Crumbling Britain: How it feels to give birth behind bars

The plight of pregnant women in our overstretched prison system.

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When Kate Somers woke up after the complicated birth of her third child, she was handcuffed on a short chain to the hospital bed with her back to the door.

It was early on Christmas Eve in 2017. She was alone and hadn’t yet seen her baby. As she came round from emergency surgery after haemorrhaging during labour, she recognised a man in scrubs across from her. He was a prison guard.

Kate, now 34, was released last October having served a 16-month sentence for arson. Having struggled with mental illness since she was 14, she had a breakdown and caused a fire by attempting to gas herself. It took more than two years to convict her, by which time she had been rehabilitated: she was having treatment, working, in a relationship and 16 weeks’ pregnant. Her baby girl, born in custody, spent the first 11 months of her life in prison.

We meet at her family’s bright, neat ground-floor flat, an hour’s train-ride from London. Her daughter, now one, looks smart for the occasion with a pink bow in her hair, and merrily sips squash. She takes a particular interest in my Dictaphone, which no amount of reading Spot the Dog books or playing with her toy picnic basket can distract her from.

The Arctic Monkeys play in the background as Kate, a matter-of-fact and witty young woman with pink hair, in a denim shirt and black jeans, makes a cup of tea.

She ran her own travel franchise business, which she has just sold, and now wants to spread the word about how pregnant women are treated in our crumbling prison system.

After the unexpected custodial sentence and without her bag packed, she was driven straight from court to prison, and held in a room with “at least ten” other newcomers. Feeling the nausea of early pregnancy, she begged to wait outside. Instead, she received a cloth to clean up her vomit.

Kate was put in a cell with a smoker. “When you arrive, you’re locked in 22 hours a day. And she’s just chain-smoking,” she recalls. She moved cells, but it happened again. “My child is not a prisoner,” Kate remembers telling officers. “She shouldn’t be subject to this, it’s harmful.” She was also given a top bunk – particularly tough for a pregnant woman, because “I was peeing constantly and being sick”. She slept on the floor instead.

It took five weeks to see a midwife. Only then was she told about the prison’s Mother and Baby Unit, where she was admitted 28 weeks into her pregnancy, after three months of wondering where her child would go. “I was panicking,” she says. “I didn’t think I could cope with having her and not seeing her grow.”

According to Birth Companions, a charity that provides support for incarcerated pregnant women and recent mothers, the majority of those with babies in prison are never admitted to these units and are separated from their children. There are six Mother and Baby Units in UK prisons and secure centres, providing for 70 women and babies. Approximately 600 prisoners are pregnant, and 100 babies are born in prison in England and Wales each year, but the MoJ doesn’t gather this data.

Kelly*, 32, another former prisoner, who was released after three years in December 2017, was ten months’ pregnant with her first child when she was remanded.

She had her son in custody, after it took officers four hours to take her to hospital when her labour began. They wouldn’t contact her family until she was in full labour. “My family live an hour away, they had to drop everything. I had none of my stuff packed, just a plastic bag, I was cuffed, there were guards.”

It can take giving birth for the Mother and Baby Unit admission system to finally kick in, so long are the delays, which means women can go through labour without knowing whether their baby can stay with them. Although it is rare, some women even end up giving birth in their cells.

After Kelly was sentenced, she was separated from her child for six weeks as she waited to be admitted to the prison’s Mother and Baby Unit.

“He was just over three months,” she says of her son at the time, who stayed with her mother. “Still to this day I carry a lot of guilt. Because of that time I wasn’t there, he’ll go to my mum before he’ll come to me. I worry about when he’s older – do I tell him? Do I not?”

Kelly wishes she had received support during the traumatic time she was separated from her new baby. “There was no help, none at all.”

Stretched resources in prisons mean staff lack the knowledge or time to follow rules for pregnant inmates. “Many aren’t getting the care they’re entitled to,” says Kirsty Kitchen of Birth Companions. “In such an overstretched and underfunded system, these women’s needs are often overlooked or ignored, with huge implications for the wellbeing of both them and their babies.”

The United Kingdom has the largest prison population in western Europe, and austerity is sapping resources. By 2023-24, Ministry of Justice real-terms funding per person will be 51 per cent lower than it was in 2010-11 when cuts began.

Most women in prison (83 per cent in 2017) have committed a non-violent crime: petty theft, unpaid council tax, TV licence evasion, and so on. Most serve less than six months; despite government rhetoric against short sentencing, such terms accounted for 62 per cent of jailed women in 2017, compared with a third in 1993.

Kate remembers feeling constantly hungry in prison; aside from a daily carton of full-fat milk she says she didn’t receive the extra food pregnant women are entitled to.

“I wasn’t getting vitamins, or fresh air,” she says. “I thought, ‘What am I producing? How is she growing? Is she going to be OK?’”

Dr Laura Abbott, a midwife who has volunteered as a birth companion for inmates and wrote a thesis on pregnancy in UK prisons, says that jailed pregnant women should receive pregnancy packs with extra fruit, and perhaps nuts and extra milk. “However, in my research I found that was inconsistent – sometimes they’d get one, sometimes they wouldn’t.”

Some are not made aware of the entitlement. “I was told nothing, absolutely nothing, and I was terrified,” says Laura*, 31, another former prisoner I speak to who was seven weeks’ pregnant with her first child when given a three-month sentence in 2016. The judge knew she was pregnant. “I remember thinking something’s going to happen to my baby.”

She says “the guards didn’t know” about the extra food she eventually discovered she was entitled to, and she had to beg for extra shampoo and underwear.

Although Laura did receive her extra mattress, it was “flung on the floor” and she had to drag and lift it onto her bed herself.

“There is no dignity,” she recalls. “It’s like you’re not a person anymore.”

When a nurse came into her cell to inspect her after some unexpected bleeding, she didn’t want to close the door – “I had my pants down, there were other people walking around, male guards, and they expected me to do that.”

Once her sentence came to an end, Laura was left to carry her bags down the stairs with no help from prison officers: a departure that summed up her experience of pregnancy in prison. “I’m still not ok now,” she tells me. “I don’t think I ever will be. Everything is taken from you – my first pregnancy was stripped away. I don’t trust anybody now, I’m scared of my child being taken away.”

Guidance for prisons on how to treat women’s prisoners is outlined in the government’s Women’s Policy Framework and Female Offender Strategy published last year. This includes stipulations such as 24-hour access to midwifery advice.

However, Dr Abbott and others working with pregnant women in prisons believe such guidelines should be specifically legally-enshrined, as the system now is inconsistent – and the parity of care enshrined in law is hard for staff to achieve.

Dr Abbott has seen the same issues repeated in many women’s prisons. “The staff are really motivated to help things change, but I think it comes right from the top. Without the resources there, it’s really difficult.” But there is another problem, she says: “Institutional thoughtlessness.”

Women account for less than 5 per cent of the prison population, and only an estimated 600 are pregnant every year. Kate was taken to her first hospital scan handcuffed to a male officer. “I didn’t want to share that moment with a guard,” she told me. After the birth of her child, a midwife had to oust another male guard while Kate was breastfeeding. This is despite the guidance requiring staff to use proportionate restraints on prisoners attending hospital for pregnancy appointments.

If Kate wanted to photograph her daughter’s early months, she had to use the prison unit’s camera, and only while being monitored. “I missed out on pictures,” Kate says, becoming tearful. “She still hasn’t been swimming, she hasn’t been to the farm. For the first time the other day we played in a sandpit. I wasn’t able to be the mum I would have been.”

A Prison Service spokesperson said: “Healthcare in prisons is provided by trained medics and nurses but we have also made training on dealing with pregnant inmates available to all prison officers. Each pregnant prisoner has an individual care plan and new guidance makes clear they should have access to 24-hour midwifery advice. But as we move towards having more female offenders serving community sentences and using women’s centres to address their needs we hope to see fewer pregnant women enter custody in the first place.”

*Kelly and Laura preferred to speak under pseudonyms.

Anoosh Chakelian is senior writer at the New Statesman.

This article appears in the 08 May 2019 issue of the New Statesman, Age of extremes