Birth Companions' response to the Chief Medical Officer's report on the health of prisoners

Birth Companions welcomes the Chief Medical Officer’s report on ‘the health of prisoners’ and its recognition of the unique and complex health needs of pregnant women and mothers of infants in prison and on probation.

We are particularly encouraged by the report's acknowledgment that all pregnancies in prison are high-risk and that imprisonment should be avoided wherever possible. As the report notes, the inclusion of pregnancy and the postnatal period as a mitigating factor in sentencing has been a vital step forward in protecting the health and wellbeing of women and their babies, but there is still much to be done.

Professor Chris Whitty’s report highlights the urgent need for consistent, trauma-informed care across the prison estate. We echo the calls for:

• Specialist perinatal mental health services in all women’s prisons.
• More transparent and fair decision-making in applications to Mother and Baby Units.
• Comprehensive support for women experiencing maternal separation, miscarriage, or loss.
• Early maternity assessments in custody.
• Integrated and continuous care on release from prison, including access to maternity, mental health and community services, appropriate housing, and support from probation services.
• Clear plans for mitigating the impact of extreme heat in prisons, with particular focus on the risk this poses to pregnant women and infants.
• The significant and urgent need to improve support for pregnant women and mothers of infants in probation.

It is of key importance that Professor Chris Whitty and his co-authors have highlighted probation in this way. The addition of pregnancy and the postnatal period as a mitigating factor in sentencing guidelines, and the Sentencing Bill currently passing through parliament, means more women should be receiving community or suspended sentences instead of prison sentences. Yet understanding of the needs and experiences of women under probation supervision during pregnancy and early motherhood is severely lacking, as is relevant data. Midwives and women on probation report significant barriers to accessing care, including stigma and a lack of support. Work must be done to address this gap, and to establish new guidance and good practice in support for pregnant women, mothers and babies throughout the critical first 1001 days, from conception to a child’s second birthday, as a matter of urgency.

1001 Days in the CJS

Birth Companions is calling for a radically different approach to the first 1001 days across the criminal justice system. The work of the Women’s Justice Board and the Sentencing Bill present real opportunities for change. We have to seize them.

The 1001 days in the CJS campaign calls for:

• An end to the imprisonment of women during the first 1001 days, in all but the most exceptional of circumstances, including through remand and recall.
• Increased use of community, deferred and suspended sentencing for women during the first 1001 days.
• Mandatory first 1001 days impact assessments to inform sentencing decisions, license conditions and community orders.
• New policy to guide police, prosecution and probation services in their work with women during the first 1001 days.
• Increased funding and support for community alternatives to custody to support women during the first 1001 days, including investment in women’s centres and specialist services.
• Improved recognition of, and responsiveness to, the needs of women who have CJS contact in the first 1001 days across wider systems and services, including health, children’s social care, and housing.

These changes would allow us to embed a trauma-informed and compassionate response to pregnancy and early motherhood throughout and beyond this system, improving outcomes for mothers and children, and breaking intergenerational cycles of harm and disadvantage.

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