268550 Pregnancy Outcomes for Women Recently Released from Jail

Monday, October 29, 2012

Jennifer Clarke, MD, MPH , Department of Medicine and OB/GYN, The Warren Alpert Medical School of Brown University, Pawtucket, RI
Unplanned pregnancies (defined as pregnancies that are either mistimed or unwanted) and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual activity. Women with a history of incarceration are at increased risk for these problems given the high rates of substance abuse and commercial sex work in this population.

We are currently conducting a randomized controlled trial of a Motivational Interviewing based intervention for incarcerated women in Rhode Island at risk for unplanned pregnancies and STIs. The overall aim of the study is to help women practice family planning behaviors that are consistent with their pregnancy intentions. Women follow up at 3, 6, 9 and 12 months after they are released and are tested for pregnancy and STIs.

So far, 77 out of 218 participants (35%) have tested positive for at least one STI (Gonorrhea, Chlamydia or Trichomoniasis). Of the 167 recruited women that have been released and had at least one follow-up, we have found that 30 out of 167 (18%) participants became pregnant after release. Of these participants, 11 (36.7%) terminated their pregnancy or planned to do so. With so many women at high risk for unplanned pregnancies and STIs passing through United States jails annually, improving contraceptive service utilization and STI prevention services in this non-traditional setting has the potential to reach the women in the greatest need of services.

Learning Areas:
Advocacy for health and health education
Provision of health care to the public
Public health or related research

Learning Objectives:
To identify the reproductive health concerns of incarcerated women; To discuss barriers to birth control initiation and to elucidate interventions that help increase birth control initiation among women recently released from jail who do not want a pregnancy; and To explain the need to improve methods to decrease substance-exposed pregnancies.

Keywords: Correctional Health Care, Reproductive Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Principal Investigator of multiple federally-funded research grants focusing on the reproductive health needs of incarcerated women at the Rhode Island Department of Corrections. I am currently conducting a randomized controlled trial of a behavioral intervention to reduce unplanned pregnancies and STIs among women after release from jail.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
The Warren Alpert Medical School of Brown University Medicine and OB/GYN Employment (includes retainer)
Memorial Hospital of Rhode Island Center for Primary Care and Prevention Employment (includes retainer)
Rhode Island Department of Corrections Internist Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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