Woman gives birth alone in jail shower after staff ignore pleas for help, lawsuit says
An Alabama woman was forced to endure nearly 12 hours of excruciating labor alone in a jail cell as staff refused to take her to a hospital, according to a new federal civil rights lawsuit.
While in labor, Ashley Caswell’s screams and pleas for help went ignored, with one jail EMT telling her to “stop screaming” and to “deal with the pain” on Oct. 16, 2021, at Etowah County Detention Center, a complaint filed Oct. 13 says.
Eventually, a correctional officer walked Caswell, who had only been given Tylenol, to a shower room, where she delivered her baby — without any assistance from the officer — standing upright and experiencing extensive blood loss, the complaint says.
After Caswell caught her baby’s head above the concrete floor of the jail shower, she became lightheaded and handed her newborn to the officer before fainting on the floor, bleeding, according to the complaint.
Then, several staff members arrived at the shower area and passed Caswell’s infant around, umbilical cord still attached to her placenta, while taking photos with her baby without her consent by the time she was conscious, the complaint says.
Meanwhile, no staff member offered to help Caswell and remained “indifferent” to her bleeding on the floor after an excruciating labor, according to the complaint.
After nearly dying while giving birth due to a placental abruption, Caswell was treated with “contempt” by jail staff, who are accused of refusing to provide her with further medical care, including pain medication, or a breast pump, the complaint says. A placental abruption occurs when the placenta comes apart from the uterus.
Now, Caswell, of Attalla, is suing Etowah County, Sheriff Jonathon Horton, several sheriff’s office employees who worked at the jail, the jails’ contracted medical providers Doctors’ Care Physicians and CED Mental Health Services, and several of the providers’ employees, the complaint shows.
“Giving birth to my son without any medical help in the jail shower was one of the most terrifying experiences of my life,” Caswell said in a news release issued by Pregnancy Justice, a legal organization which advocates for the rights of pregnant people.
“My body was falling apart, and no one would listen to me. No one cared,” Caswell added. “I thought I’d lose my baby, my life, and never see my other kids again.”
Pregnancy Justice, the Southern Poverty Law Center and Sullivan & Cromwell LLP are representing Caswell in the case.
On Oct. 17, the Etowah County Sheriff’s Office and CED Mental Health Services declined requests for comment from McClatchy News.
McClatchy News contacted Etowah County officials and Doctors’ Care Physicians for comment on Oct. 17 and didn’t receive immediate responses.
Forced to sleep on the floor
In March 2021, Caswell was detained at Etowah County Detention Center after she was arrested on a chemical endangerment charge while two months pregnant, according to the complaint, which says she was accused of substance use at the time.
Her pregnancy was considered high risk because of her “diagnosed hypertension, advanced maternal age, and history of abnormal pap smears,” the complaint says.
The jail was aware of Caswell’s needs and medical history because she was previously detained at the facility while pregnant in 2019, when she was also classified as high risk, according to the complaint.
Despite this, she was forced to sleep on a mat on the hard concrete floor of her cell during her pregnancy, the complaint says.
That’s because Caswell was housed in a cell where only top bunk beds were available, according to the complaint, despite the jail barring pregnant women from occupying the top bunks.
”For a time” while detained, the jail also refused to give Caswell her prescribed psychiatric medication she was previously allowed to take while pregnant at the facility during her 2019 detention, the complaint says.
Jail refused to take Caswell to hospital
Three days before Caswell was set to have an induced labor, her water broke on Oct. 16 — several hours before she delivered her baby in the jail shower, according to the complaint.
After she started bleeding — a potential sign of placental abruption — an EMT refused to help her despite her screams for help and requests to go to the hospital, the complaint says.
Minutes after Caswell delivered her son and received no medical attention from jail staff, first responders arrived and transported her to a nearby hospital, according to the complaint.
Due to major blood loss, she needed two iron transfusions at the hospital, where she was diagnosed with placental abruption, the complaint says.
Following her “traumatic labor and delivery,” Caswell returned to jail, where staff “again forced Ms. Caswell to sleep on the floor and denied her basic care, including her physician-prescribed Ibuprofen to manage the pain from her delivery and a breast pump to allow her to express breastmilk and prevent agonizing pain and infection,” the complaint says.
Alabama’s recent history of pregnancy related arrests
The jail is familiar with the needs of pregnant and postpartum people, as the county has an “unusually high rate” of detaining these individuals, the complaint notes.
Between 2015 and 2023, 257 pregnant women and new mothers were arrested on charges of chemical endangerment in the county, AL.com reported in July.
Overall, the state of Alabama has had a generally high rate of arrests related to pregnancy, according to a Pregnancy Justice report published in September cited in the complaint.
The report says that in the U.S. between January 2006 and June 2022, nearly 4 in 5 of these arrests occurred in five southern states, including Alabama, where the majority of them, 46.5%, took place.
“The mistreatment Ashley experienced in the Etowah County Jail is shocking and unacceptable,” Sharon Cohen Levin, a partner of Sullivan & Cromwell LLP, said in a statement.
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