Justice Core: An Innovative Response to Incarceration During Pregnancy in North Carolina

Incarceration during pregnancy is a pressing public health issue, but interventions to minimize harms for this population are not frequently described in the literature. We developed Justice Core, a pretrial diversion intervention for pregnant people with substance use disorders (SUDs), to minimize exposure to incarceration during pregnancy and increase access to SUD treatment. The intervention was feasible and acceptable to referring jail staff. In parallel, we conducted a needs assessment and identified an estimated 1,220 to 1,461 annual incarcerations during pregnancy among 77 responding jails (80% of North Carolina jails), and an estimated prevalence of perinatal SUDs of 66%. The Justice Core model of diversion into SUD treatment holds promise as a means to limit the duration and extent of incarceration, with a potential concomitant reduction in the harms experienced by pregnant people with SUD in jails and prisons.