Health and Incarceration by Amy Smith

Author:Amy Smith
Language: eng
Format: epub
Tags: ebook
Publisher: The National Academies Press
Published: 2013-12-11T00:00:00+00:00

WOMEN

Although female inmates are only about 10 percent of the correctional population, they present higher rates of disease and additional reproductive health issues. As noted earlier, mental health disease burden is considerably higher for women than men. Very high rates of childhood sexual abuse and post-traumatic stress disorder are prevalent among female inmates. Given the disproportionate burden of mental illness borne by women inmates, the proposals for addressing the mental health needs, discussed above, are particularly applicable to this population.

Jennifer Clarke (Brown University Medical Center) addressed health issues of incarcerated women, particularly reproductive health. Clarke estimated that 5 to 6 percent of women coming into prisons or jails are pregnant. The data on birth outcomes vary, but in general, babies weigh more the longer a woman is incarcerated. Reasons for better birth outcomes are likely better access to prenatal care, decrease in substance use, and, for some, stable housing and regular meals. Clarke hastened to note, “I always have to follow that by clarifying I am not advocating incarcerating pregnant women but rather underscoring the need for this population to have services in the community.”

Clarke also commented on the research finding that most of the women who enter incarceration pregnant had conceived within three months of leaving a prior incarceration. This emphasizes the need for correctional facilities to provide family planning services, as most so-called “pregnant women days” within prisons are from women who have been imprisoned previously where a more stable diet and less access to drugs may have improved fertility, and upon release, without family planning services, conceived promptly. The stress of an unplanned pregnancy could add to their difficulty of getting re-established in the community, and some are soon re-incarcerated. Clarke shared research that indicated that about 70 percent of women in the criminal justice system who are at risk for an unplanned pregnancy indicated they want to start a contraceptive method.

Sexually transmitted infections (tested on entry to prison or jail) are about 10 to 20 times higher in the incarcerated female population than the general population, and at least twice as high as that of the incarcerated male population. As health consequences of such infections for women are much greater than they are for men, Clarke affirmed the paramount importance of screening and treating women for such infections as they enter prisons and jails.

Clarke also offered observations on the rise in obesity. Women on average gain over a pound a week when incarcerated. A year’s incarceration thus results in over a 50-pound weight gain, with considerable consequences for both the physical and mental health of women inmates.

Clarke underscored the imperative of providing reproductive healthcare, with attention to continuing care after release. Recalling evidence that women expressed interest in starting a contraceptive method and also acknowledging that “there have been a lot of abuses in the past of reproductive freedom,” Clarke advocated the availability of reversible contraceptive methods.

Asked about the provision of nurseries in correctional facilities, Clarke noted “great outcomes,” including better bonding and more breastfeeding, when this is possible.

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