| Description |
This dissertation explores women's contraceptive access while incarcerated in jail. In many U.S. jails, women's hormonal contraceptive methods are discontinued and not reinitiated prior to release, and most jails do not provide women in their custody the opportunity to initiate a contraceptive method. Additionally, many women do not have access to postpartum sterilization procedures while in the custody of a jail and giving birth at a local hospital. This dissertation addresses three research questions. I answer the first research question, "What are the contraceptive needs and method preferences of women incarcerated at the Salt Lake County jail?" through a quantitative analysis of surveys completed by 194 women incarcerated at the Salt Lake County jail. I found that just over half of the participants had used contraception in the previous year. Forty-one percent of participants planned to use contraception after release, and 67% reported interest in initiating contraception in jail. Women were most interested in using condoms, IUDs, implants, the birth control shot, and the pill. Providing birth control methods in the Salt Lake County Jail could increase contraceptive use and potentially reduce the number of unintended pregnancies women experience after release. I answer the second research question, "What attitudes do incarcerated women have toward sterilization occurring while in custody?" through a qualitative analysis of transcripts from three focus groups. The majority of participants believed that sterilization should be available for incarcerated women, and they argued that an organization unaffiliated with the jail should be responsible for sterilization education and consent processes to reduce sterilization abuse. Sterilization of incarcerated women is a controversial issue and additional efforts should be made to include incarcerated women's voices in the discussion. I answer the third research question, "What mechanisms and rationales do specific jails utilize to either discontinue or continue and initiate contraceptives for women in their custody?" through a qualitative analysis of transcripts from interviews with jail health care providers working in eight different jails in the United States. Half of the providers described comprehensive contraceptive programs in their facilities, including reproductive life planning, contraceptive counseling, and the availability of a range of methods-including IUDs and implants-for women prior to release. Two providers described limited contraceptive care, and two providers described their facilities having no contraceptive care available for women. Factors associated with comprehensive contraceptive care in a facility included a "champion" who initiated the program and health care provided by a public health department. |
