Chains to Companions: Caring for Pregnant Prisoners

Sophie McGowan, Gail Anderson*

*Corresponding author for this work

Research output: Contribution to conferencePosterpeer-review


Maternity services must ensure every woman is at the centre of care, regardless of her situation, including imprisonment. Female offenders are particularly vulnerable due to social and health inequalities experienced, including substance misuse, mental health problems and sexual or domestic abuse. Research has found that as a consequence of such health issues, outcomes are poorer for pregnant women and babies in prison. Birth Companions is a public health initiative established following exposure of the inhumane failings in prison maternity care in the UK. Operating in four prisons in England, their work is dedicated to improving the experience of pregnancy, birth and motherhood for women in prison, and ensuring the best possible start in life for their babies. They also seek to raise awareness at a higher level, influencing legal and policy changes to improve conditions of women in prison.
Birth Companions work extends throughout pregnancy, from antenatal care to the postnatal period. Collaboration with prison services allows antenatal support, whilst interactions with outside charities ensures all women are provided with practical motherhood essentials. As research indicates companion support during labour reduces duration and minimises intervention, Birth Companions provide the option of individualised intrapartum support from trained volunteers who can support imprisoned women. Postnatal support is also provided for women in both mother and baby units as well as mothers separated from their babies. Overarching these provisions, is the Birth Charter, introduced by Birth Companions in 2016. It outlines the unique needs and human rights of pregnant women and babies in prison and marks a dramatic increase in their afforded legal rights across England and Wales.

Birth Companions works in partnership with midwives to ensure the fundamental concept of woman-centred care, is true wherever care is received. As midwives are the primary care giver during pregnancy and are in prime position to support these vulnerable women, they must provide non-judgemental, compassionate care, ensuring their basic human rights are respected and that entitled support is available. This involves knowing and utilising the Birth Charter 2016 to ensure all women are receiving their entitled care throughout pregnancy. Midwives should also strive to achieve continuity of care for these women as it is considered the ideal for improving outcomes.
Improving maternity care in prisons is essential for improving maternal and neonatal outcomes as unresolved health inequalities leads to increased pregnancy risks. Birth companions’ support has improved the mental wellbeing of pregnant women in prison, whilst minimising feelings of isolation. Support of a companion during labour improves outcomes whilst postnatal support boosts confidence in providing babies with the best start in life and improves breastfeeding rates. Given the positive emotional and practical impact of Birth companions, establishing a similar initiative in Northern Ireland is arguably essential to ensuring nationwide equity in prison maternity care. Not only do all women deserve uniform care, but children also deserve equality in their start to life. Where poor foundations are laid in pregnancy and there are inadequate attempts to minimise adverse effects of prison environments, neonates are at increased risk of physical and mental adverse outcomes later in life.
Original languageEnglish
Publication statusPublished - 30 Nov 0005
EventAll Ireland Annual Midwifery Conference: ‘Midwifery – adaptable and responsive during a crisis’ - online, Ireland
Duration: 05 Nov 202005 Nov 2020


ConferenceAll Ireland Annual Midwifery Conference
Internet address


  • Prisoners, Women, Pregnant, Midwife, Public Health


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