Katherine Albertson, Caroline O'Keeffe, Georgina Lessing-Turner, Catherine Burke, Mary J Renfrew
A partnership between The Hallam Centre for Community Justice, Sheffield Hallam University and The Mother and Infant Research Unit, Department of Health Sciences, University of York
There are 13 women's prisons in England[1]. There are currently seven Mother and Baby Units (MBUs) within the female estate. These are located at HMP Styal, HMP New Hall, HMP Eastwood Park, HMP Holloway, HMP Askham Grange, HMP Peterborough and HMP Bronzefield. The national MBU capacity is 77[2] places and each unit has the capacity to accommodate one set of twins.
Women in prison are disproportionally likely to be poor, unemployed, mentally ill, socially excluded and the victims of abuse (Corston Report, 2007[3] ). These are risk factors for poor parenting skills/infant feeding choices, and are likely to result in impaired physical, social and emotional wellbeing as well as adverse short, medium and long term health outcomes[4], [5]. The Public Health White Paper and key policy documents indicate the need to tackle such problems from the start of life[6],[7] to prevent the intergenerational cycle of deprivation. The Government's recent Green Paper[8] stresses the importance of addressing offender health needs as part of the rehabilitation revolution, and health is one of the reducing re-offending pathways. Childbearing women in prison and their babies are more likely than the general population to experience perinatal and maternal mortality and morbidity, and they may also suffer separation and distress that could be alleviated (Gregorie et al., 2010[9]; Birmingham et al., 2006[10]; Siefert and Pimott, 2001[11]). In addition, as this is a time of upheaval in the organisation of public health provision in the prison estate, as well as in the public sector more generally, it is particularly important to keep the needs of pregnant and childbearing women and their babies in focus.
A collaborative partnership between the Mother and Infant Research Unit (MIRU) at the University of York and the Hallam Centre for Community Justice (HCCJ) at SHU was successful in securing funding to conduct a consultation project entitled ‘Tackling health inequalities through developing evidence-based policy and practice with childbearing women in prison[12]’. This collaboration brought together the knowledge and expertise of researchers working in maternal and infant health and those with knowledge of the prison sector. The overall aim of this consultation was to scope and map the health needs and health care of childbearing women in prison, using the Yorkshire and Humberside region as a case study. In order to approach this we designed consultation exercises to:
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Critically examine how prisons interact with health care agencies to meet the needs of childbearing women both inside and outside prison
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Obtain the views of key stakeholders around improving practice and tackling barriers to equity of health care for childbearing women in prison
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Identify existing good practice in this area
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Produce an evidence base to inform future policy development and practice in this area
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Use this local pilot work to inform the development of future research in this field
This report contains key findings based on consultation data from the following sources:
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A brief scoping review
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Two Mother and Baby Unit (MBU) practitioner focus groups
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Five MBU Manager interviews
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Three activities undertaken by a web-based expert panel
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A multidisciplinary final event[13]
This report describes the consultation activities and the data produced from them. It offers suggestions for potential solutions to the challenge of providing the highest quality care for childbearing women in prison and their babies.
[1] http://www.justice.gov.uk/guidance/prison-probation-and-rehabilitation/types-of-offender/women.htm (16/12/11)
[2] correct as of 12/06/12, confirmed by the MBU Lead Operations Manager, NOMS Women's and Equality Group.
[3] Corston Report (2007) Women with Particular Vulnerabilities in the Criminal Justice System, London: Home Office.
[4] Marmot M (2010) Fairer Society, Healthy Lives: Strategic Review of Health Inequalities in England post 2010.
[5] Field F (2010) The Foundation Years: preventing poor children becoming poor adults. The report of the Independent Review of Poverty and Life Chances.
[6] DH (2010a) Healthy Lives, Healthy People: our strategy for Public Health in England White Paper and impact assessments.
[7] DH (2010b) Achieving excellence and equity for children: How liberating the NHS will help the needs of children and young people.
[8] 'Ministry of Justice (2010) Breaking the Cycle: effective punishment, rehabilitation and sentencing of offenders. http://sentencing.justice.gov.uk/?id=5&id2=14 (26/03/10).
[9] Gregoire, A, Dolan, R, Birmingham, L, Mullee, M and Coulson, D (2010) The mental health and treatment needs of imprisoned mothers of young children, Journal of Psychiatry and Psychology, Vol. 21 (3): 378-392.
[10] Birmingham, L., Coulson, D., Mullee, M., Kamal, M. and Gregoire, A. (2006) The mental health of women in prison mother and baby units, The Journal of Forensic Psychiatry and Psychology, 17 (3): 393- 404.
[11] Siefert, K. and Pimott, S. (2001) Improving pregnancy outcomes during imprisonment: A model residential care program, Social Work, Vol. 46 (2): 125- 134.
[12] Childbearing women are defined as women who are pregnant, in labour, or postpartum, or who have children up to the age of 18 months (the longest time a mother can keep her child in prison with her), including women who have suffered miscarriages or perinatal/infant deaths while in prison. We include those whose babies are with them in prison as well as those whose babies are not.
[13] The final event was particularly instrumental in identifying potential solutions to the challenges of delivering care to childbearing women in prison.
