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A human rights activist, who was, was taken into custody near her home in March 2024. Accused with a crime of "illicit association", she was jailed without evidence. Three weeks later, her relatives received a call to retrieve the body of her infant child. The reason of death remains unexamined, and the family does not know what happened or whether she obtained any care after birth.

A Global Problem

Situations like these are not rare within correctional systems globally. Pregnant women are often held in terrible environments and not given medical attention. Some miscarry, others begin childbirth and have their babies unassisted in a cell. Devastatingly, some babies die while incarcerated.

"Governments think it’s a small number of women so it’s not a problem, but that is a misconception," states a lawyer working on women's incarceration.

"Incarceration is a harmful environment for women, let alone someone who is expecting," she adds. "Extensive evidence that indicates how harmful it is. Numerous prisons were built with male inmates in mind, so women were an afterthought."

Violated UN Rules

It has been 15 years since the adoption of the UN's Bangkok Rules for the treatment of incarcerated women. This framework clearly say that prison should be a last resort for expectant mothers and that non-custodial sentences should be the first choice. They also forbid the use of shackles on women during labour.

However, these guidelines are often violated globally. "This isn’t seen as a global gender-equality priority," says the expert. "It’s not visible, and there’s a lot of shame and prejudice."

Severe Hardships in Overcrowded Systems

In various regions, conditions for pregnant prisoners are described as "extremely dire". Contact with relatives have been prohibited, and independent monitors are denied access. Interviews with formerly incarcerated women detail beatings, torture, and being deprived of basic supplies. Reports indicate some resort to exchanging favors with guards for food or medical supplies.

"Our organisation has documented miscarriages and the death of four babies … there will be more," says a local lawyer.

Reports also indicate women who were shackled to medical beds during labour and gave birth while watched by male prison guards.

Severe Overpopulation and Its Effects

Statistics lists some countries as having the highest prison occupancy levels in the world. Female inmates are particularly vulnerable to these conditions. "There is rarely enough space to fully lie down," explains a human rights outreach director. "There is a chronic lack of access to essentials."

Expectant inmates have been handcuffed to hospital beds prior to delivery. The environment for raising a newborn back in prison are worrying, as evidenced by reports of infants succumbing from pneumonia and severe malnutrition behind bars.

Stories from Around the Globe

In one African country, a former inmate remembers being in a cell with pregnant women. Cell doors were secured 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 gates, screaming: ‘Please come, somebody’s in labour!’"

These tragedies occur in wealthier nations. For example, a young woman her baby died after delivering unassisted in a cell. Her pleas for assistance went unanswered for an extended period, and she was had to bite through the cord herself.

From Experience to Advocacy

Some women have chosen to use their traumatic ordeals to instigate change. In the US, a woman who lost her pregnancy in her prison cell set up an advocacy group. She has successfully advocated for laws that prohibit restraints and isolation for expectant inmates in numerous jurisdictions.

Another story comes from South America. A woman discovered she was pregnant shortly after being sentenced. When it came time to give birth, guards chained her legs to the bed. Doctors performed a C-section. As she recovered, they offered to sterilize her. "Why would you wish to have more children, if you’re a prisoner?" they asked.

"My ordeal was obstetric violence. What I experienced should never have happened, but this is what women in prison endure," she says. Her experiences later informed provincial policies around childbirth in detention.

Potential Reforms

Other countries have introduced measures regarding expectant mothers in the justice system. Among them are:

• Considering non-custodial options for accused women who are primary caregivers, expecting, or breastfeeding.
• Introducing home detention as an alternative to being held on remand, particularly for expectant mothers.
• Permitting the deferral of sentences for women who are pregnant.

Experts and those who have been incarcerated believe that, often, expectant mothers ought not to be in prison at all. "I question whether women should be prosecuted for numerous offenses in the first place," says the expert.

"Community-based solutions that tackle the underlying reasons of women coming into contact with the justice system – for example, destitution, violence and substance issues – are truly what we should be focusing on."