A LACK OF APPROPRIATE MATERNITY FACILITIES and staffing is putting women in prison at significant risk of pre-term labour, missed midwifery appointments, and without appropriate support for mothers and young children dealing with the severe impact of separation.
Findings from the Nuffield Trust reveal that over one in ten (11 per cent) of women in prison who gave birth between 2016 and 2019 went into preterm labour, while more than a fifth of midwifery appointments are being missed by pregnant prisoners due to problems accessing hospital and care services.
It comes at a time when government continues with plans to build 500 more prison places for women despite opposition from charities and advocacy groups and following the published reports into the tragic deaths of newborns at HMP Bronzefield and HMP Styal.
The report, Inequality on the inside: Using hospital data to understand the key health care issues for women in prison calls for urgent action to better understand and tackle issues with accessing healthcare for women in prison compared with their counterparts in the general population. It finds:
- Women in prison are almost twice as likely to go into preterm labour or delivery (11 per cent) proportionately compared to the general population (6.5 per cent).
- In 2019/20, 109 women had given birth in hospital within the last two years before prison. To date, there has been no routine data collected on prisoners with young children, so it is very unclear if mothers in prison are receiving adequate support.
- The capacity of mother and baby units is not large enough for the number of women in prison who have very young children born within the last 18 months (75) and who would be entitled to make use of them. The national capacity of mother and baby units in prison is 64 mothers and 70 babies according to the Ministry of Justice .
- In 2019/20, Women in prison are almost twice as likely to miss obstetric appointments as the wider population, with 31.5 per cent of appointments missed compared to 16.8 per cent in the wider population.
- In 2019/20, Midwifery appointments were also missed by a slightly greater proportion of the prison population (21.5 per cent compared to 16 per cent).
- Just under 45 per cent of all outpatient appointments for women were missed in 2019/20. Missed appointments are a long-standing issue with access to health care services in prison and show little signs of improvement. Challenges remain likely to be a symptom of wider problems the prison estate faces, particularly staff availability.
Labour continues to be an especially high risk point. Previous findings from the Nuffield Trust revealed in 2017/18, show that just over one in 10 births by women in prison took place outside a hospital setting, meaning they gave birth either in a prison cell or on the way to the hospital.
The report, funded by the Health Foundation, calls on the government and health care bodies to prioritise better data collection about the maternity health needs of women in prison and those with children before entering prison, and to tackle the long-standing issues with access to appointments across the prison estate.
Report author and Nuffield Trust Senior Research Fellow, Dr Miranda Davies, said: “Women in prison face many of the same difficulties accessing vital health and care services that we have seen across the prison estate in England. The tragic circumstances leading to the deaths of newborns at HMP Bronzefield, and HMP Styal have led to steps that acknowledge and plan for the health care needs of pregnant and postnatal women in prison and their children, but more needs to be done.
“While the number of pregnant women in prison are small, the risks to these women and their babies are very real. Prisons and their staff are not equipped to support women or newborn babies who require specialist care, so the risks to the one in ten women in prisons going into pre-term labour or giving birth in their cell or on the way to the hospital are extremely worrying. Appointments that could help to prevent and mitigate these risks are also being routinely missed.
“If the government remains so set on building new prison places for female prisoners, it urgently needs to get a handle on these specific health care issues for women and how to address them or we continue to put these mothers and children at risk.”
* Read: Inequality on the inside: Using hospital data to understand the key health care issues for women in prison here.
* Source: Nuffield Trust