by Meredith K. Wise, Sahana Raghunathan, Sreya Upputuri, Elana Jaffe Brotkin, Tre D. Thorne, Jamie Conklin, Andrea K. Knittel
First published: 27 February 2026; https://doi.org/10.1002/ijgo.70873Digital Object Identifier (DOI)
Abstract
Background
More than 740 000 people identified as female at intake were incarcerated globally as of 2022, reflecting a 60% global increase since the year 2000, with a concomitant increase in gynecologic conditions experienced behind bars.
Objectives
The purpose of this scoping review was to examine the breadth of benign and malignant gynecologic conditions experienced during incarceration, including the prevalence, special management considerations, access to services, and the patient experience.
Method
The search strategy included a combination of keywords and subject headings for incarceration and benign or malignant gynecologic conditions with no language or date limits. Studies were eligible for the review if they: (i) discussed a benign or malignant gynecologic condition; (ii) included a population of people experiencing incarceration; and (iii) answered one or more of the four key questions identified prior to the search. One researcher independently screened each reference title and abstract for eligibility, and two reviewers independently screened each full text reference. One researcher extracted data from each study using a data extraction template, with verification and consensus by the primary and senior investigators.
Results
After screening, 135 studies corresponding to 137 reports from 38 countries were included in the review. Included studies focused on cervical dysplasia and human papilloma virus (56), normal menstruation (38), vaginitis (36), routine gynecologic care (23), abnormal bleeding (17), pelvic pain (13), menopause (8), urinary incontinence (7), and gynecologic malignancy (5) during incarceration.
Conclusion
The included studies demonstrate that across the globe, gynecologic conditions in carceral settings are common and can be exacerbated by the physical and emotional stress of incarceration, trauma histories, lack of access to care, and conditions of confinement in these settings. Gaps in the published literature exist on health education and interventions to address gynecologic health disparities and the gynecologic health needs of aging and older adults. There is a pressing need for parallel efforts at global de-carceration and policy interventions to provide for basic gynecologic needs, decrease intersectional stigma, and improve the conditions of confinement.
From the Introduction
More than 740 000 people identified as female in intake are incarcerated globally as of 2022, reflecting a 60% global increase since the year 2000.1 The USA unfortunately leads this trend, with the increase in incarceration among people assigned female far outpacing both those assigned as male in the USA and female incarceration in all other countries. The scope of this review is global, but considering national disparities in rates of incarceration, much of the framing centers on the US criminal legal system…. The American College of Obstetricians and Gynecologists states that people experiencing incarceration should have access to the full scope of reproductive care. Historically, however, research on the obstetric and gynecologic healthcare needs of people experiencing incarceration has focused on pregnancy care, sexually transmitted infections, and cervical dysplasia. Recent reviews highlighting the difficult realities of contraception and abortion access in carceral settings and the ongoing high prevalence of human papilloma virus (HPV) and cervical dysplasia and cancer among people experiencing incarceration reflect the prioritization of these issues.
The aim of this review was to answer the following questions: (1) What is the prevalence of benign and malignant gynecologic conditions among people experiencing incarceration? (2) What are special considerations for managing benign and malignant gynecologic conditions in carceral settings? (3) What is access to services for benign and malignant gynecologic conditions like during incarceration? (4) How does incarceration affect experiences of benign and malignant gynecologic conditions?