Ginette G. Ferszt

Health Care of Pregnant Women in U.S. State Prisons

Background. Although standards for pregnancy-related health care in correctional facilities have been established, there is no mandatory accreditation that requires adherence to these standards. Furthermore, this information has been difficult to access from correctional facilities across the country. Methods. To examine the health care practices of pregnant women in state prisons, a survey with 62 multiple choice questions and four open-ended questions was developed. Wardens of 50 womens state correctional facilities were contacted to describe the study and request participation. Nineteen facilities completed the survey, for a 38% response rate. Results. The findings of this study provide further evidence of the substandard care that pregnant incarcerated women receive in correctional facilities. In many state prisons, nutritional recommendations for a healthy pregnancy are not met, adequate rest is compromised and lower bunks are not required. Psychosocial support and education are minimal at best. The use of restraints, which can compromise the health and safety of the woman and her baby, continues as a matter of procedure in many facilities even during labor and delivery. Conclusions. The providers of health care for pregnant women fail to use best practices and established standards in many womens state prisons. A concerted effort is urgently needed to address the unmet health care needs of this marginalized population and support legislation to limit the use of restraints with pregnant incarcerated women in all states.

Women's Experience of Postpartum Psychotic Episodes—Analyses of Narratives From the Internet

The aim of this study was to gain an insight into womens experiences of postpartum psychosis (PPP). Ten narratives taken from the Internet, which met the definition of PPP, were analyzed using cross-case and content analyses. The results revealed womens experience of having unfulfilled dreams, being enveloped by darkness, having disabling symptoms, and being abandoned. The womens experiences point to the importance of further education of nurses and doctors concerning PPP. It is vital not only for those working in psychiatric health care but also midwives and nurses who are working in maternity wards and child welfare centers. This would facilitate early recognition of signs and symptoms of the disorder, which, in turn, would make early treatment possible, thus supporting recovery. Furthermore, greater knowledge could contribute to providing more effective and compassionate care for these women.

The Impact of an Art Program on an Inpatient Oncology Unit

Although there is a growing body of literature describing the benefits of creative arts in health care, research in this area is limited. This article describes an exploratory qualitative research study that examines the potential benefits of an arts program on an inpatient oncology unit located in a major medical center in New England. Semistructured interviews of seven patients and seven nurses who cared for these patients were conducted following participation in an established arts program. Benefits included improved patient coping with pain, improved nurse-patient communication, and improved attitude toward hospitalization.

Grief Experiences of Women in Prison following the Death of a Loved One

One of the most important issues that an individual confronts during ones life is the death of a significant person. Given the contextual nature of grief, incarcerated women are faced with unique challenges when they experience the death of a loved one during their imprisonment. Yet little is known about the grieving process under these circumstances. This article, based on a qualitative research study, examines the experience of three women who suffered the death of a significant person while in a state medium-security prison. The context of the prison complicated the grieving process, resulting in disenfranchised grief.

Development of an educational/support group for pregnant women in prison

It is estimated that 6–10% of women are pregnant when they enter the prison system. The majority have had little, if any, prenatal care and/or childbirth education. Given economic constraints, the educational and support needs of this population are often not met. In response to these needs, an educational/support group was developed and led by a social worker, a mental health clinical nurse specialist, and a nurse midwife in a womens correctional facility in the Northeast. Women in various stages of pregnancy and early postpartum voluntarily attended. The need for education and psychosocial support was overwhelming. This group fostered a safe space for women to discuss real-life issues in a supportive environment. Meeting the educational and support needs of incarcerated women is paramount.

Houses of Healing: A Group Intervention for Grieving Women in Prison

This study examines the impact of female inmate participation in a facilitator-led group on psychosocial (anxiety, depression, self-esteem) and spiritual well-being. A convenience sample of 36 women (21 intervention, 15 comparison) was recruited from a womens prison in the Northeast. Participants in the groups described positive outcomes in the interviews and in the quantitative measurements of anxiety, depression, and self-esteem. Trends in the data, however, indicated an additional differential effect related to program involvement for depression and anxiety scores. The spirituality scores were high at all times for both groups, with slight increases over the period of the study.

The Impact of a Mindfulness Based Program on Perceived Stress, Anxiety, Depression and Sleep of Incarcerated Women.

Incarcerated women enter the prison setting with remarkable histories of trauma, mental health and substance abuse issues. Given the stress of incarceration and separation from their children, families, and significant others, it is not surprising that many women experience increased anxiety, depression, and problems with sleep. Due to these negative outcomes, it is imperative to find efficient non-pharmacological interventions. This pilot study examined the impact of a 12-week mindfulness based program on the stress, anxiety, depression and sleep of women with a total of 33 completing the study. In one group, women’s perceived stress, anxiety and depression were all significantly lower following the intervention compared to prior to the intervention. Challenges with implementing the pilot study are addressed. Despite challenges and limitations, the low-cost non-pharmacological intervention has potential for a reducing the symptoms of anxiety and depression.

Navigating the challenges of prison research with women.

Despite the healthcare needs of an increasing number of incarcerated women in the United States, few researchers access this underserved population. The authors provide practical information to help novice researchers navigate potential institutional challenges including obtaining institutional review board approval, gaining entry, complying with rules and regulations, recruiting and retaining participants, and collecting data.

Nurse Researchers in Corrections: A Qualitative Study

Abstract The United States has more people, per capita, in prisons and jails than any other country in the world. Because the prison population is largely composed of people who have been economically and socially disadvantaged, a very high percentage enter correctional facilities in poor health. Because of the large concentrated numbers of women, men, and youth in prisons and jails, an exceptional opportunity exists for nurses and other researchers to conduct creative and innovative research to improve the health care of this hard-to-reach population. The purpose of this study was to explore the experiences of nurse researchers who have been successful in conducting studies in different correctional settings. A qualitative descriptive design was used, and telephone interviews with 16 participants were completed. The participants described how they established credibility, the challenges they faced, and the unexpected personal and professional rewards they received. Recommendations for potential researchers will hopefully lead to an increase in research with this invisible population.

Advocating for pregnant women in prison: the role of the correctional nurse.

ABSTRACT On any given day, approximately 6%–10% of women who are incarcerated in prisons and jails in the United States are pregnant. Although incarcerated pregnant women have been identified as a high-risk group because of compromised physical and emotional health when they enter these settings, their specific healthcare needs are frequently unmet or partially met during their imprisonment. Stressors imposed by prison life and separation from their newborn at birth often exacerbate existing mental health issues including posttraumatic stress disorder, depression, anxiety, and insomnia. Nurses in correctional settings play a strategic role in improving the health care of this population by promoting teamwork, incorporating standards of care, and advocating for changes in policies. Collaboration with the warden, physician or nurse practitioner, correctional officers, and social workers can lead to positive changes in health outcomes. Given the national emphasis on gender responsive treatment in prisons and jails, a window of opportunity exists to be a voice for these women and make significant changes in health care for this largely undeserved population.