Contraception services for incarcerated women: a national survey of correctional health providers☆☆☆
Received 17 March 2009; received in revised form 6 May 2009; accepted 21 May 2009. published online 13 July 2009.
Abstract
Background
Incarcerated women have had limited access to health care prior to their arrest. Although their incarceration presents an opportunity to provide them with health care, their reproductive health needs have been overlooked.
Study Design
We performed a cross-sectional study of a nationally representative sample of 950 correctional health providers who are members of the Academy of Correctional Health Providers.
Results
A total of 405 surveys (43%) were returned, and 286 (30%) were eligible for analysis. Most ineligible surveys were from clinicians at male-only facilities. Of eligible respondents, 70% reported some degree of contraception counseling for women at their facilities. Only 11% provided routine counseling prior to release. Seventy percent said that their institution had no formal policy on contraception. Thirty-eight percent of clinicians provided birth control methods at their facilities. Although the most frequently counseled and prescribed method was oral contraceptive pills, only 50% of providers rated their oral contraceptive counseling ability as good or very good. Contraception counseling was associated with working at a juvenile facility, and with screening for sexually transmitted infections.
Conclusions
Contraception does not appear to be integrated into the routine delivery of clinical services to incarcerated women. Because the correctional health care system can provide important clinical and public health interventions to traditionally marginalized populations, services for incarcerated women should include access to contraception.
aDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94110, USA
bDivision of Gynecologic Specialties, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
cDepartment of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15213, USA
dDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 154213, USA
eDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 154213, USA
Corresponding author. Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital, San Francisco, CA 94110, USA. Tel.: +1 415 206 4458; fax: +1 415 206 3112.
☆ This work was supported by the Irene McLenahan Young Investigator Research Fund Award from the Magee-Womens Health Foundation.
☆☆ Presented in part as an oral presentation at the 2007 American Public Health Association Annual Meeting, Washington, DC.
ABSTRACT