Two-thirds of women incarcerated are in their childbearing years, chiefly ages 18 to 40, according to the Federal Bureau of Prisons. Transitioning back into the community is a time of celebration and of reunion. It’s also an opportunity if you’ve been incarcerated to refocus on your health as you get back to living your best life. Specific health recommendations, screening guidelines, and resources will vary depending on your age. If you’re between 21 and 39 years old, this article is for you. Getting health care that helps you prevent illness is vital to staying healthy and well. As soon as you’re able, schedule an appointment with a nurse-midwife, women’s health nurse practitioner, gynecologist, or a family doctor. And plan to get regular care. At your first visit, your care provider will screen for medical problems, assess your risk for future medical issues, make sure your vaccinations are up to date, and empower you to lead a healthy lifestyle, all while building a professional and helpful relationship with you. Here’s all you need to know abut your journey from incarceration to wellness.

Getting Back to Regular Life

Look for “re-entry programs” in your community. These programs help connect folks to health care, employment, education, and housing, and improve public safety. The Lion Heart Foundation at Lionhart.org provides a list of reentry programs throughout the country. The federal Substance Abuse and Mental Health Services Administration, SAMHSA. gov, has an excellent resource entitled, After Incarceration: A Guide to Helping Women Reenter the Community online.

Protect Your Health Each Day

It’s so important for you to take care of yourself on a daily basis. Eat healthy foods, exercise at least 30 minutes every day, take a multivitamin with 400 to 800 mcg of folic acid, and get at least 7-9 hours of sleep each night. Ask your healthcare provider for help if you need to get to a healthy weight. Stay tobacco-free, and if you need help quitting smoking or vaping, your provider can help you with that, too! Try to limit alcohol use to 1 drink or less each day and avoid illegal drugs or misuse of prescription drugs altogether. And while you’re at it, be sure to wear the appropriate protective gear for sporting activities (helmets), and a seatbelt whenever you’re in a car. We want you to be well and to make the very most of your well-deserved freedom! 

Healthcare Checklist 

Women and People with Internal Genitalia, Ages 21-39

Sexual History Your sexual history focuses on the CDC’s Five P’s. You may ask about the following:

  • Partners (Who are your sexual partners?)
  • Practices (What kind of sexual contact do you have?)
  • Protection from STDs (Do you use any protection against STDs?)
  • History of STDs (Have you ever been diagnosed with an STD?)
  • Prevention of pregnancy (Are you currently trying to conceive a child? Are you using birth control?)

Physical Exam

A physical exam will likely include:

  • Height
  • Weight
  • Body Mass Index (BMI)
  • Blood Pressure
  • Thyroid Exam
  • Breast Exam
  • Abdominal Exam
  • Pelvic Exam
  • Skin Exam

STD/STI Screenings

  • If you’re ages 21-25 and sexually active, you’ll be screened for chlamydia and gonorrhea. If you’re older and are potentially at high risk for one of these infections, you should be screened. Be sure to ask if it isn’t offered!
  • A one-time test for hepatitis is recommended for all adults.
  • You should have at least one screening for HIV, and be screened more often if you’re at risk for HIV

Vaccines

  • Human Papillomavirus
  • Influenza: Every year
  • Tetanus, Diphtheria, Pertussis: Booster every 10 years
  • Varicella: 2 lifetime doses if you’re not already immune
  • Measles, Mumps, Rubella: At least 1 or 2 lifetime doses unless you have a medical contraindication or evidence of immunity

Preventative Health Screenings

Breast Cancer Screening

  • People with breasts should have a clinical breast exam every year
  • Experts don’t agree on the benefits of self-breast exams in finding cancer however, it is vital to be aware of that your breasts normally look and feel like
  • Contact your health care provider if you notice changes in your breasts at any time
  • Mammograms aren’t typically recommended for people with breasts until age 40
  • If you have a strong family history of breast cancer at a young age, annual mammograms might be considered earlier

Cervical Cancer Screening

  • People the ages of 21-29 who have a cervix should have a Pap smear every 3 years. HPV testing is not recommended for this age group
  • People ages of 30-65 should be screened with either a Pap smear every 3 years or with both a Pap smear and the HPV test every 5 years
  • People treated for cervical dysplasia (precancer) should continue to have Pap test every year for 20 years post-treatment or until age 65 (whichever is longer)

Depression: Your provider should screen for depression at least once every year

Intimate Partner Violence: Yourprovider should screen for intimateviolence partner violence at every visit

Diabetes Screening

  • If your blood pressure is elevated (130/80 or higher), your provider may test your blood sugar levels for diabetes
  • If you have risk factors for diabetes such as a history of gestational diabetes, a first degree relative with diabetes, or a high BMI, then your provider may screen for diabetes

Cholesterol Screening

  • Recommended beginning at age 20 for people with known risk factors for coronary heart disease
  • Testing should be repeated every 5 years for people with normal results

Blood Pressure Screening

  • Your blood pressure should be checked at least once every 2 years
  • If you have other medical conditions (such as kidney problems, heart disease, or diabetes), your blood pressure should be checked more frequently

Dental Exam

  • You should have a dental exam and cleaning once or twice every year

Eye Exam

  • You should have an eye exam every 2 years, or more often if you have visual problems or diabetes

Following these essential women’s health exams will ensure you become and stay healthy and make your transition from incarceration to wellness significantly smoother.

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Author

Shawana S. Moore, DNP, APRN, WHNP-BC, PNAP, is a women’s health nurse practitioner. She serves as an Associate Professor and the DNP Program Director at Emory University’s Nell Hodgson School of Nursing. She is passionate about equitable, respectful, and inclusive maternal-child care.

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