Support and Education for Incarcerated Mothers, A Pilot Study

Background and Significance:

In the United States there are over 200,000 incarcerated women. Specifically, there are almost 1500 women in the South Carolina Department of Corrections system. Of these women, 1 in 25 are pregnant upon intake.1 Often, these women receive very little prenatal care prior to being placed into prison. In addition, in most jurisdictions, they are not allowed to have support personal present at the time of delivery. This results in poor perinatal outcomes and increased c-section rates.2 Currently, six states allow doulas in the prison and to be present during deliveries in order to be a support person for the inmates. Previous studies have demonstrated that having doulas involved lowers preterm deliveries, c-section rates, and most notably, recidivism rates.3 Potential benefits could include lower preterm birth rates, higher birth weight babies, and decreased rates of postpartum depression, which would result in lower healthcare costs.3 Our ultimate goal in starting a doula program is to have students trained to become doulas for the inmates in hopes of having similar outcomes as the programs in other states. The goals of this pilot study are to determine if doula led childbirth education classes had an impact on incarcerated patients’ desire for a doula to be involved in their care and their understanding of child birth.

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Methods:

Inmates were surveyed before and after a two hour childbirth class lead by a doula. We utilized a 5 point Likert scale. The topics covered in this first session included:  the role of a doula, stages of labor, pain management during labor, and interventions that may take place during labor. A paired T-Test was used to analyze the results.

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Results:

All of the six women present were multigravida. However, only one had attended any type of childbirth class in a prior pregnancy. There were increases from the pre-survey to the post-survey in all topics. The topics with a positive trend included: the role of a doula, stages of labor, pain management during labor, and interventions that may take place during labor. The statement, “I understand the role of a doula in the birth process,” had a statistically significant increase with a p-value of 0.0063. The statement, “I am interested in having a doula involved in the birth process,” had a statistically significant increase with a p-value of 0.0125. Those two statements had the largest increases.

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Discussion:

While the sample size may be small, there was a positive trend with all questions, when comparing the pre-survey to the post-survey, with two of these statements reaching statistical significance. This pilot study shows that after completing a childbirth class, inmates are interested in having a doula involved in their birth process and they better understand the role of a doula during the birth process. In the future, research can look at the effect of medical student doulas and the impact they have on birth outcomes.