Imprisoned and Pregnant: Evaluating the Use of Correctional Restraints
ACOG ePoster. Fox M. Apr 27, 2018; 211477; 4I
Mallory Fox
Mallory Fox
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Abstract
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Introduction: The use of physical restraints in pregnant incarcerated patients is commonplace in many health care institutions. Restraints and shackles have been deemed not only unsafe but also demeaning and unnecessary for this special patient population. The American College of Obstetricians and Gynecologists (ACOG), the National Commission of Health Care standards, as well as Florida State Statues have adopted position statements opposing the use of physical restraints in pregnant patients. My project aimed to assess the baseline knowledge of the correctional guard staff implementing shackles and restraints; as well as provide an educational seminar to the correctional officers. Overall the aim of this study was to educate guard staff in efforts of aligning practices in accordance with ACOG and the state of Florida recommendations.

Methods: A brief educational seminar was presented to a group of correctional facility guards and Jacksonville Sherriff's officers involved in the care of UF Health ambulatory or inpatient obstetric patients. The presentation covered the associated health risks and implications of restraint use in pregnancy. Additionally, the current practice recommendations were presented as outlined by ACOG and the Florida State Statute in FL Senate Bill No. 524. A brief anonymous pre and post IRB approved survey was administered. The rate of correct answers by question was described across time periods using counts and percentages, and analyzed using Fisher's exact tests. Wilcoxon's Signed Rank Test was used to compare the difference in overall score from pre to post. All analyses were performed using SAS ® Version 9.4 for Windows.

Results: There were fifteen Jacksonville Sherriff's officers and correctional guard staff that participated in the educational seminar and completed the pre and post survey. There was no significant relationship between time period (pre/post) and correct responses (p=0.2148-1.0). Additionally, there was no significant change in overall score between time periods (p=0.1052).

Conclusion/Implications: Despite clear concise guidelines, the use of shackles and restraints remains commonplace in the field of OBGYN. As such, there is a need for education for patients, correctional guard staff, and health care providers. The current study showed that several guard staff are not familiar the current guidelines set forth by ACOG and the Florida State Statute. While
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