REPRODUCTIVE (IN)JUSTICE IN CANADIAN PRISONS FOR WOMEN
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Introduction: The population of people incarcerated in federal prisons for women in Canada increases every year. They experience barriers to reproductive health care and traumatic separations from children. The federal Mother Child Program (MCP) was created to address mother-child separation but has been the subject of little research. The aim of this study was to examine experiences of the federal MCP among participants and non-participants. Methods: Case study design integrated multiple data sources and used a theoretical framework of prison abolition. Three scoping reviews foreground the study: 1) Maternal health outcomes among incarcerated women; 2) Health outcomes associated with mother child programs; and 3) Sexual and reproductive health outcomes among incarcerated women in Canada. An environmental scan mapped out facilities designated for the incarceration of women and proximity to perinatal hospitals. A theoretical framework of feminist prison abolition for nurses was developed. A quantitative study was conducted to generate descriptive statistics about MCP participation from 2001-2018. Finally, semi-structured interviews were conducted with 23 people with lived experience of federal incarceration during pregnancy and early parenting and with staff of Elizabeth Fry Societies. Results: The scoping reviews found negligible maternal health research in Canadian prisons. There are 72 prisons for women and girls in the country. 133 mothers participated in the MCP from 2001-2018. In interviews, parents expressed ambivalence about the MCP due to exclusionary eligibility criteria. They experienced traumatic separation, mental distress was met with punishment, and they were subject to surveillance and violence. Parents navigated challenges through self-advocacy and peer support. Elizabeth Fry Societies’ staff perceived the MCP as out of reach for most, resulting mother-child separation and trauma bonding. The MCP introduces additional surveillance and inequities. Both types of informants described systemic problems in health services including prioritization of security operations and clinician dual loyalty. They characterize prison as incompatible with maternal health. Conclusions: Prison abolition provides a critical lens to the subject of the MCP, demonstrating failure to address health harms of incarceration to the parent-baby pair. With Elizabeth Fry staff support, parents strategically navigate federal incarceration to prioritize the best interests of their children. Alternatives to incarceration are recommended.