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A human rights activist, at 35 weeks pregnant, was taken into custody near her home in early 2024. Charged with a crime of "illicit association", she was jailed without evidence. Three weeks later, her family received a call to collect the body of her newborn baby. The reason of death has not been investigated, and her loved ones has no idea the circumstances or if she obtained any care after birth.

A Worldwide Crisis

Cases such as this are alarmingly common in prisons internationally. Expectant mothers are often subjected to terrible environments and not given proper healthcare. Some miscarry, others go into labour and give birth unassisted in a detention cell. Devastatingly, infants die in custody.

"Nations believe it’s a few of women so it’s not an issue, but that is a misconception," notes a legal advocate dedicated to women's incarceration.

"Detention is a terrible place for women, let alone someone who is pregnant," she explains. "There’s so much research that indicates how detrimental it is. Numerous prisons were designed with men in mind, so women were an secondary consideration."

Ignored International Guidelines

It has been 15 years since the creation of international guidelines for the handling of incarcerated women. This framework state that prison should be a last resort for pregnant women and that non-custodial sentences should be the first choice. They also prohibit the use of restraints on women while giving birth.

Yet, these guidelines are consistently flouted globally. "This is not considered a worldwide gender-equality priority," argues the expert. "It is overlooked, and there’s a lot of shame and prejudice."

Dire Situations in Packed Systems

In some countries, situations for pregnant prisoners are described as "really critical". Family visits have been prohibited, and independent monitors are denied access. Accounts with ex-inmates detail assaults, torture, and being deprived of essential items. Reports indicate some resort to trading sex with prison staff for nourishment or medical supplies.

"We has documented miscarriages and the loss of several infants … there will be more," reports a rights defender.

It is also reported women who were shackled to medical beds during labour and gave birth while watched by male officers.

Overcrowding and Its Impact

Data shows some countries as having the most severe overcrowding levels in the world. Female inmates are especially at risk to these situations. "There is rarely enough space to fully lie down," says a advocate. "There is a chronic lack of access to essentials."

Pregnant prisoners have been handcuffed to beds before giving birth. Conditions for raising a newborn upon return in prison are alarming, as evidenced by cases of infants dying from pneumonia and severe malnutrition in custody.

Accounts from Different Continents

In one African country, a past prisoner remembers being in a cell with pregnant women. Doors were locked overnight. If a woman started giving birth at night, the women were left to manage on their own. "We would be pleading. Others were praying. Others were hitting the floor and the doors, screaming: ‘Please come, somebody’s in labour!’"

Such events also happen in more developed nations. For example, a teenager her baby died after delivering unassisted in a prison cell. Her pleas for assistance were ignored for an extended period, and she was forced to bite through the umbilical cord herself.

Turning Trauma into Change

A number of survivors have chosen to use their experiences to advocate. In the US, a woman who miscarried in her prison cell set up an advocacy group. Her work has successfully pushed for laws that ban shackling and solitary confinement for pregnant inmates in multiple states.

A separate account comes from South America. A woman discovered she was pregnant after being sentenced. During her delivery, officers shackled her legs to the bed. Hospital staff performed a caesarean section. While still groggy, they offered to sterilize her. "Why would you wish to have more children, if you’re a inmate?" was the response.

"What I experienced was obstetric violence. It should not have occurred, but this is what women in prison endure," she stated. Her experiences later informed official guidelines around giving birth while incarcerated.

Potential Reforms

Some nations have implemented policies regarding expectant mothers in the legal system. Among them are:

• Considering non-custodial options for defendants who are primary caregivers, expecting, or nursing mothers.
• Implementing house arrest as an alternative to being held before trial, especially for expectant mothers.
• Permitting the postponement of prison terms for pregnant women.

Advocates and those who have been incarcerated argue that, often, expectant mothers ought not to be in prison at all. "I question whether women should be criminalised for numerous offenses in the beginning," argues the expert.

"Alternatives in the community that address the underlying reasons of women coming into contact with the legal system – for example, poverty, violence and substance issues – are truly what we should be focusing on."