Threats to caregiving in community following infant reentry from a prison nursery

Background: Increasing numbers of incarcerated women in the United States include 6-10% who are pregnant and especially vulnerable for poor outcomes. In the first longitudinal study of a cohort co-residing in the nation's oldest prison nursery we have fostered secure attachment and developmental milestones during the prison stay. Following reentry these infants join 2.3 million children of criminal justice involved parents growing up in the community with sparse resources. This study compares factors in the community caregiving environment. Methods: As part of a larger NIH-funded study 53 dyads enrolled in prison were re-enrolled in the community at an average of three reentry years. Primary caregiver completed established self-report instruments for depressive symptoms (CES-D), mental health, (SF-36), and parenting stress (PSI) and for child development (Ages and Stages; CBCL). T-tests and chi-squares compared scores by maternal and alternative caregivers in the third reentry year and regression models were explored for caregiver factors that predicted behavioral development. Results: Children separated from mother at end of nursery experience had more internalizing problems at third reentry year. Maternal caregivers had lower mental health status and more parenting distress. Caregiver depressive symptomatology and parent-child dysfunctional interaction explained 45% of the variance in child's internalizing problem scores and with seamless parenting by biological mother explained 62% of the variance in child's CBCL externalizing problem scores. Conclusions: Following a supportive prison nursery experience both maternal and alternative caregivers require continued community nursing resources to identify risks to mental health and parenting and to sustain healthy child development.