Tammy Jackson gave birth alone in a jail cell, her lawyers say.
CNN  — 

When two Florida public defenders wrote to the Broward Sheriff’s Office last week that a mentally ill woman, Tammy Jackson, had been forced to give birth alone in her jail cell, they slammed the facility and its medical staff for putting both her and her infant daughter at “grave risk.”

“Six hours and 54 minutes after asking for help, a [Broward Sheriff’s Office] tech notified medical staff that Ms. Jackson was holding her newborn baby in her arms, having delivered her baby without medication or the assistance of a physician,” wrote the attorneys. “Your staff did not protect either Ms. Jackson or her child.”

While the media attention surrounding this incident has been on the jail itself, the medical provider hired by the sheriff’s office was the one directly responsible for Jackson’s care.

The private contractor, Wellpath, is the largest correctional health care provider in the country – the result of a recent merger between a company called Correct Care Solutions, or CCS, and a smaller competitor, Correctional Medical Group Companies (CGMC). The Supreme Court has ruled that providing health care to inmates is mandated by the US Constitution. For Wellpath, this job is projected to bring in annual revenues of $1.5 billion.

A CNN analysis of federal court records over the past five years shows that the company has been at the center of lawsuits involving at least six different facilities. The lawsuits allege that pregnant women have been subjected to inhumane and dangerous conditions and treatment that in some cases have allegedly led to miscarriages and infant deaths.

Public records also reveal how at least one county that hired the company found medical staff had given Librium, a powerful benzodiazepine, or tranquilizer, to multiple pregnant inmates. Librium’s label recommends against the use of the drug during pregnancy because of potential risk to the fetus.

Related: Pregnant woman asked jail staff for help

Wellpath did not respond to requests for comment about Jackson or the other cases involving pregnant women in its care – all of which had been filed against the companies that became Wellpath. Five were filed against CCS, while a sixth was filed against the California Forensic Medical Group, a CGMC company.

At a Kentucky jail, a 24-year-old woman who was 21 weeks pregnant allegedly complained of contractions and “severe pain,” but a CCS nurse determined that her baby was not in distress, according to the lawsuit. More than nine hours later, the lawsuit states, she passed a blood clot, but an ambulance was not called for nearly two hours. She eventually gave birth to her child in her underwear while restrained as the ambulance transported her to the hospital.

The baby died within hours at the hospital, and the mother suffered significant blood loss and had to be treated for mental distress, according to the lawsuit. The case is ongoing, and the company has denied in court filings that it provided negligent or unconstitutional care.

When a 36-week pregnant inmate at a jail in New Mexico told the CCS medical staff she was in labor, the physician allegedly cleared her to return to her locked pod. As the woman began giving birth, emergency medical technicians arrived. But, according to the lawsuit, the doctor refused to help. The umbilical cord was wrapped tightly around the baby boy’s neck, and the lawsuit states he was ultimately determined to be stillborn. In court filings, the contractor denied that it had caused the baby’s death, noting the inmate had admitted to using drugs – including during her third trimester. The case remains ongoing.

In Arkansas, a woman entered custody 29 weeks pregnant with twins. During the following weeks, the CCS medical staff allegedly threatened her with discipline if she kept coming to the nurse’s office to seek prenatal care from a doctor, according to the lawsuit. She lost around six pounds since admission and after almost a month, she vomited blood all night and complained that she hadn’t felt one of the babies move for a while. The lawsuit claims a nurse directed a guard to drive her to the hospital in a facility car instead of calling an ambulance. This guard then stopped at a fast food drive thru on the way to the hospital. One of the babies died while the other was born with serious health issues. Court documents from the pending case show that the company has denied that it contributed to this outcome.

According to another lawsuit, a woman was already scheduled for a cesarean section because of her high-risk pregnancy when she was booked into a Michigan jail for driving on a suspended license. She was more than 34 weeks pregnant and had complained of contractions for days. The suit claims that despite being seen multiple times by the CCS medical staff, she eventually went into labor alone in a cell inside the medical unit – even after allegedly begging a nurse, “please don’t let me have my baby in this jail.” An ambulance was finally called and EMT’s arrived five minutes before the baby was born on the dirty cell floor.

The company argued in a court filing that the inmate did not have a constitutional right to deliver her baby in a hospital and that it did not cause her “early and rapid delivery.” The company was dismissed from the lawsuit, in part because a judge did not think the allegations rose to the level of constitutional violation. But the case is proceeding against three CCS nurses. In an opinion, the judge said that one of these nurses had “unreasonably delayed treatment by not calling an ambulance.”

The recent birth at a Broward County jail, as reported by The Miami Herald, unfolded in a similar way with the inmate, Tammy Jackson, reportedly complaining of contractions for hours. In their letter, the public defenders wrote how the jail staff tried to reach an on-call physician in the middle of the night, but it took hours for them to speak with him. When finally reached, the physician said he would check on Jackson when he arrived at the jail. Almost two hours later, Jackson remained in labor, isolated in her cell.

One of the attorneys on the case, Gordon Weekes Jr., talked to CNN as he left Jackson’s hospital room this week. He said she recounted how she had to crouch down in the cell and catch the baby with her own hands. Since she had previously had a C-section, which can make it dangerous to deliver a baby naturally even with medical personnel present, Weekes said Jackson was also terrified the baby wouldn’t make it. But the baby girl did survive.

The Broward County Sheriff’s Office said it is limited in what it can discuss because an internal investigation into Jackson’s delivery is underway. The county did not dispute the allegations, however, and said that a Wellpath doctor and two nurses tended to the mother and child following the delivery.