ACIP

In 2020, a snapshot of women in custody in NSW found that out of 1,533 women, 61 were pregnant, with roughly half identifying as Aboriginal or Torres Strait Islander. ¹ Women in prison are four times more likely to have minimal or no community antenatal care, or to initiate antenatal care after 20 weeks gestation. Incarceration can have both positive and negative effects on pregnant women, as custody is often the first opportunity for them to access maternal health services. Conversely, the stress of incarceration may increase the risk of poor health for mother and unborn child. ^1,3

Removing barriers to accessing antenatal care

Women entering custody often come from disadvantaged backgrounds, resulting in poor access to community health care, low health literacy and increased drug and alcohol use.^1-3 The Antenatal Care in Prison (ACIP) project looks to identify and address these health concerns within the prison environment, therefore improving antenatal services for pregnant women in NSW correctional centres.

Justice Health NSW aims to ensure that there are no barriers to accessing integrated multidisciplinary, culturally appropriate models of care, including virtual care, in all settings and locations, including a woman’s right to be part of the decision-making process. ⁴ While Justice Health NSW strives to provide quality care during pregnancy, birth, and the postnatal period, it recognises that the current model may not always support access to seamless and efficient antenatal care that is simultaneously woman-centred, culturally responsive, connected and coordinated.

Care that is women-centred and culturally responsive

The project team is in the process of developing and implementing a Model of Care (MoC), encompassing a multidisciplinary team approach, that will outline the patient's journey with the integration of various specialties, clarifying roles and duties, and detailing procedures along with a chronological framework. The MoC will be woman-centred, culturally responsive and digitally enabled, strengthening state-wide antenatal care delivery.

The team is also looking to improve the use of virtual care by rolling out an electronic antenatal checklist form, which will demonstrate care requirements enabling transparent and timely care. All clinicians will be able to see exactly where care is up to for all pregnant patients, providing a standardised overview of antenatal care.  It is important to ensure that pregnant women in prison stay connected with their community. Women who are moved away from their community area, will be able to maintain connection with their family and support network within the community by using electronic devices, such as tablets. Pregnant patients will have access to electronic devices within their cells to contact family at a time that suits them.

View this project's poster from the Centre for Healthcare Redesign graduation May 2024.

References