On 22nd September 2021 the Prisons and Probation Ombudsman published her report into the death of a baby, Baby A, in HMP Bronzefield in 2019.
Ms A the mother, was an 18 year old, child in the care of the local authority. A ‘looked after child’ who had been living in semi-independent supported housing.
She had been charged but not convicted of a crime of robbery, but was remanded to prison in August 2019. What followed is a catalogue of neglect and inadequate care from the prison. I won’t go into details here but it is all in the Ombudsman’s report.
On the night of the birth Ms A tried three times to use the call bell in her cell to ask for nursing help and an ambulance. Her requests were not responded to and then her calls were ignored. The circumstances of her baby’s birth are deeply distressing. Again they have been set out in news reports and in the Ombudsman’s report. Suffice to say Ms A was found in her cell in the morning, with blood all over the room, and her dead baby in bed with her.
I was invited on to the Radio 4 Today programme to reflect on the issues this terrible death raises.
In summary these are the reflections I shared.
Assurance of improvement is too little too late
For years, reports have drawn attention to the inadequate care for pregnant women in prison.
Saying once again that things will improve is not enough. Indicative of the continuing lack of engagement with the issues, despite two baby deaths in the past two years, the Ministry of Justice and/ or HMPPS are unable to provide centrally held information about the numbers of women in prison who are pregnant or give birth in prison.
It is dangerous for babies to be born in prison
Women in prison receive inadequate care during pregnancy, missing appointments and lacking the access to care which is available in the community. In addition, higher levels of cortisol due to stress, are experienced by most pregnant women in prison. This toxic stress crosses the placenta in the third trimester, with long term implications for the baby. It also increases the likelihood of premature birth, a situation which prisons are not equpped for. See research by Dr Laura Abbott, Dr Miranda Davies/ Nuffield Trust and a film made by myself and Dr Abbott in 2020.
What has been highlighted by the case of Baby A, and is set out clearly in the Ombudsman’s report, is that every pregnancy in prison is a high risk pregnancy (due to the risk of giving birth behind a locked door, inadequate health care, risk of premature birth care and the long term risks to the baby).
I was shocked to see in the response to the Ombudsman’s recommendations that the recommendation to have appropriate emergency resuscitation equipment for children and neonates has not been accepted.
It seems to me that it is morally wrong for the state to lock a woman up in a facility which does not have the means to try to keep her child alive if born prematurely.
What do the Sentencing Guidelines say about this?
Sentencing Guidelines, including the Imposition of Community and Custodial Sentences Guideline (2017) and the General Guideline: Overarching Principles (2019) (see section 2, Mitigating Factors, sole or primary carer for dependent children, expanded explanation) state that imprisonment should not be imposed where there would be an impact on dependents including unborn children, which would make a custodial sentence disproportionate to achieving the aims of sentencing.
I find it difficult to imagine any circumstance in which a sentence which risks the life of a baby can be deemed to be proportionate punishment.
The Chair of the Justice Committte, Sir Bob Neil, said on the Channel 4 News that for a pregnant woman to be sent to prison he thought it would have to be ‘an absolute necessity. It would have to be something like terrorism.’
But what of those who say that women who have offended should be sent to prison?
Many women in prison are on remand, this means they have not been convicted of an offence and of those women, 60% of those remanded by magistrates and 40% of those remanded by the Crown courts won’t get a custodial sentence
77% of women are in prison for non violent offences
More than 62% of women are sentenced to less than six months in prison, and 82% of women in prison have been sentenced to less than two years, meaning that instead of an immediate custodial sentence they could have been punished with a suspended custodial sentence or a community sentence.
We know prison is a punishment which rather than reducing reoffending increases it.
It is already against much of the evidence to think that punishing women by imprisonment achieves any of the aims of sentencing.
When you add to that the risk to unborn babies and pregnant mothers it is difficult to see how imprisoning a pregnant woman is either just or of benefit to society.
Children’s Rights
Finally, but most importantly, every child has a right to life and when a pregnant woman is imprisoned, her child’s right to life is put at risk.
The state has a duty under Article 2 of the Convention on the Rights of the Child (1989), which has been ratified in the UK for over 30 years, to protect children from discrimination they may face because of the status or activities of their parent.
Ensuring that babies are born in prison is discriminatory treatment of those children, and is in breach of their right to life and their right to protection from discrimination.
What next?
If you are interested in this issue please see more information from Women in Prison and Birth Companions here
Dr Shona Minson 