Etowah County, AL — Ashley Caswell, an Alabama woman who gave birth alone on the floor of a jail shower, has reached a settlement with Etowah County and its jail officials, ending a federal lawsuit that exposed alleged medical neglect and inhumane treatment behind bars.
Caswell, who nearly died after a placental abruption, sued in October 2023, claiming officials ignored her medical needs, denied care, and forced her to deliver her baby without help, medication, or basic dignity.
“I felt they treated me like I was less than nothing,” Caswell said in a statement. “I hope they’ll take steps to make sure this doesn’t happen to another woman again.”
Arrested While Pregnant, Denied Medical Care
Caswell was arrested in March 2021 under Alabama’s controversial chemical endangerment law, which criminalizes drug use during pregnancy. Advocates argue the law is disproportionately applied to pregnant women, especially those with addiction issues.
Caswell’s legal team—including Pregnancy Justice, the Southern Poverty Law Center, and Sullivan & Cromwell LLP—alleged that jail officials failed to:
- Provide prenatal care despite her high-risk pregnancy
- Transport her to a specialist hospital as had been done during a previous jail pregnancy
- Take her to weekly checkups, even after 36 weeks of gestation
- Give her a bottom bunk after medical recommendation, forcing her to sleep on a mattress on the floor
“She Delivered Her Baby Alone on a Concrete Floor”
The most harrowing part of the lawsuit describes the night Caswell gave birth. Jail staff placed her in a shower, turned on the water, and left her to labor alone. One staff member reportedly stood nearby but didn’t help.
“She turned off the water and delivered her baby while standing upright on a concrete floor,” the lawsuit said. “No medical personnel, no medication.”
Caswell said it felt like her body was “ripping apart.” Staff allegedly arrived only after the birth, with some even posing for a photo with the baby while the umbilical cord was still attached. She waited another 20 minutes for an ambulance.
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Legal Outcome and Ongoing Debate
The terms of the settlement have not been made public, but Pregnancy Justice calls it a milestone.
“This settlement sends a clear message: A person’s carceral status doesn’t make them any less human,” said Emma Roth, Senior Staff Attorney with Pregnancy Justice.
Caswell’s legal team cited a pattern of inhumane treatment at the Etowah County jail. The lawsuit highlighted a broader debate around the use of criminal law against pregnant women and the treatment of incarcerated mothers.
After her release in 2022, Caswell reportedly struggled with addiction, testing positive for meth again in August 2022 while pregnant, leading to a second chemical endangerment charge.
Do you think jails are doing enough to protect pregnant women in custody? Let us know your thoughts in the comments.
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