Evaluation of Birth Companions perinatal support in prisons during the COVID-19 pandemic

Women in prison who are pregnant or recently had a baby are a highly vulnerable population due to complex histories, increased risks of poorer outcomes, and mother-infant separation. During the COVID-19 pandemic, these women faced additional challenges due to infection risks and enforced social isolation. In England in March 2020, the Ministry of Justice and Her Majesty's Prisons and Probation Service prioritised the early release of pregnant women and mothers living with their babies in Mother and Baby units (referred to as compassionate release on ROTL - Release On Temporary Licence). Birth Companions, a UK-based charity that works with pregnant and post-natal women in prison, were commissioned to extend its reach to help coordinate care and post-release support to women released under ROTL, and those released as 'business as usual' in all English women's prisons during the pandemic. Here we report insights from an evaluation of this work. Interviews were undertaken with nineteen participants (six women, eight Birth Companions, and five health/social care professionals) and thematic analysis was undertaken. Two themes and associated sub-themes emerged. 'Facilitating support' outlines how women benefitted from the support via engendering trust, promoting coping strategies, and facilitating positive change. 'Challenges in support provision' describes key barriers that Birth Companions faced in accessing and supporting women due to communication barriers and difficulties in coordinating wider support. This study highlights a unique, service model that enabled woman-centred care, despite limitations. Prisons need to revisit existing policies and guidelines to ensure that equitable care is provided during future crises.