BIRMINGHAM, Ala. — An Alabama woman who was forced to give birth alone while standing in a jail shower has reached a confidential settlement with Etowah County, ending a federal civil rights lawsuit that highlighted the inhumane treatment of pregnant women in the state’s jails.
Ashley Caswell was in the final stages of a high-risk pregnancy high-risk pregnancy when she was jailed at the Etowah County Detention Center in March 2021. According to court filings, Caswell was repeatedly denied access to necessary prenatal care and her prescribed medication throughout her incarceration. On October 16, 2021, after her water broke, Caswell endured nearly 12 hours of labor with only Tylenol for pain relief. Her pleas to be taken to a hospital were ignored, and she was eventually told to walk to a jail shower, where she delivered her baby alone while standing upright on a concrete floor.
Caswell suffered a life-threatening placental abruption and lost consciousness on the shower floor after handing her newborn to staff. Instead of providing immediate medical care, jail staff took photos with her baby without her consent, even as the umbilical cord remained attached.
Caswell’s lawsuit, filed in October 2023, alleged deliberate indifference to her medical needs and constitutional rights. The complaint described her mistreatment as part of a broader pattern of abuse at the jail, where most pregnant women are detained under chemical endangerment charges for alleged drug use during pregnancy.
Following negotiations, all defendants—including Etowah County, jail officials, and medical contractors—entered into a confidential settlement agreement with Caswell. Advocates say the case underscores Alabama’s harsh approach to pregnant detainees and the risks posed by denying medical care to incarcerated women.
Alabama consistently ranks near the bottom for maternal and fetal health outcomes, and critics argue that punitive policies toward pregnant women in jail only worsen those statistics.