When practical barriers create ethical challenges to research with women in prison: Recommendations for researchers to advance women's health.

Authors

Rebecca J Shlafer, Karenna K Thomas, Andrea K Knittel, Melissa J Zielinski, Liz Ramey

Published in

Women's health (London, England). Volume 22. Pages 17455057261483478. Epub Nov 10, 2026.

Abstract

Approximately one million women are under correctional supervision in the United States, a number that is increasing at double the rate of men. For women who are incarcerated, the majority of whom are parents to minor children, incarceration has far-reaching impacts on individual-, family-, community- and population-level health outcomes. However, women who are incarcerated are often implicitly or explicitly excluded from biomedical and social science research, impeding researchers' and public health practitioners' ability to intervene at critical junctures to improve women's health outcomes.In this paper, we describe the ways that logistical challenges become ethical issues when conducting research focused on understanding and reducing women's health disparities in carceral settings. Building on our teams' collective experiences, we illustrate how the often-opaque and unpredictable Department of Corrections (DOC) and internal university Institutional Review Board (IRB) review processes, the difficulty in having meaningful engagement of individuals with lived experience from project design to dissemination, and the complexities surrounding informed consent and compensation all reveal a system that creates barriers to conducting equitable research to promote women's health. We provide tangible recommendations based on our experiences including actively engaging individuals with lived experience throughout the research process, cultivating collaborative relationships between researchers, DOC and participants to help navigate the carceral-specific challenges, and emphasizing intentionality about tone, timing, and venue of dissemination. The ethical challenges described must be addressed so that researchers - in partnership with individuals with lived experience - can continue to advance health equity and combat the significant health disparities created and exacerbated by incarceration.

PMID:
43006174
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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