Incarcerated Women and Reproductive Health: A Survey of Contraception Services in Correctional Health Facilities

Background: Many women entering correctional facilities are already marginalized members of society, and often have had limited access to health care prior to incarceration. The correctional health system can not only provide medical care to them, but also be an opportunity for public health interventions. Limited information exists regarding the provision of contraceptive care to incarcerated women. Objectives: To describe the current contraceptive services provided to female inmates in the US, and barriers to delivering this care. Methods: Self-administered, written surveys mailed nationally to 950 correctional health providers, who are members of the American Association of Correctional Health Providers. Results: On preliminary analysis of the first 201 surveys returned to date, about one-third of respondents do not ask women about contraceptive use at any time during their incarceration. Two-thirds report that women are not allowed to continue contraception. Contraceptive counseling is routinely performed by 12%, although 59% report doing so upon patient request. A small number of facilities provide birth control, most commonly oral and injectable methods. Few facilities dispense condoms or emergency contraception (6% for each) prior to release. Most respondents (94%) feel contraception interventions would be useful to female inmates, and viewed contraceptive workshops favorably. Respondents vary in comfort regarding contraceptive counseling, particularly with the contraceptive ring and the IUD. Discussion: Deficiencies exist in the current female contraceptive services provided at most correctional health facilities, though most providers desire resources to improve these services. Development of such programs could potentially empower women being reintroduced to mainstream society.