Navigating pregnancy and early motherhood in prison: a thematic analysis of mothers’ experiences

Sapkota et al. Health & Justice (2022) 10:32 https://doi.org/10.1186/s40352-022-00196-4 RESEARCH ARTICLE Health & Justice Open Access Navigating pregnancy and early motherhood in prison: a thematic analysis of mothers’ experiences Diksha Sapkota1* , Susan Dennison1 , Jyai Allen2 , Jenny Gamble2,3 , Corrie Williams1 , Nomxolisi Malope-Rwodzi1, Laura Baar1, Janet Ransley1 and Tara Renae McGee1 Abstract Background Maternal imprisonment negatively impacts mothers and their children and is likely to have lifelong and intergenerational sequelae. In many jurisdictions nationally and internationally, young children (usually those less than 5 years) can reside with their mothers in prison. However, there is considerable debate regarding the impact of prison environments on incarcerated mothers and their children who are born, and/or raised in prison. Research to date on the pregnancy and mothering experiences of imprisoned mothers and their preferences for care arrangements for their babies and young children is limited. Methods This study was part of the Transforming Corrections to Transform Lives project, in which workshops were conducted with imprisoned mothers to understand their needs while in custody and post-release, and the kind of supports and system changes that are required to meet those needs. Incarcerated mothers (n = 75) participated in seven workshops conducted across four Queensland prisons. Themes were generated through reflexive thematic analysis. Results Three themes characterised mothers’ experiences of being pregnant and undertaking a mothering role of a young child while in prison. First, for most mothers, imprisonment adds vulnerability and isolation during pregnancy and childbirth. Second, although mothers felt that residing together with their children in prison motivated them to change for a better future, they were concerned about the potential negative impact of the prison environment on the child’s development. Lastly, most mothers voiced losing autonomy and agency to practice motherhood independently within custodial settings. Mothers expressed a need for the correctional system to be adapted, so it is better equipped to address the unique and additional needs of mothers with young children. Conclusion Mothers’ experiences indicated that the correctional system and policies, which were predominantly designed for men, do not adequately address the varied and complex needs of pregnant women, mothers, and their young children. Imprisonment of pregnant women and mothers with young children should be the last resort, and they should be provided with holistic, individually tailored support, most preferably in community settings, to address their multiple intersecting needs. *Correspondence: Diksha Sapkota Full list of author information is available at the end of the article © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Sapkota et al. Health & Justice (2022) 10:32 Page 2 of 15 Keywords Correctional facilities, Focus groups, Mothers, Pregnancy, Qualitative, Young child Background Globally, female prisoners account for 6.9% of the total prison population and since 2000, female prisoners have increased by 53% (Walmsley, 2017). Most notably, many of these women are mothers — more than 80% have at least one child and 30% have children under five years of age (Glaze & Maruschak, 2010; Lobo & Howard, 2021; Shlafer et al., 2019). Consistent with global figures, the number of women in prison in Australia has increased by 62% (3,292) compared to 2,030 in 2011, while Indigenous women make up 30% of the female prison population (Australian Bureau of Statistics [ABS], 2021). Though research on impact of maternal incarceration and mothering in prison is robust (e.g., Casey-Acevedo et al., 2004; Dowell et al., 2019; Goshin et al., 2014; Nuytiens & Jehaes, 2022), imprisoned mothers’ voices are rarely considered in such research. Mothers’ perspectives about the effectiveness of prison-based programs, including parenting programs, prison nursery programs, or health programs have been investigated (Bard et al., 2016; Kennedy et al., 2020;; Walker et al., 2014). However, little is known about how mothers feel about mothering a young child (from birth to five years) while imprisoned and how the prison system influences their journey of motherhood. Pregnant, birthing, and postpartum in prison Pregnancy and motherhood can be positive turning points for some incarcerated women as they strive to be the best mothers they can be and achieve desistance from crime (Schinkel, 2019). Available estimates indicate that globally 5 to 10% of women in prison are pregnant (Baldwin et al., 2020), while in Australia, in 2017, 1.8% of women in prison were pregnant at the time of entering prison (ABS, 2021; Australian Institute of Health and Welfare [AIHW], 2019). Studies have shown that women, currently or formerly incarcerated, have delayed entry to antenatal care and are less likely than other women to receive the recommended antenatal care (Ramirez et al., 2020; Walker et al., 2014). Early and routine prenatal care during the imprisonment of pregnant women has shown to have positive effects on babies’ birth weight and gestational age at birth (Baker, 2019). However, late and insufficient care leads to poor perinatal outcomes (e.g., pre-term birth, low birth weight, mental illness, and increased hospital admissions and mortality; Baldwin et al., 2020; Walker et al., 2014; Dowell et al., 2018; Mukherjee et al., 2014). Despite what is known about the increased risks for adverse pregnancy-related outcomes due to incarceration, little data is available on what imprisoned women need to optimise their pregnancy outcomes. Several programs have been implemented globally to improve pregnancy and birth experiences and support the unique mothering needs of incarcerated women (Paynter et al., 2020; Tremblay & Sutherland, 2017). However, most of the existing programs do n (...truncated)