Maternity Hospital Policies for Care for People in Prisons in Canada: A Policy Review.

OBJECTIVES

Approximately 5% of incarcerated people in Canada are pregnant. These individuals are more likely to experience adverse infant and maternal outcomes. Despite this, there are no clinical practice guidelines governing reproductive care for women in prison in Canada. This research study asks what maternity hospital policies exist with respect to the care for pregnant incarcerated individuals in Canada.

METHODS

We conducted an environmental scan and document analysis of maternity hospital policies providing care to perinatal individuals who are experiencing incarceration. We contacted 58 hospitals from May 2023 to March 2025. We analyzed both formal policies according to inclusion criteria and verbal responses from hospital team members.

RESULTS

Of the 58 hospitals contacted, we received responses from 49 hospitals. Of the respondents, 46 did not have a policy, and 40 hospitals provided further verbal comments. Three hospitals provided a policy for care of incarcerated people, 2 of which met inclusion criteria. We identified 4 themes from these policies: Roles and Responsibilities, Surveillance and Restraints, Perinatal Considerations and Special Populations. Through our analysis of verbal responses, 5 themes emerged: Treat the same as any other patient, Rare occurrence, Follow prison lead, Common Practices, and Working on it.

CONCLUSIONS

There are only 2 hospital policies in Canada addressing the perinatal care of incarcerated people. These policies do not fully meet international standards of perinatal healthcare for incarcerated individuals. The need for hospital policies to ensure culturally safe, dignified, and ethical care of incarcerated people in pregnancy is dire.