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Service coordination for pregnant women in prison can improve their use of health services after release

On any given day in 2002, more than 75,000 women were held in local jails nationwide, primarily for nonviolent, drug-related crimes such as possession, theft, fraud, and prostitution. Most of these women were of reproductive age, and at least 6 percent of them were pregnant upon arrest. Jail settings can become a place of coordination between public health and criminal justice professionals to ensure that pregnant women receive essential services following their release from jail. In addition, such service coordination may increase women's use of health services during future pregnancies, concludes a study supported in part by the Agency for Healthcare Research and Quality (T32 HS13853).

University of Washington researcher, Janice F. Bell, M.N., M.P.H., and her colleagues used public health and jail records for 453 women who had an estimated delivery date from 1994 through 1998 and had at least one prenatal visit while in custody at one jail. They compared use of Medicaid-funded perinatal services for births to women who were in jail during pregnancy (jail-contact births) and births to women who had been in jail but not while they were pregnant (community births). Of the 453 women who had spent time in jail, 320 were in jail for at least part of one pregnancy, and 110 of the women were in jail for two pregnancies.

Being in jail at any time during pregnancy increased nearly six-fold the likelihood that women would receive at least some prenatal care and nearly doubled the likelihood of receiving maternal support services after release, but it also was associated with fewer total prenatal and support visits. Other factors associated with a higher likelihood of receiving prenatal care were longer Medicaid coverage, longer pregnancies, and medical complications, as well as drug use during pregnancy.

Women were not eligible to receive maternity support services or case management while in jail. However, jail health care providers referred women with a known history of substance abuse to post-release case management. The researchers recommend expanding these referrals to include all pregnant women and offering family planning services to women in jail.

See "Perinatal health service use by women released from jail," by Dr. Bell, Frederick J. Zimmerman, Ph.D., Colleen E. Huebner, Ph.D., M.P.H., and others, in the Journal of Health Care for the Poor and Underserved 15, pp. 426-442, 2004.

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