" We don't wanna birth it here": A qualitative study of Southern jail personnel approaches to pregnancy

Abstract

Each year, approximately 55,000 pregnant people are incarcerated in US jails. To learn about pregnancy and postpartum care in jails, we analyzed 34 qualitative interviews with jail personnel from facilities in five Southeastern US states. Themes included jail processes unique to pregnancy and burden on jails produced by liability and limited resources. Societal attitudes such as stigma, distrust of pregnant people, and a focus on fetal well-being were also important themes. Jail-community partnerships may mitigate the effects of scarce resources and improve jail perinatal care. Better community safety nets that decrease contact with jails are needed to improve pregnancy outcomes.

Keywords: Jail; Pregnancy; Southern US; Women.

Figure 1.

Conceptual framework of the interaction between pregnant people and the jail system from qualitative interviews with jail personnel in the Southern US, 2018–2019. The highest order themes are depicted in a nested and stepwise manner. These are societal attitudes that filter into the approaches of jail personnel and the physical experiences of incarceration. Stigma due to substance-use disorder and incarceration status leads to a general distrust of pregnant people and focuses pregnancy care on fetal well-being rather than on the well-being of a parental-fetal dyad. Below the nested arrows is a cycle of themes that describes the approach to pregnancy by jail personnel. This includes concerns about liability and limited resources, and the burden produced for each facility. At the center are the chronological processes for pregnant people inside jail facilities, from intake procedures through interactions that occur after birth.