Ashley Caswell screamed in pain from inside an Alabama jail, pleading to be taken to a hospital, according to a newly filed lawsuit. The pregnant detainee’s water had broken and she was bleeding, but Caswell was allegedly told to “deal with the pain.”
After being in labor for 12 hours, Caswell gave birth to her son in a jail shower on Oct. 16, 2021, her attorneys say. Then, staffers took photos with the baby while Caswell was passed out on the floor, according to a federal civil rights lawsuit filed Friday on behalf of Caswell by the advocacy groups Pregnancy Justice and the Southern Poverty Law Center, as well as the New York City law firm Sullivan & Cromwell.
“The mistreatment Ashley experienced in the Etowah County Jail is shocking and unacceptable,” Sharon Cohen Levin, a partner with Sullivan & Cromwell, said in a news release. “Incarcerated women who are pregnant and postpartum should not have to beg for — and still be denied — basic medical care, but that is the unfortunate reality at the jail.”
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Caswell isn’t the only pregnant detainee who has been prevented from receiving necessary medical care at the Etowah County Detention Center, according to the suit filed against Etowah County, Sheriff Jonathon Horton, Doctor’s Care Physicians, CED Mental Health Services, and several members of the medical and corrections staff. From 2018 to 2020, at least three other women said that their pleas to be taken to the hospital were ignored, the lawsuit claims. Some were allegedly forced to give birth alone and without medication. One said she experienced stillbirth after she was taken to an emergency room five days after her water broke.
The defendants didn’t respond to The Washington Post’s requests for comment.
Like Caswell, many of the women at the Etowah County Detention Center are detained under chemical endangerment of a child charges for alleged drug use during pregnancy, according to the lawsuit. Alabama passed the statute in 2006 to target people who put children at risk by converting their homes into methamphetamine labs, The Post previously reported. But the law has been increasingly applied to cases of fetal endangerment — a byproduct of Alabama’s 2018 personhood constitutional amendment that ensures “the protection of the rights of the unborn child.”
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“Ashley is the latest victim of the Etowah County Jail, which consistently punishes pregnant women in the name of protecting ‘unborn children’ while simultaneously endangering their lives,” Emma Roth, Pregnancy Justice senior staff attorney, said in a news release.
Caswell’s woes began well before she went into labor, the lawsuit alleges. In March 2021, she was arrested two months into a high-risk pregnancy, given “her diagnosed hypertension, advanced maternal age, and history of abnormal Pap smears,” the suit states. Over the next seven months, she was allegedly denied access to weekly prenatal appointments and prevented from taking her prescribed psychiatric medication. Caswell was also made to sleep atop a thin mat set on a concrete floor — which, along with stress and “poor nutrition,” may have contributed to the painful contractions she began experiencing in September, according to the lawsuit.
On Oct. 16, Caswell’s water broke around 6 a.m. — three days before she was scheduled to be induced. An amniotic fluid leak increased the risk of infection in both the fetus and the mother, the suit states. Though she begged to be taken to an emergency room, Caswell was allegedly told by Etowah County Detention Center staff that she “just needed to lie down.”
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The lawsuit states that over the following several hours, Caswell experienced heavy bleeding when her placenta detached from the womb — a serious complication known as placental abruption that can cause severe bleeding and abdominal pain. She was given Tylenol for her pain and instructed to “stop screaming,” the lawsuit states.
By 6 p.m., a jail employee walked with Caswell to a shower, where she “delivered her baby while standing upright on a concrete floor, without the aid of any medical personnel or medication,” according to the lawsuit. Soon after, she fainted because of the blood loss and was allegedly left naked on the floor. Meanwhile, the suit claims, corrections workers passed around the baby, which was still attached to Caswell through the umbilical cord. Then, they posed with the newborn for pictures without asking for Caswell’s consent, according to the lawsuit.
All the while, jail staff allegedly refused to render her any aid.
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“Giving birth to my son without any medical help in the jail shower was one of the most terrifying experiences of my life. My body was falling apart, and no one would listen to me. No one cared,” Caswell said in a news release. “I thought I’d lose my baby, my life, and never see my other kids again.”
Caswell was taken to the hospital that evening. But when she returned to the jail two days later, Caswell continued to face mistreatment and neglect, the suit alleges.
Caswell was allegedly denied the ibuprofen and breast pump her physicians had prescribed — leading to discomfort, pain, clogged milk ducts, inflammation in her breasts and a fever. The jail staff did not provide her with sanitary pads for her postpartum bleeding, forcing Caswell to “rip up a T-shirt” and use it to soak up the blood, the complaint states. She was once again allegedly made to sleep on the thin mat.
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Caswell is now serving a 15-year sentence for felony endangerment in Julia Tutwiler Prison in Wetumpka, Ala. But the advocacy groups said her case underscores a heightened crackdown on pregnant Alabamians under the guise of protecting fetuses — all while research shows that incarcerated women have poorer birth outcomes and are at a higher risk of giving birth prematurely.
Alabama, which according to a Milken Institute report has the highest maternal mortality rate in the nation, also leads the country in the number of pregnancy criminalization arrests, accounting for 46.5 percent of all cases from 2006 to 2022, a Pregnancy Justice report shows.
According to an AL.com investigation, Etowah County arrested some 257 pregnant women under chemical endangerment of a child charges between 2015 and 2023. Pregnancy Justice has dubbed it “the epicenter” of pregnancy criminalization.
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