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

项目摘要 美国被监禁的女性人数比过去增加了600%以上 三十年了据最新统计，超过225，000名妇女-其中大多数是育龄妇女-被 在监狱里随着被监禁妇女人数的增加，监狱也需要解决 妇女的健康需要，包括怀孕、分娩和产后护理。为被监禁的孕妇提供 加强妊娠和产后支持的妇女可能会改善孕产妇和新生儿 结果。一个有希望的方法是使用导乐来提供这种全面的支持。非医学 陪伴，导乐提供了一系列的支持，并已被证明可以减少分娩时间和产科 这些措施包括预防并发症、提高产妇满意度和促进低收入妇女开始母乳喂养。 一些州立监狱现在与当地组织合作， 支持;然而，对成功的方案扩展至关重要的关键问题仍然存在。的总体目标 该项目将进行一项关于加强怀孕和产后支持计划的多州研究， 被关押在六个地理位置不同的监狱的妇女，总体目标是提供有价值的，实用的， 向监狱提供关于如何实施怀孕和产后支持计划的可操作信息， 促进产妇和新生儿健康。我们将通过以下三个具体目标来实现这一目标： 确定实施怀孕、分娩和产后支持计划的促进因素和障碍 对于监狱中的妇女，2）评估方案参与者的怀孕和分娩结果，3）评估 计划参与者的产后结果。这项研究的结果将从根本上推动我们的 了解妊娠和产后支持计划以及孕产妇和新生儿结局 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地点参与者的成果将直接 通知正在进行的计划扩展。最终，这项工作将产生关键信息，以解决复杂的 监狱中孕妇的健康需求，减少健康差距，促进司法部门之间的健康公平， 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.