Title: Abortion and contraception within prison health care: A qualitative study
Version: 2 Date: 07 Nov 2024
Reviewer:  Laura E. T. Swan
Reviewer's report:
Thank you for the opportunity to review this important manuscript about the family planning
needs of people in prison. This is a powerful and well-written paper, and I look forward to seeing
it published. Below, I have highlighted some minor points for revision.
1. Abstract: The methods section of the abstract should be written in complete sentences.
2. Introduction: Some of the examples in the first sentence seem related to reproductive justice
rather than reproductive health.
3. Background: It would be useful to present the frequency of pregnancy for incarcerated people
to help readers understand the scope of the problem.
4. Theoretical Framework: I would suggest a slight rewrite of the reproductive justice framing.
Typically, RJ is conceptualized as distinct from reproductive rights and reproductive health. RJ
does use a human rights framework, so the rewrite could be as simple as changing “reproductive
rights” to “human rights.”
5. Data analysis: What methods of reflexive thematic analysis did you follow? Please provide a
citation for the methodological steps you followed and describe your coding process with a bit
more detail. For example, what made the analysis “reflexive”? What software did you use for
coding? How did you move from codes to themes?
6. Ethical considerations: Please add the gift card amount.
7. Results: The first paragraph of your results section seems to detail data collection methods,
meaning that it would be more appropriate in the methods section.
8. Results: It seemed like there were a few typos in the quotes. I know you want to honor
participants’ exact phrasing, but at times, I wondered if it was a transcription error. Please review
the quotes to ensure accuracy. One example is the quote on page 9 that reads “be picked fourteen
times.” Is this meant to say “pricked” instead of “picked”?
9. Results: Contraceptive coercion can be upward (pressure to use) or downward (pressure to
not use). The quote presented under theme 1 is also an example of upward coercion. Relatedly,
I would recommend renaming the coercion subtheme to remove “denial” since some of the
examples are upward coercion rather than downward (denial).
10. Results: Many elements of the last theme seem unrelated to the stated topic of the paper.
While this information about mental and behavioral health is critically important, it seems a
bit out of place here and muddles the story you’re telling with the abortion and contraception
quotes that come before it. I would recommend removing any quotes that do not directly relate
to the paper’s focus. One option is to briefly mention the theme and say that these results will
be presented elsewhere. If you choose to keep them in, I would recommend cutting the section
down substantially and stating upfront that this topic is outside the scope of the main focus of
the study but it came up repeatedly in the interviews.
11. I am curious about the decision to use focus groups rather than individual interviews. Either
in the methods section or the strengths/limitations section, please add a brief justification for
this decision and discussion of its implications.