Access to Doula and Midwifery Support for Washington State’s Incarcerated Population: A Qualitative Policy Assessment

Abstract

Abstract: Access to Doula and Midwifery Support for Washington State’s Incarcerated Population: A Qualitative Policy Assessment Background: This thesis assesses perceptions of key stakeholders regarding Washington State RCW 72.09.588 and its impact on the birth support choices and reproductive health of pregnant people incarcerated in the state prison system. Methods: Semi-structured qualitative interviews were conducted with individuals (N = 9) who interface through their work with pregnant incarcerated people to gain insights into the potential impact of RCW 72.09.588 on the birth experience of incarcerated people in Washington State. Data collection and thematic analysis were based on Collins’ framework for health policy analysis. Results: Most participants believed that the passage of RCW 72.09.588 was a positive first step towards providing pregnant, incarcerated people in Washington State with access to doula and midwifery services. No participants believed their work had been substantially affected by the law. We found no evidence that any pregnant, incarcerated person in Washington State had accessed a midwife or a doula as a result of this law. We identified several key barriers and facilitators impacting the implementation of the law. Conclusions: While the passage of RCW 72.09.588 is a meaningful first step towards improving incarcerated people’s maternal and infant health outcomes and expanding their overall reproductive autonomy, the law has had no reported impact on this population’s ability to access doula or midwifery services during the prenatal, perinatal, or postpartum period.