Paynter Martha, Heggie Clare, McLeod Anja, Norman Wendy V
Faculty of Nursing, University of New Brunswick, 33 Dineen Drive, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada.
Department of Interdisciplinary Studies, University of New Brunswick, 33 Dineen Drive, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada.
BMC Pregnancy Childbirth. 2025 Aug 14;25(1):856. doi: 10.1186/s12884-025-07913-5.
Although Canada completely decriminalized abortion in 1988, barriers persist, and people experiencing incarceration may face additional challenges. Family planning health professionals (FPHP) in the community may provide care to incarcerated people. This study is the first to examine their experiences and needs.
We used a community-based approach to this qualitative study and conducted interviews and focus groups with FPHP across Canada from multiple disciplines. Experts on the research team with lived experience of incarceration enhanced relevance of research questions and approaches.
We spoke with thirty participants from eight provinces, including nurses, nurse practitioners, family medicine and obstetrics-gynecology physicians, and social workers. Analysis generated three themes: Managing Multiple Systems; The Prison in the Clinic; and Future Recommendations, and six subthemes, A Firewall of Secrecy, Logistical Hoop-Jumping, Surveillance by Correctional Officers, Health Professional Strategies, A Policy for Legitimacy and We Need This in Our Training. FPHP described commitment to providing incarcerated patients equivalent care to that provided to people in community, but faced challenges with communication, preserving patient dignity, privacy, confidentiality, and safety.
Findings indicate FPHP feel ethics and safety in jeopardy when caring for incarcerated patients. FPHP express needs for improved education about roles, and for supportive professional position statements or clinical workplace policies to buttress efforts at patient advocacy. No FPHP organization in Canada has a position on care of incarcerated pregnant people. Professional position statements and workplace policies could support confident care. FPHP training should include information about incarcerated peoples' needs.
尽管加拿大在1988年完全将堕胎合法化，但障碍依然存在，被监禁的人可能面临更多挑战。社区中的计划生育健康专业人员（FPHP）可能会为被监禁的人提供护理。本研究首次考察了他们的经历和需求。
我们采用基于社区的方法进行这项定性研究，对加拿大多个学科的FPHP进行了访谈和焦点小组讨论。研究团队中具有监禁生活经历的专家提高了研究问题和方法的相关性。
我们与来自八个省份的30名参与者进行了交谈，包括护士、执业护士、家庭医学和妇产科医生以及社会工作者。分析产生了三个主题：管理多个系统；诊所中的监狱；以及未来建议，还有六个子主题，保密防火墙、后勤折腾、惩教人员的监视、健康专业人员策略、合法性政策以及我们在培训中需要这个。FPHP表示致力于为被监禁的患者提供与社区患者同等的护理，但在沟通、维护患者尊严、隐私、保密性和安全性方面面临挑战。
研究结果表明，FPHP在照顾被监禁患者时感到伦理和安全受到威胁。FPHP表示需要改进关于角色的教育，需要支持性的专业立场声明或临床工作场所政策来支持患者维权努力。加拿大没有FPHP组织对照顾被监禁的孕妇有立场。专业立场声明和工作场所政策可以支持自信的护理。FPHP培训应包括有关被监禁者需求的信息。
