In March 2021, sheriffs in Etowah county, Alabama, arrested Ashley Caswell on accusations that she’d tested positive for methamphetamine while pregnant and was “endangering” her fetus.

Caswell, who was two months pregnant at the time, became one of a growing number of women imprisoned in the county in the name of protecting their “unborn children”.

But over the next seven months of incarceration for “chemical endangerment” in the Etowah county detention center (ECDC), Caswell was denied regular access to prenatal visits, even as officials were aware her pregnancy was high-risk due to her hypertension and abnormal pap smears, according to a lawsuit filed on Friday against the county and the sheriff’s department. She was also denied her prescribed psychiatric medication and slept on a thin mat on the concrete floor of the detention center for her entire pregnancy.

In October, when her water broke and she pleaded to be taken to a hospital, her lawyer says, officials told her to “sleep it off” and “wait until Monday” to deliver – two days away.

During nearly 12 hours of labor, staff gave her only Tylenol for her pain, the suit says, allegedly telling her to “stop screaming”, to “deal with the pain” and that she was “not in full labor”. Caswell lost amniotic fluid and blood and was alone and standing up in a jail shower when she ultimately delivered her child, according to the complaint and her medical records. She nearly bled to death, her lawyers say.

After she was taken to a hospital, she was diagnosed with placental abruption, a condition in which the placenta separates from the wall of the uterus and the fetus is deprived of oxygen, meaning there was a risk of stillbirth. The baby survived, but Caswell was immediately separated from her newborn.