Experts have warned that more babies could die in prison owing to the government’s expansion of female prison places and ministers’ refusal to grant multiple requests to end the incarceration of pregnant women. The warning comes after an investigation report published by the Prisons & Probation Ombudsman on Wednesday, revealed in chilling detail how in September 2019 an 18-year-old prisoner at HMP Bronzefield in Ashford, Kent, was forced to deliver her baby alone in her cell. The baby did not survive. The teenager, who was on remand on a robbery charge and was referred to in the report as Ms A, passed out during the labour. She then climbed into bed with her dead baby. Fellow prisoners raised the alarm the next morning when they entered her cell after it had been unlocked and saw blood everywhere. The previous evening she had rung the cell bell to summon help but received none. The report says Ms A’s cell was checked as part of a routine roll count twice during the night but neither of the officers who did the check said they noticed anything untoward. In January, the government announced it was expanding the number of prison cells for women by 500. Many who are imprisoned have convictions linked to poverty, lack of education, poor mental health, past trauma, or have been a victim of violence. Eleven countries do not imprison pregnant women, or severely restrict their incarceration. These include Russia, Ukraine and Brazil. The Prison Service does not release comprehensive data on miscarriages, stillbirths and baby deaths. In the years 2017/18, 2018/19 and 2019/20 a total of 141 prisoners gave birth, 11 of them outside hospital – presumed either in an ambulance or in prison. Between July 2020 and March 2021, 31 prisoners gave birth, three on the way to hospital. In his response to the HMP Bronzefield PPO report, the deputy prime minister and justice secretary, Dominic Raab, made no mention of ending or reducing the incarceration of pregnant women, saying instead: “We have put in place important improvements to the care received by women in custody.” A recommendation in the PPO report to provide specialist neo-natal medical equipment at the prison was rejected. Another damning PPO report is expected soon into the harrowing case of Louise Powell, 31, who gave birth at HMP Styal in Cheshire in June 2020 to a baby who did not survive. She was sentenced to eight months in March 2020 after admitting common assault, racially aggravated harassment and criminal damage. Powell was not aware that she was pregnant and it was only when she started having contractions that her cellmate said she was sure Powell was in labour. The baby was breech and she begged for an ambulance to be called, saying she felt as if she was dying. She believes her baby, who she named Brooke, could have survived had she had appropriate and timely medical intervention. “It’s not safe to have pregnant women in prison, we are just treated like a number,” she said. “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.” Jane Ryan, of Bhatt Murphy solicitors, who is representing Powell, said: “My client lost her baby in the most humiliating and degrading circumstances, giving birth in a toilet in prison. If she had equivalent healthcare to the community, baby Brooke may have survived. The birth of any baby in a cell is reprehensible. The only way to ensure that no further babies die behind bars is to stop imprisoning pregnant women and use community rehabilitation instead.” A Prison Service spokesperson said: “This was a deeply sad and distressing case and our thoughts remain with everyone affected. While our view remains that custody should be the last resort for most women, we have made significant improvements to support female offenders and our new prison places will give them greater access to education, healthcare and employment – helping them to turn their backs on crime. We await the Prisons & Probation Ombudsman’s report and will respond accordingly to improve the care for pregnant women and mothers in prison.” Tamsin Morris, who previously ran a mother and baby unit at Styal and whistleblew about conditions there, warned before the loss of Powell’s baby that a tragedy like the one at Bronzefield could also happen at Styal because of conditions for pregnant women there. She said: “Pregnant women would be better safeguarded and more effectively rehabilitated in a secure community mother and baby unit that taught parenting skills and helped break generational cycles of incarceration.” Naomi Delap, director of Birth Companions, said: “Both the tragic cases reported this week – the death of Baby A in HMP Bronzefield and the death of Brooke Leigh in HMP Styal – demonstrate the severe risks posed to pregnant women in the prison system. In both these cases, and in many others across the estate, women in need of healthcare have not received it. Their calls for help have gone unanswered. This has resulted in death in some situations; in numerous others it has put women and babies’ lives at risk. Prison will never be a safe or appropriate place to navigate pregnancy. Yet rather than agreeing to end the imprisonment of pregnant women, as many other countries have, the government is focused on building more women’s prison places, putting more lives at risk.” Laura Abbott, a senior lecturer in midwifery at the University of Hertfordshire, said that the poor care received by Ms A was “not an isolated case”. “What’s really alarmed me is that these are pregnant women calling for help and not getting the help they need,” she said. “If women are locked in and can’t get the help they need they’re never going to be safe in prison.” She said Ms A’s case highlighted a tendency for women in prison to be “blamed” for not engaging with antenatal care – and for their attempts to seek help to be ignored. “I find it hard to even imagine what she went through,” Abbott said. Miranda Davies, senior fellow at the Nuffield Trust, said: “Given the increased risk to women in prison who give birth, the response to the PPO’s recommendations raises serious concerns. I am particularly worried, given these events, by the rejection of the need for emergency resuscitation equipment and staff to be trained in its use. Whilst a focus on avoiding out-of-hospital births is admirable, history shows that it happens, so it should be prepared for.”