State of abandonment: In England, women in prison give birth without midwife. Who cares?

On Tuesday, November 13, The Guardian reported “women are giving birth in prison cells without access to proper medical care.” The report was based on extensive research conducted by Dr. Laura Abbott, specialist midwife and senior lecturer at the University of Hertfordshire. On Friday, The Guardian followed up with an anonymous report by a woman who had suffered childbirth in prison. Other news venues have since picked up on the report, as has at least one Member of Parliament. While the reports draw attention to the violence committed directly and regularly on women and children in prison, they miss a salient feature of Dr. Abbott’s research, the failure, or refusal, of the State to acknowledge that there are pregnant women prisoners and women who give birth while in prison. That second issue is integral to the State of Abandonment, a State that “accelerates the death of the unwanted” through a policy of unmapping: “Zones of abandonment … determine the life course of an increasing number of poor people who are not part of mapped populations.”

After interviewing “28 female prisoners in England who were pregnant, or had recently given birth whilst imprisoned, ten members of staff, and ten months of non-participant observation”, Laura Abbott found “institutional thoughtlessness”; “institutional ignominy”; women’s coping strategies; and the ways in which women navigate the system to negotiate entitlements and seek information about their rights”. Pregnant women prisoners are both forgotten and shamed. This is how the State practices intersectionality.

At the center of Abbott’s research is a woman called Layla. When she entered prison, Layla was 24 weeks pregnant with what would be her second child. Typical of most of the women interviewed, “Layla was incarcerated for the first time for her very first offence. Similar to most participants, she was distressed as she entered prison, was unaware of her rights and entitlements and did not know what would happen with regards to her midwifery care: `I didn’t know whether I was going to see a midwife, I didn’t know anything. I was absolutely distraught’. Layla was unaware of the process of applying for a place on an MBU (Mother Baby Unit): `None of the officers spoke to me about it (MBU), I just had to go off and do it all myself’”..

When Layla lost her `mucous plug’, she was sent to the health care nurse: “Health care were like, ‘Oh, you’re fine, you’ve got at least another seven to ten days before anything will happen …  I was trying to explain … to health care, they were just like, ‘No, don’t worry about it,’ and I was like, ‘No, really, I know my own body … They were like, ‘Yeah, yeah, we’ll sort that out when and if you go into labour”.  

At 11 pm that same night, Layla started having contractions. By midnight, the contractions were coming on strong. A nurse came to her cell. Layla said she was in labor; the nurses doubted her and, finally, “`I’m telling you I am in labour,’ ‘No, you’re not. Here’s some paracetamol and a cup of tea”.At 12:30 the nurses left. At 12:40 Layla’s waters broke. Then the nurses decided to send Layla to hospital. Layla had to explain to the nurses that it was too late: “I says, ‘I haven’t got time to get to hospital. I did say to you I was in labour …`I was laid there on my bed, in my cell with a male nurse and a female nurse, not midwifery trained at all, trying to put gas and air in my mouth and I’m like, ‘I don’t want anything, I need to feel awake and I need to concentrate,’ and then out popped (baby)at twenty past one. Still no ambulance, still no paramedics and she came out foot first”.

Layla’s story is typical of the systemic abuse pregnant women prisoners receive in the prisons of England and Wales. But there’s more. In the first paragraph of her report, Dr. Abbott notes, “A review of women’s prisons in 2006 found that most women prisoners were mothers, some were pregnant, and many came from disadvantaged backgrounds. Accurate numbers of pregnant women held in UK prisons are not recorded, though it is estimated that 6% to 7% of the female prison population are at varying stages of pregnancy and around 100 babies are born to incarcerated women each year.” As The Guardian notes, “Neither the Ministry of Justice nor the NHS collects the data.”

While in prison, Layla, and many other pregnant women, were treated abysmally. At the same time, officially, they were never there. England and Wales are famous for nationwide systems of hyper-surveillance and personal data collection. As a so-called “total institution”, prisoners are under intensive surveillance, down to the filaments of their DNA. And yet the State “forgot” to note either pregnant women prisoners or women prisoners in childbirth. Where there is no data, there are no bodies.  What do you call the institutional erasure, through omission and refusal, of an entire and growing population of women? Call it femicide.

 

(Photo Credit: BBC)

States of Abandonment: South African prisons are toxic and lethal

On Thursday, the South African Judicial Inspectorate for Correctional Services, JICS, issued its 2017-2018 annual report on the state, and statelessness, of prisons in South Africa. The findings are both dismal and altogether anticipated. The prisons are in disarray. Due to restricted funding, JICS inspectors only visited 81 facilities. South Africa has 243 “correctional service centers.” Overcrowding is way up, suicide is way up, remand prisoners still make up way too much of the population. Infrastructure is a disgrace. Assault and torture are everywhere. Rehabilitation is virtually nonexistent. According to JICS inspecting judge Johann Vincent van der Westhuizen, “Overcrowding is at the core of everything else that exists (within prisons) … The situation of mentally ill inmates has become urgent.” In one year, the number of prison suicides rose from 52 to 82. In the past year, suicide was the highest cause of unnatural deaths in prison. What is going on?

On one hand, mental health institutions are overcrowded, and so patients are being transferred to prisons. The State has decided to correct of the mistakes it made in Life Esidimeni by dumping those living with mental illness into already overcrowded and under resourced spaces which have the benefit of invisibility. Out of sight, out of mind, out of luck, and, soon, out of breath. This is the State of Abandonment: “Zones of abandonment … accelerate the death of the unwanted. In this bureaucratically and relationally sanctioned register of social death, the human, the mental and the chemical are complicit: their entanglement expresses a common sense that authorized the lives of some while disallowing the lives of others.”

164,129 people are being held in South African prisons. 44,158 are awaiting trial. 27% of those persons in these hellholes are officially still innocent. Further, according to the JICS report, 1200 prisoners diagnosed with mental illness were kept with the general population. Many of those 1200 are awaiting transfer to “an accredited institution.” The public policy right now is to move people living with mental illnesses who are in overcrowded state hospitals to overcrowded prisons … and then “discover” and wonder that suicide is on the rise.

Prisons are not mental health institutions. The staff is not trained, the very architecture is inappropriate. The staff is also not trained to diagnose for mental health issues. Solitary confinement, or segregation, is traumatic. Extended solitary confinement is traumatizing. Intense overcrowding produces trauma. There are individuals who enter the prison with mental illnesses, and there are those who suffer mental illness because of the conditions in prison. 1200 is a low estimate.

Who sees prison as an “interim” solution for people living with mental illness? What is the name of that policy? Call it necropolitical abandonment, a policy of who might barely live and who definitely will die, slowly and in agony. “The report found that most facilities were in a `state of decay’.”

 

(Image Credit: Judicial Inspectorate for Prison Services / Times South Africa)