Trigger warning: baby loss.
Placing pregnant women in prison as opposed to issuing another form of sentencing has informed an ongoing debate in the UK, particularly in recent years. Now, a coroner report has laid bare the harrowing details which led to the death of prison inmate Rianna Cleary’s newborn baby, Aisha.
The “vulnerable” Black woman, who was 18-years-old at the time, gave birth alone in her cell after a number of “systematic failings.” As reported by the BBC, the inquest heard how Rianna was forced to cut her baby’s umbilical cord with her teeth, after a final call she made to prison staff went unanswered in the early hours of Sept. 27, 2019. Baby Aisha was pronounced dead the following morning, having suffered brain injuries.
The coroner, Richard Travers, was unable to determine if baby Aisha was stillborn or breathing at the time of birth. In his findings, he deduced that there were clear failings within the prison system and that opportunities to help Rianna and her baby were missed.
“There is clear evidence, not least, of systemic failings which more than minimally contributed to Aisha being delivered in a prison cell without medical assistance and, following delivery, losing the chance of resuscitation and survival,” Travers explained.
“If Aisha's mother's labour had been identified, and she had been transferred to hospital in a timely manner for Aisha's delivery, there would have been an opportunity for effective steps to have been taken.”
Rianna was imprisoned in HMP Bronzefield jail in August 2019 after she was exploited by county lines gangs. On the night she went into labour, Rianna called out for help. Prison officer Mark Johnson responded to her first call, and later said the young woman had been “abusive.” He has since been suspended from prisoner-facing duties. Rianna’s second call for assistance went unanswered. A prison officer with a torch later walked past the young woman’s cell as she was crouching down on her hands and knees in labour, but they did not stop to help her.
“It is a case that calls for compassion, not punishment.”
In a statement following the inquest, Rianna said: “I feel so sad knowing that Aisha may have survived if they had helped me. Only one prison officer, who didn’t even do anything wrong, said ‘sorry’ to me directly.”
She added: “The deputy director of Bronzefield wrote one line to me saying ‘sorry you gave birth alone’ just before the inquest started. If it wasn’t for this inquest, they would still be blaming me for giving birth alone.”
Rianna also questioned whether race was a mitigating factor in her mistreatment. “I want this inquest to give me some answers. Was I treated differently because I am a young, Black woman?” she asked. “Why was I left to give birth on my own? Why did no one answer my cell bell when I was desperately seeking help?”
Prior to the inquest, an investigation was carried out by the Prisons and Probation Ombudsman, who determined that “pregnancies in prison should be treated as high risk by the virtue of the fact that the woman is behind a locked door for a significant amount of time.”
Reflecting on the inquest, Naomi Delap, director of the Birth Companions charity, said: “The deeply distressing witness testimony heard in this inquest adds to the considerable weight of evidence showing that prisons are not, and will never be, safe environments for pregnant women. We welcome the Coroner’s conclusion.”
They added: “The prison system, by its very nature, creates significant barriers to healthcare. We’ve been working with pregnant women in prison for 27 years, during which time we’ve seen and heard of other tragic deaths as well as many serious incidents and near misses. Things have to change.”
Delap feels strongly that “the government can, and must, end the imprisonment of pregnant women and mothers of infants.” Bringing attention to the fact Rianna was in and out of the UK social care system as a minor, Delap added that urgent work needs to be done to “improve the way local authorities support girls in their care, and women whose unborn babies and infants are subject to child protection proceedings.”
Tragically, Rianna is far from the first pregnant woman who has been subjected to mistreatment while imprisoned. In 2021, GLAMOUR UK spoke to a woman who faced an “agonising delay” after going into labour behind bars. You can read her story, below.
It was 5.30am when Anna* (name changed to shield identity) woke up in her prison cell in pain and realised she might be in labour. She pressed the call bell for help but nobody came. It wasn’t until 7.30am and all the cells were unlocked that Anna could finally speak to a prison officer. “I told them I thought I was going into labour but they said a nurse had to come and establish that before they could take me to hospital,” she told GLAMOUR UK.
Right now, 1,000 Metropolitan Police officers are currently suspended or on restricted duties with another 450 being investigated for historic allegations of sexual or domestic violence.
Anna had to wait over two hours before the nurse arrived to confirm she was in labour and the prisoner officers finally called an ambulance. “The delay was agonising, I was getting myself into such a panic,” she recalled. “I was in a lot of pain by this point and I couldn’t understand why I wasn’t at the hospital already.”
“Throughout my pregnancy, my biggest fear was having my baby in my cell because so much was ignored and I had to constantly push to get help,” she added.
In the weeks leading up to her labour, Anna didn’t step outside for exercise so she had to be given a vitamin D supplement because she wasn’t getting any daylight. “Prison can be a very volatile place so I had to keep myself out of situations where people might kick off and my unborn baby would be in danger,” she explained. “I basically stayed in my cell for three months. Mentally, it was very tough.”
Anna said she was treated no differently to the other prisoners, despite her condition. She didn’t have access to pregnancy-specific nutrition, vitamins or clothing. “I was lucky because my cellmate worked in the kitchen so she would bring me back leftover fruit if any was going spare.”
Did she feel as though the prison officers were looking out for her? In short, no. “I actually remember one time an officer took issue with the fact my cellmate gave me a couple of extra apples because it was against the rules,” she shared.
Thankfully, Anna did make it to the hospital in time to give birth and her baby was delivered safely. But tragically, this isn’t always the case for women who go through pregnancy in prison. In addition to Rianna's case, another woman Louise Powell, lost her baby during childbirth while imprisoned in HMP Styal in Cheshire in June 2020. Powell said she begged for an ambulance before her baby, Brooke, died in her cell.
In 2021, a spokesperson from Spectrum Community Health CIC, the lead healthcare provider for HMP Styal said: “We extend our deepest condolences to Ms. Powell for the distress and sad loss that she has experienced. Spectrum Community Health CIC has fully co-operated with the independent investigation into this case. As the investigation report by the Prisons and Probation Ombudsman has yet to be published, we are unable to provide any further comment.”
All of these devastating cases highlight the severe risks associated with pregnancy in prison. “Prison is not the place to care for pregnant women, most of whom are there for non-violent crimes,” says Clare Livingstone, professional policy advisor at the Royal College of Midwives. “Women in prison often have higher-risk pregnancies and need enhanced levels of care. It is enshrined in law that they get equivalent care to other women, but this is not always happening. Too many pregnant women aren’t getting the right levels of support during and after their pregnancy.”
A 2020 report by the Nuffield Trust found that between 2017 and 2018, over one in 10 women gave birth in their cell or on their way to hospital. The research also revealed that 22% of pregnant prisoners missed midwife appointments, 30% missed obstetric appointments and nearly 40% didn’t attend outpatient appointments. These rates are significantly higher than those of the general population.
"The most traumatic weekend of my life to date."
Campaigners say that prison can never be a safe place for pregnant women and their unborn babies, regardless of potential changes to government policy. “There’s often no appropriately qualified person on-site should an emergency happen,” explains Dr. Laura Abbott, senior lecturer in midwifery at the University of Hertfordshire. “We know that pregnant prisoners are at risk of giving birth prematurely as well as other pregnancy conditions but there is no training in neonatal resuscitation or the management of a severe haemorrhage so if a baby is born unexpectedly, its life is in danger.”
Dr. Shona Minson from the Centre of Criminology at the University of Oxford adds that most pregnant women in prison experience higher levels of cortisol due to stress, which can affect the baby’s development and increases the likelihood of premature birth. She argues it is morally wrong for the state to lock a woman up in a facility that does not have the means to keep her child alive if it’s born prematurely. She points out that according to sentencing guidelines, imprisonment should not be imposed where there would be an impact on dependents including unborn children. “I find it difficult to imagine any circumstance in which a sentence that risks the life of a baby can be deemed proportionate punishment,” she says.
So, what is the alternative to prison sentences for pregnant women? Dr. Minson feels it’s important to point out that 77% of women are in prison for non-violent crimes and 62% of women have been sentenced for less than two years, meaning their crime is not serious or violent and they’re not a risk to the community. The trauma they experience is lasting, however. What’s more, many women in the criminal justice system have convictions linked to poverty and have been victims of crime and abuse themselves. “Prison is not the right place for these women,” she says.
Given that community sentences are more effective in reducing re-offending rates while short sentenced prisoners have the highest reconviction rates, it can be argued that that short sentences serve no useful purpose, particularly when you consider the risks posed to mothers and their unborn babies in the prison system. “Instead, pregnant women could be given a sentence in the community which will restrict their lives, have conditions which they must fulfil for unpaid work or training, but will allow them to safely deliver and care for their children," offers Dr. Minson.
