Pregnancy behind bars

Since the 1960s, the cycle of violence and drug use has mounted and an increasing number of people are being incarcerated. Coincident with this phenomena, we have experienced rising rates of morbidity and mortality among the incarcerated, many of whom suffer from infectious diseases. In fact, the spread of diseases like tuberculosis has been facilitated by the congregate nature of the penal system. As the number of people behind bars has risen, we have seen a disproportionate increase in the number of women incarcerated, most of whom are in their childbearing years. The number of pregnant women in jails and prisons has, in turn, been escalating. Certain prenatal interventions are described and evaluated in the literature, which we review in this article. Experience with the prenatal program in the New York City jail system is described. In general, the authors' position is that as society chooses a social policy of incarceration to address the problems of violence and drug use, there is solid public health reason to design and implement comprehensive prenatal programs in correctional facilities with connections to community-based health services.