Professor Chris Whitty, the chief medical officer, added pregnant women to the vulnerable group on 16 March. The government has advised them to self-isolate at home and reduce social contact during the pandemic.
However, social distancing would be challenging in prisons, campaigners say. Hygiene issues in the prison environment are also a concern, as well as limited access to healthcare.
“We have always argued that prison is the wrong place to care for pregnant women, new mothers and babies because of the risks created by the system; we fear the current crisis will put more lives in jeopardy,” Naomi Delap, the director of Birth Companions — the first organisation to call for the release of pregnant women, said. “The prison environment makes it very difficult to limit the spread of Covid-19.”
The most recent snapshot showed there were 47 pregnant women in prisons across England and Wales in November 2019, but this figure is likely to have changed since. Birth Companions warned the number shifts almost daily, particularly when pregnant women held on remand are considered.
The most robust figure, which is based on access to maternity services, shows around 600 pregnant women are in prison in England and Wales each year and about 100 babies are born in prison annually.
Meanwhile, there are six prisons with Mother and Baby Units, where mothers can care for their children up to the age of about 18 months.
Most women in prison serve short sentences because 80 per cent enter custody having committed non-violent offences.
Women in prison are already more likely to have high-risk pregnancies than those in the general population. Women in the prison estate are also more likely to give birth prematurely, more likely to suffer from health conditions such as pre-eclampsia and have smaller babies.
Ms Delap said: “Beyond the direct threat posed by the virus, we fear women and babies will face significant risk because of the inevitable reduction in prison and healthcare staffing levels.
“This will affect women’s access to midwifery appointments in prison; scans and appointments in hospital; healthcare and mental health support in prison.
“It will also heighten the risk that women’s calls for attention, particularly in labour, are not responded to quickly enough, and impact on timely transfer to hospital for birth and in other emergency situations.
“The likelihood that women will be confined to their cells for extensive periods of time is also likely to impact negatively on their mental health.”
One in five appointments with midwives is already missed by women in prison and nearly 40 per cent miss outpatient appointments. This can be because there are not enough staff to escort them.
Several women deliver their babies alone in cells or on the way to hospital.
Miranda Davies, a senior fellow at the independent health think tank the Nuffield Trust, said: “We know from our research that even before the Covid-19 outbreak, pregnant women in prison faced significant risks.
“Our analysis showed that in 2017-18 roughly one in 10 pregnant women gave birth either in their prison cell or en route to hospital, raising questions about their ability to access the right care.
“Right now, pressure is mounting in all prisons, with existing shortages of prison staff being exacerbated due to staff having to self-isolate due to Covid-19. This is likely to make social distancing in prisons a real challenge as it relies on staff being able to bring prisoners food and other supplies they may need.”
The warnings also follow the death of a baby at HMP Bronzefield in September 2019. The mother had given birth alone without medical support in her cell at night.
Alongside Birth Companions and Women in Prison, Dr Shona Minson, from the Centre for Criminology at the University of Oxford, and Dr Laura Abbott, a fellow of the Royal College of Midwives and senior lecturer in midwifery at the University of Hertfordshire, have joined the call for the release of pregnant women and mothers and babies.
Ms Delap said: “The release of pregnant women and those on Mother and Baby Units is a matter of urgency, but it must be done in the right way. All of us — the prison and probation services, local authorities, the NHS and the voluntary sector — need to work together to ensure a coordinated effort to move these women and babies to safe places where they can receive the services they require now and in the weeks and months to come.”
Vulnerable prisoners are being released in countries such as the US, Spain and Iran amid fears that Covid-19 will spread rapidly in prisons and detention centres.
A Ministry of Justice spokesperson said: “The government’s absolute priority is to protect life, and we have robust and flexible plans in place keep prisoners, staff and the wider public safe based on the latest advice from Public Health England.”
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