"They talked to me like I was dirt under their feet:" Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states.

Background: Many pregnant individuals with opioid use disorder (OUD) spend time in jail, yet access to standard of care medications for OUD (MOUD) in jail is limited. Though qualitative studies of non-incarcerated pregnant and non-pregnant incarcerated individuals with OUD demonstrate complexities that must be considered in delivering effective care, studies with pregnant, incarcerated patients with OUD are lacking.

Methods: We conducted semi-structured qualitative interviews from October 2020-November 2021 with pregnant and postpartum people with OUD who were currently or previously in jail in Florida, Maryland, Ohio, and Virginia.

Automating Racism: Is Use of the Vaginal Birth After Cesarean Calculator Associated with Inequity in Perinatal Service Delivery?

Objective: The clinical application of race-adjusted algorithms may perpetuate health inequities. We assessed the impact of the vaginal birth after cesarean (VBAC) calculator, which was revised in 2021 to address concerns about equity. The original algorithm factored race and ethnicity and gave lower VBAC probabilities to Black and Hispanic patients.

Impacts of the COVID-19 pandemic on the experiences of incarcerated pregnant people.

Background: The COVID-19 pandemic disproportionately impacted incarcerated populations, yet few studies have investigated the specific effects on incarcerated pregnant people. This study compares pregnant people's experiences of pregnancy and parenting in prison before and during the pandemic in order to explore the impacts of COVID-19 on this population.

Methods: We conducted semi-structured interviews with pregnant people at a state prison as part of a larger study on pregnant people's experiences during incarceration.

Cervical Cancer Prevention in Individuals With Criminal Legal System Involvement.

Objectives: Women with a history of criminal legal system involvement have cervical cancer rates that are 4-5 times higher than the general population-a disparity that has persisted for nearly 50 years. Our objective is to describe the intersection of mass incarceration in the United States and risk factors for cervical cancer to offer equitable prevention and treatment strategies for the field.

Results: A group was convened by American Society for Colposcopy and Cervical Pathology members and experts in the field to address a topic of importance relevant to cervical cancer elimination in underserved groups.

"Because I Was a Criminal and Drug Addict.": Experiences of Anti-Black Gendered Racism and Reproductive Injustice Among Black Pregnant and Postpartum Women with a Substance Use Disorder and Incarceration and Family Policing Histories.

Racism pervades the US criminal legal and family policing systems, particularly impacting cases involving women with a history of a substance use disorder (SUD). Laws criminalizing SUD during pregnancy disproportionately harm Black women, as do family policing policies around family separation. Discrimination within intersecting systems may deter Black pregnant women with a SUD from seeking evidence-based pregnancy and substance use care.

Allocating health care resources in jails and prisons during COVID-19: a qualitative study of carceral decision-makers.

COVID-19 created acute demands on health resources in jails and prisons, burdening health care providers and straining capacity. However, little is known about how carceral decision-makers balanced the allocation of scarce resources to optimize access to and quality of care for incarcerated individuals. This study analyzes a national sample of semi-structured interviews with health care and custody officials ( = 32) with decision-making authority in 1 or more carceral facilities during the COVID-19 pandemic.

"Maybe if we weren't in the pandemic, I would have reconsidered": Experiences of abortion care-seeking during the COVID-19 pandemic in Maryland.

Objective: To understand the COVID-19 pandemic's impact on abortion care-seeking in Maryland, a state with Medicaid coverage for abortion, high service availability, and laws supporting abortion rights.

Methods: We conducted semi-structured telephone interviews with 15 women who had an abortion between January 2021 and March 2022 at a hospital-based clinic in a mid-sized Maryland city. We purposively recruited participants with varied pandemic financial impacts.

"It's different than a doctor saying 'You're making the right choice'": A qualitative study of chaplains' experience caring for patients undergoing abortion in Washington DC, Maryland, and Virginia.

Objectives: Health care chaplains are faith providers with theological education, pastoral experience, and clinical training who provide spiritual care to patients, their families, and medical staff. This study sought to characterize chaplains' experiences providing spiritual care for patients experiencing abortion and pregnancy loss and to explore how chaplains gain competency and comfort in providing pastoral care for this patient population.

Study Design: Researchers conducted in-depth, semistructured, qualitative interviews with currently-practicing chaplains recruited via convenience sampling in the Washington DC, Maryland, and Virginia region.

Mental health, chronic and infectious conditions among pregnant persons in US state prisons and local jails 2016-2017.

Background: Pregnant individuals in incarcerated settings have unique healthcare needs. Rates of mental health, infectious diseases, and chronic disease are higher among nonpregnant incarcerated women compared with those who are not, but the prevalence of these conditions among pregnant people in custody has not been documented.

Objectives: The objective of this study is to describe the prevalence of metabolic, infectious, and mental health conditions in pregnant people to identify the medical needs of high-risk pregnancies in US state prisons and local jails.

Termination counseling among US perinatal genetic counselors in the setting of second trimester fetal anomalies.

Many pregnant people learn of fetal anomalies in the second trimester and subsequently present to prenatal genetic counselors (PGCs) for counseling, including but not limited to a nuanced discussion about whether to continue or terminate pregnancy. In those who choose to terminate, the decision between dilation and evacuation (D&E) or induction is often one of patient preference and as such, is heavily influenced by the quality of counseling received. PGCs are expertly trained to provide values-based counseling, yet little is known about their termination counseling practices, referral practice patterns, and perceived responsibilities in caring for this group of pregnant people.

Development and evaluation of measures to assess self-determination in peripartum contraceptive decision-making.

Objectives: We aimed to adapt and validate person-centered measures to evaluate various contributors to self-determination in perinatal contraceptive decision-making.

Study Design: We developed and administered four scales adapted from existing measures in the context of Self-Determination Theory: the Treatment Self-Regulation Questionnaire (TSRQ), Perceived Competence Scale, modified Health Care Climate Questionnaire, and Important Other Climate Questionnaire. The TSRQ consists of three subscales: autonomous motivation, controlled motivation, and amotivation.

Incarceration Status Among Individuals Obtaining Abortion in the United States, 2020.

To examine the abortion frequency among incarcerated people before was decided. We used data from the 2020 Abortion Provider Census to examine the number and distribution of facilities that provided abortions to incarcerated patients. Sixty-seven clinics across 25 states and the District of Columbia provided more than 300 abortions to incarcerated patients in 2020.

State Laws on Substance Use Treatment for Incarcerated Pregnant and Postpartum People.

Background: Incarcerated perinatal populations report high rates of substance use in the United States (US). Despite this, substance use disorder (SUD) treatment is not routinely available in carceral settings and state policies related to the provision of substance use screening and treatment are unknown.

Methods: We conducted a systematic search in WestLaw through the end of the 2020 legislative session combining the terms "pregnant" and "postpartum" with terms for incarceration and related terms.

Patient-Led Approaches to a Vaginal Birth After Cesarean Delivery Calculator.

Objective: To describe patient approaches to navigating their probability of a vaginal birth after cesarean (VBAC) within the context of prediction scores generated from the original Maternal-Fetal Medicine Units' VBAC calculator, which incorporated race and ethnicity as one of six risk factors.

Methods: We invited a diverse group of participants with a history of prior cesarean delivery to participate in interviews and have their prenatal visits recorded. Using an open-ended iterative interview guide, we queried and observed these individuals' mode-of-birth decisions in the context of their VBAC calculator scores.

Impact of new abortion restrictions on people in prison: Estimated number of incarcerated people without abortion access and distance to abortion providers.

Objectives: This study aimed to estimate the annual number of incarcerated pregnant people in state and federal prisons needing an abortion.

Study Design: We used 2021 Bureau of Justice Statistics data and prior studies' findings to estimate the number of pregnant incarcerated people, then calculated state-specific abortion ratios to determine the number potentially needing an abortion.

Results: Of 638 pregnant people incarcerated in prisons annually, 110 would be expected to need an abortion, including 55 in states where abortion is currently banned or restricted.

Pandemic detention: life with COVID-19 behind bars in Maryland.

Background: People incarcerated during the COVID-19 pandemic face higher vulnerability to infection due to structural and social factors in carceral settings. Additionally, due to the higher prevalence of chronic health conditions among carceral populations, they are also at risk for more severe COVID-19 disease. This study was designed to explore the experiences of people incarcerated in prisons and jails in Maryland during the height of the pandemic.

Release, Reentry, and Reintegration During COVID-19: Perspectives of Individuals Recently Released from the Federal Bureau of Prisons.

Introduction: The COVID-19 pandemic had a large negative impact on people in U.S. prisons.

"I mean, I didn't really have a choice of anything:" How incarceration influences abortion decision-making and precludes access in the United States.

Objective: To understand how the punitive, rights-limiting, and racially stratified environment of incarceration in the United States (US) shapes the abortion desires, access, and pregnancy experiences of pregnant women, transgender men, and gender non-binary individuals.

Methods: From May 2018-November 2020, we conducted semi-structured, qualitative interviews with pregnant women in prisons and jails in an abortion supportive and an abortion restrictive state. Interviews explored whether participants considered abortion for this pregnancy; attempted to obtain an abortion in custody; whether and how incarceration affected their thoughts about pregnancy, birth, parenting, and abortion; and options counseling and prenatal care experiences, or lack thereof, in custody.

COVID-19 Restrictions In Jails And Prisons: Perspectives From Carceral Leaders.

COVID-19 has been an unprecedented challenge in carceral facilities. As COVID-19 outbreaks spread in the US in early 2020, many jails, prisons, juvenile detention centers, and other carceral facilities undertook infection control measures such as increased quarantine and reduced outside visitation. However, the implementation of these decisions varied widely across facilities and jurisdictions.

Assessing provision of MOUD and obstetric care in U.S. jails: A content analysis of policies submitted by 59 jails.

Aims And Background: Thousands of pregnant people with opioid use disorder (OUD) interface with the United States (US) carceral system annually. However, little is known about the consistency and breadth of medications for opioid use disorder (MOUD) for incarcerated pregnant people in jail, even at facilities that offer treatment; the goal of our study is to illuminate the current practices for OUD management in US jails.

Methods: We collected and analyzed 59 self-submitted jail policies related to OUD and/or pregnancy from a national, cross-sectional survey of reported MOUD practices for pregnant people in a geographically diverse sample of US jails.

An exploratory study of COVID-19-related changes in abortion service availability and use in Washington, DC, Maryland, and Virginia.

Objectives: This exploratory study aimed to assess COVID-19-related changes in abortion service availability and use in Washington, DC, Maryland, and Virginia.

Design: Data came from a convenience sample of eight abortion clinics in this region. We implemented a cross-sectional survey and collected retrospective aggregate monthly abortion data overall and by facility type, abortion type, and patient characteristics for March 2019-August 2020.

COVID-19 vaccination hesitancy and uptake: Perspectives from people released from the Federal Bureau of Prisons.

People in United States (US) prisons and jails have been disproportionately impacted by the COVID-19 pandemic. This is due to challenges containing outbreaks in facilities and the high rates of health conditions that increase the risk of adverse outcomes. Vaccination is one strategy to disrupt COVID-19 transmission, but there are many factors impeding vaccination while in custody.