January 28, 2025
In December 2024, Dr Laura Abbott (University of Hertfordshire) joined the Supporting Early Minds team to discuss her research around babies born to incarcerated mothers, presenting insights gathered through conversations with women, healthcare professionals, social workers and prison staff. The research delves into the emotional intricacies and challenges surrounding newborn-mother separation in criminal justice settings.
In her work, Dr Abbott did a qualitative piece of research spending around ten months talking to women and staff members in prisons. Unsurprisingly, her findings were that prison is a brutal environment for an expectant mother. Dr Abbott described a kind of institutional thoughtlessness with a system that has not been designed to consider the needs of pregnant women or their babies.
One aspect that came up with the mothers was their intense feelings of shame. They would have repeated trips in and out of prison to hospital and back, often in handcuffs and with prison officers accompanying them. They would feel intense embarrassment and shame and have the sense that everyone was looking at them. Dr Abbott highlighted that the majority of women in prison are there for short sentences, usually for non-violent crimes of poverty. They also often have a background of trauma. These feelings of shame exacerbated much of their adverse childhood experiences.
Another finding from the research was that not many staff knew what pregnant women are entitled to. Many of the expectant mothers also did not know this either and even when they did, they often did not receive it. For example, everyone is entitled to a pregnancy pack of extra food but that food would often be mouldy or out of date or not be given at all. So even the nutritional needs of pregnant women were often not met.
Women also reported not being provided with breast pads, which was a significant issue during times when they were separated from their babies and had nothing to absorb their milk. One mother even reported that she did not have a bra.
Another frequent issue was that women would arrive in prison on medication for high blood pressure or for issues around mental health and that these would be stopped on entry for a time until they could be re-prescribed. This seems surprising given the known issues for mothers and unborn babies when medications such as these are stopped.
Particularly shocking was that around 8 out of 10 staff members have had experiences of prisoners giving birth in their cells. One mother reported going into labour and notifying staff of this. This was her second pregnancy so she was aware of how her body laboured but she was not listened to. She ended up giving birth in her cell to a baby who was in the breech position. To add further complication, the child was born at only 36 weeks gestation. The woman stated that there was still no ambulance or paramedic when the child’s foot had presented.
Dr Abbott stated that the risks in terms of danger to the child’s health are rather staggering but even beyond the safety aspects, there is the dignity and shame of that as well as the trauma around not being listened to or heard. As her research continued, Abbott worked with charities and advocacy agencies to highlight these safety issues to raise public awareness.
Dr Abbott began doing this in 2018 and prior to that there was no mention in any inspector’s report about pregnancy in prison and nothing in any of the guidance. It was almost like a footnote. When she asked politicians and ministers why there was no data around numbers of pregnant women in prison, she was told that it was for confidentiality reasons. They said they did not want to start collecting numbers because of anonymity. This was so worrying that she ended up giving evidence at the Joint Human Rights Committee in 2019. The report can be found here.
Tragically, what ended up promoting change was the deaths of two newborn babies in prisons, one in 2019 and one in 2020. These were widely reported and ombudsman reports found gross failings in the prison systems. Dr Abbott warns that these reports make for harrowing reading.
Dr Abbott and other interested parties are still working to get the laws changed. In March 2024, pregnancy became classed as a mitigating factor for courts to consider in sentencing. Additionally, this is not just for expectant mothers but also for mothers in the first 1001 critical days of their child’s life. Like all of these things, it does not necessarily mean that it is translated into practice but the laws are there.
In January 2024, a pregnant woman had her sentence for firearm offences quashed on appeal. She had found that she was pregnant when she entered prison, which is quite common. It was her first pregnancy and she was suffering from pre-eclampsia and she was able to appeal on the grounds that prison was not a safe environment for her pregnancy. Since then, several others have also been released due to these mitigating factors.
Dr Abbott and her team and now working on a project called the Lost Mothers project, which has this lived experience embedded. They found that looking at those women in prison who had been separated from their babies, they were even more invisible than the pregnant mothers. Often these women would return from hospital without their babies and just disappear into the general prison population with no clear plans in place on how to support them or what their experiences were.
The reason why this is such an important area is that separation in the postnatal period is one of the most risky times for women. One of the catalysts for this research was a woman who died by suicide while five days post-partum. She was a mother of three serving a first offence and was told on day 5 that she would no longer be allowed to express milk for her baby, that she was unlikely to be taken to see that baby in special care and that the likelihood was that the baby would be placed into foster care.
The Lost Mothers project is funded by the Economic and Social Research Council and the University of Hertfordshire, in partnership with the charity Birth Companions. They are looking at women’s experiences and also the processes that they undergo. They have been interviewing prison officers, health visitors, and social workers. They have observed Mother and Baby Unit boards where the decision-making takes place.
During their writing retreat, they were joined by artist Beci Ward who captured some of the findings in the form of pictures which were really effective visual depictions of what had been shared in the interviews.
Unsurprisingly, the themes that came up were around the great pain of the separation. Women described it as the worst pain that they had ever experienced. It was described as physical, visceral, as if something had been ripped from them. Even the nurses reported trauma at witnessing it, describing crying themselves afterwards. While some of these separations were undoubtedly necessary for child protection reasons, these feelings of grief remained universal for the women with whom Dr Abbott and her team spoke.
The stress around anticipated separations was also very difficult for expectant mothers, many of whom were unaware until late on in pregnancy whether they would be eligible for a space in a mother and baby unit. For example, the mother who had to labour with a 36-week baby in the breech position attended the hospital after delivery unaware of whether she would be separated from her baby. This stress was also dangerous for the health of unborn babies since cortisol is known to cross the placenta particularly in late pregnancy.
Speaking with the staff members was also revealing since many of them were sympathetic and felt that the pregnant women would be better off in mother and baby units. However, there are only six mother and baby units within the country. Staff reported not having a great deal of training around pregnancy and healthcare. Since the stillbirths in prisons, pregnancy, mother and baby liaison officers have been introduced. These are operational staff who have a special interest in pregnancy and early motherhood and they serve as a conduit between the NHS health services and the pregnant women. However, they are still not healthcare staff.
The mother and baby units are well-staffed with nursery workers, family engagement officers and specially-trained prison officers. They are visited by health visitors and midwives and are inspected by OFSTED. Mothers do receive a high level of support and scrutiny while in these settings. However, at some of the decision-making boards on whether separation should take place, local authorities and social services sometimes recommend that a mother should not gain a place based on past behaviour. This can be particularly difficult if a woman has made an attempt to perhaps change her lifestyle and yet is not given a chance. This can be upsetting too if prison officers have perhaps put forward their own recommendation only to see this ignored.
The difficulty there is then how to support a woman who is grieving a child when the chances of reunion are minimal. The social worker has to prepare to be the person who removes the baby. Dr Abbott argues that multi-disciplinary training is essential for all the staff involved so that they can extend compassion in this incredibly difficult time.
Another aspect around this was that women might hesitate to share any concerns with prison staff and may feel a pressure to mask their worries as they do wish to be labelled as difficult or cause any problems which may then go into a report and increase the risk of having their baby removed. This can be seen as a really disproportionate punishment for their offences.
Dr Abbott has had some links with One Small Thing, an organisation based in Hampshire which has residential rehabilitation units for women so they can be diverted directly from the courts. The setting is called Hope Street and provides specialist support for women and their children and takes a positive and compassionate approach. Dr Abbott feels that initiatives such as these would be more constructive for women rather than imprisonment.
Dr Abbott hopes that with the momentum around other law changes that there will be a greater drive for change. She hopes that there is an increasing understanding of the importance of maternal attachment for babies and young children. She shared some poems taken from statements from women who had been separated from their children which emphasise the trauma and depth of grief.
The Lost Mothers Project has also partnered with theatre company Clean Break to put together a play using the voices captured within the project to highlight the experiences of mothers in prison. This will be touring in January and February 2025.
The findings of the Lost Mothers Project shed light on the profound impact on maternal well-being, the complexities faced by healthcare and social workers, and the dynamics within the prison system. By capturing these narratives, the study emphasises the critical need for comprehensive support structures, advocating for a deeper understanding of the nuanced interplay between institutional protocols and the early development of young minds affected by maternal separation.
All images shared in this post are courtesy of Studio Beci (Beci Ward) and the Lost Mothers Project
You can watch the webinar in full on the Supporting Early Minds website.
Or, to find out more about infant mental health and book a place on an upcoming Supporting Early Minds webinar visit: Webinars – Supporting Early Minds (mhid.org.uk)