Once in the examination room, the officers fitted Beatrice with handcuffs attached to a metre-long chain so they could stand behind the modesty curtain while she was examined. “Before I took my leggings down, the officers said they had to attach a long handcuff,” she said. “It was very clumsy; it took them ages to do it. I was feeling very humiliated.

“You are stripped of your dignity in prison, but this is a hospital and I am pulling my leggings down and I am attached to a stranger. I felt like the doctor was embarrassed, and therefore everything was very rushed.”

The process was “unnecessary,” said Beatrice, pointing out that she posed no risk to the staff or the public.

But she also warned that the lack of privacy and dignity could risk women’s health. “It was dangerous,” she said. “When you are in a medical appointment, particularly an intimate appointment, it should just be you and the doctor. You don’t want to share medical information with someone who locks you in your cell every day.”

Thankfully, Beatrice’s health was fine. But “if it wasn’t, and I had to go to a follow-up, I don’t know if I would have gone. It was so humiliating.”

Proper risk assessments should be carried out before the use of restraint. Had this been the case, Beatrice said, she would have been spared the humiliation she endured during the hospital visit.

“It was so unnecessary, especially for women. Because women are not there for violent offences, they are not a risk to the public,” she said.

“When I talk about my time in prison, I feel very accountable, I feel deep remorse, and my sentence was fair. But at the same time, the treatment of women in prison does not make sense. There is no common sense because if there was, then what happened to me would not have happened. We would see a different way for women in prison.”

Russell of Women in Prison said: “Handcuffing a woman for a medical examination is humiliating, degrading and unnecessary. It will harm her relationship with her medical professional and may reduce her willingness to attend medical appointments. We know medical screening rates for women in prison are poor and this is exacerbating the situation.”

Disproportionate and retraumatising

As well as restraint and handcuffing women, our investigation revealed an increase in the use of “pain-inducing techniques”, from 232 incidents in 2021/22 up to 397 in 2024/25.

The data shows that PAVA, a synthetic form of pepper spray, has been used at least three times since 2023. The controversial spray is a prohibited weapon under the Firearms Act, and its use against children was subject to judicial review.

The Howard League’s Coomber said our figures underline “the need to ensure that staff receive appropriate training in de-escalation and in how best to support women. This has become increasingly important in recent years due to staffing pressures and levels of experience.”

"Many women in custody have been victims of crime themselves, and the use of force that is disproportionate and retraumatising typifies how prisons fail routinely to meet their complex needs,” Coomber added.

More than half (57%) of women in prison report having experienced domestic abuse, according to a report by the Prison Reform Trust, although it added that this is “likely to be an underestimate”.

“Women are spending prolonged periods locked in their cells, and use of force is too often deployed as a response to prisoner-on-prisoner bullying, to prevent self-harm, or because of complex and unmet mental health needs,” said Emily Evison, women’s programme lead at the Prison Reform Trust.

But there are “signs of progress”, Evison said, with the prison services introducing a use-of-force specialist to strengthen training and improve practice across women’s prisons.

“Recent HM Inspectorate of Prisons reports show positive steps in reducing restrictive practices,” she said. “But continued attention is required to embed consistent, safe practice across the women’s estate.”

A Ministry of Justice spokesperson said: “The prison system this Government inherited is not working for most women and we are committed to reducing the number of women in custody by expanding safer, community‑based alternatives.

“Our staff only use force when there is a clear need, such as an imminent and serious risk to someone’s safety or to preserve life, and always only when it is lawful and a genuine last resort.”