UK inmate gave birth to stillborn in prison toilets, inquiry finds

An inmate gave birth to a stillborn baby in shocking circumstances in a prison toilet without specialist medical assistance or pain relief, an investigation by the Prisons and Probation Ombudsman (PPO) has found.

© Provided by The Guardian
Photograph: Russell Hart/Alamy

A prison nurse who did not respond to three emergency calls from a prison officer to come to the woman’s aid when she developed agonising stomach cramps has been referred to the Nursing and Midwifery Council.

Louise Powell, 31, was unaware that she was pregnant and did not believe she could be due to not having relationships with men. She gave birth on a prison toilet on 18 June 2020 at HMP & YOI Styal in Cheshire.

She previously said she believed her baby girl could have survived had she had more timely and appropriate medical intervention.

Her lawyer said they had obtained expert evidence that also suggested that the baby, who Powell named Brooke, may have survived had things been handled differently.

The report is the second by the PPO in six months to investigate the death of a baby in prison.

While Tuesday’s report found that there had not been failures before the day Powell gave birth, the ombudsman, Sue McAllister, found there were missed opportunities to establish that she needed urgent clinical attention in the hours beforehand.

Powell was in prison for the first time after being sentenced to eight months in March 2020 after admitting common assault, racially aggravated harassment and criminal damage.

McAllister said she suffered a “terrifying, painful and traumatic experience” and that “even at a distance this is a deeply sad and distressing case”.

“It’s not safe to have pregnant women in prison, we are just treated like a number,” Powell told the Guardian in a previous interview. “I can’t grieve for my baby yet because there are still things I don’t know, like why an ambulance wasn’t called. I want to get justice for Brooke and I decided to go public in the hope that things will change and pregnant women will stop being imprisoned.”

The investigation found that a prison supervising officer made three calls to the duty nurse, raising concerns about Powell during a period of two hours from shortly before 7pm on 18 June. The nurse did not come to see Powell, made inadequate reference to her medical file, and concluded incorrectly that she was bleeding and suffering severe stomach pain as a result of a painful period.

“Regardless of the cause, it is not acceptable that anyone should be in unexplained acute pain for several hours without proper assessment or consideration of pain relief,” said McAllister.

She added that had the situation been assessed properly, Powell might have given birth in hospital instead of on a prison toilet attended by untrained staff.

The report found that all the other staff who tried to help Powell and her baby during and after the delivery acted with humanity and to the best of their abilities.

The report recommends that women are offered a pregnancy test at the initial and secondary health assessments after arriving at prison. It also recommends that nurses in women’s prisons should have training in recognising early labour, and that all staff in women’s prisons need to know what to do in the event of an unexpected birth.

The Prison Service and the NHS have accepted the ombudsman’s recommendations and produced an action plan setting out how they will be implemented.

The prisons minister, Victoria Atkins, said: “We have already implemented the report’s recommendations and important improvements have been made to the care received by pregnant women in custody. We are also looking at how we can better screen for pregnancy in jails so no woman falls through the cracks.”

Powell’s solicitor, Jane Ryan of Bhatt Murphy, said: “There were multiple missed opportunities to help Louise. There was no system in place to recognise unexpected birth at the time. It is inhumane to leave a woman howling in pain unaided and forced to give birth in a toilet.”

Kirsty Kitchen of Birth Companions said: “We cannot go on pretending that the prison system will ever be a safe or appropriate place to give birth.” She called on the government to reinstate its early-release scheme for eligible pregnant women and those in mother and baby units.

Janey Starling, co-director of Level Up, who is campaigning for an end to the imprisonment of pregnant women and new mothers, said: “The only way to keep mothers and babies safe in future is to keep them in their communities.”