I Thought I Had Miscarried & I Was In Handcuffs: Why We Need To Stop Imprisoning Pregnant Women

When she was just 23, Susie’s* life changed. She stood in court and was told that she was being sent to prison for six months. “I was in shock,” says Susie, who is now 30 and lives in London. Around her, everything happened at the speed of light. As she was being sentenced, what she did not know was that she was around six weeks pregnant. She found this out after being made to do a pregnancy test while being admitted into prison. 

The pregnancy was unexpected. “It was a complete surprise on entry to the prison,” Susie reflects. “But as it dawned on me that I was having a child, I started to get really worried – what was going to happen to the baby? What was going to happen to me? I’d never even set foot in a prison, I had no idea what it would be like.”

Aware that she was carrying her second baby and physically cut off from friends, family and her partner, Susie felt panicked. “How would I get to the hospital? I didn’t know,” she adds. “I needed to call my partner and tell him but I couldn’t do it right away.”

To compound her anxieties, as the nurse told Susie she was pregnant during her check-in, she handed her abortion leaflets. “I was given information about ending my pregnancy but no information about what would happen if I stayed pregnant in prison,” she adds. “Everything was very vague on that front, left open to my own interpretation. I had to figure it out by speaking to other prisoners. The care was nonexistent and I was put in a lot of situations where I felt unsafe that could have been avoided.”

When you arrive in prison you are housed in what’s known as the “welcome landing” to help you settle in. From there, you are moved on. Susie remembers clearly that as she was moved from “landing to landing” the new officers overseeing her care were not informed that she was pregnant. “I was put in a top bunk in a double cell,” she recalls. “The other ladies in my cell were like, 'You shouldn’t be up there because it’s not safe, what if you fall off in the night or hit yourself on the way up.' They were looking out for me more than the prison officers were.”

Eventually, after three or four moves, Susie was put on a “vulnerable people’s wing” where pregnant people were housed. Looking back, she feels angry that this wasn’t where she was housed on arrival because it’s where the midwives were. It took about two weeks for her to be placed on a suitable wing. 

Early pregnancy is a vulnerable time for any pregnant person. Susie’s biggest fear was that she would suffer a medical emergency. “I met a lady on one of the wings who told me that she gave birth in her cell the previous year and that her baby had died,” Susie recalls, her voice wavering over Zoom. “That scared me because I hadn’t even thought about what would happen if I went into labour. Nobody at the prison had even addressed that. There was no forward planning, no information.”

When it came to routine hospital appointments, she remembers that she was not advised in advance but simply told about and taken to them on the day. “This meant that at every scan and appointment I was not able to inform family members or have them there,” she says. “You don’t know what to expect and your birthing plan is not in your control.”

As Susie later found out from another prisoner, family members can apply to attend appointments with a pregnant prisoner. In order to do this, they would have to submit various forms, photo identification and undergo a criminal record check (also known as a Disclosure and Barring Service or DBS check). With the amount of notice Susie was given about her appointments, this would have been impossible. 

A couple of months into her sentence, Susie’s worst fears were compounded when she began experiencing stomach pain in the middle of the night, so severe that it woke her up. She checked herself and realised that she was bleeding. Panicked, she called the prison officers. They removed her from her cell but had to seek authorisation to take her to hospital. This took around two hours. During this time, Susie was in agony. 

“I was then taken to hospital in the prison van,” Susie says. “I still had to go through security, be patted down and checked out before I could be allowed to leave the building. I was doubled over in pain.”

Susie was handcuffed before being placed in the van to leave prison. The handcuffs were not removed when she arrived at the hospital. 

“It was so embarrassing. I was in pain. I didn’t know what was going on and people were staring at me,” she remembers. “Watching them stare at me while I was sitting in a waiting room in handcuffs was degrading.”

One of Susie's overriding memories of that night is that the prison officers made it clear they didn’t want to be there. “They were agitated,” she remembers. “It was nearly the end of their shift and they just wanted to go home. They were vocal about that and they kept checking the time and saying they didn’t want to be there.”

“I was so scared,” Susie says. “I thought I had miscarried as I was in my first trimester and I was in handcuffs. It was a Friday night and the early pregnancy unit wasn’t open at the hospital I was taken to, so when I did see the doctor, they couldn’t tell me much. I was stressed and upset. I wasn’t allowed to phone my partner until I got back to the prison.”

During the drive back to the prison, one of the prison officers said something that only worsened Susie’s mental state. “One of the prison officers turned to me and said, ‘Maybe it’s just not meant to be’. So I spent the whole weekend with her words in my thoughts, waiting until Monday to go back to the early pregnancy unit. It was the longest weekend of my life. And the expectation was that I would just carry on by the prison’s rules. The officers who were with me that night didn’t tell those on duty the next day what had happened, so nobody knew. The officers were telling me to get out of bed and tidy my room but I just couldn’t do anything.”

Thankfully, everything was fine with Susie’s pregnancy. However the experience has had a huge impact on her. “I would never want anyone to go through what I went through,” she says. “It’s so disheartening that pregnant women’s basic needs aren’t met in prison.”

Susie’s story is just one example of the devastating impact that being pregnant in prison can have on women and their unborn children. Her physical and mental health was put at risk. A newly published investigation by the Prisons and Probation Ombudsman which looks into the death of a newborn baby after an 18-year-old mother gave birth alone in her cell in October 2019 at Britain's largest women's prison, HMP Bronzefield, shows that the outcome of Susie's experience could have been much worse.

The true scale of this problem is not known because there is currently no publicly available data on the number of pregnant women passing through Britain's prison system each year, or on the outcomes of their pregnancies. What is known is that two babies have died in women's prisons in the last two years: one at Bronzefield and one at HMP Styal in June 2020. Thirty-one-year-old Louise Powell is the mother who lost her baby at HMP Styal. She has since said publicly that she begged for an ambulance before her baby, Brooke, died in a cell.

We also know, thanks to research by the Nuffield Trust released in 2020, that between 2017 and 2018 just over one in 10 women who gave birth during a prison sentence did so before they reached hospital – either in the prison or while on transfer to hospital. Analysis of hospital records has also shown a steady increase year on year in the number of babies born to women serving prison sentences, reaching 67 in 2018-19 compared to 43 in 2013-14. Following the release of this report, The Royal College of Midwives (RCM) warned that imprisoning pregnant women risks their life and the life of their unborn child.

There are 12 women's prisons in the UK and there are now more women serving custodial sentences in prison than there were 25 years ago. According to the Prison Reform Trust, many are sent to prison on short sentences like Susie’s. In 2020 5,011 women were sent to prison. According to the campaign group Women In Prison, most of the women in prison in Britain are serving short sentences for non-violent offences, with many swept up into crime as a result of their experiences of poverty, trauma and abuse. Indeed, 72% of women in prison are serving sentences of 12 months or less according to the Prison Reform Trust and almost half of them have committed crime to support somebody else’s drug use. According to the government’s own Female Offender Strategy, 63% of women in prison are survivors of domestic abuse. 

Added to all the above, because women make up less than 4% of Britain’s total prison population, they are too readily overlooked in policy and planning. As a result, the Prison Reform Trust warns that self-harm in women’s prisons reached record levels in 2020. There were 11,988 incidents of self-harm compared to 7,670 in 2016. Women made up 22% of all self-harm incidents in 2020, despite making up such a small proportion of the prison population.

Dr Laura Abbott is a senior lecturer in midwifery at the University of Hertfordshire. From a midwifery perspective, she says: “Prison is an unsafe environment for pregnant women and their unborn babies.” Her own research has found that in-cell births are not uncommon and that women are giving birth in the prison estate, without qualified midwifery support and in non-sterile, inappropriate environments, far more often than they should be. “There are no midwives or doctors on duty in prisons overnight,” she adds, “so women going into labour lack appropriate medical assessment and care. This is highly concerning and must be addressed as a matter of urgency, so women and babies can be protected.”

Women who go into labour in prison are transferred to hospitals to give birth but many do not have 24-hour direct access to a midwife while in prison. In 2018, Dr Abbot interviewed 28 women who were pregnant or had recently given birth and 10 staff members at three prisons in England. She found that none of the staff at two of the three prisons she observed had specialist training in emergency births. 

Other experts agree that pregnant women should not be sent to prison. From a legal perspective, Dr Shona Minson of the Centre for Criminology at the University of Oxford says: “The rights of dependent children must be taken into account when a mother is sentenced, and that includes children who may be born inside prison.” She points to a report from the Prisons and Probation Ombudsman as evidence that prison is an unsafe place for pregnant women and their unborn children. “Deciding that a child should be born in prison, with all the known risks of that situation for the child in both the short and long term, is to discriminate against that child in breach of Article 2 of the United Nations Convention on the Rights of the Child, which has been ratified by the UK,” she explains in no uncertain terms. 

There is uniform acceptance of the impact of maternal separation in the critical first two years of a child’s life. This is well documented. Added to that, separation from and loss of children "were the most commonly cited factors leading to the high risk of suicide and self-harm within prisons" in England and Wales, as reported by the Independent Advisory Panel on Deaths in Custody. 

For these reasons, a coalition of campaigners is calling for an end to prison sentencing for pregnant women in the UK. Prison, they say, will never be a safe place for pregnant women or mothers of young children. No matter what changes are made to government policy. The campaign is spearheaded by Level Up, Birth Companions and Women in Prison in partnership with a group of mothers who have been pregnant in prison – including Susie – and supported by leading academics such as Dr Laura Abbott, Dr Shona Minson and Dr Lucy Baldwin. Incarceration, they say, interrupts healthcare, separates women from their support networks, destroys employment and housing, and breaks families apart. 

Earlier in 2021, the government reiterated its commitment to reducing the number of women in custody and improving conditions for those who are serving time. In the same breath it said that up to 500 new prison places will be built in existing women’s prisons. Janey Starling, the co-director of Level Up, warned that this plan, which "includes provision for children to stay overnight with their mothers in prison, could see more pregnant women and new mothers sent to prison."

"The government may try and introduce procedural changes inside prisons but they are completely missing the wood for the trees: the fact remains that no pregnant woman should ever be trapped behind locked doors in the first place, or isolated from her partner and family," she added. "The toxic stress of the prison environment causes lasting harm to both mother and child. The government can, and must, change the law to end the imprisonment of pregnant women – and support them in the community instead.”

Like Susie, 35-year-old Leanne* is speaking out about her experience of being pregnant in prison because she wants the practice of imprisoning pregnant woman to end once and for all. Leanne was 29 years old and six months pregnant when she was initially arrested and remanded in custody. She says her experiences in prison will impact her forever.

"The whole experience was very emotional and it has stayed with me," she explains. "It was my first child and nothing was communicated to me. I was just told to press the call bell in my cell if I went into labour. If I wanted to see the midwife I had to put in a request through a prison officer."

When Leanne did go into labour it was around 5.30 in the morning and she says it wasn't until around 10am that the prison nurse came to take her blood pressure. "I wasn't in an ambulance on my way to hospital until at least 11.30," she remembers. At that point, she had been in labour for hours with no pain relief.

Leanne arrived at hospital just in time to give birth there but, she says, "it was cutting it fine." She stayed one night in the hospital where she gave birth to her son before being moved to the mother and baby unit of a different prison. Once there, she had what she describes as a "meltdown".

"I was in bed holding my newborn son and I was in pieces. I just kept thinking that it wasn't fair, it wasn't fair on him. I had to take him home but I couldn't." Leanne's son was then taken away from her. She was separated from him for five months while she remained in prison and her baby stayed with her mother.

The newly published Bronzefield report affirms Susie's and Leanne's experiences. Sue McAllister, who is the Prisons and Probation Ombudsman behind the report, concluded that at Bronzefield: "Midwives visit only twice a week, the obstetrician holds only eight clinics a year and the prisoners do not have direct access to them." This, she said, is in contrast to women in the community who are able to contact their midwife directly as and when they need to.

McAllister added that a series of failings such as "poor" information sharing "within and between the prison and health agencies" contributed to the death of a baby at Bronzefield. As a result, she said: “We consider that all pregnancies in prison should be treated as high risk by virtue of the fact that the woman is locked behind a door for a significant amount of time. In addition, there is likely to be a higher percentage of ‘avoidant’ mothers who have experienced trauma and who are fearful of engaging with maternity care.”

Looking back, Leanne describes her experience as "extremely traumatic" and says she is speaking out now because it is "inhumane".

"It doesn't stop when the sentence is over," she says, "you have a lifelong issue hanging over you. I had my son in a prison. I feel constant guilt. He's five now, I worry about how it has affected him. When I was pregnant, I wasn't listened to. When I went into labour, I wasn't listened to. When I was on the mother and baby ward, I wasn't listened to. [If you're pregnant in prison] everything is taken away from you. You can't be a mother. It will shape my life forever."

A Prison Service spokesperson said: “While our view remains that custody should be the last resort for most women, a decision which is made by independent judges, we have made significant improvements to support female offenders.”

“We are undertaking a fundamental review of how we support pregnant women and their babies in prison and as part of this have just announced £500,000 for a Pregnancy and Mother and Baby Liaison Officer in all women’s prisons, to ensure early identification and extra support.”