Across the globe, a hidden human rights crisis is unfolding behind prison walls, where pregnant women are routinely subjected to dangerous and degrading conditions. From being shackled during labour to giving birth alone in a cell, their plight remains largely invisible, despite international guidelines designed to protect them.
A Disturbing Global Pattern of Neglect
The case of Dina Hernández, a 28-year-old human rights activist from El Salvador, is tragely emblematic. Arrested in March 2024 while 35 weeks pregnant and accused of "illicit association" without evidence, she was imprisoned. Three weeks later, her family was called to collect the body of her newborn baby. The cause of death remains uninvestigated, and Hernández's own condition is unknown.
This is far from an isolated incident. Campaigners report that pregnant inmates worldwide are often held in deplorable conditions, denied essential medical care, and forced to endure labour and birth in terrifying isolation. Some suffer miscarriages; others see their babies die in custody. "Prison is not a good environment for women, let alone someone who is pregnant," states Sabrina Mahtani, a lawyer with Women Beyond Walls. "Many prisons were built with men in mind, so women were an afterthought."
Flouting International Rules
Fifteen years ago, the United Nations adopted the Bangkok Rules, the first international guidelines specifically for female prisoners. They state unequivocally that prison should be a last resort for pregnant women and that instruments of restraint must never be used during labour, birth, or immediately after.
Yet these rules are "consistently flouted around the world," says Mahtani. The problem is compounded by a severe lack of data, particularly in poorer nations, and a perception that the numbers are too small to matter. However, the statistics tell a different story: since 2000, the global population of women and girls in prison has surged by 57%, compared to a 22% rise for men.
In El Salvador, the female prison population has nearly increased sevenfold since 2000. Lawyer Zaira Navas of Cristosal describes conditions as "really critical," with reports of beatings, torture, and women having to trade sex with guards for basic supplies. She has documented miscarriages and the deaths of four babies, noting, "There will be more."
From Cambodia to the UK: A Universal Failure
The crisis spans continents and economic divides. In Cambodia, which has the world's second-highest prison occupancy rate, severe overcrowding leaves little space to lie down. Naly Pilorge of Licadho reports pregnant prisoners being handcuffed to hospital beds. In one harrowing 2020 case, a five-month-old baby died of pneumonia and severe malnutrition in prison after its mother was detained for possessing a tiny amount of drugs.
Even in wealthier nations like the UK, tragedies occur. 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 the United States, Pamela Winn miscarried in her cell, lying in a pool of blood for hours. After her release, she founded RestoreHer and has successfully campaigned for legislation in 24 states to ban shackling and solitary confinement for pregnant inmates.
Survivors Leading the Fight for Change
Some who have endured this trauma are now powerful advocates. In Argentina, Nora Calandra was chained to a hospital bed by guards while giving birth via caesarean section in 2010. 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, Calandra believed this was part of her punishment. "What I experienced was obstetric violence," she now says. Her advocacy helped shape new guidelines for Buenos Aires province, where she now holds a government role focused on prisoner welfare.
Some countries have introduced alternatives. Sierra Leone's 2017 bail rules require courts to consider options other than detention for primary caregivers or pregnant defendants. Brazil allows house arrest for pregnant women or mothers with young children awaiting trial. Georgia, Russia, and Vietnam permit sentence deferrals.
The Call for Community-Based Solutions
Experts argue that, in most cases, pregnant women should not be in prison at all. They point to the root causes that often bring women into the justice system—poverty, abuse, and substance dependency—and advocate for investment in community-based solutions that address these issues directly.
"I question whether women should be criminalised for many issues in the first place," says Sabrina Mahtani. Her organisation's report highlights laws that criminalise women due to poverty or gender discrimination. The consensus is clear: the current system is failing some of society's most vulnerable women and their children, with devastating and preventable consequences.
