When the Yarl’s Wood immigration removal centre opened its doors in November 2001, it was billed as an extension of an airport waiting lounge, but for some of those who have passed through its barbed wire fences, it feels more akin to a prison. And a secretive prison at that. Just last year, the United Nations special rapporteur for violence against women was denied entry. Cameras are prohibited within the facility.
Rather than a short “transit”, some detainees will spend months and even years in detention. And despite the hotel-like description on its website (“All bedrooms have en-suite wet room and toilet and are tastefully decorated with floral curtains”), two former detainees I spoke to, a husband and his pregnant wife, described their experience as “worse than in the third world – the UK says it has the best human rights, but as someone who’s been through the system, I didn’t experience this”.
Yarl’s Wood has become notorious for a number of controversies since its opening, including the detention of children until as recently as 2010. Over the years, campaigners have pointed to consistent allegations of abuse within its walls, including racist taunts and “improper sexual contact” with female detainees. And in 2011, the treatment of pregnant women at the centre hit the headlines when it was revealed one pregnant detainee collapsed after enduring a four-day journey from Belfast to Yarl’s Wood in Bedfordshire via Scotland and Manchester. In a recent case, a pregnant detainee miscarried after collapsing at the facility.
New evidence from the charity Medical Justice now shows that some pregnant women in detention are receiving sub-standard medical care, putting the life of both mother and child at risk.
A Home Office investigation is currently pending into claims against Serco, the private company contracted to run the centre, made by the couple I spoke to. The allegations include the manhandling of an expectant woman, despite it being unlawful to use force on pregnant women to achieve removal, and accusations medical staff ignored serious symptoms including abdominal pain and vaginal bleeding. The woman, who is currently five months pregnant, complained: “I kept being told everything was normal, but I knew something was wrong.” Upon release, she was treated for an infection that can cause miscarriages and stillbirth.
A recent investigation by Channel 4 News highlighted the abuse and harassment of women within the centre and the devastating consequences for their mental and physical wellbeing, particularly when many have been victims of sexual assault, trafficking, and various forms of violence in their countries of origin. The consequence of this abuse is even more precarious for pregnant women who – according to the government’s own guidelines – should only ever be held in exceptional circumstances. In damning evidence to an inquiry by the all-party parliamentary group on refugees and the all-party parliamentary group on migration into the detention of pregnant women, team inspector at HM Prisons Inspectorate Hindpal Singh Bhui stated: “…we haven’t found those exceptional circumstances in the paperwork to justify their detention in the first place.”
Serco claims it provides “a comprehensive primary care service for all of our residents” but Medical Justice, a charity whose volunteer clinicians visit and assess detainees, has observed that the standard of care within the centre often falls short of NICE Guidelines and comparable recommendations. One volunteer midwife said:
I’ve seen women who need urgent medical and obstetric care, who I would have admitted immediately to hospital if I’d seen them in my normal practice, be denied access to hospital, one had an ambulance they called turned away at the gates and many have been denied pain relief and other symptomatic treatment. The delay in getting them to an obstetrician was sometimes over a week. Some of these women had risk factors for life-threatening conditions.”
The UK Border Agency claims not to know the exact number of pregnant women detained, but over a ten-month period beginning in March 2013, Medical Justice saw 21 detained pregnant women, one of whom was held for 122 days. Their case review showed that the detained pregnant women were around 7 times more likely to experience complications in pregnancy and for Phoebe Pallotti RM, a registered midwife and academic who volunteers with Medical Justice, the reasons are all too clear: “I’ve seen women with serious complications of pregnancy been forced to miss vital appointments because of their detention and recommendations from previous treating doctors and advice given by myself be routinely not acted upon and urgent care seriously delayed.”
For Pallotti, stories of pregnant women’s concerns about their and their child’s health being ignored by medical staff at Yarl’s Wood are all too common. In the majority of the cases she documented, medical staff seemed to flout standards of care applied in the wider community, including basic procedures such as informing patients about the medications they were being given and their potential side effects: “I’ve seen very vulnerable pregnant women with documented histories of depression or presenting with symptoms of depression and PTSD been given medication for preventing malaria (so that they could be removed) which we never use in the NHS for anyone with mental health problems because it can and does cause psychosis and suicidal ideation. In some cases their mental health seriously deteriorated.”
One former detainee charged midwifery staff from a local trust with falsifying information in her pregnancy records – she says she was denied routine consultations, including the standard testing for down-syndrome. She also accused the nurses at Yarl’s Wood of being complicit in the abuse she says she suffered: “They [the guards] were pulling me by my (pregnant) stomach and the nurses were just watching on even though I was calling for help.”
The primary purpose of detention is removal, but according to the most recent review by Medical Justice, of the 21 pregnant women they visited, none were actually removed and all but one were released back into the community. One woman left the UK voluntarily.
In response to the allegations made by Medical Justice, a Home Office spokesperson said:
Home Office detention policy is that pregnant women should not normally be detained. However, pregnant women may be detained when their removal is imminent and medical advice does not suggest the baby is due before the woman’s expected removal date. Women who are less than 24 weeks’ pregnant may also be detained under the fast track asylum process.
All detainees have access to healthcare facilities and medical advice at all times. There is a complaints system for anyone who feels they have not been treated in accordance with our standards and all complaints are investigated thoroughly.
The former Prisons and Probation Ombudsman, Stephen Shaw, is undertaking an independent review of detainee welfare and will pay particular attention to detainees who may be especially vulnerable, including pregnant women.”
As debates on immigration heat up close to the elections, the cost of detention to the tax payer is a hot topic. But the charity points out that detaining someone is around £30,000 more expensive annually than supporting them in the community and that contrary to popular belief, not only do pregnant women rarely abscond, but where deemed necessary, they can be removed from the country after the child’s birth. For Pallotti, this just confirms her view that the policy of detaining pregnant women needs reviewing. “Regardless of one’s views on immigration,” she noted, “the detention of pregnant women may not often be successful at achieving deportation, costs a lot of unnecessary money, and can be very damaging to the pregnant mother.”