INCARCERATED WOMEN: FROM THE ADVERSITIES OF PRENATAL TO CHILDBIRTH.

Objective: Investigate the profiles of incarcerated pregnant women and the main problematic factors they face while pregnant, such as prenatal consultations to problems related to the time of give birth.
Method: This is an exploratory descriptive study of the type (RIL) where we used the search for data in the SciELO, BVS and LILACS databases listing only studies that met the eligibility criteria in the period from 2009 to 2020.
Results: The study shows that pregnant women deprived of their liberty suffer from not having the appropriate number of prenatal consultations, as recommended by the Health Ministry, and claim that their rights are not respected at the time of parturition.


INTRODUCTION
In Given the context presented, this research aimed to understand the adversities of pregnant women incarcerated in carrying out prenatal care and at the time of delivery.

LEGISLATION TO SUPPORT PREGNANT WOMEN IN prison
According to Andrade and Gonçalves (2018), Brazil has a large number of prisons involving women. Most of them are women deprived of liberty who have a low income, as well as little education and who are of childbearing age with little family support and belong to a group of social vulnerabilities that become worse from the moment they are introduced into prison. Among the women who make up the prison system, are pregnant women whose pregnancy may have been identified before or during their stay in prison.
These women are in the age group of 19 to 25 years old, being mostly single, with incomplete elementary education, low pay, with reports of lack of health care along with complaints regarding the lack of structure in the prison system to meet their needs. specificities and with difficult access to prenatal care. The neglect of health care for these pregnant women reveals that both the mother and the fetus do not have their rights respected in Brazilian prisons (GALVÃO AND DAVIM; 2013).
According to Fochi et al (2017), studies show that more than 50% of these pregnant women do not receive effective multiprofessional assistance. When it is approached that prenatal care is mandatory in this phase in which the woman is, there

Deficiency in prenatal care
Obstetric care must rely on welcoming conducts and humanized treatment by services and health professionals who must receive women with dignity, organization, Santana, Oliveira and Bispo (2016), affirm that even with rights guaranteed by law, which ensures complete care during the pregnancy-puerperal period, nursing monitoring for some prisoners is non-existent. It is noteworthy that the frequent contacts between nursing and the client during consultations allow greater adherence of these women to prenatal care, better monitoring of the pregnant woman and the fetus, in addition to detecting early complications of any problems during pregnancy. In Brazil, incarcerated women are therefore usually transferred in the third trimester of pregnancy (seven to nine months) from their prison unit to a specific unit that will house the pregnant woman and her future baby. The parturient is taken to a public hospital at the time of delivery and then must return to a prison prepared to receive lactating mothers and their babies, as well as stay in these units for a period ranging from 6 months to 1 year (LEAL et al; 2016).

The separation between mother and baby
For mothers in prison, motherhood becomes difficult due to living in an unfriendly environment, the moment of separation is lived with regret and suffering, as these women will miss living with their children who were together for about six months. The fact that they cannot follow the phases of their growth and development brings losses caused by the distance. (Batista, Loureiro; According to Kennedy, Mennicke, Allen (2020) for many incarcerated mothers, family relationships are broken during incarceration, visiting policies in prisons and the lack of intensive family-oriented programming further distances the bond between mother and child, although there are proven benefits for mothers and children through regular contact, most mothers have never even received a visit from their children in prison after six months of breastfeeding, many children are adopted by another family or the family that is legally responsible chooses not to take the child in prison for the visit.
Brazil has few prison facilities specific to women. 117 records were filtered. 91 records were excluded due to: studies that did not have penitentiaries as a subject and / or imprisoned pregnant women as the object of investigation (n = 58), studies whose publication exceeded 10 years (n = 33). 26 full-text articles were assessed for eligibility. 11 articles were excluded due to being abstracts or master's dissertations. 15 articles in the synthesis. To achieve the objective, the following guiding question for the study was defined: What adversities do incarcerated pregnant women face from prenatal to childbirth?
From the answers to these questions, we made the discussions, as set out in the next paragraph of this work.

Flowchart of the results obtained on the research platforms
After searching for articles through the scientific databases at the Virtual Health Library (VHL), Scielo, Lilacs and PubMed, 137 studies were identified and after filtering and analysis, 15 were selected because they met the study inclusion criteria .
After detailed reading of each selected article, the data were crossed according to the objectives of the work and thus, a total of 847 pregnant women were studied in the 15 articles, with the age group between 18 to 39 years old with the prevalence of Adequate care for pregnancy and childbirth is essential to reduce maternal and child morbidity and mortality rates. Predraza (2016) estimates that a quarter of infant deaths and almost all maternal deaths result from the provision of inadequate care from the beginning of pregnancy to the immediate postpartum period. The same author points out that even with an investment in the last twenty years by the government to improve basic health care, the assistance offered to pregnant women has been of low quality. Considering that Pedraza's research (2016) was carried out with an audience considered free, when comparing with articles from the population of prison women, this ideal quality is practically non-existent.
When analyzing the study, if all the obstacles to pregnancy and childbirth that they face in the prison environment were not enough, the inmates still deal with different issues when they are taken out of prison and taken to the hospital.
Differentiated care according to the mother's schooling reveals a distortion in the assistance given to childbirth, which is more linked, apparently to extra technical factors such as economic issues than to issues related to the health of the motherchild binomial.
Pedraza (2016) points out that many times the pregnant woman of a higher socioeconomic level still has the differential of knowing and being linked to the maternity hospital where she will receive assistance within the scope of the Unified Health System, which for other groups and, especially pregnant women in prison, suffer the violation of the pregnant woman's right because they do not know where the birth of their child will occur. Khesia, Susanne and Juciara (2018) point out that, in addition to the difficulties in accessing health services, they possibly also do not know where they will be taken, so pregnant women do not enjoy the right to a companion in labor. In this way, the feelings of guilt and distress experienced by thinking that their children will also be future prisoners are guided by the term "prison", as they need to remain with their mothers in incarceration, not experiencing common moments in the outside world and not enjoying the Family living. Is the timing of parturition a cause for concern or how it will occur, that is, The moment of delivery, as it is unique and marked by different feelings, becomes enhanced when the mother faces a particular situation like the one mentioned above. For many pregnant prisoners, the stress of prison associated with the intrinsic shocks of pregnancy produces psychological destabilization, which tends to hinder the perception of their children in the womb as well as putting themselves in the role of mother. If you consider that many do not even want to be pregnant and that they are in prison because of their partners and that they have lost social and family references, these women should receive differentiated attention with a diverse and effective multidisciplinary team.

CONCLUSION
The study on women incarcerated, from the adversities of childbirth seeks to show and raise awareness in society in general about the precarious and fragile situation faced by the female prison population, especially pregnant women within the prison system in Brazil.
Nevertheless, as nursing professionals, we must not only show the reality that is present in Brazilian prisons, but also find ways that lead health authorities to rethink the ways and strategies of caring for this prison population as fragile as incarcerated pregnant women, as well as their babies who are born in conditions of difficult maternal care.
Therefore, this study enabled us to identify the profiles of women who experience pregnancy behind bars, as well as how prenatal care is performed and their differences during delivery. In view of what was exposed in the study, it is necessary to have systematic monitoring of prisoners from their entry into the prison unit until the puerperium, so that all care is directed by health professionals. Thus, it is expected that this work promotes the reflection of people and prison professionals in relation to pregnant women who experience neglect in the prison environment.

Inglish
Pubmed It focuses on children of incarcerated mothers and the need to expand prisonbased programs to enable women to have a more densely connected motherchild connection. 15 Batista e Loureiro.
'' Will he call me a mother: Maternity and overcoming in jail.''

Portuguese
Lilacs The objective is to know the experiences of mothers imprisoned where their child was born in a prison environment and consequently these mothers go through the process of separating their children.