Birth behind bars

By Charlotte Wilson, Policy advisor on 10 August 2020 Maternity Services Covid-19

In the early hours of the morning on 27 September 2019, a woman gave birth alone in her cell at HMP Bronzefield. When prison staff reached the cell later that morning, the baby was unresponsive, and was later confirmed to have died. An investigation into the events leading up to the death is ongoing. To date, very few details have been released, but the case, like many before it, raises important questions around when it is appropriate to keep pregnant women and new mothers in prison.

In the UK, women typically commit less serious, non-violent offences, and are often given short custodial sentences of six months or less, even though the Ministry of Justice (MOJ) has publicly acknowledged that short custodial sentences offer limited public protection and are less effective in terms of reducing future offending.

As well as being ineffective, placing pregnant women and new mothers in prison can have an immensely negative effect on her children. As was made clear in the tragic example at HMP Bronzefield, maternity outcomes after often poor for pregnant women in prison. This is because women in detention are more likely to have their antenatal care disrupted, to receive inadequate nutrition or hydration, and subsequently to have a premature or small for dates baby. The impact of separating mother and child has also been identified as one of ten adverse childhood experiences known to have a significant negative impact on children’s long-term health and wellbeing.

Earlier this month, this Ministry of Justice published its review of the operational policy on pregnancy, Mother and Baby Units (MBU)*. This review announced several changes which reflect the RCM’s recommendations on this subject, which were published last year. For example, the review has announced adjustments to pre-sentence admissions procedures for those suitable for a place on an MBU. This will speed up decisions and reduce stress for mothers and their babies. The review will also extend the age at which babies can remain in an MBU from 18 months to two years, although we are disappointed the government chose not to accept our recommendation that the age limit be removed entirely.

The review has also announced better quality and ongoing support for prison staff, including practical training on basic perinatal needs. This is something we highlighted in our recommendations, as it is vital that prison staff receive dedicated training on the needs and experiences of perinatal women and their babies. According to a Government announcement made after the review, prison staff will also now be supported by a ‘resident mother and baby specialist’.

Although there is a lot more work to do, we are pleased to see the MOJ is taking some positive steps toward righting this problem and ensuring horrific incidents like that at HMP Bronzfield never happen again. At RCM, we will be monitoring the progress of MOJ’s proposed actions carefully, while continuing to call for additional measures like mandatory training for the judiciary on the impact of separation on mother and child and the importance of the first 1001 days, and continuity of midwifery care in prison.

*A Mother and Baby Unit MBU is a unit in or near a prison in which women can keep their baby for the first 18 months (to be extended to 2 years) while serving a custodial sentence.