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O09Punished with pregnancy: incarcerated pregnant individuals’ perspectives on abortion access and decision making in custody

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      Objectives

      To understand how being incarcerated shapes pregnant individuals’ abortion desires, experiences, and access in this punitive, rights-limited, racially stratified environment.

      Methods

      From May 2018 to November 2020, we conducted semi-structured, qualitative interviews with pregnant incarcerated people in a prison and a jail each in two states, one abortion restrictive and one abortion supportive. Interviews explored whether participants considered abortion for this pregnancy; attempted to obtain an abortion in custody; whether and how incarceration affected their feelings about pregnancy, parenting, and abortion; and options counseling and prenatal care experiences in custody.

      Results

      We interviewed 38 people. Participants’ abortion and pregnancy decisions were deeply shaped by the conditions of incarceration, and some experienced pregnancy continuation as punishment. Four themes emerged: (1) staff explicitly preventing people from accessing abortion, giving false information or imposing anti-abortion views on patients; (2) participants assuming that, because incarceration removes autonomy, they had no right to abortion; (3) temporal uncertainties of court and carceral medical care influencing abortion access; (4) degrading and traumatic conditions of incarceration, poor healthcare, and impending post-birth separation from infants made people wish they had obtained an abortion. Themes were similar in restrictive and supportive states.

      Conclusions

      Being incarcerated shaped pregnant people's abilities to access abortion, to consider whether it was even an option, their pregnancy decision-making processes, and their feelings about being pregnant. These subtle carceral control aspects were more prominent barriers to abortion than overt logistical ones. Incarceration constrains and devalues reproductive wellbeing, and in punitive ways that are a microcosm of broader forces of reproductive control in US society.
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