At least four prisoners at HMP Bronzefield have given birth in potentially unsafe circumstances since 2017

The death of a newborn baby girl in a cell at HMP Bronzefield in September came after a string of concerning incidents involving pregnant women at the prison in the past two years, the Guardian has learned.

On at least four occasions in this period, women held at the privately run Surrey prison have given birth in distressing and potentially unsafe circumstances, including one woman who gave birth in her cell and another who was left in labour at night-time supported only by another pregnant prisoner.

The revelations raise questions about the safety of pregnant women in prison and come as calls grow for an end to their detention in all but the most exceptional circumstances.

The Ministry of Justice does not collect any central figures on the numbers of pregnant women, births or stillbirths within the prison estate. But the Guardian has obtained hospital records that suggest there has been a steady increase in the number of babies born to prisoners in the past five years. In 2017-18, unpublished findings by the Nuffield Trust suggest that one in 10 of these women gave birth in cells or ambulances.

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The prison reform campaigner Jean Corston said: “To me it seems absolutely counterintuitive to have pregnant women and women giving birth in prison. There aren’t many women who should be in prison at all but certainly not pregnant women. No woman at the end stage of pregnancy should be in a cell.”

In December 2017, one woman suffered a stillbirth and another baby was admitted to neonatal intensive care, in both instances after women were transferred from Bronzefield to hospital at a late stage of labour. In the latter case, it is understood that the woman alerted the prison to concerns two days before she was eventually taken to hospital.

Board meeting minutes from Ashford and St Peter’s NHS trust, from July 2018, refer to the two incidents, stating: “Adverse outcomes were reported in both cases … significant learning and process change were identified for both hospital and prison teams.”

The minutes state that Bronzefield, Europe’s largest female prison, intended to review its policy concerning the transfer of pregnant women to hospital and its criteria for risk assessment.

Sodexo Justice Services, which runs the prison, said that following the December 2017 incidents it had worked with Ashford and St Peter’s Hospital and changed arrangements with its midwives. It added that there is a pregnancy scanner on-site at Bronzefield for use by midwives who hold clinics several times a week, which reduces the need for off-site appointments, and that it has a dedicated escort team to accompany women to off-site appointments when they are needed. Sodexo said it could not comment on individual cases.

The Guardian also heard of a woman who alerted prison staff that she was in labour in July 2018. She was not seen by a midwife and was left in labour during the night, supported only by another pregnant prisoner.

In March 2019 a woman, understood to have been in the prison on remand, gave birth in her cell with no midwife or doctor present. A nurse reportedly delivered the baby.

Former prisoners, including one from Bronzefield, said midwife appointments and scans were frequently missed as a result of prison staff shortages and described the humiliation of attending scans and obstetric examinations in handcuffs while accompanied by officers.

NHS Digital records obtained by the Guardian show that 67 babies born in hospital to prisoners or women in police custody were recorded in 2018-19 compared with 43 in 2013-14, with a steady year-on-year increase. Experts said these figures were likely to be significant underestimates. The overall female prison population has remained roughly the same, with 3,850 women imprisoned in 2015 and 3,830 in 2019.

Separately, an audit by the Nuffield Trust, shared with the Guardian ahead of the publication of a report next year, show that in 2017-18 six births took place outside of hospital, presumably in cells or ambulances, accounting for about one in 10 births to prisoners recorded by the NHS in that year. The finding appears to undermine the suggestion last month by the justice minister Lord Keen that births in cells were distressing but a “rare occurrence” and were the result of “the unpredictability of labour”.

Dr Miranda Davies, a senior research analyst at Nuffield Trust, said the rate of births outside hospital was deeply concerning. “Prisons are no place for a woman to give birth,” she said. “They are not staffed with round-the-clock midwives who are trained to support women in labour and there is no access to the range of pain relief options that a woman might use if she gave birth in hospital.”

The MoJ said that Sodexo had not incurred contractual penalties relating to the levels of care to pregnant women in custody in the past three years. The MoJ declined to comment on recent incidents at HMP Bronzefield.

Naomi Delap, the director of the charity Birth Companions, called for an end to the imprisonment of pregnant women and new mothers in all but exceptional cases. “Until that happens, the lives of mothers and babies will continue to be put at risk,” she said. “The recent tragedy in HMP Bronzefield is a terrible illustration of the fact that prisons are not safe or suitable places for pregnant women and babies.”