PREGNANT WOMEN IN PRISON: MENTAL HEALTH, ADMISSION TO PRISON MOTHER AND BABY UNITS AND INITIAL OUTCOMES FOR MOTHER AND CHILD

Abstract

Abstract Background Little is known about the mental health of pregnant women in prison in England or the factors which impact admissions to prison mother and baby units (MBUs). Research suggests women with more 'stable' backgrounds and lower prevalence of mental disorder are more likely to be admitted to prison MBUs, and that women in MBUs have a lower prevalence of mental disorder, but the reasons for this are unclear. Aims To describe the socio-demographic background of pregnant women in prison; to establish the prevalence of mental disorder in pregnant women in prison; to identify the factors which influence MBU applications and admissions for pregnant women in prison; to measure the impact of MBU residence and separation on initial outcomes for mother and child and to explore the experiences of pregnancy, childbirth and motherhood and separation whilst imprisoned. Methods A mixed methods design was used. Eighty-five pregnant women completed quantitative interviews at baseline, and 55 at follow-up in nine different prisons. Data was collected on mental health, drug misuse, hazardous drinking, personality disorder, quality of life and mother-child bonding. Qualitative data were collected via 31 interviews with pregnant women, and 24 postnatal interviews. Framework Analysis was used to explore, summarise and report the data. Results Fifty-one percent of participants had depression and 57% had anxiety. Sixty-three per cent were admitted to MBUs. Those who were working prior to imprisonment were more likely to be admitted, and those with prior Children's Services involvement, diagnosis of personality disorder or history of suicidality were less likely to be admitted. Perinatal depression was greater at baseline than follow-up, and lower for women admitted to MBUs. Quality of life was higher at follow-up than at baseline, except for the social quality of life for participants not admitted to MBUs, suggesting poorer perceived social support. Conclusions The high levels of depression and anxiety may have negative impacts on both the mother and child. Pregnant women with more complex backgrounds are less likely to be given a place in a prison MBU, and MBU placement may contribute to a reduction in perinatal depression. Women not admitted to MBUs may experience reduced social support. Participants were depressed, stressed and worried, mostly about what would happen to their unborn child, basic needs were unmet, and emotional support varied. Lack of information compounded feelings of stress.

Date of Award	31 Dec 2018
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Jennifer Shaw (Supervisor), Mark Hann (Supervisor) & Dawn Edge (Supervisor)