Contraceptive needs among newly incarcerated women in a county jail in the United States

Purpose: The purpose of this paper is to examine the risk of unintended pregnancy among women during Cook County Jail intake by assessing basic contraceptive history, the need for emergency contraception (EC) at intake, and contraception at release. Design/methodology/approach: This is a cross-sectional study of women 18–50 years old at Cook County Jail in Chicago, Illinois from June 2011 through August 2012. The authors administered the survey at the time of intake on 33 convenient evenings. Surveys consisted of multiple-choice close-ended questions administered via interview. Topics included contraceptive use, pregnancy risk and pregnancy desire. The authors computed frequencies to describe the distribution of question responses and used logistic regression modeling to identify factors significantly related to the use of contraception at intake and to the acceptance of contraception at release. Findings: Overall, 194 women participated. Excluding women not at risk for pregnancy (4.6 percent currently pregnant, 17.5 percent surgically sterilized/postmenopausal and 4.6 percent using long-acting reversible contraceptives), 73.2 percent of women were at risk for pregnancy (n = 142) and, therefore, had a potential need for contraception. Among these women at risk for unintended pregnancy, 68 (47.9 percent) had unprotected intercourse within five days prior to survey administration. When asked about EC, most women (81.4 percent) would be interested if available. Additionally, 141 (72.7 percent) of women would be interested in contraceptive supplies if provided free at release. Originality/value: Newly incarcerated women are at high risk for unintended pregnancy. Knowledge about EC and ability to access birth control services are both significantly limited. These conclusions support providing an intake screening in jails to identify women at risk for unintended pregnancy.