Exploring access to desired and appropriate contraception during incarceration: A qualitative description of the experiences of women in custody in Ontario, Canada

Background: Women who experience incarceration lack equitable access and often face barriers to reproductive healthcare, including unmet needs for contraception. Previous studies have demonstrated that women who experience incarceration may want access to contraception and that providing contraception in prisons is feasible; however, it is unclear how this population wants to access contraception, and what their preference is for different forms of contraception. Objectives: We aimed to explore whether and how people with the capacity for pregnancy would like to access contraceptive education and services while incarcerated in provincial correctional facilities in Ontario. Design: We used a qualitative descriptive methodology using a qualitative content analysis approach. Methods: We conducted five focus groups with people aged 18–49 with the capacity for pregnancy and with current or prior experience of incarceration at an Ontario provincial correctional facility. Four groups were held at a provincial correctional facility for women, and one was held over Zoom for community-based participants. Results: Participants expressed a desire for contraception education and access during the incarceration period, including at intake, discharge, and throughout incarceration. They identified interests in accessible information about contraception, including through pamphlets, posters, and programs, and for care to be provided by a qualified women’s health clinician, who preferably was not employed by the jail. Participants felt that there were several barriers to accessing contraception while incarcerated, including long wait times, health care provider and other correctional staff attitudes, and lack of information on contraception options. Conclusion: This study identifies concrete strategies to address unmet needs for contraceptive care for women in custody. Study findings could inform the development of programs to support equitable contraceptive care access and reproductive health.