COVID-19 Impacts on Health Services and Social Support for Pregnant and Postpartum People in Prison

PROJECT ABSTRACT Since March 2020, there have been over 200,000 COVID-19 cases among pregnant people, and nearly 300 COVID-19-related deaths in the United States. Pregnant and postpartum people have increased health risks and are more likely to get severely ill from COVID-19 infections, with grave consequences for their health and the health of their offspring. For pregnant and postpartum people in prison, the conditions of incarceration make the COVID-19 pandemic even more precarious. Crowded living conditions, poor ventilation, and unsanitary environments all create conditions in which COVID-19 can easily spread. Throughout the pandemic, COVID-19 incidence and mortality rates in prisons and jails have been consistently higher than in the general population. To limit the spread of disease, prisons have modified policies related to health services, housing, employment, recreation, volunteer-run programming, and visiting. Yet, little is known about the impacts the COVID-19 pandemic has had on the health services and social supports of pregnant and postpartum people in prison, or how these impacts have influenced the health and well-being of this population. Leveraging our ongoing work with enhanced perinatal programs in six state prisons through our Parent R01, this Administrative Supplement aims to assess the impact of COVID-19 on health services and social support for pregnant and postpartum people in prison and the implications of these impacts for their health and well-being. Our long-term goal is to utilize this information to develop timely, evidence-based strategies to ensure pregnant and postpartum people in prison have access to high-quality health services and comprehensive social support - particularly amidst times of crisis - to reduce health disparities among this marginalized population. We will accomplish this goal by analyzing qualitative interviews with key stakeholders; conducting a systematic document review; surveying prison administrators; and interviewing pregnant and postpartum people to: 1) measure the impact of COVID-19 on health care services and 2) assess the impact of COVID-19 on social support for pregnant and postpartum people in prison. Results from this study are expected to fundamentally advance our understanding of how COVID-19 has impacted the health services, social supports, and well- being of pregnant and postpartum people in prisons. Identifying key factors that impacted the health and well- being of this population during the pandemic will inform changes to prison policies, practices, and programs. Ultimately, this work will yield critical information to address the complex health needs of this population, reduce health disparities, and promote health equity among justice-involved women and their infants.