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Long-Acting Reversible Contraceptives for Incarcerated Women: Feasibility and Safety of On-Site Provision

Carolyn Sufrin, Johns Hopkins School of Medicine Tianyi Oxnard Joe Goldenson Kristin Simonson Andrea Jackson

First published online:

| DOI: https://doi.org/10.1363/47e5915
Abstract / Summary
CONTEXT

Many incarcerated women have an unmet need for contraception. Providing access to long-acting reversible contraceptive (LARC) methods—IUDs and implants—before release is one strategy to meet this need and potentially prepare them for reentry to the community, but the safety and feasibility of providing these methods in this setting have not been described.

METHODS

A retrospective descriptive study of all LARC insertions at the San Francisco County Jail in 2009–2014 was conducted. Data from community clinic and jail clinic databases were assessed to examine baseline characteristics of LARC initiators, complications from insertion, method continuation, and pregnancy and reincarceration rates. Correlates of method discontinuation were assessed in multivariate logistic regression analyses.

RESULTS

Eighty-seven LARC devices were inserted during the study period—53 IUDs and 34 implants. There were no cases of pelvic inflammatory disease or other insertion complications in IUD users and no serious complications in implant users. Median duration of known use was 11.4 months for IUDs and 12.9 months for implants. Women who discontinued a LARC method most commonly cited a desire to get pregnant (32%). Black women were more likely than whites to discontinue use (odds ratio, 4.4).

CONCLUSIONS

It is safe and feasible to provide LARC methods to incarcerated women. Correctional facilities should consider increasing access to all available contraceptives, including LARC methods, in a noncoercive manner as a strategy to reduce reproductive health disparities among marginalized women at high risk of unplanned pregnancies.

Perspectives on Sexual and Reproductive Health, 2015, 47(4):TK, doi: 10.1363/47e5915

Author's Affiliations

Carolyn Sufrin is assistant professor, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore. Tianyi Oxnard is a student at the School of Medicine, University of California, San Francisco. Joe Goldenson is director, Jail Health Services, San Francisco Department of Public Health. Kristin Simonson is assistant director of program management, and Andrea Jackson is assistant professor, both at Bixby Center for Global Reproductive Health and Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco.

Disclaimer

The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.