Health care and social justice implications of incarceration for pregnant people who use drugs

Abstract

The experiences of and care for pregnant, incarcerated people with substance use disorders represent a convergence of numerous clinical, historical, racialized, legal, and gendered factors. Understanding how these forces shape how they became enmeshed in the criminal legal system as well as the context of the care they do or do not receive while in custody is essential for promoting equitable maternal health care. In this review, we describe the prevalence of SUD among pregnant people behind bars, the health care landscape of incarceration, access to treatment for opioid use disorder for incarcerated pregnant and postpartum people, and nuances of providing such treatment in an inherently coercive setting. Throughout, we highlight the ways that the child welfare system and mass incarceration in the U.S. have had a unique and discriminatory impact on pregnant and parenting people, and have done so in distinctly racialized ways. Situating the clinical care of incarcerated pregnant people who use drugs in this context sheds light on fundamental social justice and health care intersections.

Keywords:

• Incarcerated pregnant women
• substance use disorder in pregnancy
• correctional health care

Acknowledgment

The authors would like to acknowledge attorney Claire Knittel for her input into the manuscript.

Geolocation Information

This paper focuses on the United States.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Dr. Sufrin’s time was supported by a grant from the National Institutes of Health/National Institute on Drug Abuse [NIDA-5K23DA045934-02].