Author Identifier (ORCID)
Abstract
Background: Evidence indicates high levels of unmet contraceptive need among justice-involved women, linked to intersecting vulnerabilities such as housing instability, substance use, violence and poor mental health. In Australia, limited research has explored how women in prison navigate access to family planning services. This study aimed to examine the experiences of incarcerated women in New South Wales (NSW) in accessing contraception and making fertility-related decisions.
Methods: The study formed part of the Second Sexual Health and Attitudes of Australian Prisoners (SHAAP-2) study. Seventeen women aged 19–45 were recruited from two NSW correctional centres. Semi-structured qualitative interviews were conducted face-to-face or via video call, recorded, transcribed, and analysed thematically in NVivo14. Coding drew on the Behavioural Model for Vulnerable Populations, supplemented by inductive thematic analysis to capture cross-cutting themes. Content analysis was also applied to describe contraceptive needs.
Results: Three overarching findings were identified. First, women’s access to contraception was less shaped by mistrust of providers than by system unreliability. While some reported supportive care, many described unanswered requests, long delays, and unsafe practices such as attempting implant removals. Second, incarceration prompted reflection and deliberate fertility planning. Women re-evaluated what it meant to be “ready” for motherhood, some seeking to delay pregnancy until achieving stability, others eager to conceive quickly after release, due to a sense of lost time. Third, women’s choices were constrained by side-effects and limited method options. Repeated failures with pills, injections, or devices sometimes led women to sterilisation as the “only certain” option, though some later regretted this decision.
Conclusions: Prisons represent a critical but underutilised setting for meeting reproductive health needs. Despite policy commitments to equivalence of care, contraceptive services in custody remain neglected. Findings highlight the need for stronger structural supports including timely service pathways and effective pre-release planning, to ensure women can access safe, flexible, and non-coercive contraception. Addressing these gaps is essential to upholding reproductive rights and reducing health inequities for incarcerated women.
Keywords
contraception access, incarcerated women, prison healthcare, reproductive health, sterilisation, unmet need
Document Type
Journal Article
Date of Publication
12-1-2026
Article Number
158
E-ISSN
17424755
Volume
23
Issue
1
PubMed ID
42316355
Publication Title
Reproductive Health
Publisher
Springer
School
Kurongkurl Katitjin / Centre for Indigenous Australian Education and Research
Funding Information
Helene Smith was funded by a UNSW Scientia PhD Scholarship.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Recommended Citation
Smith, H., Donovan, B., Jones, J., Butler, T., & Simpson, P. (2026). “My story is good. . . It’s not like that for all”: Uneven access to contraception among incarcerated women in New South Wales, Australia. Reproductive Health, 23, Article 158. https://doi.org/10.1186/s12978-026-02382-1