Following 27 September 2019, several investigations have been launched into the death of a newborn child after its mother gave birth entirely alone inside her cell at HMP Bronzefield, Britain’s largest women’s prison.
This incident has drawn attention to the fact that the UK has failed for years to make any significant developments towards the better treatment of incarcerated pregnant women, despite being a signatory to the UN Rules for the Treatment of Female Prisoners. Otherwise known as the Bangkok Rules, this document outlines standards of care that incorporate the specific needs and characteristics of female offenders and inmates.
Pregnant women are subjected to a particularly deficient level of care within prisons. Due to overcrowding and understaffing of health professionals, women are often forced to go without pre and anti-natal care, trained nurses, or access to midwives. Women who alert staff that they are going into labour are often ignored. Such cases include a woman who, after complaining of contractions, was given paracetamol and a cup of tea before being returned to her cell, and another with similar complaints, who ended up giving birth alone to a premature baby born feet-first. Prison diets also do not provide adequate nutrition, and there is a general absence of maternal educational services.
There is a right to good healthcare for all UK citizens. This includes inmates. It is provided within the European Convention of Human Rights 1950. Regardless of this, almost half of England’s jails provide inadequate healthcare services. The Prison Act of 1952 does not make any mention of the legal obligation to provide health services to incarcerated persons—nor does the Health and Social Care Act (2012). Compare this to countries like Canada, whose Corrections and Conditional Release Act (1992) explicitly states that all inmates will be provided with essential health care.
In 2016, the National Health Service, responsible for the provision of healthcare in detained settings, published a report summarising their strategic directives for improving healthcare services within the justice system by 2020. There is no mention of pregnant women in this report - a disappointing exclusion given the UK’s commitment to the Bangkok Rules.
Evidently, inmate health care is a grey area within UK legislation. Following the lead of several other countries, a potential solution may be to pass legislation preventing the imprisonment of pregnant women. For example, Article 80 of the Swiss Criminal Code allows a ‘departure from the rules governing the execution of sentences in the favour of an inmate in the event of pregnancy.’ Swedish law allows sentence postponement when a female inmate is pregnant, the duration of which is determined by what is considered to be reasonable. Even in China, the Criminal Procedure Law allows for a woman sentenced to imprisonment to temporarily serve her sentence outside of the prison while she is pregnant. While it is unclear whether the UK has contemplated such options, the death at Bronzefield has led to activists now calling for an end to the imprisonment of pregnant women altogether. This may therefore be a debate that becomes more relevant as the results of the investigations come to light.
The well-being of female inmates in England and Wales is not only a concern during pregnancy, but also after childbirth. According to UK law, women who have given birth in prison may keep their children with them in mother and baby units for the first 18 months. What happens after that period, however, is often unclear. The United States has addressed this issue through the use of prison nurseries. Additionally, Australia’s mother and children programme has introduced full-time and occasional residence programmes, and options for mothers to serve their sentences in alternate environments. These examples demonstrate international commitments towards laws and policies that recognise, support, and protect incarcerated women - developments that the UK has regrettably not been a part of.
Since the tragic incident in September, the government has begun data collection on pregnant inmates, identifying for the first time an official figure for the number of incarcerated pregnant women. The Ministry of Justice has introduced hourly welfare observations at night for women more than 28 weeks pregnant. The Prisons and Probation Ombudsman will also be leading an investigation into what happened at Bronzefield and is expected to report back next year. While these are steps in the right direction, directives to solidify the legal foundation for inmate healthcare need to be organised. Such action may include a) amending the Prison Act 1952 to explicitly require equal healthcare for inmates and b) ratifying the Bangkok Rules into domestic law. In order to remain in accordance with Article 8 of the European Convention on Human Rights - the right to private and family life - the UK will need to acknowledge and consider the injustices taking place against incarcerated mothers in this country.