The Unmet Contraceptive Need of Incarcerated Women in Ontario

Supporting women leaving prison through peer health mentoring: a participatory health research study

“…This finding is consistent with a study in Ontario in which 80% of incarcerated women reported an unmet need for contraception before their admission to a correctional facility, and 38% expected this as an unmet need after release. 31 The positive experiences expressed by our participants are reflective of the impact of peer support described in other studies. In a US randomized controlled trial, people leaving prison who were connected with a transition health team that included a peer mentor had reduced use of emergency departments 32 compared to another accessible clinic.…”

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

“…In 2016, we completed a survey of women in an Ontario provincial prison to quantify their unmet need for contraception [ 4 ]. We originally planned this survey as part of a mixed-methods study that included focus groups, because we anticipated that reasons for using or desiring contraception may not be fully described or understood using either a quantitative or qualitative approach independently.…”

“…However, during the process of seeking approval for the protocol from the Ministry responsible for provincial prisons there were concerns raised about the burden the study would place on the institution, so we removed the qualitative component of the study. In the survey, we found that 77% of women (N = 85) had experienced an unintended pregnancy, that 80% of women who were at risk for unintended pregnancy had not been using a reliable form of contraception prior to imprisonment, and that only 44% of all participants wanted more information about contraception [ 4 ]. These results, along with written responses in which women described a wide range of salient and traumatic experiences when asked “Do you have any other comments about pregnancy or birth control?” at the end of the survey, solidified our motivation to collect qualitative data to better understand women’s perspectives and experiences regarding pregnancy, contraception, and related healthcare in prison.…”

“…Women experiencing imprisonment in North America lack access to reproductive healthcare [1][2][3]. Studies in two prisons in Canada and the US, respectively, both found that approximately 80% of women in prison had an unmet need for contraception [1,4], and internationally, women who experience imprisonment are found to have less access to prenatal care and higher rates of pregnancy complications, such as preterm birth and low birth weight, compared with women in the general population [5][6][7][8][9].…”

Addressing Women’s Unmet Health Care Needs in a Canadian Remand Center: Catalyst for Improved Health?

“…Incarcerated women have higher rates of HIV and sexually transmitted infections (STIs) and are at increased risk of cervical cancer compared to the general female population (Altice et al, 2005; Proca, Rofagha, & Keyhani-Rofagha, 2006). Furthermore, reproductive health care has been cited as an unmet health need among incarcerated women with high rates of unintended pregnancy (approximately 80% or higher in studies conducted in the United States and Canada) and poor access to contraception both during incarceration and in the community (Liauw, Foran, Dineley, Costescu, & Kouyoumdjian, 2016; Schonberg, Bennett, Sufrin, Karasz, & Gold, 2015). Barriers to accessing health care services during incarceration include long waiting lists, difficulty accessing medications, underskilled or nonempathetic health care staff, lack of continuity of care, lack of health literacy, and poor transitional planning (Donelle & Hall, 2014; Harner & Riley, 2013; Hatton, Kleffel, & Fischer, 2006; Plugge, Douglas, & Fitzpatrick, 2008).…”