Essential standards for perinatal care of women and children living in prison

The female prison population continues to rise, with prisons worldwide failing to meet international human rights standards. Many are overcrowded, poorly resourced, and unsafe, especially for women. Women in prison are an obstetric group at high risk, with deficits in perinatal care leading to preventable maternal and child morbidity and mortality. Mother-child imprisonment and mother-child separation can have substantial intergenerational health and social consequences. In this Viewpoint, we present essential standards for perinatal care of women and children who are incarcerated, aligned to human rights obligations, prioritising alternatives to imprisonment, and where custodial sentences are applied, emphasising essential core best practices in prison (inclusion of prisons in national maternal health strategies, resourcing of prison facilities, services, staffing, and medical competencies, comprehensive medical management of pregnancy, obstetric and postpartum care, and release planning). To ensure the rights of women and children in diverse contexts are upheld, standards should be enforced through independent inspections, clinical audits, and integrated public and prison health monitoring of perinatal health outcomes.