , 35 , 41 , 43 , 44 , 45 – 48 , 50 ]. Two studies included formerly incarcerated people [ 32 , 34 ]; four studies included prison staff [ 37 – 40 ]; one included people under community supervision [ 49 ]; and one included people involved in the criminal legal system broadly defined [ 36 ].…”

“…Additionally, Erickson et al, (2017) [ 51 ] focused on sex workers; we included this study because 27% of respondents reported being formerly incarcerated, and sex work is criminalized in Uganda, the site of the study. All 43 included studies focused on women and/or girls: 34 focused solely on women [ 2 , 4 , 5 , 12 – 18 , 22 , 24 – 27 , 29 , 31 – 33 , 36 , 41 , 43 , 44 , 45 – 48 , 50 ]; and six on adolescent girls [ 19 – 21 , 28 , 30 , 34 ]. No studies specified if trans or nonbinary people were included.…”

“…Twenty-four studies used quantitative methods, including 14 surveys [ 5 , 14 , 15 , 17 – 19 , 22 , 24 – 26 , 29 , 30 , 37 , 45 ]; four secondary data analyses [ 21 , 31 , 40 , 48 ]; one randomized control trial [ 13 ]; four prospective studies [ 4 , 40 , 41 , 43 ] and one study using geo-localization [ 35 ]. Our results also included 14 qualitative studies [ 2 , 12 , 20 , 23 , 28 , 32 , 34 , 38 , 39 , 46 , 47 , 49 – 51 ], four cross-sectional studies [ 18 , 36 , 42 , 44 ], and one mixed-methods study [ 33 ].…”

“…Incarcerated people experience logistical, financial, and geographic barriers to care, such as distance from services; restrictive security, transportation, and escort policies and practices; staff shortages; and prohibitive private costs. They also face stigma and threats to privacy and confidentiality from both institutional health care providers and correctional staff [ 2 ], and barriers to health information and literacy [ 3 ]. Even where abortion services are completely decriminalized, lack of understanding about how to access care is a serious impediment to seeking services.…”