"I don’t want to remember those horrible moments of my life which I spent in detention, when I cried for food and cried due to pain. I was in a detention centre for seven months. I had severe morning sickness which lasted five months. I couldn’t eat the food which was provided for detainees. I remained there living just on fruit, juices, biscuits, crisps and popcorn for five months. I got weaker day by day. I lost 6kg of my actual weight – it should increase in pregnancy. The doctors and nurses there shouted at me many times. They mentally tortured me by saying that I was on hunger strike. I was never on hunger strike: I love my baby so why would I go on hunger strike?"

Stillbirth, miscarriage and acute psychosis are amongst the problems experienced by pregnant women held in immigration removal centres, according to a disturbing new report from the charity Medical Justice.
The report, Expecting Change: the case for ending the immigration detention of pregnant women, released today, exposes the injustice and ineffectiveness of detaining pregnant women for immigration purposes. It is based on detailed analysis of 20 cases and an earlier audit of 56 cases. (It can be downloaded here).

Case examples show some of the adverse outcomes suffered by the women in the sample. 

·         Maria was restrained and forcibly removed to her home country by four escorts. A few months after her return, she suffered a stillbirth.
·         Aliya developed acute psychosis after she was prescribed anti-malarial medication in anticipation of her forced removal.
·         Anna, who had complained for three weeks about abdominal pains, was sent to A & E where she miscarried with two guards in attendance. She subsequently attempted suicide and was admitted into a psychiatric ward.

People can be held in immigration detention indefinitely and the decision to detain is not subject to automatic judicial oversight. Self-harm, hunger strikes and reports of assault and racism are common. In separate cases in the past two years, the High Court has ruled that the care of four people held in immigration detention amounted to inhuman and degrading treatment.

It is government policy to detain pregnant women in only very exceptional circumstances, but the Home Office does not know how many pregnant women are detained.

In 2011, 93 pregnant women were held in Yarl's Wood the Bedfordshire detention centre according to the Yarl Wood Independent Monitoring Board PDF. The stated primary purpose of detention is removal, yet this research and a previous Medical Justice audit show that only around 5 per cent of pregnant women were successfully removed. Removal of pregnant women is difficult because the Home Office is no longer permitted to use force on them, following a court case earlier this year.

Experts say that travelling to a malarial area is higher risk for pregnant women than other groups, yet the government persists in trying to effect these removals.

Asylum seeking women have poorer health outcomes during and after childbirth than others. Many women in the report were victims of rape, torture and trafficking. The healthcare they received was inadequate and fell short of the NHS equivalent. Healthcare staff failed to identify and manage some of the complex cases.

Louise Silverton, Director for Midwifery at the Royal College of Midwives said: “The detention of pregnant asylum seekers increases the likelihood of stress, which can risk the health of the unborn baby. Midwives can only work in the context of what they are allowed to do by their managers. The very process of being detained interrupts a woman’s fundamental human right to access maternity care. The detention system makes it very difficult for midwives to put women at the centre of their care. We have concerns that the system in place actively inhibits the provision of good care. This is an untenable situation for midwives.”

Dr Tony Falconer,  President of the Royal College of Obstetricians and Gynaecologists (RCOG) said: “Pregnant asylum seekers and refugees are often very vulnerable and any form of detention puts them and their babies at greater risk.  We must ensure that these pregnant women receive high quality NHS maternity care. This includes antenatal support and access to purpose-built medical facilities away from detention centres.”     

Our research suggests that the current policy of detaining pregnant women for immigration purposes is ineffective, unworkable and damaging. We estimate that the government could save £800,000 per year if it stopped detaining and forcibly removing pregnant women.

Diane Abbott MP, Labour’s shadow public health minister and MP for Hackney North and Stoke Newington said: “The government cannot go on turning a blind eye to this.  This inhumane treatment of women who are pregnant is a hidden national scandal.”

The report backs calls made by Asylum Aid in its women’s charter, which was signed by 337 different organisations, for an end to the detention of pregnant women. We call on the government to stop detaining pregnant women.

Expecting Change: the case for ending the immigration detention of pregnant women, can be downloaded here. Published 11 June, 2013 by Medical Justice. Author: Natasha Tsangarides.