New Research Finds Better Pregnancy Outcomes Among Imprisoned Women

September 30, 1997

CHAPEL HILL -- Babies born to women who were in prison while pregnant appear to have healthier birthweights as a group than infants born to women imprisoned at some other time, according to a unique new study.

Conducted at the University of North Carolina at Chapel Hill School of Public Health, the study found infants whose mothers spent part of their pregnancy behind bars were significantly heavier than other infants whose mothers spent time in prison, but not during pregnancy. Previous research has linked low birthweight to physical and mental impairment and infant mortality.

Also, babies whose mothers served more time in prison while pregnant were heavier than those born to women who spent less of their pregnancy locked up.

"Why such babies are born of heavier birthweights as a group is not clear," said Dr. Sandra L. Martin, assistant professor of maternal and child health at UNC-CH.

"It could be that their mothers received better prenatal care, food and shelter than comparable women not in prison or because they are much less likely to be able to abuse alcohol or drugs," Martin said. "It also could that they are less subject to domestic and sexual abuse, or perhaps some combination of these and other factors is responsible."

A report on the work appears in the September issue of the American Journal of Public Health, published Wednesday (Oct. 1). Besides Martin, authors are Dr. Haesook Kim of the National Institute of Child Health and Development, Dr. Lawrence L. Kupper, professor of biostatistics, and Melissa Hays, research assistant in maternal and child health, both at UNC-CH; and Dr. Robert E. Meyer of the N.C. State Center for Health and Statistics.

Researchers analyzed N.C. Department of Corrections and other information from live infant births between 1988 and 1991 among three groups of N.C. women -- 3,910 who were never locked up, 168 imprisoned during pregnancy and 630 others who had served time, but not while pregnant. No data were available on stillbirths or spontaneous abortions.

After controlling for complicating factors such as smoking and alcohol use, Martin and colleagues found no significant birthweight differences between infants born to women never jailed and those whose mothers carried them as prisoners. On average, however, women incarcerated at a time other than during pregnancy bore infants 182 grams lighter than those pregnant in prison.

The team undertook the study because health professionals disagreed about the effects of prison on pregnant women and their unborn babies. Some felt stresses caused by imprisonment traumatized expectant mothers. Others thought the enforced security offered something of a safe haven.

The research marks the first time a study has compared imprisoned and non-imprisoned pregnant women and was significantly larger than the few previous comparable investigations.

"More research is needed to understand why particular components of the prison environment may be health-promoting for some high-risk pregnant women," Martin said. "Prison, however, is no panacea for the problems of such women, including those who abuse drugs or alcohol.

"Some have advocated that incarceration and other punitive strategies be used to force high-risk pregnant women to modify their risky behaviors to improve the health of the fetus," she said. "Many health professionals believe that such measures might actually backfire by causing these women to avoid health and social services that could be helpful."

The N.C. Governor's Commission on Reduction of Infant Mortality and the Maternal and Child Health Bureau of the Health Resources and Services Administration supported the UNC-CH research.

In 1994, more than 64,000 women were confined to U.S. prisons, and about 6 percent of those were pregnant, Martin said. Growth of the U.S. female prison population is greater than the growth of the male prison population.

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Note: Martin can be reached at (919) 966-5973. If she is out of her office, press "0" to leave a message with her secretary.

Contact: David Williamson

University of North Carolina at Chapel Hill

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