Across the globe, a hidden human rights crisis is unfolding behind prison walls, where pregnant women are routinely subjected to degrading and dangerous conditions. Campaigners report that incarcerated expectant mothers are often denied basic medical care, forced to give birth alone in cells, and even shackled during labour, leading to tragic outcomes for both mother and child.
A Disturbing Global Pattern of Neglect
The case of Dina Hernández, a 28-year-old human rights activist from El Salvador, is a stark illustration. Arrested in March 2024 while 35 weeks pregnant and accused of "illicit association" without evidence, she was imprisoned. Just three weeks later, her family was called to collect the body of her newborn baby. The cause of death remains uninvestigated, and her family has no knowledge of whether Hernández received any postnatal care.
Such harrowing stories are far from isolated. From Latin America to Southeast Asia and even within wealthier nations, pregnant prisoners face systemic failures. They are held in overcrowded, unsanitary facilities designed for men, often resulting in miscarriages or solitary, traumatic births. Some babies do not survive their incarceration.
Sabrina Mahtani, a British-Zambian lawyer with Women Beyond Walls, emphasises the inherent harm. "Prison is not a good environment for women, let alone someone who is pregnant," she states. "Many prisons were built with men in mind, so women were an afterthought. There's a real lack of gender-responsive care."
Flouting International Guidelines
This crisis persists despite the existence of international standards. It has been 15 years since the UN General Assembly adopted the Bangkok Rules, the first international guidelines specifically for female prisoners. These rules clearly state that prison should be an absolute last resort for pregnant women and that instruments of restraint must never be used during labour, birth, or immediately after.
Yet, these guidelines are "consistently flouted around the world," according to Mahtani. The issue suffers from a lack of visibility and political will, often dismissed due to the smaller number of women in prison systems compared to men. However, the female prison population is growing at an alarming rate. Since the year 2000, the number of women and girls in prison globally has surged by 57%, compared to a 22% increase for men.
The situation is particularly acute in countries like El Salvador, where the female prison population has nearly increased sevenfold since 2000. Lawyer Zaira Navas of Cristosal reports "really critical" conditions, with women subjected to beatings, torture, and denied basic supplies. She has documented cases of women shackled to hospital beds during labour, watched by male guards, as well as miscarriages and infant deaths.
Overcrowding and Obstetric Violence
In Cambodia, home to some of the world's most overcrowded prisons, pregnant inmates are also vulnerable. Naly Pilorge of Licadho reports that pregnant prisoners have been handcuffed to hospital beds, and newborns face dire conditions upon returning to jail. One tragic 2020 case involved a five-month-old baby dying of pneumonia and severe malnutrition in prison after its mother was detained for possessing a tiny amount of drugs while pregnant.
This brutality is not confined to the global south. In the UK in 2019, 18-year-old Rianna Cleary gave birth alone in a cell at HMP Bronzefield after her pleas for help were ignored for 12 hours. She was forced to bite through the umbilical cord, and her daughter, Aisha, did not survive.
In Argentina, Nora Calandra's experience epitomises what she now calls "obstetric violence." During her labour in 2010, guards chained her legs to the hospital bed. After an unexplained caesarean section, while still groggy from anaesthetic, she was asked if she wanted to be sterilised. "Why would you want to have more children, if you're a prisoner?" they asked. For years, she believed this treatment was part of her punishment.
A Push for Change and Alternative Solutions
Survivors like Calandra and Pamela Winn in the United States are now driving reform. Winn, who miscarried alone in a cell, founded RestoreHer and has successfully campaigned for laws banning shackling and solitary confinement for pregnant inmates in 24 US states. Calandra's advocacy informed new childbirth guidelines for Buenos Aires province.
Some nations have introduced alternative measures. Sierra Leone's bail regulations require courts to consider alternatives for primary caregivers or pregnant defendants. Brazil allows house arrest for pregnant women or mothers with young children awaiting trial, while countries like Georgia and Russia permit sentence deferrals.
However, experts argue that the solution must go further. They advocate for investing in community-based responses that address the root causes—such as poverty, abuse, and discrimination—that bring women into the justice system. "I question whether women should be criminalised for many issues in the first place," concludes Sabrina Mahtani. The growing consensus is clear: for pregnant women, prison is rarely, if ever, the answer.
