Correction facilities are now playing a significant role in public health. The range of health conditions that jails and prisons deal with run the gamut. Those incarcerated are likely to suffer from physical or mental illnesses and substance abuse disorders, it also includes pregnant women who need special medical attention.

Dr. Carolyn Sufrin is this session’s instructor and she joins Justice Clearinghouse to discuss the management of pregnant women in jail-based settings. Dr. Sufrin is a medical anthropologist and an obstetrician-gynecologist. She is an assistant professor in the Department of Gyn/Ob at the School of Medicine at the School of Public Health of Johns Hopkins University. In her work, she focuses on incarcerated women’s reproductive health issues providing clinical care and conducting extensive studies to affect policies and improve health care for women in custody.

On this webinar, Dr. Sufrin goes into detail on the most common pregnancy-related issues that arise in jails, the challenges that facilities encounter, and how to address these appropriately through best practice. Some of the points she unpacked during the course include:

• Facts and figures that provide a snapshot of the prevalence of pregnancy cases in jails.
• The critical first step of pregnancy screening.
  • How it enables the jail to provide time-sensitive medical care, appropriate nutrition, and additional accommodations.
  • Conducting the screening soon upon intake or during initial medical triage.
  • How to manage expectations and explain the reason for the need for screening and uphold HIPAA considerations.
• Special considerations for pregnant women who use opioids.
  • Administering medication-assisted treatment (MAT) using methadone or buprenorphine as the standard of care for pregnant women.
  • The dangers involved in detoxing those who use opioids.
  • The common logistical concerns that jails encounter when administering MAT and workarounds to overcome these.
• Medical issues for pregnant women in custody.
  • Bleeding in pregnancy, what it means for each of the trimesters, and the need for urgent response in such cases.
  • Going on labor, how to evaluate if a woman is in labor, and the importance of having emergency delivery kits on site.
  • Mental health care during pregnancy that stresses the need for medication assistance and mental health support.
• Pre-natal care inside the jail broken down by trimester.
• Prohibition on and the dangers of using restraints on pregnant women in custody.
• Other accommodations that correctional facilities may extend to their pregnant inmates.
• Further support that jails must provide for postpartum care and breastfeeding inmates.
• The audience raised their inquiries and concerns related to:
  • Methamphetamine use during pregnancy, its risks and treatment options.
  • Providing basic knowledge about prenatal care to correctional staff.
  • Existing facilities that can be used for policy and practice model.
  • How the living conditions of pregnant inmates can adversely impact their pregnancy.
  • Caring and treating pregnant women on prescription opioids.
  • The scope of the Pregnancy in Prisons Statistics (PIPS) project.
  • Switching medications from methadone to buprenorphine.

Resources Mentioned During Webinar

• SAMHSA Medication-Assisted Treatment (MAT)
• SAMHSA Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
• Best Practices in Use of Restraints with Pregnant Women and Girls