Pregnancy and Postpartum Support Programs for Women in Prison: Maternal and Neonatal Outcomes

项目摘要 在美国被监禁的女性人数比过去增加了600%以上 三十年了。根据最新统计，超过22.5万名妇女--其中大多数是育龄妇女-- 在监狱里。随着被监禁妇女人数的增加，监狱也有必要解决 妇女的健康需求，包括怀孕、分娩和产后护理。提供被监禁的孕妇 加强孕期和产后支持的妇女可能会改善产妇和新生儿 结果。一种有希望的方法是使用DULA来提供这种全面的支持。作为非医疗费用 与之相伴的是，助产士提供了一系列的支撑，并已被证明可以减少产程和产科 减少并发症，提高产妇满意度，促进低收入妇女开始母乳喂养。 几个州立监狱现在与当地组织合作，为怀孕和产后提供强化服务 支持；然而，对成功扩展计划至关重要的关键问题仍然存在。总的目标是 该项目是对加强怀孕和产后支持计划的多个州进行研究，以 妇女被关押在六个不同地理位置的监狱，总的目标是提供有价值的、实用的、 并向监狱提供关于如何实施怀孕和产后支持计划的可行信息 促进孕产妇和新生儿健康。我们将通过追求三个具体目标来实现这一目标：1) 确定实施妊娠、分娩和产后支持计划的促进者和障碍 对于监狱中的女性，2)评估项目参与者的怀孕和分娩结果，3)评估 计划参与者的产后结局。这项研究的结果将从根本上推动我们的 对孕期和产后支持计划以及孕产妇和新生儿结局的了解 在项目参与者中。确定监狱中促进计划的关键可修改因素 实施和可持续性以及记录各站点参与者的结果将直接 告知正在进行的计划扩展。最终，这项工作将产生解决复杂问题的关键信息 监狱孕妇健康需求，减少健康差距，促进司法中的健康公平-- 涉及妇女和她们的婴儿。

PROJECT ABSTRACT The number of women incarcerated in the United States has increased more than 600% over the past three decades. At last count, more than 225,000 women – a majority of whom were of reproductive age – were behind bars. As the number of incarcerated women has risen, so too has the need for prisons to address women’s health needs, including pregnancy, childbirth, and postpartum care. Providing incarcerated pregnant women with enhanced pregnancy and postpartum supports may improve both maternal and neonatal outcomes. One promising approach is to use doulas to provide this comprehensive support. As non-medical companions, doulas provide an array of supports and have been shown to reduce labor length and obstetric complications, improve maternal satisfaction, and promote breastfeeding initiation among low-income women. Several state prisons are now partnering with local organizations to offer enhanced pregnancy and postpartum support; yet, key questions that are critical to successful program expansion remain. The overall objective of this project is to conduct a multi-state study of enhanced pregnancy and postpartum support programs for women incarcerated in six geographically-diverse prisons, with the overall goal to provide valuable, practical, and actionable information to prisons about how to implement pregnancy and postpartum support programs to promote maternal and neonatal health. We will accomplish this goal by pursuing the three specific aims: 1) identify facilitators and barriers to implementation of pregnancy, childbirth, and postpartum support programs for women in prison, 2) evaluate the pregnancy and birth outcomes of program participants, and 3) evaluate the postpartum outcomes of program participants. Results from this study will fundamentally advance our understanding of pregnancy and postpartum support programs and the maternal and neonatal outcomes among program participants. Identifying key modifiable factors across prisons that facilitate program implementation and sustainability and documenting the outcomes of participants across sites will directly inform ongoing program expansion. Ultimately, this work will yield critical information to address the complex health needs of pregnant women in prison, reduce health disparities, and promote health equity among justice- involved women and their infants.