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Mother Sues Alabama Jail After Being Forced to Give Birth Alone in a Shower

Alabama jailed Ashley Caswell on charges of endangering a fetus, then made her give birth without medical support.

Attorneys for an incarcerated mother in Alabama say she experienced nothing less than “torture” when she was jailed while pregnant, denied prescribed psychiatric medication and forced to give birth alone in a shower.

Authorities in Gadsden, Alabama, jailed Ashley Caswell during her high-risk pregnancy, ostensibly to protect the fetus from alleged drug use. However, after seven months of alleged medical neglect and being forced to sleep on a mat on the floor, Caswell gave birth alone inside the jail’s filthy shower in October 2021, according to a groundbreaking federal lawsuit filed on October 13 against the Etowah County Detention Center.

Caswell reportedly screamed in pain for hours after her water broke, demanding medication and asking to go to the hospital, but she was dismissed or ignored by jail staff, according to the complaint. After giving birth alone, she handed the baby to staffers who allegedly left her bleeding in the shower as they took photos holding the newborn. The umbilical cord was still attached to the placenta, which was moving violently inside Caswell’s body as she passed out from blood loss and pain.

According to Emma Roth, a senior staff attorney at Pregnancy Justice representing Caswell, when she was finally taken to a hospital, Caswell received an iron infusion due to severe blood loss. Her newborn son was soon “ripped from her arms” and put into foster care. Caswell returned to the Etowah County Jail, where she allegedly experienced further abuse and medical neglect before being transferred to a state prison. Her son is now a toddler, and Caswell is still in prison after failing a drug test and facing additional charges, Roth said.

“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 statement. “I thought I’d lose my baby, my life, and never see my other kids again.”

The complaint adds that Caswell’s medical records indicated she suffered from “poor nutrition,” was “highly stressed” and losing sleep while in jail during a pregnancy that was deemed high risk due to preexisting medical conditions. Yet prosecutors and jailers incarcerated Caswell under the guise of keeping the fetus safe. It was the second time Caswell was charged with “fetal endangerment,” and she was incarcerated during a previous pregnancy as well.

The details listed in the lawsuit are gut-wrenching: A family ripped apart. A mother who could have died while giving birth inside the jail, only to be returned to the same facility without her child. What could justify such trauma?

The answer lies in the anti-abortion movement and its fraught concept of “fetal personhood,” which has been deployed in courts and legislation to crush the human and reproductive rights of pregnant people and new mothers in multiple red states, especially after the Supreme Court overturned the constitutional right to abortion in 2022.

“We want to highlight the hypocrisy of criminal prosecutions against pregnant women based on ‘fetal personhood’ with this case,” Roth said in an interview. “This county claims they are protecting ‘unborn children,’ when the reality is those prosecutions put that baby at risk.”

Roth said Alabama leads the nation in criminalizing pregnancy and Etowah County is the “epicenter,” where at least 257 pregnant women and new mothers have been targeted for incarceration and forced rehab during Alabama’s brutal crackdown on prenatal drug use over the past decade.

In 2006, Alabama passed a “chemical endangerment” law aimed at deterring parents from bringing young children around methamphetamine labs. In 2013, anti-abortion judges on the Alabama Supreme Court accepted an expansive interpretation of “fetal personhood,” allowing prosecutors to charge people with “chemical endangerment” for allegedly using drugs during pregnancy — including drugs prescribed by doctors to treat chronic pain and addiction.

The result was an unprecedented crackdown that saw the state aggressively policing pregnant people and new mothers and tearing families apart in the name of “fetal personhood.” A 23-year-old woman was reportedly jailed in Etowah County for three months after using a small amount of cannabis the day before she learned she was pregnant.

Until September 2022, when public outcry reached a fever pitch and attorneys with Pregnancy Justice got involved, it was Etowah County policy to essentially deny bail to pregnant people charged with “chemical endangerment” and jail them for months at a time as they waited for beds in mandatory rehab facilities to become available.

Last year, Etowah County District Attorney Jody Willoughby defended the criminalization and incarceration of women during pregnancy in a statement to local media that was couched in anti-abortion rhetoric. Willoughby’s office has not responded to a request for comment from Truthout.

“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,” Roth said. “They stripped her of her dignity, violated her constitutional rights, and again showed their callous disregard for mothers and children.”

Caswell is not the only alleged victim of criminalization at the Etowah County Detention Center (ECDC). According to Pregnancy Justice:

  • In 2018, ECDC staff refused to take a woman in labor to the hospital for hours on end as she suffered through severely painful contractions, even after her water broke and she experienced vaginal bleeding.
  • In 2019, ECDC staff refused to take a pregnant woman to the hospital for five days after her water broke prematurely, and she experienced vaginal bleeding and lost amniotic fluid. She later experienced a stillbirth.
  • In 2019, the ECDC forced a woman who had recently delivered her baby via cesarean surgery to sleep on a concrete floor without a mat for nine days and denied her access to her prescribed pain medication despite her excruciating pain.
  • In 2020, yet another woman was forced to labor and give birth alone without medical assistance or pain medication in an ECDC jail cell.

Along with other states in the South that have cracked down on reproductive rights, Alabama consistently ranks near the bottom for maternal and fetal outcomes, in large part because criminalization deters pregnant people who use substances from seeking necessary medical care.

In fact, the Alabama Maternal Mortality Review Committee recommended back in 2020 that “punitive measures for pregnant women with mental health and substance use disorders must be eliminated in order to create an environment that encourages them to seek assistance during pregnancy.”

South Carolina and Oklahoma have likewise seen pregnant people incarcerated under “fetal personhood” precedents, but in 2014 Tennessee became the first state to pass a law specifically criminalizing prenatal drug use. The law was allowed to sunset and expire within two years as research concluded it created far worse health outcomes for mothers and infants and increased the risk of infant death.

Fearful of an arrest and losing their baby, many mothers simply went without comprehensive prenatal care in Tennessee. Mothers suffering from substance use disorders — or simply using cannabis to treat morning sickness — are likely still living in fear in Alabama, where the Republican-controlled government instituted a near-total ban on abortion with few exceptions after the Supreme Court ruling in 2022.

“Every single major health organization opposes these policies because the evidence is so clear,” Roth said.