Perinatal mental health provisions for birthing
people impacted by the carceral state: a scoping review
Birthing persons face unique health barriers that are exacerbated by racial disparities. These racial disparities are most apparent within our criminal legal (CL) system, a legacy of oppression and discrimination against Black populations in the United States. The CL system is not typically conceptualized as a structural or social determinant of health, but in fact, it’s potentially one of our most important indicators of well-being at multiple levels: it disproportionately impacts people of color, tears apart families and reinforces cycles of poverty and socioeconomic disadvantage. The United States incarcerates more people than any other country. One year spent in prison correlates with two years of life lost from general life expectancy. People living inside carceral facilities (prisons and jails) are more likely to have a mental health condition upon entry and are more likely to develop mental health conditions once they’re inside.
While incarceration rates are lower in female* populations than males, the rate of growth for female incarceration is approximately 2x higher than males. Within these facilities, there is a significant lack of family planning services, including contraception, abortion, and menstrual hygiene products, and there are no mandatory standards of care for individuals who are pregnant. The United States is only one of four nations that separate incarcerated mothers from their babies, despite overwhelming evidence of its negative impact on the child’s development of emotional and behavioral coping skills. People separated from their babies after birth face significant mental health concerns, including increased risk of suicide and self-harm; these risks are compounded by poor maternal health outcomes that are already apparent in Black birthing persons in the general population.
Incarceration impacts individuals, families, and communities in ways that have yet to be discovered. Research on perinatal mental health disparities among birthing people who have been incarcerated is particularly limited. To identify the extent of this gap, we’re performing a scoping review that evaluates the current literature on perinatal mental health provisions for birthing incarcerated and formerly incarcerated persons. We are reviewing literature inclusive of people incarcerated or formerly incarcerated that includes health equity considerations in the screening, assessment, and treatment of marginalized birthing persons in the U.S. The carceral status of birthing people is an important health equity consideration that should be more adequately addressed in the literature, particularly in research that is aimed at identifying and addressing health equity barriers.
*This data does not adequately capture the experiences of non-binary and transgender people due to the lack current research and data reporting from the Federal Bureau of Prisons.