At the end of September a baby died in Britain's largest female prison after its mother gave birth alone in her cell at night. The incident happened at HMP Bronzefield in Surrey after the inmate, who was on remand (in custody pending trial) rather than serving a sentence, went into labour in the middle of the night. When prison staff eventually visited the woman's cell in the morning, they found the baby unresponsive.
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The death sparked 10 investigations at the prison and led to the government conducting its first official audit of pregnant prisoners. But questions are still being asked about how, in 2019, this could have happened. Four women have died at Bronzefield since 2016, including Natasha Chin, whose death has been attributed to neglect and systemic failings at the prison.
Women make up around 5% of the UK's overall prison population. In 2018, 82% of women's prison sentences were for nonviolent offences, such as theft. According to the Prison Reform Trust, 39% report having a drug problem and 24% an alcohol problem when they arrive at prison, and at least half (49%) have experienced domestic abuse.
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Thirty-nine percent of women report having a drug problem and 24% an alcohol problem when they arrive at prison, and 49% have experienced domestic abuse.
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An estimated 600 pregnant women are held in prisons in England and Wales every year, and about 100 babies are born there. Following the incident at HMP Bronzefield, the government has revealed that there are 47 pregnant women currently in prisons across England and Wales.
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Sodexo, the private company that runs HMP Bronzefield, said last month that there were 13 pregnant prisoners at the facility and another 12 at HMP Peterborough, which it also runs. It also said that 39 women had given birth while serving sentences or while on remand at the two prisons in the past year.
This is the first time any information has been released on the number of pregnant women and prison births, yet it's still unclear how these women are treated while inside.
Of the 12 women's prisons in England, only six have mother and baby units (MBUs), with 54 places available nationally. To get a place in an MBU, where new mothers can keep their babies with them for up to 18 months, prisoners have to apply themselves. Once the baby is 18 months old, they are either taken by a suitable family member on the outside or turned over to social services.
Dr Laura Abbott, a senior lecturer and specialist midwife at the University of Hertfordshire, has conducted extensive research into the experiences of pregnant women in prison, the conditions they are faced with and the treatment they receive before, during and after the birth of their babies.
Dr Abbott carried out interviews with 28 female prisoners from three prisons in England who were pregnant or had recently given birth while imprisoned between 2015 and 2016. She also interviewed 10 members of prison staff. Her paper, "The Incarcerated Pregnancy: An Ethnographic Study Of Perinatal Women In English Prisons", published in 2017, highlighted concerns over the welfare of incarcerated pregnant women, including women giving birth in cells without midwifery care, and led to a call from parliament for mandatory guidance for pregnant women and new mothers in prison.
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Here are some of the key findings from Dr Abbott's extensive research.
A dangerous lack of care
When a woman goes into labour in prison, she is usually transferred to the local hospital via taxi or prison van, accompanied by prison officers. Some inmates who have been incarcerated in their third trimester of pregnancy told Dr Abbott they feared being locked up alone during labour. One said: "If I'm in a slow labour, I'm going to be locked behind my door, that's my only worry."
For one inmate, this did happen. Dr Abbott spoke to a prisoner, Layla*, who described giving birth in her cell at 36 weeks pregnant. Layla's daughter was born in the breech position. She said she had told nurses repeatedly that she was in labour and needed proper medical attention but was ignored. The baby was born a few hours later without any midwifery care or support, amid what was described as "absolute panic" among staff.
"I was laid there on my bed in my cell with a male nurse and female nurse, not midwifery trained at all, trying to put gas and air in my mouth...and then out popped [my baby] at twenty past one. Still no ambulance, still no paramedics and she came out foot first," she said.
Layla was the only prisoner Dr Abbott spoke to who had given birth in her cell but staff members described experiences of women labouring and giving birth in prison. One staff member said: "We don't have mobile phones in the prison, so a mobile phone was brought down for (the nurse) to ring to be talked through delivering the baby."
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I was there on my bed in my cell with a male nurse and female nurse, not midwifery trained at all, trying to put gas and air in my mouth ... No ambulance, no paramedics and she came out foot first.
Layla*
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Other inmates, however, described positive experiences of being pregnant in prison, including one who described her experience of compassionate and timely staff to Dr Abbott: "Within half an hour the ambulance was here, and I was off. When we left the prison, the number one governor was at the gate and she stopped, and she said good luck."
PHOTO BY FRANCESCO SAMBATI/EYEEM.
An urgent need for more training and midwives
Many inmates and staff expressed concern over the lack of access to trained professionals and suggested that there needs to be more maternity provision in prisons. Some prisoners described the midwifery care as "horrible", "awful" and "more like a check-up", and because "the midwife isn't based here, she doesn't have a lot of jurisdiction about what happens."
Dr Abbott's findings indicated that prison staff are being put in a difficult situation when it comes to pregnant women, a system at "crisis point". In her research, Dr Abbott found that staff were unaware whose role it was to look after pregnant women. Prison staff members lacked knowledge and experience and were unaware that a registered nurse could not act as a registered midwife. This raises questions over who should be carrying out checks on pregnant women overnight and whether they are trained to treat them.
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I just had to wrap her up in clothes, completely naked underneath my nightie. She had nothing.
layla
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What happens once the baby is born?
Once the baby has been born, a mother and her child will be transferred to an MBU – if they have been allocated a place. If not, the mother will return to the general prison without her baby.
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After her cell birth, Layla was confused as to what would happen next and whether she would be able to keep her baby. No plans had been activated for a place on an MBU, nor did she know what to do about feeding.
While Layla was eventually transferred from prison to the local hospital, she had no provisions, such as nappies or clothes, for her daughter. She told Dr Abbott: "I just had to wrap her up in clothes, completely naked underneath my nightie. She had nothing."
There's a major issue with food
Women have described prison food as "horrible" and "disgusting", with some going so far as to compare it to dog food. Kayleigh*, whom Dr Abbott interviewed, expressed concerns over the little amount of food she was receiving when pregnant.
She said: "I am absolutely starving...it is bloody terrible...it's HMP, Your Majesty's Pleasure...rations...I'm hungry all the time, because I'm pregnant, they don't give you enough. I'd be happy with rations, that's how bad it feels."
Dr Abbott noted how unhealthy some of the women looked. Some were thin, others in low mood. Dr Abbott noted how, at 26 weeks pregnant, Kayleigh was very thin, "her abdomen small for her gestation," she wrote.
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Yes, I'm a criminal, but I'm still human like everybody else. I'm still in pain like everybody else. But it's not just me, it's my unborn child.
Kayleigh*
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Waiting on family members to top up their prison bank accounts to buy extra food was a common occurrence for some pregnant inmates, who said they felt they had to negotiate their nutritional needs as a survival mechanism. One inmate, Sammy*, said: "I'm pregnant, how can you just not give me a little bit of extra fruit or food at 11 O'Clock at night because I couldn't eat tea because I had heartburn?"
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Others felt their nutritional needs weren't being met and felt their unborn baby would suffer as a result: "My baby's not getting any food because I'm always dehydrated."
An incredibly hostile environment for mother and baby
During her research, Dr Abbott was told of an instance when the prison was in lockdown due to a woman being attacked then raped by three female inmates. They thought the victim had drugs inserted into her vagina. This attack scared several of the pregnant women, who worried about their unborn babies.
Pregnant prisoners Lola* and Trixie* expressed fears of other inmates, with Lola suggesting that a male prison would have been a better environment: "Lads will fight it out, lasses won't...it's just girls they're bitchy. I'd rather be in prison with lads."
Women also expressed distress over their unborn baby's health after being placed on smoking wings. Jane* told Dr Abbott she was placed in a cell with five others who were smoking. The cell had no windows.
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I'd rather be in prison with lads.
Lola*
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Neglect of pregnant inmates
Pregnant women described feeling categorised as "just a criminal" with many of their pregnancy symptoms denied and pain disregarded by prison staff. Kayleigh told Dr Abbott: "Yes, I'm a criminal, but that doesn't matter. I'm still human like everybody else...I'm still in pain like everybody else. But it's not just me, it's my unborn child."
Other inmates described how distressing it was for them to enter prison at a late stage in their pregnancy, not being told by prison staff that they were entitled to a place on an MBU and instead having to find out from other pregnant women on their wing. Layla said: "It was the other prisoners that told me that there was a Mother and Baby Unit and that you can apply for it...none of the officers spoke to me about it."
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Speaking to Refinery29 UK, Dr Laura Abbott said her research shone a light on how perinatal women were treated in prison and the impact it has.
"The woman’s experience of being pregnant in prison suggests a deep-rooted psychological pain which appears to punctuate all aspects of her incarceration. I found that women experienced frustration and stress which impacted upon their emotional wellbeing. Being unable to access basic comfort and adequate nutrition and fresh air was commonly expressed by women.
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Pregnant women in prison are in a minority but this should not render them invisible.
Dr Laura Abbott
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"A key finding of this doctoral research is that breaches of pregnant women’s rights and entitlements are being experienced in some English prisons on multiple levels. It is not surprising to find prison to be a place of tension, stress, loss of autonomy and basic provisions. Pregnant women appear incongruous to the patriarchal prison system.
"Seamless collaboration is required between the prison service, NHS Trusts and charities to facilitate the support of pregnant women.
"Women should not be giving birth in prison cells and if, on a rare occasion, an unexpected birth occurs, the minimum she should expect is to have an appropriately trained professional to support her and her baby. Pregnant women in prison are in a minority but this should not render them invisible."
*Names have been changed
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