Pregnant women in English jails are seven times more likely to suffer stillbirth

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Women in prison have a seven-times higher probability of suffering a stillbirth than those in the general population – an increase from a five-times higher probability since the data was last collected two years ago – the Observer can reveal.

Figures obtained through freedom of information requests sent to 11 NHS trusts serving women’s prisons in England also showed that for the years 2020-22, 25% of babies born to women in prison were admitted to a neonatal unit afterwards – almost double the national figure of 14%.

Meanwhile, 12% of babies had a low birth weight, compared with 6.5% among the general public. Stillbirths were at a rate of 27.1 per 1,000 births compared with 4 per 1,000 for the wider population. This is up from a rate of 20.9 compared with 4.2 for the period 2015-2019. On average, there were 29 pregnant women in prison during 2021 and 2022 and 50 births to women spending time in custody over the same period, according to Ministry of Justice figures. Of these, 94% (47) took place in a hospital and three occurred either in transit to hospital or within a prison.

Birte Harlev-Lam, executive director at the Royal College of Midwives (RCM), said the “shocking” statistics should jolt the Prison Service and government into action.

“It is a national scandal that women are still giving birth in prison, and it’s a practice that needs to stop,” she said.

Last year, the RCM was among those to sign an open letter to the Sentencing Council calling for a review of sentencing practices for pregnant women.

Harlev-Lam said the “potentially fatal impact” of a custodial sentence should be taken into consideration.

There has been growing concern about the incarceration of pregnant women after the deaths of two babies in custody in recent years.

Laura Abbott, associate professor in midwifery at Hertfordshire University, said: “In-cell births are not uncommon and 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.”

Rebecca, who did not want to give her real name, was 17 weeks’ pregnant when she was sentenced to prison. She rarely saw a midwife and became so underweight that she was booked in for an induction.

However, when the day of her hospital appointment arrived, she sat waiting with her bag but nobody came to collect her. “I was told: ‘We haven’t got enough staff to get you out’,” she explained. “I was waiting for hours. I felt helpless and abandoned and like nobody cared about me or my baby’s safety. We were just an inconvenience.”

After an emergency C-section, Rebecca’s baby was seriously ill and taken to the neonatal unit. “They tried to take me back to prison but I was hellbent on breastfeeding, so I was able to stay.”

Back in prison, she was placed in the mother and baby unit but lived in constant fear of having her baby removed. “While nursing my newborn, I was living in a state of continuous anxiety. I wasn’t coping but I couldn’t tell anyone in case they took my child.”

She recalls an incident when one of the babies on the unit had breathing difficulties. “We were so worried waiting for the ambulance but there was no rush on the part of the guards. The babies aren’t prisoners, they have a right to emergency care.”

In 2019, a vulnerable 18-year-old gave birth alone in a prison cell more than 12 hours after her calls for a nurse were ignored at Europe’s largest women’s prison in Ashford, Surrey. A damning report by the prison watchdog concluded maternity services at HMP Bronzefield were “outdated and inadequate”.

Then, in 2020, a women gave birth to a stillborn baby in a prison toilet at HMP Styal in Cheshire without medical assistance or pain relief. A prison nurse failed to respond to emergency calls after Louise Powell, who was not aware she was pregnant, developed agonising stomach cramps.

Kath Abrahams, chief executive of the pregnancy charity Tommy’s, said women in prison come from some of the most deprived backgrounds so are more probable to experience a high-risk pregnancy.

“Socioeconomic factors like smoking, poor mental health, domestic violence, diet, obesity and substance misuse will increase the risk of stillbirth. But we know that, with the right care, many of these women can be supported to have healthier pregnancies with better outcomes for mothers and babies.”

The Sentencing Council is due to review whether there is a need for new guidance on sentencing pregnant women.

Janey Starling, co-director of Level Up, which campaigns for gender justice, said: “It’s long overdue to end the practice of sentencing pregnant women to custody. When supported in their communities, they can give their baby the best start in life.”

An NHS spokesperson said: “The latest data shows the rate of stillbirth overall in England is 19.3% lower than the rate in 2010 – but any baby lost to a stillbirth is one too many. The NHS continues to take action to reduce stillbirths and neonatal deaths as well as working hard at ensuring pregnant women in secure environments receive high-quality, safe specialist maternity care.”

A government spokesperson said: “We know that 60% of women who end up in custody have experienced domestic abuse and 50% have drug addictions, which is why custody is always a last resort for women.

“It’s also why we have taken decisive action to improve the support available, including specialist mother and baby liaison officers in every women’s prison, additional welfare observations and better screening and social services support so that pregnant prisoners get the care they require.”