Motherhood Experiences of Incarcerated Pregnant Women: A Phenomenological Study

INTRODUCTION

Previous research has shown that approximately 7% of the global prison population are women, ¹ with 61% of these women being mothers with children under the age of 18. ² Among these incarcerated mothers, around 71% have their children living with them during their imprisonment. In another study, it has also been reported that 85% of imprisoned women experience separation from their children for the first time and for an extended duration. ³ In Iran, a significant proportion of incarcerated women fall within the childbearing age range and have an average of 3.1 children. ⁴ The prison rules in Iran allow children to live with their mothers in prison for a period ranging from two to six years. ⁵

Motherhood, deeply intertwined with femininity, relies on the recognition and respect of a mother’s emotions. ⁶ However, the experience of motherhood within incarceration presents unique challenges. Imprisonment restricts individuals from fulfilling social roles and impacting the mothers’ experiences. ⁷ Balancing criminal actions and maternal responsibilities creates confusion for incarcerated mothers and is hindered further by prison constraints. ⁶ Conflicting roles and negative external factors shape incarcerated women’s understanding of motherhood. ⁸ Imprisonment demands resilience and adaptability, altering the nature of motherhood itself. Stigma and discrimination towards incarcerated mothers contribute to social isolation and hinder their ability to maintain their maternal role. ⁹

Despite these challenges, incarcerated mothers endeavor to maintain connections with their children through letters, gifts, and parenting programs. ¹⁰ Limited access to support networks, unlike mothers in free society, necessitates reliance on prison staff, volunteers, fellow inmates, and support groups to navigate their maternal roles. ¹¹

Previous studies on maternal identity in the context of prison revealed that incarcerated women often grappled with balancing their identities as mothers and prisoners, attempting to separate these two aspects. They strive to either detach their motherhood from the prison environment or disconnect their incarceration from their identity as mother. The unique nature of this topic highlights the necessity of further exploration. ^{12 , 13} These studies have highlighted the requirement for a comprehensive understanding of the experiences of incarcerated mothers and the impact of incarceration on their maternal identity and the relationships with children. The description of the phenomenon of motherhood in the criminal justice system, particularly in the context of prison, is a crucial issue that needs attention. Pregnant prisoners face unique challenges related to their maternal feelings and roles. Therefore, it is essential to give voice to incarcerated pregnant women in order to understand their experiences of motherhood. ¹⁴ Despite growing global attention to incarcerated pregnant women, research on this topic in Iran is notably limited. The previous studies, which have been focused on health care needs, prenatal care, and sexually transmitted infections, collectively highlight the scarcity of research addressing the multifaceted experiences of pregnant women, particularly experience of motherhood in Iranian prisons. ^{15 - 17} Numerous challenges contribute to the research gap in Iran, including cultural considerations, restricted prison access, and financial limitations. This shortage of comprehensive research underscores the existing lack of understanding, particularly regarding the intricate challenges that incarcerated pregnant women face in their maternal roles. To address this gap, concentrated research efforts are imperative. A thorough investigation into the distinctive challenges confronted by incarcerated mothers within Iranian prison system is necessary to inform evidence-based policy formulation, effective interventions, and tailored support services. Such research initiatives offer valuable insights into the unique circumstances and needs of this vulnerable population, contributing to an enhanced comprehension of their experiences and well-being as mothers within the context of incarceration.

This study aimed to fill the existing knowledge gap by employing a phenomenological approach to delve into the lived experiences of incarcerated pregnant women in Iran and their perspectives on motherhood during imprisonment. By adopting this approach, researchers can gain a comprehensive understanding of the phenomenon and interpret it from the incarcerated mothers’ standpoint. The objective of this study, therefore, is to describe the phenomenon of motherhood in prison by exploring the lived experiences of incarcerated pregnant women in Iran.

METHODS

This study was conducted using a descriptive-interpretive phenomenology adopted by Van Manen (2016) ¹⁸ in one of the central prisons in Iran from August 2019 to May 2021. Van Manen’s method of phenomenological inquiry has been widely used in the field of health sciences to explore the lived experiences of patients and caregivers. Van Manen tried to provide phenomenology in a contemporary and modern way in six steps, which was followed in the current work. ¹⁸ These six practical steps include: 1) Turning to the nature of the lived experience, 2) exploring the experience as it is lived and not how we conceptualize it, 3) reflecting on the essential themes that reveal the characteristics of the phenomenon, 4) describing the phenomenon through the art of writing and rewriting, 5) maintaining a strong and oriented relation with the phenomenon, and 6) balancing of research context by considering the parts and the whole. ¹⁸

In the first step, the researchers focused on the nature of the lived experience. In this study, the researchers aimed to comprehend the essence of the phenomenon by examining how incarcerated pregnant women experience it.

Step two of van Manen’s phenomenological approach itself consists of three phases including identifying the study setting, identifying and selecting the participants who are key informants, and managing the process of data collection.

The setting of the study was one of the Central Prisons of Iran. This prison currently houses approximately 700 women prisoners. From those, 40 to 50 inmates are pregnant at any given time. The prison is comprised of 12 resident buildings with security levels ranging from low to high. Participants were included in the study if they had a minimum one-month history of pregnancy during their time in prison, expressed interest in participating in the study, possessed the ability to communicate in Persian, and provided informed consent. Those who faced challenges in effective communication or ability to continue their participation after interview were excluded from the research. There was no individual who refused to participate or dropped out of the study. Eleven participants including seven pregnant and four early postpartum women in prison were included in the study. The participants’ age ranged from 21 to 42 years. Four multiparous women were at the time of the study residing with their child/children. Nine participants intended to raise their child upon their release from prison and two planned to place their newborn to state welfare organization. The demographic characteristics of the participants are presented in Table 1.

Regarding the participants’ selection, we used the purposeful method with a strategy of maximum variation. For this reason, participants were selected from different age groups, educational levels, number of pregnancies, gestational week, duration of incarceration, as well as different circumstances of pregnancy such as legitimate or illegitimate, intended or unintended, and types of crimes committed.

As to the process of data collection, after obtaining permission to attend the women’s ward of Central Prison, participants’ recruitment was started, the objectives of the research were explained to the participants, and their informed consent was obtained. The researchers maintained a state of openness throughout the study, employing strategies to foster openness and create a conducive environment for incarcerated mothers to freely share their personal experiences and feelings. The researchers attentively considered the participants’ descriptions, remaining attuned to the nuanced details and richness of their experiences. Additionally, the researchers established a foundation of trust with them by building rapport and demonstrating empathy and non-judgmental attitudes. The interviews began in a semi-structured way with questions about why participants were incarcerated like “How did you get here?” and then continued with questions such as “Could you please describe as detailed as possible the prison environment that you have experienced?” In addition, questions like “What does the experience of being a mother in prison look like?” was asked to help the researchers to reconstruct the experience with its relationships and structures. Finally, the questions like “What does it means to you?” allowed the participant to reflect the meaning of her experience. The supplementary interview was conducted with participant number 2. She gave birth while still incarcerated after the initial interview. Therefore, it was decided to conduct a supplementary interview with her to delve into her experiences of pregnancy and motherhood in prison with more details. Sampling was continued until data saturation was achieved, i.e., rich, relevant, and in-depth data was obtained, and no new codes or themes emerged from the analysis of the data. This approach allowed for a comprehensive exploration of the phenomenon under investigation, capturing the essence of the participants’ experiences and uncovering the underlying meanings inherent in their narratives. The researchers strived to ensure the thoroughness and validity of the study by employing the Van Manen phenomenological approach and diligently conducting the sampling process. We used narrative anecdotes during the interview to further reflect on the methodology of studying and analyzing the data. The interviews lasted from 30 to 50 minutes. MAXQD10 software was used to facilitate data management.

Data analysis was conducted primarily based on the step three of Van Manen’s methodology, which recommends reflecting on the essential themes. ¹⁸ In this study, the researchers reflected on the essential themes identified in the previous step and tried to understand them in a deeper and more meaningful way. In the Van Manen’s approach, observing reflection involves a deep and deliberate examination of one’s experiences, feelings, and thoughts in a particular situation. ¹⁹ In this study, throughout conducting the interviews and analyzing the data, researchers remained aware of their own biases and assumptions and approached the data with an open and curious attitude. By doing so, they could gain more nuanced and complex understanding of the phenomenon under investigation. Furthermore, the researchers moved towards the lived experience that gave rise to it and posed the question, “What does this experience look like?” As an active participant in the research process, the researchers deeply immersed themselves in the research data and frequently returned to the phenomena, data, and texts to gain further insights and understanding. According to the Van Manen approach to phenomenological research, the process of “immersion in data” refers to the researchers’ active participation, allowing themes and patterns to emerge from the live experiences of the study participants. ¹⁹

In the process of data analysis, the researchers employed three approaches, namely the holistic, selective, and detailed techniques. In the holistic approach, each transcript was thoroughly read several times to achieve a comprehensive understanding. Once familiarization with the transcript was attained, the researchers composed a descriptive text that represented their perceived essence of the transcript. This descriptive text was reviewed several times, and a concise summary using a phenomenological approach was written, capturing the core of the text.

Next, using the selective approach, phrases, or statements that revealed the phenomenon under investigation were identified, allowing for the extraction of thematic sentences or paragraphs. Moving on to the detailed approach, the researchers meticulously examined the transcripts line by line, extracting key phrases or terms related to the experiences of caring for incarcerated mothers. Thematic phrases were extracted, and the content of each interview was compared with previous interviews to identify similarities. Based on these similarities and interrelationships, the contents were categorized into subthemes. The subthemes were further integrated based on their interrelationships, ultimately leading to the emergence of the main themes.

Step four of Van Manen’s method focuses on describing the phenomenon through the art of writing and rewriting. ¹⁸ In this study, the researchers wrote a descriptive narrative of the phenomenon being studied, based on the insights gained from the previous steps. In addition, an evocative and vivid language was used to bring the phenomenon to life and make it accessible to the readers.

Van Manen in step five of his method highlights maintaining a strong and oriented relationship to the phenomenon. ¹⁸ In this study, the researchers maintained a strong and focused relationship with the phenomenon under study by revisiting the data and approaching it from novel perspectives, seeking fresh insights and interpretations. This iterative process of reflection and exploration allowed for a deeper understanding of the phenomenon, as the researcher continuously examined the data from different angles and considered alternative viewpoints. The researchers also sought input from experts in the field to gain diverse perspectives on the interpretation of the phenomenon. This collaborative approach allowed them to benefit from constructive feedback, critiques, and specialized insights. By incorporating the perspectives of others, the researchers aimed to enhance the richness and validity of their findings.

Step six of Van Manen’s approach is about the balancing of research context by considering the parts and the whole. ¹⁸ Recognizing the significance of this issue, which involves a dynamic movement between the whole and the parts, the researchers ensured that the research question was carefully considered at each level of the study. This deliberate approach facilitated a comprehensive exploration of the topic, enabling a deeper understanding of the phenomenon under investigation.

It is noteworthy that the research team had a good experience in using Van Manen’s approach to conduct a phenomenological inquiry, with the particular focus on exploring the experiences of women during pregnancy and childbirth. The first author was trained for Van Manen’s approach, and the second was an experienced qualitative researchers, who adopted Van Manen’s method in several previous studies.

The Van Manen’s criteria of credibility in phenomenological research included orientation, strength, richness, and depth. ¹⁸ To ensure orientation in the study, the researchers maintained active engagement with the data and repeatedly analyzed the textual accounts of the participants to extract the underlying meanings. As to achieving strength in the study, descriptive-interpretive summaries were meticulously crafted to accurately depict and interpret the intentions and meanings of motherhood in prison as articulated by incarcerated women. To achieve richness in the study, the researchers carefully examined the collected data, considered the social and cultural conditions within the prison and pregnancy environment, and crafted descriptive-interpretive summaries that accurately captured the multifaceted aspects of motherhood in prison as expressed by incarcerated women. To achieve depth, the researchers were engaged with the data and studied participants’ textual accounts repeatedly to extract the underlying meanings, enabling a comprehensive exploration of the topic and a deeper understanding of motherhood in prison as expressed by incarcerated women.

The Research Ethics Committee of Mashhad University of Medical Sciences approved the present study with the code of IR.MUMS.REC.1398.099. Necessary permissions were also obtained from the General Directorate of Prisons Organization of the Province to access the women’s ward of the prison. Prior to participating in the study, informed written consent was obtained from each participant. They were assured that they have the right to withdraw from the study at any time without facing any negative consequences. Detailed explanations were provided regarding the participants’ right to choose whether to participate or refuse the study, as well as the principles of confidentiality. To ensure a safe and private environment for the interviews, a dedicated room was provided where participants could feel comfortable and secure to express themselves. Confidentiality was strictly maintained throughout the study, guaranteeing anonymity and protecting the identities and responses of the participants. It is important to note that the name of the prison in which the participants were selected was also not disclosed. This commitment to confidentiality created a sense of ease and willingness among the participants to share their personal information. Due to the restrictions on recording interviews in the prison, the researchers had to take notes during the interviews instead.

RESULTS

“Living in a dichotomous world” was the theme, which emerged in relation to the experience of motherhood in prison. It consisted of two subthemes of “moving between unity and separation” and “being subject to ambiguity and uncertainty”. It portrays the experience of mothers who find themselves trapped in a dichotomous world, torn between their deep maternal affection for their child and the anxiety that comes with motherhood in the context of incarceration. Uncertainty looms over both their own future and that of their child, creating a complex and challenging landscape to navigate. The summary of the emerged theme and sub-themes is shown in Table 2.

1. “Moving between Unity and Separation”

The theme “Moving between unity and separation” captures the feelings and instinctive response of women in prison to the experience of motherhood. This concept refers to the emotional conflicts of women in prison with the child inside them. When these women realized the existence of their child, this connection and closeness immersed them in a range of different emotions, but in the desperation of reaching and separation, they were forced to accept a feeling, justification, and conclusion. This theme was emerged from two sub-themes of “From estrangement to unity with the unborn child” and “The restlessness for separation from the child”.

1.a. From Estrangement to Unity with the Unborn Child

The journey of incarcerated women started with an initial estrangement with the unborn child due to having a broken and disrupted attachment and emotional distance with them. They assumed the unborn child as an uninvited guest who increased the pain and suffering that they were tolerating. However, after a while, they arrived a transformative process, guided by the compassion and empathy, which allowed the incarcerated mothers to move from a fragmented and alienated connection with their child to a close and nurturing bond. One of the participants candidly expressed her feeling of estrangement and sense of emotional detachment from her child, showing a feeling of being distant or disconnected:

“I do not have a special feeling for her. Honestly, I have endured significant suffering during my time here, which has caused me to detach from these emotions and no longer prioritize them. It doesn’t matter for me at all.” (P6)

Another participant similarly referred to her estrangement from her unborn child as such:

“I feel she is not my baby. It is not my skin, flesh, and blood. I felt the same way when I was pregnant, as if someone else’s baby was in my womb.” (P4)

At some time in the future, despite the restrictions of prison, imprisoned pregnant women, following acceptance of their pregnancy and observing themselves as mother, tried to make unity with their unborn child. For this reason, they eagerly anticipated the darkness of night when the lights were switched off, offering them a chance to connect intimately with their unborn child. Placing a hand on their abdomen and gently touching and rubbing it, they engaged in heartfelt conversation throughout the night. These moments of closeness provided comfort and companionship, underscoring the deep bond they shared. In these fleeting hours, the barriers of their confined existence faded away, and was replaced by an infinite love for their child. A participant said:

“I wait the whole day until nightfall when the lights are turned off; then, you know, I can be alone with my child. I gently touched and rubbed my belly and talked to my baby all the night. I felt sorry for him. It is very good to have someone in prison who is so close to you and intimate with him.” (P11)

The journey from estrangement to unity with one’s unborn child extended far beyond the physical act of carrying. It encompassed a deep emotional bond that brought companionship and solace, even in the midst of isolation. This extraordinary connection surpassed the constraints of the prison setting, providing a profound sense of belonging and purpose and transforming their experience from estrangement to a profound unity with their child. A mother implied:

“I feel connected to my child, not because of just carrying him, but because I feel very close to him in my womb; you know, he is the only thing that I have here with myself.” (P2)

1. b. The Restlessness for Separation from the Child

Separation from the child was identified as one of the most painful aspects of imprisonment for mothers. Interviews with expectant mothers revealed their deep concerns and anxiety about the impending separation, whether planned or forced. The uncertainty of their sentence and release dates added to their distress. This experience intensified the already challenging and turbulent nature of pregnancy in prison, highlighting their unfulfilled yearning for their child. A participant said:

“I’m anxious…, I cannot sleep at night. I always think about my child; you know, I’m thinking how long he will stay with me, and what will happen to him if I’m not released.” (P5)

Women in prison found themselves at a crossroads of doubt and uncertainty regarding their children. They faced the agonizing decision of either keeping their child with them or placing them in welfare organizations. This dilemma intensified their heartache, as they feared loneliness for their child in an institutional setting or isolating them within the prison walls. A mother stated:

“I think about him a lot. To put him in a welfare organization, you know, going to and staying in a big place that.... I do not know, sometimes I think it is a sin. Sometimes I think that I will not take him to a welfare organization at all, as one day he will feel like me that has no family at all. That’s why I might keep him in jail with me.” (P2)

A participant who had recently delivered her baby expressed her concerns about obtaining permission to keep her child with her in prison. She strongly believed that she must take care of her child herself, as she feared that being separated from her in the outside world would subject him to profound loneliness. Her anxiety reflected the unfinished turmoil of the potential separation from her beloved child:

“I’m very stressed; I don’t know if they will let me to keep the baby with myself in the prison or not. I just want to keep him with myself because I do not have anyone outside to take care of him.” (P4)

The prospect of being separated from the child after a legally permissible period of up to two years was extremely distressing for women. The mere thought of being apart from a part of themselves compelled women to endure the challenges of caring for their child, rather than being separated from them. This interpretation reflects the unresolved turmoil of potential separation from their beloved child:

“I can’t even imagine that my child will be separated from me. I know that I can legally keep him with me for up to two years, but I know how difficult it is to take him away from me. It does not matter how many children you have, you know, it is very difficult to do so.” (P1)

2. Being Subject to Ambiguity and Uncertainty

For some women in prison, the concept of motherhood became elusive. While becoming a mother may have seemed attainable within the prison walls, the reality of motherhood proved to be challenging. Motherhood, for these women, marked the onset of profound worries and uncertainties. This interpretation highlights the perplexity and ambiguity that surrounded their perception of motherhood. This theme emerged from two subthemes of “Engagement in confusing thoughts about childbirth” and “Elusive perceptions of unconditional motherhood.”

2.a. Engagement in Confusing Thoughts about the Childbirth

Pregnant women incarcerated in prisons grappled with an enduring fear linked to the childbirth due to the lack of support, especially during night-time hours. An illustrative anecdote highlighted the absence of assistance as a pregnant woman gave birth without aid, accentuating their vulnerability and uncertainty. This atmosphere of anxiety and confusion underscored their experience of childbirth within the prison context. The fear extended to concerns about not having a conventional delivery, enduring labour without support, and lacking agency in decision about the delivery method. Hospital staff behaviour further heightened their trepidation, fostering a sense that entrusting themselves or their babies to medical care put their lives at risk. This narrative unveils a theme of navigating childbirth uncertainties amidst incarceration restrictions. A mother told:

“I was often consumed by concerns and uncertainties about my ability to have a natural childbirth. I expressed my worries to the doctor multiple times, emphasizing my feelings of incapability. The daunting prospect of facing the hospital staff’s negative attitude further intensified my fears as I desperately wanted to safeguard myself and ensure my baby’s safety. The conflicting emotions and confusion overwhelmed me, especially as a pregnant woman confined within the prison setting.” (P4)

Pregnant women in prison faced anxiety and uncertainty about childbirth. They lacked control over where to give birth, who would assist them, and experienced difficulties with escort officers at the hospital. Their confusing thoughts surrounding childbirth reflected their challenging circumstances. A participant said:

“I want my body to be in control; I do not want anyone to constantly growl when I am going to give birth to get an ambulance.” (P3)

Incarcerated pregnant women faced heightened confusion during childbirth, particularly when they were restrained in bed. They were unsure if they were in labor or about experiencing tolerating extreme physical and mental pain in labor. Some even contemplated death as a preferable alternative to enduring the agony of being chained. This emphasizes their deep entanglement in confusion and uncertainty surrounding childbirth concerns. A participant implied:

“I know that if I want to go out of prison for childbirth, they will handcuff and tie me. At times like this, you do not know whether to bear your pain or the pain of handcuffing and tying as, you know, the pain of childbirth doubles when I think about it. It’s better to die. It would be much better if a person can easily give birth without a bracelet.” (P8)

2.b. Elusive Perceptions of Unconditional Motherhood

For incarcerated women, motherhood was characterized by ineffective efforts due to the lack of prison facilities. They could not provide what they wanted for their child, but they believed in offering unconditional love confronting with adversity instead. A mother told:

“I think I can never be a good mother to her. I always feel that I cannot do my job in the way I wish to be as a mother because there is nothing you can give your child; there are no facilities and the only job that I can do is to love her.” (P2)

Despite the challenges of childcare in prison, some mothers did their best within the limitations of the law and circumstances. However, they were ultimately compelled to give their child to a family member against their will, or if that was not possible, surrender them to a welfare organization. Separation from their child was not only difficult, but also incredibly painful for the mother. This interpretation showcases their selfless belief in the face of a heartbreaking outcome. A participant said:

“I will keep my child with me for as long as I am allowed for two years, but then if someone is not willing to accept him, I will have to give him to a welfare organization. Although it is difficult for a child to be separated from his/her mother, it is a thousand times harder for me.” (P11)

DISCUSSION

The objective of this study was to understand the experiences of motherhood based on the lived experiences of incarcerated pregnant women. The authors arrived at the main theme of “Living in a dichotomous world” which emerged from two sub-themes including “Moving between unity and separation” and “Being subject to ambiguity and uncertainty”, through examining the experiences of incarcerated pregnant Iranian women.

Regarding the main theme of the present study titled “Living in a dichotomous world,” the exploration of motherhood among women in prison unveils a complex dynamic where, on one hand, a sense of hope for bonding with their children to be delivered coexists with a profound fear of the inevitable separation to come. On the other hand, an undercurrent of anxiety and latent apprehension regarding unforeseen maternal challenges shroud their experiences. Within the incarcerated context, mothers grapple with a spectrum of intricate emotions, oscillating between deep attachment to their children and lingering feelings of abandonment, which collectively contribute to an overarching sense of uncertainty surrounding their future paths. The experience of motherhood within the prison’s confines can aptly be likened to traversing a landscape defined by stark contrasts and intricate realities. Insights garnered from prior research underscore two divergent perspectives that converge upon narratives elucidating the tribulations of motherhood within the prison setting: one perspective accentuates how children become a wellspring of optimism, fostering unwavering determination among incarcerated mothers as they navigate the challenges of confinement. ²⁰ Conversely, the opposing viewpoint emphasizes that the presence of children, coupled with the demanding nature of assuming maternal responsibilities in such constrained conditions, gives rise to profound anxiety and an enduring sense of guilt. ²¹

Within the context of “Moving between unity and separation”, it is evident that many incarcerated women face significant challenges in maintaining communication with their children. The process involves navigating internal struggles and emotional turmoil, which initially bind them closely to their children, followed by an inevitable separation. Research indicates that the experience of imprisonment can profoundly alter, disrupt, or even terminate a mother’s journey of motherhood. ⁶ While some mothers in the community may abandon their children for various reasons, incarcerated women may exhibit lower levels of empathy and tolerance towards their children, making them more inclined towards separation. ¹⁰

In the realm of incarcerated mothers and their children, the emotional journey can be understood through the lens of the theme “Moving between unity and separation.” This theme encapsulates the intricate dynamics that these mothers experience, as they navigate a continuous cycle of emotions oscillating between the desire for connection and the pain of separation. ^{2 , 22 , 23} The prison environment serves as a catalyst, intensifying this emotional turmoil and perpetuating the oscillation between yearning and suffering. ^{2 , 22 , 23} Ultimately, this cyclic pattern offers a poignant insight into the complex nature of the mother-child relationship within the context of incarceration.

The theme of “Moving between unity and separation” sets the tone for this paragraph, delving into the intricate emotional landscape shaping the experiences of incarcerated women. This theme reverberates through poignant scenes witnessed at the beginning of the maternal journey for incarcerated pregnant women. Confined to maternity beds, these women grapple with both physical and emotional limitations as they strive to establish a connection with their unborn children. The emotional tension inherent in this struggle aligns with the overarching theme of emotional oscillation. ²⁴ Similarly, the challenges faced by incarcerated mothers in embodying maternal roles amid the constraints of imprisonment are underscored by the theme “Being subject to ambiguity and uncertainty.” These mothers frequently find themselves torn between societal ideals of motherhood and the reality of their situation, leading to emotional turmoil and self-doubt. ⁸

Furthermore, the theme “Being subject to ambiguity and uncertainty” sheds light on the emotional reality faced by incarcerated pregnant women. As these women grapple with impending motherhood within the confines of the prison, they are confronted with a host of fear, anxiety, and conflicting emotions, collectively representing the theme of uncertainty. Their emotional state, clouded by ambiguity, reflects the unique challenges they face in navigating the ambiguous landscape of motherhood within the prison context. ²

As the narrative unfolds, the theme of “Elusive perceptions of unconditional motherhood” becomes apparent, offering insights into the struggles these women are face with. The clash between their maternal roles and the harshness of incarceration creates an elusive and challenging terrain to navigate. ⁸

Meanwhile, the theme of “Engagement in confusing thoughts about childbirth” reflects the emotional upheaval faced by incarcerated pregnant women. Within the prison context, these women must grapple with the uncertainty and fear surrounding childbirth, further adding to the theme of uncertainty. ²

Overall, the seamless interplay of these themes paints a comprehensive picture of the emotional landscape experienced by incarcerated mothers. The theme of “Moving between unity and separation” serves as the backdrop against which the emotional struggles, and challenges tied to “Being subject to ambiguity and uncertainty” are vividly portrayed. Through these themes, the reader gains insight into the complexities of motherhood within the context of incarceration and the profound emotional journeys that these women undertake.

To sum up, it is noteworthy to mention that the findings of this study could be influenced by the cultural, religious, and contextual conditions of Iran, contributing to the distinct experiences of Iranian incarcerated women and shaping their understanding and practice of motherhood within the prison setting. These factors create a dualistic world where the challenges and dynamics of motherhood are influenced by the unique cultural and societal context of Iran. Therefore, further research is recommended to be conducted in different societies with pro-natalist and anti-natalist policies towards the meaning of motherhood in prisons.

Exploring the maternal phenomenon in prison and highlighting the voices and experiences of these marginalized mothers are the strengths of this study. However, it is important to acknowledge the potential influence of social and selection biases on our findings and interpretations. While in this study we tried to minimize such biases, it is essential to recognize that broader contextual and societal factors can influence the perspectives and experiences of incarcerated mothers. Future research endeavors should consider the multifaceted impact of contextual and societal conditions as important contextual elements, which might influence the findings of this study.

The results of this study have implications for the society to perceive incarcerated mothers, highlighting their ambivalence and ambiguity towards the motherhood role attainment and, as a consequence, the need for support and being understood within a dualistic world. Acknowledging the challenges faced by these women, society can foster empathy and inclusivity in approaching motherhood in the context of incarceration. The findings also suggest the importance of implementing supportive institutions and organizations that can contribute to the success of mothers in their role and relationships with their children. By addressing the unique needs of incarcerated pregnant women, these initiatives can facilitate the development of more effective policies and practices.

CONCLUSION

The study delved into the experience of motherhood in prison, spotlighting incarcerated mothers’ challenges. The overarching theme, “Living in a dichotomous world,” emerged from subthemes of “Moving between unity and separation” and “Being subject to ambiguity and uncertainty.” Incarcerated mothers experience mixed emotions of attachment and abandonment towards their children, which leaves them uncertain about the future. This necessitates providing psychological support for this vulnerable population both by the policymakers and community authorities to make them capable of fulfilling their maternal role in an appropriate way.

Policymakers should reconsider laws for incarcerated pregnant women, focusing on compassionate measures to enhance their well-being and maternal roles, and prioritize mental health, prenatal and postpartum care. Communities should adopt empathetic maternity care, increase access to community-based prenatal programs, acknowledge prisoners’ experiences for a compassionate society valuing motherhood, promote rehabilitation, and nurture the bonds between mothers and children. Families and security personnel should offer emotional support to incarcerated mothers. Families can maintain further supportive communications, and security personnel can receive training to better understand and empathize with pregnant inmates. This collaborative approach enhances the well-being of incarcerated mothers and their children.

ACKNOWLEDGEMENT

The present article is a part of a doctoral dissertation of the first author (Somayeh Alirezaei) in Reproductive Health, which is financially supported by Mashhad University of Medical Sciences, Mashhad, Iran under grant number of 980109. The research team is sincerely grateful for the support of the Vice Chancellor for Research of Mashhad University of Medical Sciences and all the imprisoned pregnant women who shared their experiences with the researchers.

Conflict of Interest:

None declared.

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