title: Highly Effective Birth Control Use Before and After Women's Incarceration.
abstract: BACKGROUND
  We examined factors associated with women's use of highly effective birth control before and after incarceration, since women with ongoing criminal justice involvement bear a disproportionate burden of sexual and reproductive health problems, including high rates of unintended pregnancy and inconsistent contraceptive use.
  
  
  METHODS
  Using a longitudinal study design, we conducted surveys with 102 women in an urban midwestern jail and then followed up with 66 of them 6 months after incarceration. We used stepwise logistic regression to assess individual, interpersonal, resource-based, organizational, and environmental factors associated with utilizing highly effective birth control.
  
  
  RESULTS
  Forty-two percent of women reported utilizing highly effective birth control (e.g., sterilization or other highly effective reversible methods) prior to incarceration, and 54% reported using these methods after release from jail (p<0.001). Ninety percent of women reported not wanting to get pregnant. Consistent use of birth control (p=0.001) and alcohol problems (p=0.027) were associated with utilization of highly effective birth control prior to incarceration. Previous pregnancies (p=0.012) were the only factor associated with utilization of highly effective birth control after release from jail.
  
  
  CONCLUSIONS
  Clinicians and public health practitioners can use findings from this study to develop clinical and intervention efforts aimed at improving unintended-pregnancy prevention among incarcerated women both during their confinement and during the tumultuous period after their release from jail.
authors.affiliation: 1 Department of Preventive Medicine and Public Health, University of Kansas School of Medicine , Kansas City, Kansas.
authors.forename: Megha
authors.initials: M
authors.lastname: Ramaswamy
authors.affiliation: 2 Center for Research Methods and Data Analysis, University of Kansas , Lawrence, Kansas.
authors.forename: Hsiang-Feng
authors.initials: HF
authors.lastname: Chen
authors.affiliation: 3 Department of Psychiatry, School of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Cropsey
authors.affiliation: 4 Center for Primary Care and Prevention, Memorial Hospital/Brown Medical School , Pawtucket, Rhode Island.
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Clarke
authors.affiliation: 5 School of Nursing, University of Missouri-Kansas City , Kansas City, Missouri.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Kelly
mesh_terms: D000328:Adult; D017677:Age Distribution; D003267:Contraception / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008923:Missouri; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons; D016387:Women's Health; D055815:Young Adult