Why do we still imprison pregnant women?

Mother and baby HMP Askham Grange
Lucy Baldwin and Laura Abbott question why we continue to allow pregnancy in prison.

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How can it be allowed to continue?

"it’s a horrible place to be pregnant is prison, you don’t get extra food, not even milk and you are worried all the time it will kick off and your baby will get hurt, the stress is unreal’

Emma (Mum in Baldwin research)

This is a  guest post by Lucy Baldwin (@LucyBaldwin08) Senior Lecturer/researcher  in criminology and criminal justice at De Montfort University and Laura Abbott (@Midwifeteacher) Senior Lecturer in Midwifery at University of Hertfordshire.

Researchers Lucy Baldwin and Laura Abbott  have both investigated the experiences of mothers in prison.  They have revealed in their research horrific, tragic experiences of women miscarrying in cells, giving birth in their cells, and having their babies torn from their arms when they have not gained a precious space on a prison mother and baby Unit (MBU), left bereft at their loss.

It is shocking that, despite (in theory) all women being offered a pregnancy test on reception into custody, the number of women pregnant at any one time is not formally recorded. As Birth Companions have logically stated,  if we don’t know who these pregnant mums are and where they are, how can we support them and meet their needs effectively?.

 Both Abbott and Baldwin have spoken to women who revealed that their basic maternity care needs were not met whilst pregnant in prison. Baldwin in a previous blog highlighted the lack of equality in terms of healthcare for women in prison. However, in pregnancy, arguably where women’s health care requirements are most important, not only for her but for the wellbeing of her unborn child, those needs are even greater. Yet, fundamental rights of the child and the mother are repeatedly being denied. Mothers, as the opening quote reveals, do not have access to extra or additional pregnancy specific nutrition, they do not always have easy access to a midwife, to pregnancy guidance or support, to maternity wear, heartburn tablets or as Abbot states, ‘not even a comfortable bed’ or ‘breast pads’.

I’ve asked for breast pads, but they havnt given me anything. Ive been told (by prison staff) to just rip a  {sanitary} pad in half and just put each side on one breast!’ (Sylvia, Mum in Abbott’s research)

Women in both authors research have described being taken to ‘outside’ ante natal appointments in handcuffs,  with some describing how they were cuffed even through their scan’

‘I could tell the scan lady didn’t want to do it with me in cuffs, she was embarrassed, I was embarrassed, she asked the officer to uncuff me, but they refused, it was humiliating’ (Kady a mum in Baldwins research).

Guidelines not followed

There are guidelines for how pregnant women are responded to in prison, however for many it seemed the reality was very different to the expectation. Jolene, who knew what she was supposed to receive as a pregnant prisoner, told Abbott,

well apparently you get two extra pillows, which I havnt got, you get extra milk, which I don’t get, you get extra fruit, which I don’t get, you get night snacks, which I don’t get, and you get the use of a toaster at dinnertime, which I don’t get. So, loads of good things that you just don’t get!’ (Jolene, Abbott’s research)

 Abbott found that women would often only discover their entitlements through ‘serendipity’, or as one mother in her research stated, ‘you have to find out for yourself’. Mothers told us how they would often rely on the goodwill, compassion and professionality of individual officers for access to support or maternity needs. Both Baldwin and Abbott heard examples of good and compassionate practice where officers had gone above and beyond to support the women in their care.

I was pleased if it was Miss Brown (pseudonym) on at night because I knew she would save me a sandwich to eat later, and Mr White well he was just lovely to me,  his daughter was pregnant and I think that made him be kind to me and he looked out for me’ (Tarian, Baldwins research)

Sadly, mothers were not always met with compassion and care, mothers told us of refused requests for pregnancy and/or post-natal related issues like maternity pads or a failure to respond to requests to see nurses or midwives, tragically sometimes with devastating consequences.

I was pregnant and had had two episodes of spotting – which they knew, and they still put me on my own. I wanted to see a midwife and I was told I couldn’t. I’d have to see the nurse. I was upset and wanted to ask loads of questions, but I never got to ask them because I lost the baby anyway. I think it was the shock of going to prison that made me lose my baby. I had no history of miscarriage, there was no other reason. When I lost my baby, I was bleeding on my own in my cell for hours. I was terrified, and the prison said they would get me to the doctors in the morning. I was in so much pain they called an ambulance eventually. I lost my baby on the way to the hospital, in handcuffs. I will never forgive them for that. There was no need for cuffs. I wasn’t exactly running away, was I?’ (Polly, Baldwins research)

HMP/YOI Askham Grange. © Andy Aitchison

Mother and baby units

In the UK there are six mother and baby units (including HMP Askham Grange shown above) with the capacity to hold 66 babies and 54 mothers (there is an allowance for twins). However as discovered by Maya Sikand in her report ‘Lost Spaces’ , overall the  units are rarely more than 50% full (there is some variation between individual units). Sikand found that rejection rates were high, most often down to a social workers reluctance to support the mothers application. However, Sikand also found that many of the involved social workers had not visited a prison MBU and were therefore making uninformed decisions that were often risk averse. There is no doubt that when mothers do secure a space on the MBU that most mothers and babies benefit from their experience and reoffending rates for mothers who leave MBU’s are much lower than those for mothers leaving general population. However, the actual process of applying for an MBU space is inconsistent and very stressful for the mothers. Mothers in both Baldwin  and Abbotts research described how their boards[1] were not sat until quite late in their pregnancies and decisions were delayed, sometimes not being made until after the birth (the case for two mums in Baldwin’s study).

I sat my board really late which was stressful in itself, I spent my whole pregnancy trying not to bond with my baby in case they took him… then I went into labour and I still didn’t know. Can you imagine that I went to hospital not knowing if I was coming back with him or not ‘ (Dee, Baldwins research)

I’m anxious…I can’t sleep at night, Like I need to know now, I want to know. Its my baby. I want them to tell me if I’m allowed my baby or not’ (Abi, Abbotts research)

Imagine what it feels like if that decision is a ‘no’, imagine carrying your child knowing when they were born they would be taken from you very shortly after birth. Michelle Barnes didn’t have to imagine.

Michelle Barnes, took her own life at HMP Low Newton, five days after the birth of her baby, after being refused an MBU space and separated from her baby 48 hours after her birth. An independent inquiry found that Michelle’s post birth mental health care was inadequate and that planning  and preparation for the separation of her and her baby was poor. Michelle was traumatised and alone when she hung herself in her cell. Since her death HMP Low Newton have implemented many improvement’s and in consultation with Birth Companions have drastically improved  their pregnancy and post-natal provision, which includes the appointment of a specialist midwife. They responded to the investigation positively and decisively. However, it still a prison.

Although all prison MBU’s do their best to appear less stark and ‘prison like’, they are often covered in brightly coloured murals and the floor strewn with toys. The babies can go outside in the MBU grounds with their mothers in prison prams and pushchairs to get some much needed fresh air… but then they come back and are locked in,  the babies are prisoners alongside their mothers, governed by rules and regulations every bit as much as their mothers are. Are we advocating then for babies to be separated from their mothers? Absolutely we are not – instead, we are advocating for prison MBU’s to be located outside of prison and modelled on resources like Trevi House, modelled on the principles advocated for by Birth Companions, staffed by non-prison staff, with easy access to pregnancy health care and midwives to protect them and their unborn babies.

Mothers and babies should not be in prison

We fundamentally do not believe that Mother and Baby Units should be attached to prisons, or that babies should spend their early months seeing prison bars and prison officers with key chains. Not when there are much more appropriate options possible in the community. As illustrated by Kady, a prison MBU is still by definition a prison within a prison.

‘… they threw all her stuff man….my baby’s clothes everywhere….everything of the walls….[…]it was like , remember where you are…don’t get too comfortable. It wasn’t the mother and baby unit no more… it was just prison…make no mistake it was prison’ (Kady, Baldwins research).

Trevi House operates as a real alternative to custody, therapeutically supporting the mother through addiction recovery while addressing the root causes of her substance misuse (which is regular contributor to  women’s offending). It is known that most women who are convicted of drugs offences have offended to assist the supply of drugs for another person, or they began misusing substances themselves as a result of repeated trauma in their lives or due to mental health issues. We believe that resources like Trevi House  and Dawn House in Birmingham (linked to Anawim), could be replicated as viable alternatives to custody for all women, but especially for pregnant women. Prison is not an appropriate environment for pregnant women, it is not conducive to either the mothers or the unborn baby’s health.

Baldwin, Abbott and organisations such as Birth Companions and Women in Prison argue that all solutions for female criminality and criminalisation should be sought in the community with therapeutic community responses favoured over punitive short prison sentences, that often do more  harm than good. Until such a time, it is imperative, that the frequently called for presumption against custody for pregnant and nursing mothers is actioned as soon as humanly possible. If it isn’t more mothers and babies are at risk of losing their lives in UK prisons. How can that be allowed to continue?

[1] A multi-agency panel meet to discuss the mothers application and consider submitted reports , the decision is rarely made on the day and can take several weeks or even months to get to the mother.

This discussion is continued from a children’s rights perspective in this forthcoming publication: 

O’Malley, S. Baldwin, L. Abbott, L. (Forthcoming) Starting Life in Prison: Reflections of the UK and Irish contexts of pregnant and new mothers in prison, through a children’s rights lens. In Donson, F. Parks, A. (eds) Presenting a Children’s Rights Approach to Parental Imprisonment. Palgrave.

Thanks to Andy Aitchison for kind permission to use the images in this post. You can see Andy’s work here.

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