Enhancing Postpartum Care for Incarcerated People With Opioid Use Disorder: A Multimodal Intervention for Jail Staff

Incarcerated postpartum individuals with opioid use disorder (OUD) are vulnerable to poor health outcomes, but care provision in custody for this population is variable. Addressing their distinct needs is crucial for improving correctional health care for postpartum people. In this paper wea document challenges jail staff experience providing postpartum care, and describe shifts in jail staff knowledge and practice changes related to postpartum care that may be attributable to participation in a training resource for perinatal OUD in corrections. We developed a web-based resource for jail staff called "Maternal Opioid Use Disorder Management and Care Resources in Custody" (MOMCARE). From May 2024 to January 2026, we conducted a 12-month pilot MOMCARE intervention at five jails of varying sizes across the United States. We collected facility data on postpartum services, provided ongoing facilitation activities, and conducted qualitative interviews with jail staff to explore postpartum care challenges and opportunities. Through a needs assessment survey and qualitative interviews with staff at baseline, we documented gaps and challenges in service provision for postpartum people. Through ongoing interviews and facilitation activities, jail staff reported promising practice changes including systematically screening for postpartum status at intake, streamlining lactation support processes, and assessing postpartum mental health using validated screening tools. Jail staff also learned that it is safe and recommended for postpartum people to breastfeed while on medications for OUD. Jail staff were receptive to educational and support tools. MOMCARE prompted jails to make changes that align with best practices for postpartum care.