On the out, as it is colloquially known in prison, a general practitioner doesnt have to ascertain physically that someone has been up all night vomitinghis or her word is accepted as the truth. Unfortunately, someone residing at Her Majestys pleasure is and always will be an inmate first and foremost.
From my experience there is a complete lack of health care for everyone. At HMP Drake Hall there is no night cover, and only three officers on for a population of 315 women, which is shocking. This led to one pregnant inmate being taken down to the segregation unit to miscarrythe segregation unit is the only place where there are officers constantly in attendance. We had no panic buttons in our cells to call for help in an emergency. Losing a baby is bad enough without being subjected to this type of dehumanising treatment.
Other inmates are the main carers for those who are sick and mentally ill. I personally telephoned Stafford Hospitals maternity unit, using my own valuable telephone units, in an attempt to get some help for the woman, only to be told that unless a directive came from the prison itself the hospital could do nothing. This inmate was finally transferred to HMP Foston Hall, which has a hospital wing. It was some days before the medical staff arranged a scan, only to discover that the inmate had been carrying twins and had lost only one. It is inconceivable that this could happen anywhere other than in prison.
So vast is the scale of mental health problems that accompany the physical needs of women in prison that it would take a team of highly trained and dedicated professionals to begin to come to grips with them. Most women in prison have been sexually abused either during childhood or in adolescence. These problems are greatly magnified simply because women come into prison with all their emotional baggage (unlike men, who get their heads down and do their time while their wives or girlfriends keep their lives intact for them.) Women have often left their children behind and are typically the sole or primary carers. Not knowing where the children are and not seeing them on a regular basis, if at all given the distances some mothers are placed away from their families, only makes matters worse. There are only 13 womens prisons in England and none in Wales.
Without doubt the most horrific thing that I have come across while in prison is decrutching. This is the term used when a prisoner comes in with drugs secreted in her vagina and other inmates pin her down and remove those drugs with any available tool. This has led to serious injuries, which are all kept quiet because if the victim reports them, she will be charged with supplying. Female rape with implementsdoes it get any worse than this?
Finally a warninghepatitis and HIV are rife in the female estate and most women conduct sexual relationships with other prisoners for all sorts of reasons. Many are also prostitutes when not in prison. These relationships go on without any protection or education at all. How long before the ticking bomb explodes into the wider population and everyone pays the price?
Penny A Mellor advocate, Coven, Staffordshire This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Competing interests: PM is a former inmate of three prisons and is currently involved in an investigation into the health care for pregnant prisoners that is being conducted by HMP Womens Estate. If you would like to submit a personal view please send no more than 850 words to the Editor, BMJ, BMA House, Tavistock Square, London WC1H 9JR or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it
