Female prisoners are almost twice as likely to give birth prematurely as women in the general population, leaving them and their babies at risk, research has revealed.
More than one in 10 (11%) women who have a child while behind bars do so before 37 weeks of their pregnancy, compared with 6.5% of mothers in the community, the Nuffield Trust found.
The thinktank and birth campaigners said the findings were of acute concern because premature birth carries higher risks compared with full-term delivery, including infection, blood loss, disability and death, and jails are not set up to help women go through labor and birth.
In 2019 a prisoner’s baby died around the time it was born at Bronzefield women’s jail in Surrey when its 18-year-old mother gave birth alone in her cell with no staff present – despite her twice pressing her call bell and asking for a nurse. The death prompted 10 different inquiries, including one by the Prisons and Probation Ombudsman ordered by the justice secretary.
“While the numbers of pregnant women in prison are small, the risk of giving birth in prison or going into premature labor and delivery without appropriate medical care is very real, putting mother and unborn child at significant potential harm”, said Dr Miranda Davies, a senior research fellow at the Nuffield Trust and author of its new report on healthcare services for female inmates.
“Prisons and their staff are not equipped to support women or newborn babies who require specialist care, so the risks to the one in 10 women going into pre-term labor or giving birth in their cell or on the way to hospital are extremely worrying. ”
Drawing on official NHS statistics, the Nuffield Trust found that of the 127 women in prison in England who gave birth between 2016 and 2019, 11% went into pre-term labour. This is almost double the proportion who does so in the general population.
The risks of women going into early labor in custody rather than in hospital were also highlighted by Louise Powell undergoing a stillbirth in a cell toilet in Styal women’s prison in Cheshire in 2020. Powell said the jail refused her request the day before to call an ambulance . The ombudsman’s report on the incident criticized a nurse for not visiting Powell, despite being contacted three times.
Naomi Delap, the director of Birth Companions, said early labor in prison carried “a real threat to the lives of women and babies, and their short and long-term outcomes”.
Female prisoners’ complex health needs, and their higher rates of alcohol, drug use, stress, mental health problems and trauma as a result of domestic violence, are thought to explain their greater tendency to give birth prematurely.
Davies also found that pregnant female inmates missed almost a third (31.5%) of hospital consultations with an obstetrician, almost double the usual rate (16.8%). They also do not attend 16.8% of appointments with a midwife and 45% of general hospital outpatient appointments. Shortages of prison staff to accompany them is thought to be the main reason.
Delap said that the medical risks facing expectant prisoners and their babies were “exacerbated by the difficulties women face in accessing obstetric care during a prison sentence”.
“Obstetricians are there to help manage and mitigate risk in pregnancy and birth, and women in prison are meant to have access to this vital healthcare in the same way women in the community do. Clearly they don’t,” she added.
Mothers-to-be should only be jailed in “the most exceptional of circumstances”, she said.
A government spokesperson said: “Women in prison are entitled to the same range of services as they would receive in the community, including midwifery services and access to the local NHS pregnancy free advice line number.
“NHS England is developing a new maternity and post-natal service for pregnant women in prison, to ensure that they receive high quality, consistent and respectful care during their pregnancy.”