“Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, Canada
Abstract Background Incarcerated pregnant individuals face barriers to perinatal care and health disparities when compared to the general population. Social and healthcare providers serving incarcerated pregnant clients are uniquely positioned to identify systemic barriers which hinder clients’ acce...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07696-9 |
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| author | Xaand Bancroft Audrey Ferron Parayre Amy McGee Lisa Morgan Wendy Peterson |
| author_facet | Xaand Bancroft Audrey Ferron Parayre Amy McGee Lisa Morgan Wendy Peterson |
| author_sort | Xaand Bancroft |
| collection | DOAJ |
| description | Abstract Background Incarcerated pregnant individuals face barriers to perinatal care and health disparities when compared to the general population. Social and healthcare providers serving incarcerated pregnant clients are uniquely positioned to identify systemic barriers which hinder clients’ access to care and service delivery. This study explores the experiences of providers and the systemic challenges they encounter while delivering perinatal health and social services to individuals incarcerated in Ontario, Canada. Methods We conducted a qualitative study using a descriptive design. We administered virtual, semi-structured interviews with social service and healthcare providers. Participants were recruited through purposeful and snowball sampling based on their experience delivering services to at least one individual who was pregnant while incarcerated in Ontario, Canada. All interviews were conducted individually to facilitate discussions and ensure confidentiality. We employed thematic analysis to identify and develop themes and subthemes. Results Twenty-three participants (15 social service providers and eight healthcare providers) were interviewed. Participants explained how overlapping systems shaped their ability to deliver care, which we conceptualized as the carceral perinatal care system, composed of carceral, clinical, and community subsystems. Through thematic analysis, we also identified five themes, visually depicted as three concentric circles to reflect providers’ layered and compounding experiences. The outermost circle, divided into three segments, represents the main challenges providers encountered when delivering perinatal care: (1) operating within a fragmented system, (2) knowing too little, and (3) witnessing dehumanization. These challenges contribute to the middle circle theme of (4) feeling powerless, which culminates in the centre circle theme of (5) enduring occupational stress. Conclusion Participants provided insights about the challenges involved in delivering perinatal care to incarcerated individuals. This study underscores the multifaceted, systemic barriers providers encounter, enhancing our understanding of the complexities surrounding perinatal care in carceral settings. The knowledge generated forms a foundation for developing policies, guidelines, and training resources tailored to the carceral context. Such interventions may strengthen providers’ capacity to deliver equitable care, improving perinatal experiences and health outcomes of pregnant individuals and their infants. Future research should explore perinatal care from incarcerated individuals’ perspectives to inform evidence-based solutions and guide comprehensive reforms. |
| format | Article |
| id | doaj-art-68708bb90e374937bd2cb582161e71e7 |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-68708bb90e374937bd2cb582161e71e72025-08-20T01:51:35ZengBMCBMC Pregnancy and Childbirth1471-23932025-05-0125111810.1186/s12884-025-07696-9“Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, CanadaXaand Bancroft0Audrey Ferron Parayre1Amy McGee2Lisa Morgan3Wendy Peterson4Interdisciplinary School of Health Sciences, University of OttawaCivil Law Section, Faculty of Law, University of OttawaOttawa Hospital Research InstituteInterdisciplinary School of Health Sciences, University of OttawaSchool of Nursing, University of OttawaAbstract Background Incarcerated pregnant individuals face barriers to perinatal care and health disparities when compared to the general population. Social and healthcare providers serving incarcerated pregnant clients are uniquely positioned to identify systemic barriers which hinder clients’ access to care and service delivery. This study explores the experiences of providers and the systemic challenges they encounter while delivering perinatal health and social services to individuals incarcerated in Ontario, Canada. Methods We conducted a qualitative study using a descriptive design. We administered virtual, semi-structured interviews with social service and healthcare providers. Participants were recruited through purposeful and snowball sampling based on their experience delivering services to at least one individual who was pregnant while incarcerated in Ontario, Canada. All interviews were conducted individually to facilitate discussions and ensure confidentiality. We employed thematic analysis to identify and develop themes and subthemes. Results Twenty-three participants (15 social service providers and eight healthcare providers) were interviewed. Participants explained how overlapping systems shaped their ability to deliver care, which we conceptualized as the carceral perinatal care system, composed of carceral, clinical, and community subsystems. Through thematic analysis, we also identified five themes, visually depicted as three concentric circles to reflect providers’ layered and compounding experiences. The outermost circle, divided into three segments, represents the main challenges providers encountered when delivering perinatal care: (1) operating within a fragmented system, (2) knowing too little, and (3) witnessing dehumanization. These challenges contribute to the middle circle theme of (4) feeling powerless, which culminates in the centre circle theme of (5) enduring occupational stress. Conclusion Participants provided insights about the challenges involved in delivering perinatal care to incarcerated individuals. This study underscores the multifaceted, systemic barriers providers encounter, enhancing our understanding of the complexities surrounding perinatal care in carceral settings. The knowledge generated forms a foundation for developing policies, guidelines, and training resources tailored to the carceral context. Such interventions may strengthen providers’ capacity to deliver equitable care, improving perinatal experiences and health outcomes of pregnant individuals and their infants. Future research should explore perinatal care from incarcerated individuals’ perspectives to inform evidence-based solutions and guide comprehensive reforms.https://doi.org/10.1186/s12884-025-07696-9Health services for prisonersIncarcerationPerinatal carePregnancyHealthcare providerSocial worker |
| spellingShingle | Xaand Bancroft Audrey Ferron Parayre Amy McGee Lisa Morgan Wendy Peterson “Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, Canada BMC Pregnancy and Childbirth Health services for prisoners Incarceration Perinatal care Pregnancy Healthcare provider Social worker |
| title | “Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, Canada |
| title_full | “Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, Canada |
| title_fullStr | “Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, Canada |
| title_full_unstemmed | “Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, Canada |
| title_short | “Is that a policy thing or is that a guard thing?”: A qualitative study of providers’ experiences supporting pregnant individuals incarcerated in Ontario, Canada |
| title_sort | is that a policy thing or is that a guard thing a qualitative study of providers experiences supporting pregnant individuals incarcerated in ontario canada |
| topic | Health services for prisoners Incarceration Perinatal care Pregnancy Healthcare provider Social worker |
| url | https://doi.org/10.1186/s12884-025-07696-9 |
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