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A human rights activist, who was, was arrested near her home in early 2024. Accused with a vague offense, she was held without evidence. Three weeks later, her relatives were contacted to collect the remains of her infant child. The cause of death was not looked into, and her loved ones remains unaware what happened or if she received any postnatal care.

An International Crisis

Cases such as this are alarmingly common in prisons globally. Expectant mothers are often kept in appalling situations and denied medical attention. Some lose their pregnancies, others begin childbirth and give birth by themselves in a cell. Tragically, some babies perish in custody.

"Governments think it’s a few of women so it’s insignificant, but that is a misconception," says a legal advocate focused on women's incarceration.

"Detention is a terrible setting for women, not to mention someone who is pregnant," she explains. "Extensive research that shows how damaging it is. Most prisons were constructed with male inmates in mind, so women were an secondary consideration."

Ignored Global Standards

It has been 15 years since the establishment of international guidelines for the treatment of female prisoners. These guidelines clearly say that prison should be a last resort for pregnant women and that alternatives to detention should always be considered. They also prohibit the use of restraints on women in childbirth.

However, these guidelines are often violated globally. "This is not viewed as a global gender-equality priority," argues the advocate. "It is overlooked, and there’s a lot of stigma and prejudice."

Severe Hardships in Overcrowded Prisons

In various regions, situations for pregnant prisoners are described as "exceptionally severe". Contact with relatives have been prohibited, and rights groups are denied access. Interviews with ex-inmates describe assaults, torture, and being denied basic supplies. Reports indicate some are forced into trading sex with prison staff for food or medicine.

"Our organisation has recorded miscarriages and the loss of four babies … it is certain there are more," says a local lawyer.

It is also reported women who were shackled to hospital beds during labour and delivered while watched by male prison guards.

Severe Overpopulation and Its Impact

Statistics lists some countries as having the highest prison occupancy levels in the world. Women are particularly vulnerable to these situations. "There is rarely enough space to fully lie down," says a human rights outreach director. "There is a chronic lack of access to basic items."

Pregnant prisoners have been handcuffed to hospital beds prior to delivery. Conditions for caring for an infant back in prison are worrying, as shown by cases of infants dying from pneumonia and malnourishment in custody.

Stories from Around the Globe

In Zambia, a former inmate remembers being in a cell with expectant mothers. Cell doors were secured overnight. If a woman started giving birth at night, the women were left to fend for themselves. "We begged. Others were praying. Others were hitting the floor and the doors, yelling: ‘Please come, somebody’s in labour!’"

These tragedies occur in more developed nations. For example, a young woman her baby died after giving birth unassisted in a prison cell. Her calls for help were ignored for hours, and she was forced to bite through the umbilical cord herself.

Turning Trauma into Change

Some women have decided to use their traumatic ordeals to drive reform. In the United States, a woman who lost her pregnancy in her cell set up an organisation. Her work has successfully pushed for legislation that ban restraints and isolation for expectant inmates in multiple states.

A separate account comes from South America. A woman discovered she was pregnant after being given a prison term. When it came time to give birth, officers chained her legs to the bed. Doctors performed a caesarean section. As she recovered, they suggested to sterilize her. "Why would you wish to have more children, if you’re a prisoner?" was the response.

"My ordeal was obstetric violence. What I experienced should never have happened, but this is what women in prison go through," she says. This trauma later shaped provincial policies around giving birth while incarcerated.

Potential Reforms

Some nations have implemented measures for pregnant women in the justice system. Among them are:

• Evaluating non-custodial options for accused women who are mothers, expecting, or nursing mothers.
• Introducing house arrest as an option to being held before trial, especially for expectant mothers.
• Allowing for the postponement of prison terms for pregnant women.

Experts and people with experience believe that, in most cases, pregnant women should not be in prison at all. "I question whether women should be prosecuted for numerous offenses in the first place," says the advocate.

"Community-based solutions that address the root causes of women entering the justice system – for example, destitution, violence and substance issues – are truly what we should be investing in."