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An advocate, while she was, was taken into custody near her residence in March 2024. Charged with a crime of "illicit association", she was imprisoned without evidence. Weeks afterward, her relatives received a call to retrieve the body of her newborn baby. The cause of death was not looked into, and her loved ones remains unaware what happened or if she obtained any postnatal care.

A Global Problem

Situations like these are not rare in detention centers internationally. Expectant mothers are often kept in deplorable conditions and denied medical attention. Some miscarry, others deliver and give birth alone in a prison cell. Tragically, some babies die in custody.

"Countries think it’s a minority of women so it’s insignificant, but that’s not true," states a legal advocate focused on women's incarceration.

"Incarceration is a harmful place for women, especially not for someone who is pregnant," she continues. "There’s so much evidence that indicates how detrimental it is. Most prisons were designed with male inmates in mind, so women were an afterthought."

Ignored International Guidelines

It has been 15 years since the establishment of the UN's Bangkok Rules for the handling of incarcerated women. These guidelines specify that prison should be a final option for pregnant women and that non-custodial sentences should be the first choice. Furthermore, they ban the use of restraints on women during labour.

However, these rules are consistently flouted globally. "This isn’t seen as a worldwide priority for women's rights," says the advocate. "It’s not visible, and there’s a lot of shame and stereotyping."

Dire Situations in Overcrowded Prisons

In certain nations, situations for expectant inmates are reported to be "really critical". Family visits have been prohibited, and civil society are denied access. Accounts with formerly incarcerated women reveal assaults, torture, and being denied essential items. Reports indicate some are forced into exchanging favors with guards for food or medical supplies.

"Our organisation has recorded miscarriages and the death of four babies … it is certain there are more," says a rights defender.

Reports also indicate women who were chained to medical beds while in labor and delivered while observed by male prison guards.

Overcrowding and Its Consequences

Data shows some countries as having the most severe prison occupancy levels in the globe. Women are especially at risk to these situations. "There is seldom enough space to fully lie down," says a advocate. "There is a chronic lack of access to essentials."

Pregnant prisoners have been restrained to hospital beds prior to delivery. Conditions for raising a newborn back in prison are alarming, as shown by cases of babies succumbing from pneumonia and severe malnutrition in custody.

Stories from Different Continents

In one African country, a former inmate recalls being in a detention block with expectant mothers. Doors were locked overnight. When someone started giving birth at night, the women were forced to manage on their own. "We begged. Others were asking for divine help. Others were banging on the floor and the doors, yelling: ‘Please come, somebody’s in labour!’"

These tragedies also happen in wealthier countries. In one case, a teenager her baby died after delivering alone in a prison cell. Her pleas for assistance went unanswered for hours, and she was forced to sever the cord on her own.

From Experience to Advocacy

A number of survivors have chosen to use their traumatic ordeals to instigate change. In the United States, a woman who miscarried in her cell set up an advocacy group. Her work has successfully advocated for legislation that ban restraints and solitary confinement for expectant inmates in numerous jurisdictions.

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

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

Potential Reforms

Other countries have introduced policies for expectant mothers in the justice system. Among them are:

• Evaluating non-custodial options for defendants who are primary caregivers, pregnant, or nursing mothers.
• Implementing home detention as an option to being held before trial, particularly for expectant mothers.
• Allowing for the postponement of sentences for pregnant women.

Advocates and those who have been incarcerated believe that, often, expectant mothers should not be in prison at all. "We must ask whether women should be criminalised for many issues in the first place," says the expert.

"Alternatives in the community that tackle the underlying reasons of women coming into contact with the legal system – for example, destitution, abuse and drugs – are truly what we should be focusing on."